Back Blue Boxes Flashcards by Bryan Edwards

What is a common metabolic bone disease that is often detected during routine radiographic studies?

Vertebral body osteoporosis

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What results from a net demineralization of the bones caused by a disruption of the normal balance of calcium deposition and resorption?

osteoporosis

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Osteoporosis affects which areas of the skeleton the most?

neck of the femurbodies of the vertebraemetacarpalsradius

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Vertical striping on radiographs of the vertebral column indicates what?

loss of the horizontal supporting trabeculae and thickening of vertical struts

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What is the general name for posterior concave curvature of the spine?

lordosis

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What is the general name for anterior concave curvature of the spine?

kyphosis

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Surgical excision of one or more spinous processes and the adjacent supporting vertebral laminae

laminectomy

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Performed surgically to gain access to the vertebral canal, providing exposure of the spinal cord

laminectomies

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Often performed to relieve pressure on the spinal cord or nerve roots cuased by a tumor, herniated IV disc, or bony hypertrophy

surgical laminectomy

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Which vertebrae can be dislocated in neck injuries with less force than is required to fracture them?

cervical vertebrae

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Slight dislocation of the cervical vertebrae can occur without damaging the spinal cord because of what?

large vertebral canal in the cervical region

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Stage I cervical vertebrae dislocation

flexion sprain

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Stage II cervical vertebrae dislocation

anterior subluxation with 25% anterior translation

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Stage III cervical vertebrae dislocation

50% translation

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Stage IV cervical vertebrae dislocation

complete dislocation

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Bony ring, with two wedge-shaped lateral masses, connected by a relatively thin anterior and posterior arches and a transverse ligament

the atlas

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A Jefferson or burst fracture is fracture of which vertebrae?

the atlas

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Vertical forces, as would result from striking the bottom of a pool in a diving accident, can easily fracture which vertebrae

atlas

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Spinal cord injury is more likely with a C1 fracture if what has also been ruptured?

transverse ligament

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One of the most common injuries of the cervical vertebrae (up to 40%)

fratures of the vertebral arch of the axis

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Bony column formed by the superior and inferior articular processes

pars interarticularis

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Fracture in the pars interarticularis of the axis is called?

traumatic spondylolysis of C2

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A traumatic spondylolysis of C2 most often occurs as a result of what?

hyperextension of the head on the neck (whiplash)

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How was hyperextension of the head and neck used to kill people?

execution of criminals by hanging (hangman’s fracture)

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Paralysis of all four limbs

quadriplegia

Fracture that can result from a horizontal blow to the head or as a complication of osteopenia (40-50% of axis injuries)

fractures of the dens

Narrowing of the vertebral formane in one or more lumbar vertebrae

lumbar stenosis

Lumbar spinal nerves ______ in size as the vertebral column descends, but the IV foramen ______ in size

increasedecrease

When the developmental costal element of C7 becomes abnormally enlarged in 1-2% of people

cervical rib

When a supernumerary (extra) rib places pressure on structures that emerge from the superior thoracic aperture

thoracic outlet syndrome

closes the sacral hiatus

sacrococcygeal ligament

connective tissue strand extending from the tip of the spinal cord to the coccyx

filum terminale

local anasthetic agent is injected into the fat of the sacral canal that surrounds the proximal portions of the sacral nerves

caudal epidural anesthesia or caudal analgesia

palpable bony landmarks important for locating the hiatus

sacral cornua and S4 spinous process (medial sacral crest)

Caudal epidural anesthesia acts on which spinal nerves of the cauda equina?

S2 - Co1

Sensation is lost ____ to epidural blocks

inferior

Anesthetic agents is injected through the posterior sacral foramina into the sacral canal around the spinal nerve roots

transsacral epidural anesthesia

An abrupt fall onto your ass may cause a painful subperiosteal bruising or fracture/ dislocation of what?

coccyx / sacrococcygeal joint

Condition in approx 5% of people where L5 is partly or completely incorporated into the sacrum

hemisacralization / sacralization of the L5 vertebra

Condition where S1 is separated from the sacrum and is partly or completely fused with L5 vertebra

lumbarization of the S1 vertebra

When L5 is sacralized, the ______ level is strong, and the _____ level degenerates

L5-S1 (strong)L4 - L5 (degenerates)

As you get older, the IV discs become increasingly _____

convex

What are osteophytes?

bony spurs

Birth defect where the neural arches of L5 and/or S1 fail to develop normally and fuse posterior to the vertebral canal

spina bifida occulta

Spina bifida is often concelaed by the overlying skin but its location can often be indicated by what?

a tuft of hair

One or more vertebral arches fail to develop completely

spina bifica cystica

spina bifida associated with a meningeal cyst

meningocele

spina bifida associated with the spinal cord

meningomyelocele

IV discs lose their turgor, becoming stiffer and more resistant to deformation when what dehydrates?

nuclei pulposi

It has been shown that the IV discs ____ in size with age

increase

When ______ degenerates, the _______ may herniate into the vertebral column and compress the spinal cord.

anulus fibrosusnucleus pulposus

Where herniations of the nucleus pulposus usually extend in which direction

posterolaterally, where the anulus fibrosus is relatively thin

A posterolateral herniated IV disc is more likely to be symptomatic becuase of the proximity of what?

spinal nerve roots

Posterolateral herniations of the nucleus pulposus are most common here

lumar and lumbosacral regions(IV discs are largest in these regions)

Approximately 95% of lumbar disc protrustions occur at which spinal levels?

