Pediatric Cervical Spine Cheat Sheet : A Comprehensive Approach
< 8 y/o – falls, mostly upper cervical spine injuries (occiput – C4)
> 8 y/o – sports related, mostly lower cervical spine injuries Other causes: birth trauma, MV related accidents, firearms, electrical shock, child abuse
Bone fractures, subluxations, dislocations, and SCIWORA.
Bilateral Facets Dislocation – unstable ; spinal cord injury
Unilateral Facet Dislocation – stable; nerve root injury
Altered vital signs, pain, scalp laceration, facial/upper body injury, torticollis, focal midline tenderness, numbness, stiffness, ROM limitation < 45 degrees, paresthesia, weakness, abnormal sensation/sensory loss,
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abrasions, edema, ecchymosis)
NEXUS
Radiographs – all cervical vertebrae and T1; AP view open mouth and lower c-spine, lateral, R & L oblique
CT – recommended in acute trauma cases, congenital developmental abnormalities, tumors; limited use since many c-spine pediatric injuries are ligamentous in nature
MRI - recommended due to persistent neurological deficits, soft tissue involvement, ligamentous & disc injuries, spinal cord hemorrhage, SCIWORA Also prescribed when radiographs are clear BUT child is unconscious and/or intubated.
A-P odontoid/open mouth view: in supine, shows articulation of C1-C2 : width of lateral masses should be = , none or very minimal overhanging of atlas, dens symmetrically between lateral masses of atlas, C2 spinous process in midline
A-P lower cervical view: in supine, shows 5 lower c- vertebrae, upper thoracic vertebrae with ribs, clavicles and trachea : c & t vertebral bodies are vertically aligned, spinous processes are in midline, illusion of bone L column on each side of vertebral bodies; transverse processes within image of L column, pedicles - radiodense oval – like cortical outline, interpendicular distance =
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borders of vertebral bodies, line # 2, post. borders of vertebral bodies, line # 3 spinolaminar, vertebral bodies have box-like appearance, intervertebral spaces are well preserved, articular pillars and facets joints - a pair at each level, bursa between dens & facet on atlas - dark radiolucent line ant.to dens, distance kept by transverse ligament at atlas during neck ROM is 4.5mm, transverse processes superimposed over vertebral bodies, 6mm between post. pharyngeal & AI aspect of C2, 14mm between post. wall of trachea and AI aspect of
An MRI was performed of the lumbar spine. The examination found no significant extra
DOI: 4/16/2012. Patient is a 29-year-old male technician who sustained injury when he was 25-feet up on a ladder when the ladder slid and he fell onto the pavement. He had an open reduction internal fixation (ORIF x 2) for a compound tibia fibula fracture and had hardware removal in 4/25/2013. MRI of the lumbar spine performed on 3/24/2016 revealed L5-S1 small right paracentral disc protrusion without significant spinal canal stenosis or neuroforaminal narrowing.
This is a 47-year-old male with a 2/1/2007 date of injury, who injured his low back from lifting a large bucket of cut grass. DIAGNOSIS: 1. Left SI radicular symptoms. Lumbar discogenic pain with high-intensity zone at L5-S1 per MRI April 2007. X-ray showed 4-mm retrolisthesis at L5-S 1.
QEP Scripts for Two Recordings – Audio for Musculoskeletal System; “OK, Team! We have a new patient in Room 3B who is being admitted with a progressive (gradual, advancing) decrease in mobility (movement) of his back and legs, and increase in pain located in the lumbosacral (lower back above the tailbone of the spine) area. The patient’s Primary Care Provider has sent along Computed Tomography scans (CT, a rotating x-ray emitter, detailed internal scanner) showing spinal stenosis (narrowing of the spine causing pressure on the nerves and spinal cord causing lower back pain.) and decrease of the normal lordosis (abnormal curvature lower spine, excessive inward curvature of the spine) in the thoracic vertebrae (upper and middle back). Lumbosacral
Range of motion is limited with flexion and extension of 20 degrees limited by pain. Spurling test is positive. Sensation is diminished C5-C6 bilaterally. Diagnoses are cervical strain, bilateral C5-C6 cervical radiculopathy, and diminished sensation, C6 reflex bilaterally.
