2 Flashcards
pt was handcuffed now has a neuro deficit, what is it called and describe the finding
cheralgia paresthetica, compression neurop of superficial ___ over dorsolat aspect of hand
after trauma, body dev an abnormal resp that magnifies the effects of the injury leading to the changes in both neuro and vasc
complex regional pn syndrome aka RSD
disc lesions can be either contained or non, define both terms and give examples of ea
contain: nuc material hasn’t escaped/bulge
noncontain: nuc material has escaped/extrusion
what % of asymptomatic pt will show a disc hern on MRI
76%
describe the 4 criteria necessary for performing discography
- 4m/pn
- unresp to conserv care
- advanced CT/MRI neg
- contemplating surgery
in what decade of life does the annulus fibrosus begin to show cracking
20’s, second decade
according to one study, what % of spinal surgeries could be unnecessary
60%
according to dr cox 95% of FD procedures are used for __ and only 5% are used for __
facet syndrome
disc prob
what is meant by the term annulus fibrosus “rent”
non contained disc, is leaking out
describe the reason why you should always examine the skin on the pt
post surgical scars
ecchymosis/bruising
cervical disc space narrowing of only 2mm is show to result in how much of a reduction in foraminal area
30-40%
after performing history and phys exam you suspect disc herniation, if your suspicion is confirmed on mri how will that affect initial tx plan
it wont change anything
what nerve innervates PLL, annulus fibrosus, neurovasc contents of epidural space
sinuvertebral
there are many effects of FD name
open disc space reduced intradiscal pressure stretching PLL push NP back open up Z jt thinning of flaval lig break up adhesions
rank the positions in order of increasing intradiscal pressure
lying down standing sitting bending and lifting while stnad bending and lifting while sitting
a herniation of l4/5 disc will most likely compress which nerve root
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]
study with 1000 pt with LBP/sciatic pn, regardless of dx, what were the overal tx in days and tx for all
29 days, 12 tx
pt has rt medial disc hern at L5/S1 what antalgic posture are they likely to adopt
toward side of hern
C8/T1 innervated musc, loss of hand/finger ext, atrophy of hypothenar, LOS to ulnar aspect of hand/forearm, horner’s syndrome
klumpke’s palsy
what are the three stages of disc degen in degen cascade
dysfxn, instab, and stabilization
when performing cox f/d use more ___ for facet and more ___ for disc d/o
flexion / distraction
in which phases of degen cascade are disc injuries more likely to occur and why
dysfx and instab bc by the time you get to stabilization, movement is reduced
where in disc are intradiscal pressures the highest
mid/inner annulus
in disc hern pt, what is the only absolute for surgery
cauda equina, neuro
flowchart for stages of care for radic pn mgmt for first line of care, describe time range, imaging, tx approriate at time
4-6w conservative care, adj and modalities, simple meds, LB wellness school
describe wallerian degen
degen nerve distal to site of injury
T/F the size of disc lesions correlates well to pn/disability
F
which part of the disc is resp for pain generation
annulus fibrosus
according to a study, what % of pt undergoing multiple back surgeries had not returned to work 4y later
95%
which is more likely to cause pn and why: protrusion or sequestration
protrustion bc the little chunk that comes off with sequestration can move away from pn site