L4 - L5L5 - S1

Often caused by a herniated lumbar IV disc that compresses and compromises the L5 or S1 component of the sciatic nerve

sciatica

Make up 40% of fractures of the axis

fractures of the dens

incomplete dislocation of the median atlanto-axial joint

atlanto-axial subluxation

When the transverse ligament of the atlas ruptures, the dens of the axis is set free, resulting in what?

atlanto-axial subluxation

20% of people with Down syndrome exhibit laxity or agenesis of which ligament?

transverse ligament of the atlas

Steele's Rule of Thirds?

Approximately 1/3 of the atlas ring is occupied by the dense, 1/3 by the spinal cord, and the remaining 1/3 by the fluid-filled space and tissues surrounding the cord

Where are the alar ligaments?

extend from the sides of the dnese of the axis to the lateral margins or the foramen magnum(attach the cranium to the C1 vertebra and act as check ligaments in preventing excessive rotation at the joints)

Combined flexion and rotation of the head may tear which ligaments?

alar ligaments

Rupture of an alar ligament results in what?

increase of approx 30% in the range of the movement of the contralateral side

Cervical IV discs most common ruptured

C5 - C6 and C6 - C7

Head butting or illegal face blocking in football may lead to what kind of injury?

hyperextension injury of the neck

Type of hyperextention injury where the anterior longitudinal ligament is severely stretched and may be torn

severe hyperextesion of the neck (whiplash)

The most commonly fractured noncervical vertebrae

T11 and espicially T12

Dislocation of the vertebrae in the thoracic and lumbar regions is uncommon becuase of what?

interlocking of their articular processes

dislocation between adjacent vertebrae

spondylolisthesis

Ear of the scotty dog sign

superior articular process

eye of the scotty dog sign

pedicle

nose of the scotty dog sign

transverse process

neck of the scotty dog sign

pars interarticularis

front leg of the scotty dog sign

inferior articular process

body of the scotty dog

lamina

tail of the scotty dog

spinous process

hind leg of the scotty dog

contralateral inferior articular process

consists of all the muscles or part of muslces receiving innervation from one spinal nerve

myotomes

a procedure used for the treatment of back pain caused by disease of the zygapophysial joints involving percutaneous rhizolysis

denervation of lumbar zygapophysial joints

rhizolysis

nerves are sectioned or destroyed by radiofrequency to reduce pain

Second most common reason people visit their doctor

general back pain

The 5 categories of structures that receive innervation in the back and can be sources of pain

fibroskeletal structures (periosteum, ligaments etc)meningessynovial jointsmusclesnervous tissue

Characterized by an abnormal increase in the thoracic curvature, the therbetral column curves posteriorly

excessive thoracic kyphosis

Dowager's hump

excessive thoracic kyphosis resulting from osteoporosis

characterized by an anterior tilting of the pelvis with increased extension of the lumbar vertebrae

excessive lumbar lordosis

Women often develop this spinal curvature temporarily during late pregnancy

excessive lumbar lordosis

An abnormal lateral curvature accompanied by rotation of the vertebrae

scoliosis

An injury in which only ligamentous tissue, or the attachment of ligament to bone is involved, without dislocation or fracture

back sprain

Common injury resulting from overly strong muscular contraction

back strain

A sudden involuntary contraction of one or more muscle groups

spasm

hardening of arteries

arterioslerosis

radiopaque contrast procedure that allows visualization of the spinal cord and spinal nerve roots

myelography

the arachnoid and pia mater form the?

leptomeninges

withdrawal of CSF from the lumbar cistern

Lumbar puncture

in a lumbar puncture, the needle is inserted in the midling between the spinous processes of which vertebrae?

L3 and L4 (or L4 and L5)

plane transecting the highest points of the iliac crests

supracristal plane (marker for a lumbar puncture)

deficient blood supply

ischemia

Transection of the spinal cord at C1-C3 level will result in?

no function below head level; ventilator is required to maintain respiration

transection of the spinal cord at the C4-C5 level results in?

quadriplegia; respiration occurs

transection of the spinal cord at the C6-C8 level results in?

loss of lower limb function combined with a loss of hand and variable amount of upper limb function

transection of the spinal cord at the T1 - T9 level

paraplegia

transection of the spinal cord at the T10-T1 level

some thigh muscle function, may allow walking with long leg braces

transection of the spinal cord at the L2-L3 level

retention of most leg muscle function; short leg braces may be required for walking