Spinal Cord and Vertebral Trauma Flashcards
6 cards from real TNCC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Spinal Cord and Vertebral Trauma flashcards as text
A patient with a suspected unstable cervical spine fracture has vomited. To manage the airway while protecting the spine, the nurse should:
Answer: Logroll the patient to a lateral position while maintaining spinal alignment, then suction
The patient should be logrolled as a unit to a lateral position to allow vomitus to drain by gravity, while maintaining strict spinal alignment to prevent secondary cord injury.
Central cord syndrome is most commonly seen in which patient population and mechanism?
Answer: Elderly patients with pre-existing cervical spondylosis after hyperextension injuries
Central cord syndrome most commonly occurs in elderly patients with pre-existing cervical spondylosis (narrow spinal canal) who sustain a hyperextension injury, often from a ground-level fall.
During the secondary survey, the nurse palpates a palpable step-off deformity in the thoracolumbar spine. This finding suggests:
Answer: Vertebral fracture with possible posterior element disruption
A step-off deformity (one spinous process displaced anteriorly or posteriorly relative to adjacent processes) indicates a vertebral fracture-dislocation with disruption of the posterior spinal elements, suggesting an unstable injury.
Which medication used in spinal cord injury management acts by reducing secondary injury from free radical damage?
Answer: Methylprednisolone
Methylprednisolone was historically used in acute SCI as a neuroprotective agent to reduce secondary injury from lipid peroxidation and free radical damage, though its use is now controversial.
A patient is brought in on a long spine board after a motorcycle collision. The nurse should prioritize removing the patient from the board because:
Answer: Prolonged immobilization on rigid boards causes pressure injuries and respiratory compromise
Rigid spine boards cause pressure ulcers (within 30 minutes on bony prominences), restrict respiratory excursion, increase pain, and provide no therapeutic benefit beyond transport. Patients should be transferred off the board as soon as possible.
SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) is most common in which population?
Answer: Pediatric patients under age 8
SCIWORA occurs predominantly in children under 8 due to the hypermobility of the pediatric spine — elastic ligaments and cartilaginous vertebrae allow the spine to stretch beyond the tolerance of the spinal cord without bony fracture.