74.第七十四日——《张博士医考红宝书》百日复习计划（74. The seventh day - a review plan for doctor zhangs medical examination）.docVIP

74.第七十四日——《张博士医考红宝书》百日复习计划（74. The seventh day - a review plan for doctor zhangs medical examination） Section iv spine and pelvis (day 74) One. Spinal fracture 1. An overview of the (1) spinal fractures and dislocation are common, accounting for about 5% to 6% of total fractures. (2) anatomical summary, the injury most often occurs at the junction of the spinal stability part and the activity part, such as the thoracolateral lumbar segment (chest 11,12 to waist 1, 2). (3) most are caused by indirect violence. The few are directly caused by direct violence. (2) clinical manifestations 1. There is a history of severe trauma, such as falling from a high altitude, a heavy weight hitting the head, neck, shoulder or back, diving injury, and being buried by soil and ore during the cave-in accident. 2. After thoracolumbar injury, the patient has local pain, muscle spasm in the back of the lower back, often deformities, unable to stand up, difficult to turn over, and feel weak in the waist. As the retroperitoneal hematoma stimulates the abdominal ganglion, the intestinal peristalsis slows down, and the symptoms of abdominal distention, abdominal pain, and bowel movements often occur. When the cervical vertebra is damaged, have head, neck pain, cannot move, the injured person commonly hold the head with two hands. The swelling and postsudden deformities were not obvious, but there was significant tenderness. When examining the spine, note the local swelling and apparent local pressure in the middle line; Also check for signs of spinal cord or cauda nerve injury. (y2005-2-150) (3) imaging examination The X-ray film is the first choice check, and it is important for definite diagnosis to determine the damage site, type and displacement, as well as the guidance and treatment. CT examination can show fracture condition, whether fracture fragments into the spinal canal. MRI can show spinal cord injury. Ii. Spinal cord injury (assistant not required) (I) classification, clinical ma