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MSK > Back and Spine Injuries > Flashcards

Back and Spine Injuries Flashcards

1
Q

What is lumbago?

A

Low back pain

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2
Q

What are some causes of mechanical back pain?

A

Muscle or ligament sprain
Facet joint dysfunction
Sacroiliac joint dysfunction
Herniated disc
Spondylolisthesis
Scoliosis
Degenerative changes

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3
Q

What are red flag causes of back pain?

A

Spinal fracture
Cauda equina syndrome
Spinal stenosis
Ankylosing spondylitis
Spinal infection

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4
Q

What is sciatica?

A

Irritation of sciatic nerve
Unilateral pain from the buttock radiating down the back of the thigh to below the knee or feet
Paraesthesia, numbness
Motor weakness

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5
Q

What are the main causes of sciatica?

A

Herniated disc
Spondylolisthesis
Spinal stenosis

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6
Q

What is bilateral sciatica a red flag for?

A

Cauda equina syndrome

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7
Q

What type of disc prolapse is most common?

A

Lateral prolapse

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8
Q

What are the 4 types of disc problem?

A

Bulging- asymptomatic
Protrusion- annulus weak but intact
Extrusion- through annulus
Sequestration- desiccated disc material free in canal

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9
Q

Where are the majority of disc prolapses?

A

L4/L5/S1

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10
Q

What is cauda equina syndrome?

A

Compression of cauda equina
Surgical emergency

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11
Q

What causes compression in cauda equina?

A

Herniated disc
Tumours
Spondylolisthesis
Abscess
Trauma

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12
Q

What are the red flags for cauda equina?

A

Saddle anaesthesia
Loss of sensation in bladder and rectum
Urinary retention or incontinence
Faecal incontinence
Bilateral sciatica
Bilateral motor weakness in legs
Reduced anal tone

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13
Q

What is the management of cauda equina?

A

Immediate admission
Emergency MRI
Lumbar decompression surgery with 48 hours

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14
Q

What is spinal stenosis?

A

Narrowing of part of the spinal canal causing compression of the spinal cord or nerve roots

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15
Q

What is the most common type of spinal stenosis?

A

Lumbar

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16
Q

What are the 3 types of spinal stenosis?

A

Central stenosis- narrowing of central spinal canal
Lateral stenosis- narrowing of the nerve roots canals
Foramina stenosis- narrowing of the intervertebral foramina

17
Q

What causes spinal stenosis?

A

Congenital
Degenerative
Herniated disc
Thickening of ligamentum flava
Spinal fractures
Spondylolisthesis
Tumours

18
Q

What is spondylolisthesis?

A

Anterior displacement of a vertebra out of line with the one below

19
Q

What is the presentation of spinal stenosis?

A

Claudication
Lower back pain
Buttock and leg pain
Leg weakness
Worse working down hills

20
Q

What is the management of spinal stenosis?

A

Exercise and weight loss
Analgesia
Physio
Decompression surgery

21
Q

What are complete spinal injuries?

A
  • No motor or sensory function distal to lesion
  • No anal squeeze
  • No sacral sensation
  • ASIA Grade A
  • No chance of recovery
22
Q

What are incomplete spinal injuries?

A
  • Some function is present below site of injury
  • More favourable prognosis
23
Q

What are 2 types of complete spinal injury?

A

Tetraplegia/quadriplegia
Paraplegia

24
Q

What are the features of quadriplegia?

A

All 4 limbs
Injury to cervical region
Resp. failure- phrenic nerve
Spasticity in limbs (UMN)

25
Q

What are the features of paraplegia?

A

Lower limbs
Arm function spared

26
Q

What are 3 types of incomplete spinal injury?

A

Central cord syndrome
Anterior cord syndrome
Brown Sequard syndrome

27
Q

What are the features of central cord syndrome?

A

Hyperextension injury
Weakness of arms>legs

28
Q

What are the features of anterior cord syndrome?

A

Hyperflexion injury
Damaged anterior spinal artery
Fine touch and proprioception preserves
Motor weakness

29
Q

What are the features of Brown Sequard syndrome?

A

Hemi section of cord
Penetrating injuries
Paralysis on affected side- corticospinal
Loss of proprioception and fine discrimination (dorsal column)
Pain and temp loss on opposite side below lesion (spinothalamic)

MSK (20 decks)

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