2

Question 1

pt was handcuffed now has a neuro deficit, what is it called and describe the finding

Answer 1

cheralgia paresthetica, compression neurop of superficial ___ over dorsolat aspect of hand

Question 2

after trauma, body dev an abnormal resp that magnifies the effects of the injury leading to the changes in both neuro and vasc

Answer 2

complex regional pn syndrome aka RSD

Question 3

disc lesions can be either contained or non, define both terms and give examples of ea

Answer 3

contain: nuc material hasn’t escaped/bulge
noncontain: nuc material has escaped/extrusion

Question 4

what % of asymptomatic pt will show a disc hern on MRI

Answer 4

76%

Question 5

describe the 4 criteria necessary for performing discography

Answer 5

• 4m/pn
• unresp to conserv care
• advanced CT/MRI neg
• contemplating surgery

Question 6

in what decade of life does the annulus fibrosus begin to show cracking

Answer 6

20’s, second decade

Question 7

according to one study, what % of spinal surgeries could be unnecessary

Answer 7

60%

Question 8

according to dr cox 95% of FD procedures are used for __ and only 5% are used for __

Answer 8

facet syndrome

disc prob

Question 9

what is meant by the term annulus fibrosus “rent”

Answer 9

non contained disc, is leaking out

Question 10

describe the reason why you should always examine the skin on the pt

Answer 10

post surgical scars

ecchymosis/bruising

Question 11

cervical disc space narrowing of only 2mm is show to result in how much of a reduction in foraminal area

Answer 11

30-40%

Question 12

after performing history and phys exam you suspect disc herniation, if your suspicion is confirmed on mri how will that affect initial tx plan

Answer 12

it wont change anything

Question 13

what nerve innervates PLL, annulus fibrosus, neurovasc contents of epidural space

Answer 13

sinuvertebral

Question 14

there are many effects of FD name

Answer 14

open disc space
reduced intradiscal pressure
stretching PLL push NP back
open up Z jt
thinning of flaval lig
break up adhesions

Question 15

rank the positions in order of increasing intradiscal pressure

Answer 15

lying down
standing
sitting
bending and lifting while stnad
bending and lifting while sitting

Question 16

a herniation of l4/5 disc will most likely compress which nerve root

Answer 16

L5

[L4 NR exits there, but v high up, so the disc is more likely to hit the L5 NR even tho it doesnt actually exit L5/S1]

Question 17

study with 1000 pt with LBP/sciatic pn, regardless of dx, what were the overal tx in days and tx for all

Answer 17

29 days, 12 tx

Question 18

pt has rt medial disc hern at L5/S1 what antalgic posture are they likely to adopt

Answer 18

toward side of hern

Question 19

C8/T1 innervated musc, loss of hand/finger ext, atrophy of hypothenar, LOS to ulnar aspect of hand/forearm, horner’s syndrome

Answer 19

klumpke’s palsy

Question 20

what are the three stages of disc degen in degen cascade

Answer 20

dysfxn, instab, and stabilization

Question 21

when performing cox f/d use more ___ for facet and more ___ for disc d/o

Answer 21

flexion / distraction

Question 22

in which phases of degen cascade are disc injuries more likely to occur and why

Answer 22

dysfx and instab bc by the time you get to stabilization, movement is reduced

Question 23

where in disc are intradiscal pressures the highest

Answer 23

mid/inner annulus

Question 24

in disc hern pt, what is the only absolute for surgery

Answer 24

cauda equina, neuro

Question 25

flowchart for stages of care for radic pn mgmt for first line of care, describe time range, imaging, tx approriate at time

Answer 25

4-6w conservative care, adj and modalities, simple meds, LB wellness school

Question 26

describe wallerian degen

Answer 26

degen nerve distal to site of injury

Question 27

T/F the size of disc lesions correlates well to pn/disability

Answer 27

F

Question 28

which part of the disc is resp for pain generation

Answer 28

annulus fibrosus

Question 29

according to a study, what % of pt undergoing multiple back surgeries had not returned to work 4y later

Answer 29

95%

Question 30

which is more likely to cause pn and why: protrusion or sequestration

Answer 30

protrustion bc the little chunk that comes off with sequestration can move away from pn site