Cervical and Thoracic Spine Flashcards
1
Q
- Where do you most commonly get degeneration in the spine?
- You also commonly get what here?
A
- Uncovertebreal region in which degeneration occurs.
- This is where you get the osteophytes.
2
Q
What are the lines pointing to?
A
3
Q
- Nerve root exits above the pedicle with what number in the cervical spine?
- C8 root exits above the ____ pedicle?
- Nerve root exits below the pedicle with what number in the thoracic and lumbar spine?
A
- the same
- T1
- the same
4
Q
Do we become more kyphotic or lordotic as we age?
A
Life is a kyphosing event. We lose lordosis.
5
Q
Axial Pain Generator
Pain fibers located where?
5
A
- Annulus
- Joint – uncovertebral, facet
- Ligaments
- Periosteum
- Muscle/Fascia
6
Q
Radicular Pain Generator
- Nerve root mediated how? 2
- Quality? 3
- Associated with what? 2
A
1.
- Compression
- Chemical/ inflammatory
2.
- Dermatomal sharp pain,
- numbness,
- parasthesia
3.
- weakness,
- hyporeflexia
7
Q
- What is Referred Pain?
- Cause?
- Quality?
- Associated with?
A
- Axial or external pain localized to a site remote from location of nocioceptors
- Probable activation of contiguous cerebral cortex
- Dull, achy, nondermatomal pain
- Associated with axial pain
8
Q
What areas are the following nerve roots associated with:
- C2-C3?
- C3-4?
- C 4-5?
- C 5-6?
- C6-7?
A
9
Q
Pathophysiology/ Normal Aging
- Normal aging results in a degenerative cascade that may result in a what?
- what triggers the degenerative cascade?
A
- pathologic state
- Intervertebral disc biologic aging
10
Q
Intervertebral Disc
- _______ is metabolically active, hydrostatic proteoglycans, shock absorber effect?
- Nucleus is vascular in childhood via what?
- Beginning at adolescence nutrition is via _______ only
- ___________ degenerate, loose H2O content(dehydrate)
- Alters biomechanical properties of the disc and the motion segment – loss of what?
A
- Nucleus
- annular arteries
- diffusion
- Proteoglycans
- shock absorber
11
Q
- What happens to the quality of the disc as you age? 2
- There is also increased strain on the annulus? 3
A
1.
- Disc dehydration,
- disc narrowing
2. Increase strain on annulus - Diffuse bulging annulus
- Annulur tears
- Focal disc herniation
12
Q
Normal Aging
- Stress transfer to where? 2
- What does this lead to? 2
A
1.
- uncovertebral
- facet joints
2.
- Arthrosis (bone spurs), stiffness
- Instability
13
Q
Pathological States
DDx for Axial neck pain? 4
A
- Facet , uncovertebral joint arthritis
- Loss of lordosis resulting in muscular pain
- Instability
- Discogenic pain
14
Q
- What is radiculopathy?
- Examples? 2
- What is myelopathy?
- Examples? 3
A
- Radiculopathy – pressure related nerve root disfunction (peripheral nerves)
2.
- Disc herniation
- Uncovertebral, facet joint spurs
3. Myelopathy – pressure related spinal cord disfunction (cord)
4.
- Large disc herniation
- Spurs
- Congenitally narrow canal
15
Q
Which nerve roots are involved with the following Disc Space levels:
A