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Traumatic Spine Injury

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Acute Neuro Care

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Abstract

A 26-year-old male suffered a motor vehicle accident. He is conscious, oriented, and able to follow commands. His vitals are Blood Pressure—84/60 mm Hg, Heart Rate—55/m, Respiratory Rate—30/m. He has labored breathing and inability to move all four limbs.

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Author information

Authors and Affiliations

  1. All India institute of medical sciences, New Delhi, India

    Niraj Kumar & Ashish Bindra

Authors
  1. Niraj Kumar
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  2. Ashish Bindra
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Editor information

Editors and Affiliations

  1. Division of Neuroanaesthesiology, Department of Anaesthesiology and critical care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

    Prasanna Udupi Bidkar

  2. Senior consultant and Head, Neuroanaesthesiology & Neurocritical care, MGM Healthcare Pvt Ltd, Chennai, Tamil Nadu, India

    Ponniah Vanamoorthy

Multiple Choice Questions

Multiple Choice Questions

  1. 1.

    A 24-year-old construction worker is admitted to a trauma center following a history of fall from 20 feet. He has bradycardia, low blood pressure, labored breathing, and inability to move all four limbs. Which of the following injuries do you suspect in this patient?

    1. (a).

      Tension pneumothorax

    2. (b).

      Ruptured spleen

    3. (c).

      Fracture of cervical spine

    4. (d).

      All of the above

  2. 2.

    Which of the following region is the most common site for spinal column injury?

    1. (a).

      Cervical

    2. (b).

      Thoracic

    3. (c).

      Thoraco-lumbar

    4. (d).

      Lumbo-sacral

  3. 3.

    Which of the following is the sensory dermatome for thumb?

    1. (a).

      C5

    2. (b).

      C6

    3. (c).

      C7

    4. (d).

      C8

  4. 4.

    Which of the following statement is correct about the pathophysiology for the development of neurogenic shock in cervical spine injury?

    1. (a).

      Loss of sympathetic activity and preservation of parasympathetic activity

    2. (b).

      Loss of both sympathetic activity and parasympathetic activity

    3. (c).

      Preservation of sympathetic activity and loss of parasympathetic activity

    4. (d).

      Preservation of both sympathetic activity and parasympathetic activity

  5. 5.

    Which of the following is a characteristic feature of neurogenic shock?

    1. (a).

      Hypertension and tachycardia

    2. (b).

      Hypertension and bradycardia

    3. (c).

      Hypotension and tachycardia

    4. (d).

      Hypotension and bradycardia

  6. 6.

    Which of the following statements is correct about central cord syndrome?

    1. (a).

      There is a greater loss of motor strength of lower as compared to upper extremities

    2. (b).

      There is an equal loss of motor strength of both upper and lower extremities

    3. (c).

      There is an equal preservation of motor strength of both upper and lower extremities

    4. (d).

      There is a greater loss of motor strength of upper as compared to lower extremities

  7. 7.

    Which of the following statements is correct about an adequate cervical spine X-ray film in case of suspected cervical spine injury?

    1. (a).

      The upper three cervical vertebrae must be visualized

    2. (b).

      All seven cervical spine must be visualized

    3. (c).

      All seven cervical and first thoracic vertebra must be visualized

    4. (d).

      All seven cervical and upper three thoracic vertebrae must be visualized

  8. 8.

    How many individuals are required for logrolling a patient with an unstable spine?

    1. (a).

      1

    2. (b).

      2

    3. (c).

      3

    4. (d).

      4

  9. 9.

    Which of the following is the imaging modality of choice for screening an unconscious patient with suspected spinal cord injury?

    1. (a).

      Contrast-enhanced computed tomography

    2. (b).

      Noncontrast computed tomography

    3. (c).

      Magnetic resonance imaging

    4. (d).

      Focused assessment sonography in trauma

  10. 10.

    Which of the following should not be done for the management of patients with spinal cord injury?

    1. (a).

      Open mouth view X-ray in patients with suspected odontoid fracture

    2. (b).

      Using vasopressors to maintain a MAP 85–90 mmHg

    3. (c).

      Loading dose of methylprednisolone at the time of admission in patients with proven spinal cord injury

    4. (d).

      Immobilization on a long spine board

Answers: 1. (d), 2. (a), 3. (b), 4. (a), 5. (d), 6. (d), 7. (c), 8. (d), 9. (b), 10. (c)

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Kumar, N., Bindra, A. (2020). Traumatic Spine Injury. In: Bidkar, P., Vanamoorthy, P. (eds) Acute Neuro Care. Springer, Singapore. https://doi.org/10.1007/978-981-15-4071-4_9

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  • DOI: https://doi.org/10.1007/978-981-15-4071-4_9

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-4070-7

  • Online ISBN: 978-981-15-4071-4

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