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Anne Flashcards

1
Q

Arthordesis

A

The surgical fixation of a joint to promote fusion of the bones

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2
Q

Crankshaft deformity

A

They potential deformity which occurs when the posterior elements of the skeletally mature patient fuse. The vertebral bodies may continue to grow after posterior fusion, resulting in deformity resembling the crankshaft of an automobile engine

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3
Q

Decompensation

A

Relative to scoliosis, the loss of spinal balance when the thoracic cage is not centered over the pelvis in the coronal plane.

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4
Q

Discectomy

A

The removal of all or part of intravertebral disc

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5
Q

Discogram

A

Radiographic procedure in which contrast material is injected into the vertebral disc under fluoroscopy, and the patient see the patency of the disc is evaluated.

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6
Q

Ablation

A

The removal of a body part or destruction of its function

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7
Q

Etiology

A

The cause or origin of a path ologies; also spelled aetiology

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8
Q

Hyperkyphosis

A

A spinal deformity of the sagittal plane in which excessive flexion occurs. The deformity be maybe smooth with a small degree of excessive flexion at multiple levels or angular with acute flexion at one or two segments. Commonly referred to as humpback or hunchback

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9
Q

Hypokyphosis

A

Alignment of the sagittal plane in which there is less than normal amount of flexion, the way the sagittal plane continues to have anterior concavity

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10
Q

Iatrogenic

A

The clinical response, usually unfavorable, to a medical or surgical treatment.

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11
Q

Idiopathic

A

Of unknown cause comment or etiology.

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12
Q

Kyphosis

A

The posterior curve in the sagittal plane of the spine; a normal spine has a kyphotic curve at the thoracic level of approximately 20° to 40°, as well as a sacral kyphosis.

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13
Q

The layers of collagen and elastin fibers that are arranged concentrically to make up the annulus fibrosis of the intervertebral disc. The horizontal fibers each lamella run in the opposite direction of the adjacent layers to create strong, flexible lattice structures.

A

Lamella, pl. lamellae

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14
Q

Surgical removal of part or all of the posterior vertebral elements to allow space for the neural structures

A

Laminectomy

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15
Q

Surgical reconstruction of the posterior vertebral elements to increase base for the neural structures while maintaining the posterior arch.

A

Laminoplasty

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16
Q

And interior curb in the sagittal plane of the spine; most wind has a lordotic curve at the cervical level of approximately 20° to 40° and at the bombard level of approximately 30° to 50°.

A

Lordosis

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17
Q

What planes does the king classification relate to and what region of the spine does it describe?

A

Thoracic, coronal region

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18
Q

Which planes to the lenke classification system relate to and what regions of the spine does it describe?

A

Sagittal plane, lumbar

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19
Q

What are the five main indicators to help determine the risk of curve progression?

A
  1. Gender of the patient
  2. Magnitude of the curve
  3. Curve patten.
  4. Age at onset of the curve
  5. Skeletal maturity of the patient
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20
Q

Describe how the Risser sign is used

A

Iliac crest is divided into four regions. As the patient grows these regions progressively fuse. Designated by scale of one through five according to which region fused.

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21
Q

List and describe the three basic treatment options for adolescent idiopathic scoliosis

A
  1. Observation
  2. Non-operative treatment with observation
  3. Surgical intervention
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22
Q

Briefly describe each of the following steps and evaluation process of scoliosis: Family in general health history

A

A complete review of the medical history of the patient and family should undergo (familial incidence of scoliosis)

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23
Q

Describe physical examination in the evaluation process of scoliosis

A

Patient shoulder, thorax, back, and pelvis her observed (red pump measurement with scoliometer degrees of rotation)

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24
Q

Describe radiographic evaluation in the evaluation process of scoliosis

A

Standing, sitting, or recumbent x-rays taken in the AP and lateral of entire spine

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25
Q

Describe the Cobb angle measurement in the evaluation process of scoliosis

A

Measures magnitude of severity of scoliotic curve in degrees of curvature

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26
Q

Describe determination of skeletal maturity in the evaluation of scoliosis

A

Risser sign: radiographic observation of the iliac crest growth plate

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27
Q

Briefly describe nonoperative treatment in the evaluation process of scoliosis

A

Electrical stimulation, biofeedback, and manipulation (casting, orthotics, braces etc.)

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28
Q

Describe the differences between patients who have adult idiopathic scoliosis under 40 versus over 40

A

Under 40: present because of continued progression or cosmetic appearance of their curve.

Over 40: generally present to a doctor because of pain

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29
Q

List for indications for treatment of adult scoliosis

A
  1. Progression of the deformity
  2. Unrelieved pain
  3. Decreased pulmonary function (rare)
  4. Cosmesis (controversial)
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30
Q

What is DeNovo scoliosis?

A

Degenerative scoliosis, onset of the scoliotic curve in a previously straight spine.

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31
Q

Define spondylosis

A

Did generative changes invertebrate at the articulation point

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32
Q

Define spondylolysis

A

Defect in the vertebrae, usually at the pars articulation.

