Clinical Anatomy of the Back

Question 1

What are the 3 stages of the interpretation of the lateral C-spine X-ray?

Answer 1

Adequacy, alignment and asymmetry.

Question 2

What do you look for in adequacy?

Answer 2

Can you see all seven cervical vertebrae and the top of T1.

Question 3

What do you look at in alignment?

Answer 3

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.

Question 4

What do you look at in asymmetry?

Answer 4

Look for abnormal asymmetry between the 7 cervical vertebrae.

Question 5

What is a burst fracture of c1 called?

Answer 5

Jefferson’s fracture which is very unstable.

Question 6

What does a winking owl suggest on an X-ray of the spine?

Answer 6

A possible fracture.

Question 7

What is the important questions for pain acronym?

Answer 7

PQRST.

Question 8

What does PQRST stand for?

Answer 8

Provocative and palliative factors, quality of pain, radiation, severity and systemic symptoms and timing.

Question 9

What is the other name of facet joints?

Answer 9

Zygapophysial joints.

Question 10

What is the function of facet joints?

Answer 10

Prevent excess rotation or lateral flexion of the vertebrae.

Question 11

What a symptom of Spondylosis?

Answer 11

A common cause of back pain which is common in cervical and lumbar regions.

Question 12

What is a DEXA?

Answer 12

Dual energy X-ray absorptiometry.

Question 13

What does a DEXA measure?

Answer 13

Bone mineral density.

Question 14

What is listhesis?

Answer 14

Forward movement of the body of one vertebrae on the vertebra below it.

Question 15

What is Spondylosis?

Answer 15

Degeneration of the spinal column, especially that resulting in abnormal fusion and immobilization of the vertebral bones.

Question 16

What is paraesthesia?

Answer 16

An abnormal sensation, typically tingling or pricking.

Question 17

What causes paraesthesia?

Answer 17

Pressure on or damage to the peripheral nerve.

Question 18

What is Spondylolisthesis?

Answer 18

Anterior slip of a vertebra on the lower segment.

Question 19

What can cause Spondylolisthesis?

Answer 19

Weakness of ligamentum flavum or fracture of pedicle.

Question 20

Where is Spondylolisthesis common?

Answer 20

L4/4 or L5/S1 due to spondylosis.

Question 21

What might Spondylolisthesis cause?

Answer 21

May compress on the spinal cord or cauda equina.

Question 22

What are the possible aetiologys of cauda equina syndrome?

Answer 22

Degenerative, traumatic, infective and malignant.

Question 23

What are example of degenerative causes of cauda equina syndrome?

Answer 23

Lumbar disc herniation and spondylolisthesis.

Question 24

What are examples of traumatic causes of cauda equina syndrome?

Answer 24

Vertebral fracture and epidural haematoma.

Question 25

What are examples of infective causes cauda equina syndrome?

Answer 25

Epidural abscess and tuberculosis.

Question 26

What are examples of malignant causes of cauda equina syndrome?

Answer 26

Metastases and primary CNS malignancies.

Question 27

What are the symptoms of cauda equina syndrome?

Answer 27

Saddle anaesthesia, pain, incontinence and numbness.

Question 28

What is saddle anaesthesia in cauda equina syndrome?

Answer 28

Loss of feelings around the buttocks, anus and genitalia.

Question 29

Where is the pain in cauda equina syndrome?

Answer 29

Severe nerve pain in back and or legs.

Question 30

What is the incontinence in cauda equina syndrome?

Answer 30

Bladder incontinence or difficulty urinating or bowel incontinence.

Question 31

Where is the numbness in cauda equina syndrome?

Answer 31

Lack of sensation and weakness in the legs.

Question 32

What are the age related changes of a lumbar intervertebral disc herniation?

Answer 32

Annular tears occur when the water content declines with age, reducing tension in the AF.

Question 33

What are the degenerative causes of lumbar intervertebral disc herniations?

Answer 33

Gelatinous NP replaced with fibrous tissue.

Question 34

How does the degenerative changes cause disc herniation?

Answer 34

Weight transferred to AF causing fissures over time.

Question 35

What are the symptoms of lumbar intervertebral disc herniation?

Answer 35

Lower back pain and sciatica.

Question 36

What is sciatica?

Answer 36

Pain or paraesthesia in the dermatomal distribution of sciatic nerve (L4-S3) and weakness of those myotomes.

Question 37

In which direction does the disc usually herniate?

Answer 37

Usually postero-laterally, impinging on spinal nerve root.

Question 38

What is osteomyelitis?

Answer 38

Infection of the bone and bone marrow.

Question 39

What is discitis?

Answer 39

Infection of the intervertebral disc.