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Locomotor Y2 > Back pain > Flashcards

Back pain Flashcards

1
Q

Name 2 main causes of abnormal spinal curves

A

1- Developmental anomalies

2- Pathological conditions (missing half vertebrae/ osteoporosis)

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2
Q

What would someone look like if they had kyphosis?

What are some main cause of the condition?

A

Increased thoracic curvature
Erosion/fracture of anterior part of one or more vertebrae
Osteoporosis

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3
Q

How does kyphosis affect the vertebrae?

A

Erosion/fracture of anterior part of one or more vertebrae

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4
Q

Name the surgical procedure used to treat Kyphosis?

A

Kyphoplasty (vertebroplasty, vertebral augmentation)

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5
Q

Describe the process of a kyphoplasty procedure

A
  1. Tube is inserted into the damaged vertebrae
  2. A special balloon is inserted through the tube and inflated
  3. As the balloon inflates it returns the vertebra to a more normal size and creates a cavity
  4. The balloon is removed and the cavity is filled with polymethylmethacrylate (cement like)
  5. PMMA hardness and stabilises the bone
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6
Q

Outside of kyphosis, what else can a kyphoplasty be used to treat?

A

Compression fractures

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7
Q

What is Adolescent kyphosis (Sheuermann’s disease)

A

Affects epiphyseal growth plates of one or more vertebral bodies. The back side of the vertebral body grows normally and the front grows more slowly or abnormally. This leads to a vertebra with a distinct wedge shape and kyphosis.

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8
Q

List 2 distinct symptoms of Adolescent kyphosis (Sheuermann’s disease)

A

Pain

Difficulty breathing

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9
Q

Name one key radiological finding associated with Adolescent kyphosis (Sheuermann’s disease). What causes this finding?

A

Smorl’s nodes

Some of the IV disc (nucleus pulposus) pushes into the end plate of vertebral body

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10
Q

What is lordosis?

A

When the anterior rotation of pelvis produces increased lumbar curvature.

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11
Q

Name two main causes of lordosis

A

weakened trunk muscles

weakened hip flexors

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12
Q

what is psoas dysfunction and how does it cause lordosis and back pain - describe 6 components

A

– Chronic psoas shortening and weakness
– Increased lumbar lordosis
– Shortening of the thoraco-lumbar fascia and erector spinae muscles
– Stretching and weakness of abdominal muscles
– Hamstring and gluteal muscles tightened and often hypertonic
– This increases the shearing forces on the intervertebral discs
- intervertebral discs degenerate and arthritic changes develop in the facet joints

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13
Q

What is flat back syndrome?

A

When the pelvis tils backwards and pulls the lumber spine flat

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14
Q

List 5 key features of flat back syndrome including potential causes

A

Tight musculature between ribs makes breathing shallow
Hamstrings tight – knees flexed
Hip flexors weak – hip flexed (gravity)
Pelvis tilts backwards pulls vertebral column flat
Ankylosing spondylitis, degenerative disc, spinal fusion

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15
Q

What is scoliosis?

A

abnormal lateral curvature

Usually accompanied with rotation of the vertebrae

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16
Q

What causes scoliosis? - list 4

A

developmental defects, asymmetric muscle strength, poor posture, or idiopathic

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17
Q

Which demophragic is most likely to have scoliosis?

A

Females around puberty

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18
Q

How is scoliosis treated?

A

Brace is curve is 20-40o

If cure is greater than 50-

Vertebral fusion
Harrington rods
Newer flexible rods attached to each vertebrae

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19
Q

List 5 signs of degenerative spine disorders

A 
Osteophytes (syndesmophytes)
Loss of disc height
Loss or increase in curves
Spinal Stenosis
Ossification of vertebral ligaments
20
Q

What kind of joint is the intervertebral disc?

A

cartilaginous joint (symphysis)

21
Q

List 4 main features of the nucleus pulposus

A

70-90% water
Proteoglycans
Avascular
No innervation

22
Q

List 4 main features of the annulus fibrosis

A

Alternating layers of collagen
Type I
Outer 1/3rd is innervated
Firmly attached to outer margin of vertebral body

23
Q

At what age will the IV disc begin to dry out? Which part of the disc dries out?

A

After the age of 30 IV discs dry out – nucleus pulposus

24
Q

Where along the spine is the herniated/ prolapsed disc most likely to occur?

A

commonly IV disc between L4/5 or L5/S1

25
Q

What is the cause of pain when someone is suffering from a herniated/ prolapsed disc?

A

Nucleus pulposus irritates and/or compresses the spinal nerve root

Pain felt along distribution of the compressed/irritated nerve root

26
Q

List 6 symptoms associated with cauda equina syndrome

A

Low back pain

Unilateral or bilateral sciatica

Saddle and perineal hypothesia or anaesthesia

Bowel and bladder disturbances

Lower extremity motor
weakness and sensory deficits

Reduced or absent lower extremity reflexes

27
Q

Name the 2 surgical treatments use to treat cauda equina syndrome

A

Discetomy

laminectomy

28
Q

List 2 immediate complications of a burst fracture

A

Compression of the spinal cord or nerve roots

instability

29
Q

List a late complication of a burst fracture

A

Hematoma- in center of the injured disc

Necrosis-

30
Q

Where do osteophytes commonly develop?

A

around margins of vertebral body and zygapophysial joints

31
Q

Name 3 conditions which can cause osteophytes

A

Spondylosis and osteoarthritis

32
Q

What causes Vertebral-basilar artery insufficiency?

A

OA or degenerative disc disease

33
Q

What is Diffuse idiopathic skeletal hyperostosis?

A

Ossification of ligaments

e.g. anterior longitudinal ligament

34
Q

Which age does Diffuse idiopathic skeletal hyperostosis affect most often?

A

50-75 years

35
Q

In an X-ray what is the main radiological sign for Diffuse idiopathic skeletal hyperostosis (DISH)?

A

osteophytes
bone spurs
Disc height maintained

36
Q

Which joint does Diffuse idiopathic skeletal hyperostosis (DISH) not effect?

A

sacroiliac joint

37
Q

At what age is Ankylosing spondylitis most likely to occur?

A

19-25 year olds

38
Q

Which part of the boy does Ankylosing spondylitis mostly affect?

A

Axial skeleton

39
Q

List for X-ray features for Ankylosing spondylitis

A

AP and lateral X-rays show “Bamboo-spine”

Narrowing and sclerosis of both sacroiliac joints

Sclerosis and ankylosis of vertebral bodies with no loss of disc space

Bone formation extends across anterior and lateral margins of IV discs

40
Q

Which gene is associated with Ankylosing spondylitis and how?

A

HLA-B27
>95% of patients positive
5% chance of developing AS

41
Q

Which sex is most affected by Ankylosing spondylitis and by how much?

A

Males, 3 times more affected

42
Q

What is Enthesopathy?

A

inflammation of entheses

where tendon or ligament attach to the bone

43
Q

How does the HLA B27 gene affect the gut?

A

It influences the composition of the endogenous gut flora

causing a leaky gut

Leaky gut allows substances trigger cascades of inflammatory reactions

44
Q

What type of joint connects C1 and C2?

A

pivot synovial joint

45
Q

Which type of subluxation is most common in Rheumatoid arthritis?

A

Atlantoaxial subluxation

46
Q

Which arteries can be compressed in Rheumatoid arthritis?

A

Vertebral arteries

Locomotor Y2 (8 decks)

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