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Detailed Lesson PlanChapter 32Spinal Column and Spinal Cord Trauma90–100 minutesChapter 32 objectives can be found in an accompanying folder.These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.Minutes Content Outline Master Teaching Notes5I. IntroductionA. During this lesson, students will learn special considerations of assessment and emergency care for a patient suffering from a possible spine injury.B. Case Study1. Present Dispatch and Upon Arrival information from the chapter. 2. Discuss with students how they would proceed. Case Study Discussion- What are the patient management priorities in this situation?- Based on the mechanism of injury, what injuries do you suspect?5II. Anatomy and Physiology of Spine Injury—The Nervous SystemA. Parts of the nervous system—Structural divisions1. Central nervous system—Brain and spinal cord2. Peripheral nervous system—Nerves outside the brain and spinal cordB. Parts of the nervous system—Functional divisions1. Voluntary nervous system—Influences action of voluntary (skeletal) muscles2. Autonomic nervous system—Influences activities of involuntary muscles and glandsa. Sympathetic nervous systemb. Parasympathetic nervous systemDiscussion QuestionWhat are the functions of the autonomic nervous system?15III. Anatomy and Physiology of Spine Injury—The Skeletal SystemA. The skull1. Rests at the top of the spinal column2. Contains the brain 3. Comprises cranium (brain case) and faceB. The spinal (vertebral) column1. Principal support system of the bodya. Ribs originate from spinal column to form thoracic cavity.b. Rest of skeleton is indirectly attached to spine.2. Made of 33 irregularly-shaped bones called vertebraea. Body—Anterior aspect of vertebra Discussion QuestionDescribe the structure of the spinal column.PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 32 PAGE 1MASTER TEACHING NOTES- Case Study Discussion- Teaching Tips- Discussion Questions- Class Activities- Media Links- Knowledge Application- Critical Thinking DiscussionChapter 32 objectives can be found in an accompanying folder.These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.Minutes Content Outline Master Teaching Notesb. Spinous process—Posterior aspect of vertebrac. Bound together by strong ligamentsd. Arranged on either side of discs (fluid-filled pads of cartilage) that act as shock absorbers3. Divided into five parts:a. Cervical spine i. Seven vertebrae that form the neckii. Most mobile and delicate of the vertebrae, thus most vulnerable to spinal cord injuryb. Thoracic spine—12 vertebrae that form the upper backc. Lumbar spine—Next five vertebrae that form the lower backd. Sacral spine (sacrum)—Five fused vertebrae that form rigid posterior of pelvise. Coccyx (tailbone)—Four fused vertebrae that form lower end of spineC. Spinal cord1. Exits brain through opening at base of skull2. Surrounded by sheath of protective membranes (meninges) and cerebrospinal fluid3. Wider at head/neck area; narrower in lower back4. Source of origin of all nerves to trunk and extremities5. Carries all messages from brain to rest of body6. Three main types of tracts to test in injury assessmenta. Motor tractsi. Carry impulses from spinal cord to musclesii. Test by having the patient move on same side of body as tractb. Pain tractsi. Carry impulses from pain receptors from spinal cord to brainii. Test by applying pain to patient on opposite side of body from tractc. Light touch tractsi. Carry light-touch impulses from spinal cord to brainii. Test by touching patient lightly on same side of body as tractTeaching TipThe use of graphics will enhance students’ understanding of the anatomy and physiologyof the spinal tracts.PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 32 PAGE 2Chapter 32 objectives can be found in an accompanying folder.These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.Minutes Content Outline Master Teaching Notes5IV. Anatomy and Physiology of Spine Injury—Common Mechanisms of Spinal InjuryA. Compression1. Weight of the body is driven against the head2. Common in falls, diving accidents, motorcycle crashes3. Usually results when a person impacts an object head firstB. Flexion1. Severe forward movement of head in which chin meets chest2. Excessive forward curl of torsoC. Extension1. Severe backward movement of head in which neck is stretched2. Excessive backward arch of torsoD. Rotation—Lateral movement of head or spine beyond normal rotationE. Lateral bending—Severe bending of body from sideF. Distraction—Stretching and pulling apart of vertebrae and spinal cord (common in hangings)G. Penetration—Injury to cranium or spinal column from penetrating trauma such as gunshots or stabbingsDiscussion QuestionDescribe mechanisms that can lead to spinal column and spinal cord injuries.Critical Thinking DiscussionWhat factors might increase a patient’s chances of sustaining a spine injury?25V. Anatomy and Physiology of Spine Injury—Spinal Column Injury vs. Spinal Cord InjuryA. Spinal column injury1. Bone injury (injury to one or more vertebrae)2. Can be fracture or dislocation3. Symptoms—Pain and tendernessB. Spinal cord injury1. Nerve injury (damage to nervous tissue inside spinal column)2. Symptoms—Loss of motor and/or sensory functionC. Complete spinal cord injury1. Spinal cord is transected (cut crossways) either physically or physiologically.WeblinksGo to www.bradybooks.com and click on the mykit link for Prehospital Emergency Care, 9th edition to access web resources on spinal cord injuries, figures about spinal cord injuries, and spinal fractures. PREHOSPITAL EMERGENCY CARE, 9TH EDITION DETAILED LESSON PLAN 32 PAGE 3Chapter 32 objectives can be found in an accompanying folder.These objectives, which form the basis of each chapter, were developed from the new Education Standards and Instructional Guidelines.Minutes Content Outline Master Teaching Notes2. Results in total loss of motor and sensory function below level of injuryD. Spinal shock1. Temporary, concussion-like insult to spinal cord2. Usually occurs high in cervical region3. Results in loss of muscle tone, loss of light-touch


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