PHTLS Spinal Trauma Management 2

Question 1

A patient involved in a high-speed MVC is found ambulatory at the scene but complains of neck pain. What is the PHTLS-recommended approach to spinal motion restriction (SMR)?

Accepted Answer

Apply a cervical collar and consider full SMR based on mechanism and symptoms

Answer

Advise the patient to walk to the ambulance carefully

Answer

Immobilize only if the patient is unconscious

Answer

Spinal precautions are unnecessary if the patient is walking

Question 2

Which vertebral region is MOST commonly injured in blunt trauma due to its transitional anatomy?

Accepted Answer

Thoracolumbar junction (T12-L1)

Answer

Cervical-thoracic junction (C7-T1)

Answer

Mid-thoracic (T5-T8)

Answer

Lumbar-sacral junction (L5-S1)

Question 3

During extrication of a seated vehicle crash victim, which technique best maintains spinal alignment?

Accepted Answer

Manual in-line stabilization throughout the move

Answer

Rapid extrication without a collar to save time

Answer

Allow the patient to self-extricate with verbal guidance

Answer

Use a short backboard only if the patient is symptomatic

Question 4

A patient with a cervical spinal cord injury presents with bradycardia and hypotension but warm, dry skin. This pattern is MOST consistent with:

Accepted Answer

Neurogenic shock

Answer

Hemorrhagic shock

Answer

Obstructive shock

Answer

Cardiogenic shock

Question 5

When applying a cervical collar to a trauma patient, what is the FIRST step?

Accepted Answer

Apply manual in-line stabilization

Answer

Select the correct collar size

Answer

Log-roll the patient supine

Answer

Assess for distracting injuries

Question 6

A PHTLS provider assesses a patient with a stab wound to the posterior neck at C4. The patient has bilateral arm weakness but intact leg function. This pattern suggests injury to the:

Accepted Answer

Central cord

Answer

Anterior cord

Answer

Posterior cord

Answer

Brown-Séquard (hemicord)

Question 7

Which finding would SUPPORT withholding spinal motion restriction in a conscious, alert trauma patient per PHTLS selective SMR criteria?

Accepted Answer

No midline spinal pain or tenderness and no neurologic deficit

Answer

Tenderness over the spinous processes

Answer

Intoxication with alcohol

Answer

Distracting painful injury to the extremity