Paramedic Review-Jake M. 🚒🚑 Trauma-Neuro
Spinal Cord Injuries
2 categories
Complete SCI=Transection
Incomplete SCI
Basic Anatomy of the spine
Vertebrae (Bones)
Spinal Cord
Spinal Nerves (33 nerves)
Spinal nerves
Motor movement
Pain
Temperature
Vibrations
Proprioception (Positioning)-the ability to know the position of our body
Levels of the spine
Memory Tool
Breakfast Lunch and 2 Dinners
Cervical-7
C1 & C2=Atlas & Axis
C3, 4, and 5=Keep the diaphragm alive (Phrenic Nerve)
C6/C7-Controls the hands, arms, elbows, shoulders
Thoracic-12
Control intercostal muscles, abdominal function
T4=Nipple line
T10=Umbilicus
Lumbar-5 (L is for LEGS)
Controls the hips, thighs, knees, ankles, feet
Sacral-5 (S is for SEX & Shitting)
Bowel & Bladder control
Sexual function
Incomplete SCI (3)
Central Cord Syndrome
The center part of the cord in injured
Occurs in the Cervical region
Due to a Hyperextension injury
Memory Trick
" The guy who CAN walk into a bar, but he CANNOT take a drink"
NO loss of function to the lower extremities
LOSS of Motor function to the upper extremities
Anterior Cord Syndrome
The front part of the cord is injured
Cervical level
Due to Hyperflexion
memory trick
"This guy CANNOT walk into a bar, but he CAN take drink
LOSS of Motor, temp, and pain to the Lower extremities
NO Loss of anything to the Upper extremities
Brown Sequard Syndrome
A lateral injury to 1 side of the cord
occurs in Cervical & Thoracic level
Most often, happens from Penetrating trauma
Ipsilateral Side-The side of the injury
LOSS of motor, vibration, proprioception
Contralateral Side-The opposite uninjured side
LOSS of pain & Temperature
Compression
Transection
Distraction
Hypovolemic Shock=FLUID Problem
Cardiogenic Shock=PUMP Problem
Distributive Shock=VESSEL Problem
Distributive
Neurogenic Shock
ONLY occur in SCI above the level of T-6
The spinal nerves are unable to send or receive messages to control vascular tone
UNABLE to compensate!!
Hypotension
Unable to shunt blood=Warm/Dry/Flushed
Bradycardia
Cauda=tail
Equine=Horse
Cauda Equina
A bundle of nerves near the tail bone gets compressed
Meninges
The coverings of the brain and spinal cord
Dura mater (Tough mother)
Arachnoid (Spider web)
Pia mater (Soft mother)
Hematoma-An accumulation of blood
TBI
Epidural Hematoma
A FAST Bleed!!!!
Arterial Bleed
Ruptured meningeal artery
Blood is accumulation above the Dura, and below the skull
IMMEDIATE LOC, followed by periods of lucid intervals
Leads to Increased ICP
Subdural Hematoma
SLOW BLEED
Venous Bleed
Torn bridging vein
They do NOT have an immediate LOC
Onset of symptoms-48 hrs-3 weeks
Must monitor for increased ICP
Axon
The long portion of a neuron (Brain cell)
DAI (Diffuse Axonal Injury)
Massive destruction or tearing of the brain's axons
Caused by deceleration injuries
Straight into the Cabbage Patch=Instant Brain Death
Hip=Femur
femoral head, neck, trochanter
Sedatives
Etomidate
Ketamine
Versed
Ativan
Fentanyl
Paralytics
Succinylcholine
Rocuronium
Vecuronium