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33
Q

Spondyloptosis

A

Spondylolisthesis in which the entire L5 body has fallen below the horizontal line across the top of the sacrum

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34
Q

Most vertebral slips are the result of the defect in the __________ area of the _______.

A

Pars interarticularis

Lamina

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35
Q

Describe type I spondylolisthesis as defined as Wiltse’s classification system

A

Dysplastic. L5 slips forward at the sacrum. Defective S1 articular process

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36
Q

Describe type II Spondylolisthesis as defined by Wiltse’s classification system

A

Isthmic. Most common type of spondylolisthesis. Defect in pars interarticularis area of the lamina.

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37
Q

Describe type 2Atypes of spondylolisthesis as defined by Wiltse’s classification system

A

Stress fracture of pars caused by recurrent microfractures in pars from hyperextension. Common in football lineman gymnast and weightlifters

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38
Q

Describe type IIC Types of spondylolisthesis as defined by Wiltse’s classification system

A

An acute fracture of pars. Very rare

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39
Q

Describe type III Types of spondylolisthesis as defined by Wiltse’s classification system

A

Most common at L4 L5. degenerative changes in facets

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40
Q

Describe type IV Types of spondylolisthesis as defined by Wiltse’s classification system

A

Occurs from fractured pedicle, lamina, or facets

41
Q

Describe type V Types of spondylolisthesis as defined by Wiltse’s classification system

A

Caused by a tumor or metabolic type of bone disease

42
Q

Describe type VI Types of spondylolisthesis as defined by Wiltse’s classification system

A

Iatrogenic Spondylolisthesis caused by excessive surgical decompression in the posterior elements

43
Q

Describe “Low dysplastic spondylolisthesis”

A

Translational shift of one vertebra

44
Q

Define “high dysplastic spondylolisthesis”

A

Forms significant segmental kyphosis associated with transitional shift. (Either lysis or elongation)

45
Q

The cartilaginous layer is highly porous and nutrition diffuses across the surface from the __________ layer.

A

Bony

46
Q

The facet joints are important in stabilizing the spine. Their ______ and ______ affect the mobility of each spinal region.

A

Anatomical position and orientation

47
Q

The facet joints in the lumbar region are oriented in the ______ plane and limit the _______ In rotation.

A

Sagittal and range of motion

48
Q

Ligaments have many functions. Name four:

A
  1. Provides stability
  2. Protect spine and neurological structures
  3. Prevent exceeding of motion segment
  4. Allow for normal spine motion
49
Q

List the seven ligaments that attach the motion segment together

A
  1. ALL
  2. PLL
  3. Ligamentum flavum
  4. Interspinous
  5. Supraspinous
  6. Inter transverse ligament
  7. Facet capsular
50
Q

Major trauma or repetitive minor trauma may lead to _______

A

Nonspecific synovitis

51
Q

The articular process begins to override each other as the joint capsules become stretched. This results in……

A

Malalignment of the joints and abnormal biomechanical function of the motion segment.

52
Q

How did the spinal ligaments show the effects of aging

A

Through partial ruptures, necrosis, and calcifications of the fibers.

53
Q

List 7 changes to the motion segment that may occur due to degenerative disc disease

A
  1. Just loses water, causing it to shrink in volume
  2. Disc space begins to narrow
  3. Compressive loads are transferred away from the nucleus pulposis/ Central endplate interface to the peripheral annulus/ vert. Endplate margins
  4. Sclerosis of the central endplate further reduce his disc nutrition
  5. Motion segment becomes hypermobile do to narrowed intervertebral space and overriding of the facets.
  6. Osteophytes develop in an attempt to stabilize excessive motion
  7. Osteophytes may encroach on neurological structures
54
Q

Though degenerative disc disease may be found in every spinal level, what are the most frequently affected levels by region?

A

C-5 C6/ L4 L5/ L5 S1

55
Q

What does stenosis mean

A

The narrowing of the tube

56
Q

What is the most common form of spinal stenosis?

A

Acquired degenerative type

57
Q

What are the most frequent discs to herniate in the cervical and lumbar regions of the spine?

A

C-5 C6, C6-C7, and C-4 C-5,

L4- L5, L5- S1, L3-L4.

58
Q

Define nuclear herniation

A

Occurs when the nucleus ruptures through the innermost fibers of the process but does not cause any disruption or distortion of outer annulus fibrosis

59
Q

What is nuclear extrusion

A

A complete split in the anulus that allows nuclear material to leak out into the surroundings basis. The profound material remains attached to the nucleus remaining inside of the desk.

60
Q

What is disc protrusion?

A

Ruptured nucleus distorts the outermost fibers of anulus, causing them to pull it out word. Also called a prolapsed disc.

61
Q

What is a sequestered nucleus?

A

The extruded nuclear substance is no longer attached to the material remaining inside the desk. The sequestered fragments may float around the spinal canal and become totally removed from which it originally extruded.

