Clinical Anatomy of the Back Flashcards
What are the 3 stages of the interpretation of the lateral C-spine X-ray?
Adequacy, alignment and asymmetry.
What do you look for in adequacy?
Can you see all seven cervical vertebrae and the top of T1.
What do you look at in alignment?
Draw 3 vertical parallel lines along the anterior and posterior border of the cervical bodies and a third line through the base of each spinous process.
What do you look at in asymmetry?
Look for abnormal asymmetry between the 7 cervical vertebrae.
What is a burst fracture of c1 called?
Jefferson’s fracture which is very unstable.
What is a hangman’s fracture?
a fracture of both pedicles or pars interarticularis of the axis vertebra (C2)
What does a winking owl suggest on an X-ray of the spine?
A possible fracture.
What is the important questions for pain acronym?
PQRST.
What does PQRST stand for?
Provocative and palliative factors, quality of pain, radiation, severity and systemic symptoms and timing.
What is the other name of facet joints?
Zygapophysial joints.
What is the function of facet joints?
Prevent excess rotation or lateral flexion of the vertebrae.
What a symptom of Spondylosis?
A common cause of back pain which is common in cervical and lumbar regions.
What is a DEXA?
Dual energy X-ray absorptiometry.
What does a DEXA measure?
Bone mineral density.
What is listhesis?
Forward movement of the body of one vertebrae on the vertebra below it.
What is Spondylosis?
Degeneration of the spinal column, especially that resulting in abnormal fusion and immobilization of the vertebral bones. Caused by a degeneracy in the invertebral discs.
What is paraesthesia?
An abnormal sensation, typically tingling or pricking.
What causes paraesthesia?
Pressure on or damage to the peripheral nerve.
What is Spondylolisthesis?
Anterior slip of a vertebra on the lower segment.
What can cause Spondylolisthesis?
Weakness of ligamentum flavum or fracture of pedicle.
Where is Spondylolisthesis common?
L4/4 or L5/S1 due to spondylosis.
What might Spondylolisthesis cause?
May compress on the spinal cord or cauda equina.
What are the possible aetiologys of cauda equina syndrome?
Degenerative, traumatic, infective and malignant.
What are example of degenerative causes of cauda equina syndrome?
Lumbar disc herniation and spondylolisthesis.
What are examples of traumatic causes of cauda equina syndrome?
Vertebral fracture and epidural haematoma.
What are examples of infective causes cauda equina syndrome?
Epidural abscess and tuberculosis.
What are examples of malignant causes of cauda equina syndrome?
Metastases and primary CNS malignancies.
What are the symptoms of cauda equina syndrome?
Saddle anaesthesia, pain, incontinence and numbness.
What is saddle anaesthesia in cauda equina syndrome?
Loss of feelings around the buttocks, anus and genitalia.
Where is the pain in cauda equina syndrome?
Severe nerve pain in back and or legs.
What is the incontinence in cauda equina syndrome?
Bladder incontinence or difficulty urinating or bowel incontinence.
Where is the numbness in cauda equina syndrome?
Lack of sensation and weakness in the legs.
What are the age related changes of a lumbar intervertebral disc herniation?
Annular tears occur when the water content declines with age, reducing tension in the anulus fibrosus.
What are the degenerative causes of lumbar intervertebral disc herniations?
Gelatinous nucleus pulposus replaced with fibrous tissue.
How does the degenerative changes cause disc herniation?
Weight transferred toanulus fibrosus causing fissures over time.
What are the symptoms of lumbar intervertebral disc herniation?
Lower back pain and sciatica.
What is sciatica?
Pain or paraesthesia in the dermatomal distribution of sciatic nerve (L4-S3) and weakness of those myotomes.
In which direction does the disc usually herniate?
Usually postero-laterally, impinging on spinal nerve root.
What is osteomyelitis?
Infection of the bone and bone marrow.
What is discitis?
Infection of the intervertebral disc.
