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MSK > Clinical anatomy of the spine > Flashcards

Clinical anatomy of the spine Flashcards

1
Q

What are common spine conditions?

A

Mechanical back pain and spondylosis
Facet joint arthritis
Multi-level degenerate back pain/ OA
Discogenic bacn pain
Disc prolapse, sciatica and radiculopathy
Spinal stenosis and bony root entrapement
Trauma and OA fracture

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2
Q

What are rare spine conditions?

A 
Scoliosis
Apondylolisthesis
Ankylosing Spondylitis
Beinign tumours - osteoid osteoma 
Malignant tumours - metastatic diseaes, multiple myeloma 
Discitis and osetomyelitis
Cauda Equina Syndrome
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3
Q

What are the different sections of the spine?

A 
C1-7
T1-12
L1-5
5 sacral fused
4 coccygeal fused
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4
Q

From what region will the vertebrae come from if they have a bifid process?

A

Cervical

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5
Q

What joints are in between the intervetebral joints?

A

Secondary cartilaginous joints - fibrocartilage joints

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6
Q

What does the facet joint connect in the spine?

A

Plane joints between the articular processes of two adjacent vertebrae
Each facet joint is innervated by the recurrent meningeal nerves

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7
Q

What movements can occur with a facet joint?

A

Flexion
Extension
Lateral flexion

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8
Q

How does OA occur in the spine?

A

IV discs lost water content from nucleous puloposa with aging leading to an oveload of weight on the facet joints

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9
Q

What type of movement will make spinal OA worse?

A

Extension

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10
Q

What is the structue of an IV disc?

A

Outer anulus fibrosis capsule to aid with weight bearing

An innter nucleus pulposus

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11
Q

Where are IV discs most likely to degenerate in the elderly?

A

L4/5 and L5/S1

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12
Q

How will an acute disc prolapse present?

A

Lifting of a heavy object can cause an annulus tear, feeling of a twang in back
The annulus tear means the nucelus pulposa can pop out and cause compression of the surrouding nerve roots

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13
Q

What type of nerve roots originate anteriorly?

A

Motor neurone roots

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14
Q

What type of nerve roots originate posteriorly (dorsal root ganglion)?

A

Sensory nerve roots

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15
Q

Where does the spinal cord run?

A

In the spinal canal formed by the vertebral foramina

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16
Q

Where do spinal nerves exit the spinal canal?

A

Intervertebral foamen

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17
Q

Where does the cauda equina start?

A

L1

18
Q

Where does the exiting nerve root pass?

A

Outside the thecal sac, it will pass under the pedicel fo the corresponding vertebrae (L4 nerve root passes under L4 pedicle)

19
Q

Where is the transversing nerve root in the spinal cord?

A

Remains in the thecal sac and is positioned anteriorly (lateral recess) to be able to penetrate the thecal sac and become the next extiting nerve root

20
Q

What nerve is likely to be compressed in disc prolapse?

A

Transversing nerve root i.e. L5 root for L4/5 root prolapse and S1 root for L5/S1 prolapse

21
Q

What symptoms will nerve root compression result in?

A

Radiculopathy resulting in pain down the sensory distribution of the dermatome (SCIATICA)

22
Q

What clincal presentations will nerve root compression show?

A

Weakness in corresponding myotome

Reduced or absent reflexes

23
Q

What nerve roots cause flexion of hip?

A

L2/3

24
Q

What nerve roots cause extension of the hip?

A

L5/ S1

25
Q

What nerve roots cause flexion of the knee?

A

L5/ S1

26
Q

What nerve roots cause extension of the knee?

A

L3/4

27
Q

What nerve roots cause dorsiflexion of the ankle?

A

L4/5

28
Q

What nerve roots cause plantarflexion of the ankle?

A

S1/2

29
Q

What nerve roots cause inversion of the foot?

A

L4/5

30
Q

What nerve roots cause eversion of the foot?

A

L5/S1

31
Q

Whta forms the the sciatic nerve?

A

L4-S3

32
Q

Whta can cause spinal stenosis?

A

Nerve roots can be compressed by osteophytes and hypertrophied ligaments in OA

33
Q

What symptoms will spinal stenosis cause?

A

Radiculopathy or burning of walking - neurogenic claudication

34
Q

What will spinal cord compression cause?

A

Myelopathy and upper motor neuron signs

Babinski sign - fanning of toes on the extensor plantar response

35
Q

What causes cauda equina syndrome?

A

Pressure (usually prolapsed disc) on all lumbrosacral nerve roots at level of lesion including sacral nerve roots for bladder and bowel control (S2,3,4)

36
Q

What are the symptoms of cauda equina syndrome?

A

Bilateral lower motor neurone signs
Bladder and bowel dysfunction
Saddle anaesthesia
Loss of anal tone - ALWAYS PERFORM PR EXAM

37
Q

What muscles make up the erector spinae muscles?

A

Iliocotalis
Longissimus thoracis
Spinallis thoracis

38
Q

What are the ligaments of the spine?

A

Anterior and posterior longitudinal ligament
Ligamentum flavum
Supraspinout ligament
Interspinous ligament

39
Q

What is a chance fracture?

A

Fracture of vertebral body with disruption of posteior ligmanets
This requires surgical stabilistaion

40
Q

Where are lumbar punctures and spinal anaesthesia given?

A

Posterior iliac crest at L4

MSK (34 decks)

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