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Cervical Thoracic spine clinical conditions Flashcards

1
Q

What is cervical spondylosis?

A

Degenerative osteoarthritis
of intervertebral joints
in cervical spine

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2
Q

What are the intervertebral joints?

A

Between vertebral bodies

Between facets x2

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3
Q

What is compressed as a result of cervical spondylosis?

A

Nerve roots

Spinal cord

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4
Q

What does compression of the nerve roots lead to?

A

Radiculopathy

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5
Q

What is radiculopathy?

A

Dermatomal sensory symptoms

Myotomal motor weakness

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6
Q

What are some dermatomal sensory symptoms?

A

Paraesthesia

Pain

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7
Q

What does compression of the spinal cord lead to?

A

Myelopathy

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8
Q

What is myelopathy?

A

Global weakness

Gait dysfunction
Loss of blanace

Loss of bowel and bladder control

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9
Q

What are the types of C2 axis fractures?

A

Hangman’s fracture

Peg fracture

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10
Q

What part of C2 axis is fractures in a hangman’s fracture?

A

Pars interarticularis

on both side (polo mint principle)

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11
Q

What happens after hangman’s fracture?

A

Forward displacement of C1 and body of C2

on C3 vertebrae

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12
Q

What is the consequence of the displacement in a hangman’s fracture?

A

Transaction of cord - death

in extreme cases

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13
Q

What causes a hangman’s fracture?

A

Hyperextension of head on neck

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14
Q

What is a peg fracture?

A

Fracture at base of dens

detaching it from C2 axis

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15
Q

What causes a peg fracture?

A

Blow to back of head

e.g. falling against wall

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16
Q

What scans are done for a peg fracture?

A

Open mouth AP X-ray
MRI

Because it’s difficult to see on a lateral x-ray as it’s covered up by other structures

17
Q

What is an example of a C1 atlas fracture?

A

Jefferson’s fracture

18
Q

What part of C1 atlas is fractures in a Jefferson’s fracture?

A

Anterior and posterior arches of atlas

19
Q

What causes a Jefferson’s fracture?

A

Skull is driven into it
Atlas expands radially
Breaks in two places (polo mint principle)

20
Q

Give some examples of injuries that may give a Jefferson’s fracture

A

Diving into shallow water

Impact against roof of vehicle

21
Q

What are the consequences of a Jefferson’s fracture?

A

Pain

No neurological symptoms

Damage to arteries at base of skull

22
Q

Why are there no neurological symptoms with a Jefferson’s fracture?

A

Large vertebral foramen

23
Q

What does damage to the arteries at the base of the skull lead to?

A

Secondary neurological sequelae

24
Q

What are some secondary neurological sequalae?

A

Ataxia

Horner’s syndrome

25
Q

Horner syndrome info

A

Damage to sympathetic trunk

Gives miosis - constricted pupil
ptosis - weak droopy eyelid
anhydrosis - decreased sweating

26
Q

What is whiplash injury caused by?

A

Hyperextension

then hyperflexion

27
Q

What is damaged in whiplash injury?

A

No identifiable structure is damaged

28
Q

What are the symptoms of whiplash injury?

A

Neck pain

29
Q

Why is the cervical spine prone to whiplash injury?

A

More mobile

lack of stability

30
Q

How do patients describe a cervical prolapsed disc?

A

Waking up with pain

31
Q

What are the causes of cervical myelopathy?

A

Osteoarthritis of cervical spine - osteophytes

Thickened ligamentum flavum

32
Q

What are the causes of thoracic cord compression?

A

Fracture of vertebra, bony fragments in canal

Tumour developing in spinal canal

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