Back Clinical Notes Flashcards
Jefferson fracture
Burst fracture
fracture of both arches of the atlas secondary to a blow to the top of the head; does not typically injure the spinal cord
hangman’s fracture
fracture of the vertebral arch of the axis secondary to hyperextension of the head on the neck
fracture of the odontoid process
may occur after a horizontal blow to the head
- if it breaks at its base it will not heal
- if it breaks inferior to the base it is more likely to heal
spina bifida occulta
development abnormality in which the veterbral lamina fail to fuse and close off the verterbral canal
- commonly occurs at L5 and S1
- tuft of hair present
spina bifida cystica
when spina bifida occulta incorporates the neural tissue and the meninges
why does it require less force to dislocate the cervical vertebrae
the articulating facets of the cervical vertebrae are more horizontal than the other vertebrae so it requires less force
spondylosis
degenerative joint disease which involves calcification of the edges of the vertebral body
- causes localized pain and stiffness
Spondylolysis
separation of the vertebral arch from the vertebral body
Spondylolisthesis
Anterior displacement of the Vertebral Body on the Inferior Vertebral Segment
- can occur secondary to spondylolysis
lumbar spinal stenosis
narrowing of the lumbar vertebral foramen; may cause compression of one or more spinal nerve roots
lumbar puncture
needle inserted at L3/L4 or L4/L5 vertebae at the level of the iliac crest; needle passes through ligamentum flavum and “pops” as it passed into the lumbar cistern through the spinal dura and arachnoid mater
sacrilization of L5 vertebra
partial or complete incorporation of the L5 vertebral segment into the sacrum
lumbarization of S1 vertebra
separation of S1 vertebra from the sacrum
coccygodynia
follows coccygeal trauma
kyphosis
exaggerated curving of thoracic vertebral column resulting in “hunchback”
lordosis
exaggerated curving of the lumbar vertebral column results in “sway back”
scoliosis
lateral curving of the spine either to the right or left
whiplash
results in excessive stretching and even tearing of the anterior longitudinal ligament
treatment for fracture of the vertebral column
patient should be kept in hyperextension at all times; the pull of the anterior longitudinal ligament will help realign fragments of bone and keep further injury to the spinal cord from occurring
disc herniation
nucleus pulposis herniates through the annulus fibrosis; the resultant bulge compresses spinal nerve roots, the cauda equina, and spinal nerves in the vertebra canal and interverterbal foramina
where is disc herniation most common and why
L4/L5 and L5/S1
- the discs are much larger and more mobile
back sprain
injury to ligamentous attachments between bone
- usually the result of inadequate stretching before activity
back strain
excessive stretching and sometimes tearing of muscle fibers produced by an overly strong muscular contraction
back spasm
muscle tissue spasms (involuntarily contracts) in response to injury and inflammation as a protective measure
transection of spinal cord at C1-C3
no function below the head; respirator necessary for life (cannot breath on own)
transection of spinal cord at C4-C5
no function of any limbs; able to breath on own
transection of spinal cord at C6-C8
loss of hand and variable upper limb function; may be able to propel a wheelchair
transection of spinal cord at T1-T9
paralysis of both lower limbs
transection of spinal cord T10-L1
some thigh muscle function; may allow walking with long leg braces
transection of spinal cord L2-L3
most lower limb functions present, may be able to walk with short leg braces
muscular back pain is often the result of
spasm in muscular tissue producing ischemia
back joint pain is usually the result of
osteoarthritis or disease arthritis
fibroskeletal back pain is usually the result of
fractures and dislocation of ligamentous structures