The Dmanisi skull 4, also known as D3444 with its mandible D3900, is one of five Homo erectus skulls discovered in Dmanisi, Georgia. Described in a publication in October 2006, it is believed to be about 1.8 million years old. Dmanisi D3444/D3900 is believed to be a Homo erectus adult female with a marked edentulous (toothless) grin. The cranium (D3444) was found first in 2002 and the mandible (D3900) was found later in 2004, immediately adjacent to the spot the cranium was found. The brain has an endocranial capacity of 650 cm.
This has increased in extent on the left. There is complete erosion/destruction of the left acetabular roof. This is a clear indication of a degenerative disease as opposed to a traumatic
It was also determined that prehensile tailed platyrrhines had more pronounced and convex articular surface curvatures. Greater contour curvatures on intervertebral articular surfaces are associated with an increased range of flexibility and mobility of the caudal vertebrae, benefiting prehensile primates that use their tails in a variety of complex movements. Hence, through analyses of the morphology of caudal vertebrae, specifically their articular surface area and curvature, it was concluded prehensile and non-prehensile tails could be distinguished according to these structural features. Both of these characteristics relate to effective use of the tail during locomotion. This article is useful towards my GEM as it describes differences in bone structure of the tails of prehensile and non-prehensile primates, and explains the reasons that certain variations confer advantages to prehensile tail
Nonetheless, our group observed specific locations in the skull that over time, changed among species. The following methodology will include how to observe or examine the different locations that were relevant to the study. By looking for the widest part in the back of the skull the location of the maximum skull breath can be identified. The degree of postorbital constriction can be recognized by observing the space behind the brow/supraorbital ridge. The zygomatic flare can be examined by evaluating how wide is the zygomatic bone.
FOR IMMEDIATE RELEASE (Colorado Springs, Colorado) Colorado Springs Spine & Injury Clinic announces the launch of its new website, one designed to allow victims of injury, poor health or accidents to learn more about health, obtain information on chiropractic technique and how it may be of benefit to them and to contact the clinic personally for assistance. The new website provides valuable information on what to do to recover physically and financially following a devastating accident and why chiropractic care is the best choice for many. Colorado Springs Chiropractors want individuals to know they have options open to them and all should be considered when seeking medical care. "
An incomplete injury at the cervical level will invariably cause central cord syndrome. The occurrence of central cord syndrome is much higher amongst people who sustain hyperextension injury with the presence of degenerative change in the cervical spine, much like Mr X. The characteristic weakness in the arms compared to the legs is due to the pattern of lamination of the spinothalamic and corticospinal tracts being more medial to the central canal. Anterior cord syndrome is characterised by loss of pain and temperature sensation, and motor function, below the level of the injury whilst touch and proprioception are preserved. This syndrome is caused by damage inflicted to the anterior aspect of the spinal cord or as a result of decreased vascular supply. Brown-Sequard syndrome occurs in the presence of damage to one side of the spinal cord more so than the other, resulting in ipsilateral loss of motor function and sensory loss too.
Injuries and growths in the high cervical region of the spine, including the C2, have limited or no movement from the neck down, though a person
Whiplash is a neck injury that can occur during automobile collisions, when the head suddenly moves back and then forward. These extreme movements push the muscles and ligaments of the neck beyond their normal range of motion. Causes A sprained whiplash neck occurs when the head is suddenly shaken back and forth or suddenly turned hard. This can cause the abnormal elongation of some neck muscles and ligaments (distortion).
In this set of materials, the reading passage claims that the T-rex dinosaur has the remaining of the blood vessels, blood and collagen and provides three reasons of support. Whereas, in the lecture, the professor opposes the reading passage and says the evidences are skeptic. Also, he refutes each of the author’s reasons. First of all, the reading passage contends that the hollows in the T-rex’s bone are branching channels of the blood vessels. They contain flexible soft organic matter .
Introduction PIVD stands for prolapsed intervertebral disc. It occurs due to the outgrowth of the disc. This outgrowth is the nucleus pulposus that seeps through a shred in the annulus fibrosus. It is also called slipped or herniated disc.