62
Q

What is sciatica

A

Disc herniation in a position to contact physically and exert pressure on the existing nerve root at the level.. at that point the patient begins to experience pain down the back and the leg

63
Q

What are the most common symptoms with SI radiculopathy

A

Pain in the posterior aspect of the thigh and calf in the lateral aspect of the bottom of the foot from the heel to last two toes

64
Q

What are the most appropriate radiographic studies done for evaluating herniated lumbar disc

A

MRI & CT

65
Q

What are the most common surgical procedures for lumbar disc herniation

A

Laminectomy with discectomy, Microdiscectomy, endoscopic discectomy and ablation

66
Q

Describe the presentation of the patient with cervical herniated disc

A

Neck pain, radicular arm pain, myelopathy, or neural taxis of the upper arm

67
Q

What are the most appropriate radiographic studies were evaluating herniated cervical disc?

A
  1. MRI

2. CT scan and cervical myelogram maybe used occasionally

68
Q

What are the most common surgical procedures for cervical disc herniation?

A
  1. ACDF
  2. ACDF without fusion
  3. Partial anterior discectomy
  4. Posterior laminectomy
  5. Posterior laminoplasty
69
Q

What is a stable fracture?

A

No significant displacement of deformity to the pony or soft tissue architecture

70
Q

What is an instable fracture

A

The spine may not be able to carry normal loads without risk of causing new or additional neurological injury

71
Q

Describe Denis’ classification of spinal structures

A

A frequently used classification method based on a three column theory of the spine developed by Denis. Anterior, middle, posterior.

72
Q

Describe magerl’s classification of spinal structures

A

Classification method for thoracolumbar fractions

73
Q

What is “ cauda equine syndrome”?

A

Neurological injury below L1

74
Q

How many pairs of spinal nerves are found in the spinal column

A

31

75
Q

Describe frankel’s Classification of neurologic impairment

A
  1. Complete loss of motor and sensory function
  2. Only sensory function remains
  3. Motor function present, but no practical use (i.e. person can move legs but is unable to ambulate)
  4. Motor function impaired (I.e person can ambulate but not with normal gate)
  5. No neurological impairment noted
76
Q

What is a craniovertebral junction injury?

A

An injury that affects the base of the skull (C0), The Atlas (c1) and/or the axis (c2)

77
Q

What are the three types of Thoracolumbar injuries

A
  1. Burst fractures:
  2. Flexion/compression fracture: fractures
  3. Flexion/ distraction fractures
78
Q

Flexion/ distraction fractures:

A

also known as a chance fracture. All three columns my fail by distraction forces. Bone, ligaments us subluxation is often encountered. flexion/ distraction injuries are often caused by automobile seat belts.

79
Q

Define Flexion/ compression fracture

A

frequently occur at T 12 through L1. Interior column failure depended on amount of compressive force. Usually some loss of vertebral height with this injury

80
Q

Define a burst fracture

A

The table height is significantly decreased in the unstable fracture

81
Q

List two types of low lumbar injuries

A
  1. Flexion distraction fracture

2. Compression/ torsion/ translational fractures

82
Q

Define Flexion/ distraction fractures

A

Also called a jumpers fracture, results from severe compressive load on the anterior column and destructive forces on the middle and posterior columns.

83
Q

Define torsion/ translational fractures

A

Usually occurs together with or without flexion. Compression effects may occur on the lateral margin of the vertebral body, while torsional and translational forces may affect the body or disc and ligamentous structures

84
Q

Where is the most common site for metastasis in the skeleton

A

The vertebral column

85
Q

What is the five-year survival rate for all forms of lung cancer

A

Less than 10%

86
Q

What is the five-year survival rate for breast cancer

A

Exceeds 75%

87
Q

What is the five year survival rate for patients with global metastases of prostate cancer

A

Approximately 20%

88
Q

What is osteoporosis

A

A progressive disease that is age-related it is distinguished by a decrease in the skeletal bone mass

89
Q

What factors may influence osteoporotic bone loss

A

Race and genetic factors

90
Q

Describe the conservative treatment for compression fractures

A

Bedrest, pain medication, bracing

91
Q

Describe the treatment for secondary osteoporosis

A

Treating the underlying malady or discontinuing the offending agent

92
Q

What is “Paget’s disease”?

A

A chronic, usually localized, skeletal disorder resulting from the rapid metabolism of new bone

93
Q

What is osteomalacia

A

Soft bones

94
Q

What are the most common causes of osteomalacia

A

Vitamin D deficiency due to inadequate nutritional intake or inadequate sunlight exposure, hereditary, or acquired disorders of metabolism of phosphates

95
Q

Describe the clinical presentation of tuberculosis (TB) infections of the spine.

A

It progresses gradually and symptoms may not be apparent

96
Q

What is the treatment of choice for spinal tuberculosis

A

Multiple drug therapy For at least six months. Surgical intervention is indicated when there is a significant bony collapse and deformity

97
Q

What is “osteomyelitis” of the spine

A

Inflammation of the bone marrow of vertebral body and the adjacent cortical bone due to an infection

98
Q

What is the difference between casting and orthotics

A

Cast: plaster jacket
Orthotics: also called bracing. It does not correct the curve.. It prevents the progression of the curve

SST (2 decks)

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