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MSS > Basic Spine MSK Exam > Flashcards

Basic Spine MSK Exam Flashcards

1
Q

spondylolysis

A

fracture of pars interarticularis (spottie dog)

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2
Q

spondylolisthesis

A

anterior displacement of one vertebrae on another

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3
Q

basic spine exam do what?

A

assess appearance, palpate, check ROM, basic strength, basic reflexes, basic sensory exam, any special tests

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4
Q

appearance: looking for what?

A

symmetry, scoliosis, scapular winging, cervical/lumbar lordosis, thoracic kyphosis, cafe au lait spots (neurofibromatosis), atrophy

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5
Q

palpate what/where?

A

spinous processes/interspaces, paraspinal muscles, cervical spine (cervical musculature) lumbar spine

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6
Q

cervical spine landmarks?

A

hyoid bone- C3
thyroid cartilate- C4-5
first cricoid ring- C6
most prominent spinous process- C7

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7
Q

lumbar spine landmarks?

A

top of iliac crest, L4-5

PSIS, S2

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8
Q

cervical spine ROM?

A

rotation: 70
flexion: 45
extension: 55
sidebending: 40

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9
Q

lumbar spine ROM?

A

flexion: 75
extension: 30
lateral bending: 35
rotation

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10
Q

pathologic reflexes (signs of upper motor neuron process)

A

hoffman: passive rapid flexion of distal middle finger (+ = flexion of thumb, index finger)
babinski: stroking sole of foot resulting in great toe extension and toe spreading

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11
Q

special tests?

A

straight leg raise, femoral stretch test, spurling test (cervical spine extension etc = ipsi radicular stx), Lhermitte (electric shock sensation in limbs with cervical flexion)

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12
Q

lumbar strain history + etiology

A

axial low back pain after acute injury. muscle disruption from excessive stretch/tension

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13
Q

lumbar strain exam + treatment

A

localized muscle tenderness, reduced ROM. no imaging, relative rest, NSAIDs

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14
Q

osteoarthritis (facet joints) history + etiology

A

axial low back pain w gradual onset. d/t gradual degenerative changes/OA to facet joints. > 55

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15
Q

osteoarthritis (facet joints) exam + treatment

A

nonspecific, pain provoked with active extension, relieved with flexion. no imaging, NSAIDs, mild analgesics. PT.

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16
Q

radiculopathy history + etiology

A

pain & possible numbness/weakness in limb > axial spine. disc herniation more common.

17
Q

radiculopathy exam + treatment

A

SLR or Spurling +, neuro deficits (weakness, decreased reflex, reduced sensation). MRI, maybe EMG. relative rest, PT, NSAIDs

18
Q

lumbar stenosis history

A

slowly progressive back and unilateral/bilateral leg pain. shopping cart sign. differentiate from vascular claudication.

19
Q

lumbar stenosis etiology

A

narrowing of spinal canal d/t disc herniation/protrusion, ligamentum flavum thickening, osseous thickening of bone/facet joint, spondylolisthesis

20
Q

lumbar stenosis exam

A

nonspecific. possibly flexed standing posture, reduced lumbar lordosis

21
Q

lumbar stenosis treatment

A

MRI, maybe CT or EMG. NSAIDs, PT, use of walker

22
Q

cervical myelopathy history + etiology

A

pain, numbness, weakness in arms &/or legs, balance and gait difficulties, bowel/bladder dysfunction. d/t cervical canal stenosis w spinal cord compression

23
Q

cervical myelopathy exam + treatment

A

arm and/or leg weakness, UMN signs. MRI, surgical decompression. no role for nonoperative treatment.

24
Q

compression fracture history + etiology

A

usually sudden thoracic or lumbar pain, often little to no trauma. osteoporosis relation in older patients. younger consider malignancy, multiple myeloma. 1/3 asymptomatic.

25
Q

compression fracture exam

A

tender over spinous processes, paraspinals. worse with lumbar flexion. better with lumbar extension. normal neuro exam.

26
Q

compression fracture treatment

A

imaging: plain x-rays, poss MRI or CT. DEXA scan for osteoporosis. different if malignancy considered. bracing. PT. consider vertebroplasty

27
Q

ankylosing spondylitis history

A

onset of low back pain < age 40, insidious, better with exercise, pain at night and on waking, not improved with rest

28
Q

ankylosing spondylitis etiology

A

inflammatory spondyloarthropathy, usually sacroiliitis initially. can be assoc w uveitis, inflammatory bowel disease, psoriasis

29
Q

ankylosing spondylitis exam

A

reduced lumbar ROM, often tender to palpation over sacroiliac joints with positive joint provocative tests

30
Q

ankylosing spondylitis treatment

A

imaging: plain x-rays, earliest finding sacroiliitis. later, bamboo spine.
labs: HLAB27, CRP, sed rate.
meds: NSAIDs, possibly anti-TNF agents. PT, spine extension

31
Q

cauda equina syndrome history

A

leg pain, numbness, weakness, saddle anesthesia, bowel/bladder dysfunction

32
Q

cauda equina syndrome etiology

A

large herniated disc compressing cauda equina most common

33
Q

cauda equina syndrome exam + treatment

A

reduced or absent reflexes, weakness, decreased rectal tone. surgical emergency!

MSS (28 decks)

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