74.第七十四日——《张博士医考红宝书》百日复习计划（74., seventy-fourth - Dr. Zhang Kao Yi Bao book hundred day review plan）.docVIP

74.第七十四日——《张博士医考红宝书》百日复习计划（74., seventy-fourth - Dr. Zhang Kao Yi Bao book hundred day review plan） Fourth sections of the spine and pelvis (seventy-fourth days) I. spinal fractures 1. overview (1) spinal fractures and dislocations are common, accounting for about 5% to 6% of all fractures. (2) anatomical outline, the most common injuries occurred at the junction of the spinal stability part and the active part, such as thoracolumbar (chest 11,12 to lumbar 1,2) most. (3) the vast majority are caused by indirect violence. The minority is caused by direct violence. (two) clinical manifestation 1., there are serious trauma history, such as falling from high altitude, heavy objects hit the head, neck, shoulder or back, diving injuries, landslides, dirt, ore burial, etc.. 2., after the thoracolumbar spine injury, the patient has local pain, low back muscle spasm, often kyphosis, can not stand up, turn over difficult, feel the waist weak. Due to the stimulation of retroperitoneal hematoma on celiac ganglion, slow down peristalsis, abdominal distension, abdominal pain, often appear symptoms such as constipation. When the cervical vertebra injury, has the head, the neck pain, cannot move, the wounded person usually uses two hands to hold the head. The swelling and kyphosis were not apparent, but there was marked tenderness. When examining the spine, pay attention to local swelling and marked local tenderness in the midline, while checking for signs of spinal cord or cauda equina injuries. (y2005-2-150) (three) imaging examination X-ray examination is the first choice, which is of great significance for the definite diagnosis, the location of injury, the type and displacement, and the guidance of treatment. The CT scan shows the fracture status and whether any fracture fragments enter the spinal canal. MRI can show the condition of spinal cord injury. Two. Spinal cord injury (assistant does not require) (1) classification, clinical manifestation and diagnosis of spinal cord