Back: Clinical App Flashcards
Wear and tear of the Anulus Fibrosus can allow what structure to protrude and impinge on what other structures? What is this condition called?
Herniated Disc: Thinning of the Anulus Fibrosus can allow the herniation of the Nucleus Pulposus into the vertebral canal, which can impinge the spinal cord or nerve root.
The fracture of the pars interarticularis results in what condition?
What are the probably causes?
Spondylolysis:
Due to genetic defect or trauma (young athletes)
Most commonly occurs at the L5 vertebra
Spondylolisthesis is considered the forward displacement of what structure?
How can it occur?
What does it cause?
Forward displacement of the vertebral body, resulting from Bilateral Spondylolysis.
This can cause pressure on spinal nerves as they pass through the vertebral canal
What procedure is used to gain access to the Spinal Cord?
It is accomplished by cutting through what structure?
Laminectomy:
Used to gain access to the spinal cord or relieve pressure on the spinal cord due to pathology (i.e. spinal stenosis). It requires cutting through the laminae of the vertebra.
A lumbar Puncture (Spinal Tap) is used for what?
Where must it be done and why?
A lumbar puncture is used to obtain a sample of CSF for evaluation.
The needle must be inserted into the subarachnoid space, usually between spinous processes of L3/L4 or L4/L5 (in adults).
Location is important to avoid sticking the needle into the spinal cord.
How can you locate the L3/L4 level?
The L4 spinous process is located by “drawing” a horizontal line at the top of the iliac crests.
The needle can be then inserted above or below that mark.
What are dermatomes?
How are they clinically relevant?
Dermatomes are regions of the skin innervated by a single spinal nerve and reflects the pattern of embryonic development.
They can help ID nerve damage.
What pathology is expressed as a superficial cutaneous infection that follows a dermatomal pattern?
Herpes Zoster (Shingles)
A reactivated form of chicken pox (varicella-Zoster virus) which spreads along the nerves associated with DRG’s
Pain felt at a different region is called what?
What is the reasoning behind it?
Sensory nerves from the associated dermatome/region that enter the spinal cord at the same location.
What are the (3) common sites of referred pain?
- Stomach (epigastrium; T5-T9)
- Appendix (Umbilicus; T10)
- Heart (Upper Left part of Trunk (T1-T5)
