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LOCO > 15 - Back Problems > Flashcards

15 - Back Problems Flashcards

1
Q

What percent of the population will experience back problems

A

80%

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2
Q

Cause of an abnormal curve

A

Developmental abnormalities
Pathological
Osteoporosis

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3
Q

What is kyphosis

A

Excessive thoracic curvature

Hunchback

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4
Q

What causes kyphosis

A

Erosion/fracture of anterior part of one or more vertebrae

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5
Q

What is a kyphoplasty

A

aka vertebroplasty
Provides pain relief + prevents further collapse
Put in a needle percutaneously - insert inflatable balloon - reinflate vertebrae and insert cement to support

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6
Q

What is Sheuermann’s disease

A

Adolescent kyphosis
Whereby the epiphyseal growth plates of vertebral bodies are affected
causes kyphosis

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7
Q

Severe symptoms of sheuermanns disease

A

Pain

difficulty breathing

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8
Q

What is Schmorls node

A

indentaion in the middle of the vertebrae caused by protusions of nucleus pulposus through the endplate into the vertebral body

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9
Q

Treatment for sheuermanns disesae

A

brace until grown

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10
Q

What is Lordosis

A

Hollow back

Excessive lumbar lordosis

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11
Q

What causes lordosis

A 
Anterior rotation of pelvis
Weakened trunk muscles
Weakened hip flexors 
Pregnancy/obesity 
Due to vertebral bodies being designed for the weight bearing - however now weight is shifted onto posterior elements
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12
Q

What is psoas dysfunction and how does it cause lordosis

A

Aka weakened hip flexors

  • Chronic psoas shortening
  • Lumbar lordosis
  • Shortening of thoraco-lumbar fascia + erector spinae muscles
  • Stretching and weakness of abdominal muscles
  • Hamstring + gluteal muscles tightened and hypertonic
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13
Q

Symptoms of lordosis

A

Back ache
Sciatica
as easier to compress lumbar spinal nerves

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14
Q

Flat back syndrome

A

Hamstrings are tight
Hip flexors are weak
Pelvis tilts backwards pulls vertebral column flat
Ankylosing spondylitis

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15
Q

Scoliosis

A

Crooked, curved back

Abnormal lateral curve + rotation of vertebrae (sometimes)

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16
Q

Causes of scoliosis

A

Hormonal changes at puberty
Developmental defects
Asymmetrical muscle strength
Poor posture

17
Q

Treatment for scoliosis

A

0-20 degrees = nothing
20 - 40degrees = Brace
>50degrees = Surgery (vertebral fusion, harrington rods)

18
Q

What do you look for for age related changes of the spine

A 
Oseophytes (syndesmophytes)
Loss of disk height
Loss or increase in curves
Spinal stenosis
Ossification of vertebral ligaments
19
Q

What type of joint is the intervertebral dis

A

Cartilaginous joint

20
Q

What is the nucleus pulposus

A

70-80% water
Proteoglycans
Avascular
No innervation

21
Q

What is the annulus fibrosus

A

Altering layers of type 1 collagen

Outer 1/3rd is innervated

22
Q

Where is a prolapsed disk most common

A

between L4/5 or L5/S1 as most weight bearing - under most stress

23
Q

What are symptoms of cauda equina syndrome

A

Low back pain
Sciatica
Saddle and perineal hypothesia or anesthesia
Bowel and bladder disturbances
Lower motor extremity weakness and sensory deficits
Reduced/absent lower reflexes

24
Q

Treatment for cauda equinasyndrome

A

Disectomy
Removing the vertebrae segment
or
Laminectomy

25
Q

immediate complication of burst fracture

A

Compression of the spinal cord/nerve roots

Instability

26
Q

Late complication of burst fracture

A

Hematoma/necrosis

Hardening of the IV disk due to blood clot

27
Q

Where do Osteophytes commonly develop

A

Margins of vertebral body

zygapophysial joints

28
Q

Vertebral arteries blood flow to brain

A

Brainstem

posterior 1/3rd of brain

29
Q

What is diffuse idiopathic skeletal hyperostosis

A

Ossification of anterior longitudinal ligament +/- osteophytes
Disk height is maintained

30
Q

Ankylosing Spondylitis

A

A chronic inflammatory disorder mainly involving the axial skeleton causing the fusion of bones - BAMBOO spine on xray
Narrowing and sclerosis of both sacroilliac joint

31
Q

What is the gene which patients with Ankylosing spondylitis are positive?

A

HLA-B27

>95% of patients are positive

32
Q

How does HLA B27 influence gut flora

A

B27 flora predisposes a leaky guy
Antibiotic therapy prevents spondylitis and colitis
Leaky gut allows substange trigger cascades of inflammatory reaction

33
Q

Synovial joints of the vertebral column

A

o Zygapophysial joints (Facet joints)

o C1 and C2 pivot synovial joint

LOCO (25 decks)

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