ATLS - Advanced Trauma Life Support Spine and Spinal Cord Trauma Questions and Answers

Question 1

A 28-year-old is involved in a motorcycle crash and presents with a blood pressure of 85/45 mmHg, a heart rate of 55 bpm, and warm, dry extremities.
There is no obvious external hemorrhage.
Which type of shock is most likely responsible for this clinical picture?

Accepted Answer

Neurogenic shock

Answer

Hemorrhagic shock

Answer

Cardiogenic shock

Answer

Septic shock

Question 2

A patient with a flexion injury to the cervical spine demonstrates complete paralysis and loss of pain and temperature sensation below the level of the injury. However, their sense of vibration and proprioception remains intact. Which incomplete spinal cord syndrome do these findings represent?

Accepted Answer

Anterior cord syndrome

Answer

Brown-Séquard syndrome

Answer

Central cord syndrome

Answer

Posterior cord syndrome

Question 3

A 30-year-old trauma patient is alert (GCS 15), not intoxicated, and has no focal neurological deficits. According to the NEXUS low-risk criteria for clinical clearance of the cervical spine, which of the following findings would mandate radiographic imaging?

Accepted Answer

Presence of a painful wrist fracture

Answer

History of a brief loss of consciousness

Answer

Patient is over 60 years of age

Answer

Complaint of minor anterior neck pain

Question 4

During the secondary survey of a patient with paraplegia following a severe fall, the examiner assesses for sacral sparing. Which of the following findings indicates an incomplete spinal cord injury?

Accepted Answer

Voluntary anal contraction

Answer

Absence of deep tendon reflexes in the lower extremities

Answer

Presence of priapism

Answer

Flaccid paralysis below the lesion

Question 5

A patient suffers a penetrating stab wound to the right side of the neck, resulting in a Brown-Séquard syndrome at the C7 level. Which pattern of neurological deficits would be expected below the injury?

Accepted Answer

Paralysis and loss of proprioception on the right; loss of pain and temperature on the left

Answer

Paralysis and loss of proprioception on the left; loss of pain and temperature on the right

Answer

Bilateral loss of motor function with preserved sensation

Answer

Bilateral loss of pain and temperature sensation with preserved motor function

Question 6

Which statement best reflects the current ATLS-aligned principle of managing a patient with a potential spinal injury in the prehospital and emergency department setting?

Accepted Answer

The primary goal is spinal motion restriction, using a rigid collar and securing the patient to a firm surface to minimize gross movement.

Answer

All trauma patients should be fully immobilized on a rigid longboard until imaging is complete.

Answer

Forcing a patient's head into a neutral position is mandatory to ensure proper collar fit.

Answer

Spinal motion restriction is not indicated for patients with penetrating trauma, regardless of neurologic deficits.