ATLS Spine and Spinal Cord Trauma 2

Question 1

A diving accident patient has bilateral motor loss and pain/temperature loss but preserved proprioception and light touch. Which syndrome?

Accepted Answer

Anterior cord syndrome

Answer

Anterior cord syndrome affects motor (corticospinal tracts) and pain/temperature (spinothalamic tracts) while sparing posterior columns.

Question 2

An elderly patient falls and develops upper extremity weakness greater than lower. Most likely diagnosis?

Accepted Answer

Central cord syndrome

Answer

Central cord syndrome characteristically affects upper extremities more due to somatotopic organization of corticospinal tracts.

Question 3

According to ATLS, what is the preferred method for log-rolling a patient with suspected spinal injury?

Accepted Answer

Minimum four-person team with one maintaining cervical stabilization

Answer

ATLS recommends minimum four people: one for cervical stabilization, three for coordinated body roll.

Question 4

A C5 SCI patient has hypotension with HR 52 and warm extremities. After fluids, BP remains low. Best pharmacologic intervention?

Accepted Answer

Norepinephrine or phenylephrine infusion

Answer

Neurogenic shock requires vasopressors after volume resuscitation fails. Norepinephrine provides combined alpha and beta effects.

Question 5

Which imaging study is the gold standard for evaluating spinal cord injury and ligamentous disruption?

Accepted Answer

MRI

Answer

MRI is the gold standard for evaluating the cord itself, ligaments, disc herniations, and epidural hematomas.

ATLS - Advanced Trauma Life Support Practice Test