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MSK exam 1 AP > Clinical correlations of Back disorders > Flashcards

Clinical correlations of Back disorders Flashcards

1
Q

Scoliosis

A

Primary and secondary curves

most likely occurring in prepubescent girls

causes:

  • wedged vertebrae
  • shorter leg
  • neuromuscular disease
  • post menopausal women
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2
Q

harrington rods

A

surgical rods used to correct scoliosis

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3
Q

impact of scoliosis

A

may affect breathing
abdominal organs
intervertebral discs

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4
Q

Cervical spine compression/burst fracture

A

all pressure onto a certain vertebral body causing the whole vertebral body to shatter

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5
Q

vertebroplasty

A

using polymer injection into vertebral body to “pump” it back up

can’t do this if there is a disk that is blown out
MUST HAVE INTEGRITY of IV DISK

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6
Q

Pathological fracture

A

fracture due to underlying disease (such as osteoporosis)

Metastases to bone from:
Breast
Ovary
Prostate
Hodgkin’s lymphoma
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7
Q

osteoporosis

A

Lack of dense matrix in trabecular bone

in progressive stage of osteoporosis vertebrae can become biconcave, flat, wedge, planar

ALSO their spine becomes kyphotic
b/c when you get compression fractures from stepping off a curve they are going to have an anterior compression fracture

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8
Q

Metastases to bone

A

go through vertebral venous plexus***

no valves so meaning pressure changes in abdomen/thorax leads blood to wherever it wants to go that is why there is usually spread of cancer to spine!

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9
Q

function of vertebral venous plexus during inspiration and expiration

A

in normal inspiration–> pressure is reduced, blood splits its way back into the thorax by passing into intervertebral plexus

during expiration, pressure is high, little blood comes in, larger amount of blood goes into vertebral venous plexus

forced expiration pressure is Really high, blood mainly flows into vertebral venous plexus

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10
Q

what is the most commononly fractured/dislocated vertebrae?

A

C6

simply b/c of space in this area

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11
Q

Jefferson (Burst) fracture of CV1

A

fracture of the anterior and posterior arch of the atlas

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12
Q

Hangman’s fracture

A

C2/C3 spondylolysthesis

so fracture of the pars interarticularis

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13
Q

fracture of the dens (cv2-axis)

A

can walk around and not know this has happened

transverse ligament of the atlas intact

can lead to vascular necrosis b/c lose blood supply to the dens

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14
Q

disarticulation of the dens

A

CV1/CV2

the atlas is collaring the dens so compressing the spinal cord!! very bad–> if you survive this you are quadriplegic

tear transverse ligament of the atlas***

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15
Q

rupture of the alar ligament the “owl” ligament

A

Pre load the alar ligament (so the head is already flexed) and then turn and then it will rupture

(think of a football player whose head is in a turn)

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16
Q

spondyloysis

A

unilateral fracture of the pars interarticularis

sitting right at the lamina so much closer to the lamina than the pedicle

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17
Q

spodylolisthesis

A

bilateral fracture

tend to have these in areas where there are high mobility (cervical and lumbar)

most common at L5 and S1 b/c it is at an angle that wants to slide forward

as it slides forward it stretches the nerves of the cauda equina (if in the lumbar region)

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18
Q

grading spondylolisthesis

A

grade 1 slides a little bit

grade 4 just getting ready to fall off

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19
Q

Batson’s plexus

A

inside and outside vertebral column

those plexus inside are immune to pressures that the outside venous plexuses are NOT immune to

so when there are changes in pressure in the abdomen and thorax the outer vertebral plexuses are the ones that are being drained in to…

20
Q

Spina bifid occulta

A

happens at L5-S1 more than anywhere else

defect of lamina

can be overlayed with a fat pad, or tuft of hair

21
Q

in order to see the dens…

A

go through the mouth

22
Q

Case 26 year old male hurt neck while water skiing …

A

vertical fracture of the dens??

no it is spina bifida of the atlas!! incomplete fusion of lamina

23
Q

how many views are needed to confirm diagnosis

A

2

24
Q

cervical spondylosis

A

degenerative changes between the body and the disk

25
Q

spinal stenosis

A

in the intervertebral canal (spinal cord) (can be caused by growth of articular processes/facets)

OR

intervertebral foramen at the spinal nerve (degenerative disk)

these both will give you different symptoms

26
Q

spinal stenosis in vertebral canal

A

upper motor neurons lesions

27
Q

spinal stenosis in intervertebral foramen

A

lower motor neurons lesions

28
Q

osteoarthritis (effects vertebral bodies and facet joints)

A

degeneration of disks and disk spaces

extension of the vertebral column

spinal column doesn’t move as well

also have involvement of zygopophyseal joints
can cause pressure on spinal nerves –> leads to radiculopathy –> lower motor neuron lesions

29
Q

what indicates osteophytic vertebrae

A

narrowed vertebral foramen

biconcave “Lip” of body

30
Q

laminectomy

A

to fix spinal stenosis

31
Q

foraminotomy

A

opening intervertebral foramen

take off portion of lamina

32
Q

posterior longitudinal ligamen

A

serrated to keep IV disk in place

33
Q

Mild hyperextension

A

Whiplash

can cause tear in the anterior longitudinal ligament

avulsion fracture

worse case scenario–> tear the disk, lose integrity, now have to fuse vertebrae

34
Q

whiplash muscle spasms

A

pull the cervical column into a more kyphotic curve

35
Q

ankylosing spondylitis

A

“bamboo” spine

spine is fused due to inflammation of synovial joints and ligaments

X-ray shows inflammation and calcium formation

36
Q

Disk pathologies

A

degenerated

bulging

herniated- happens more in cervical and lumbar (L4-L5, L5-S1)

thinning

disc degeneration with osteophyte formation

37
Q

posterior herniation

A

towards the cauda

effects a much larger span of nerves

38
Q

posterolateral herniation

A

goes toward spinal nerve

39
Q

stages of intervertebral disk herniation

A

disc degeneration
prolapse
extrusion
sequestration

40
Q

acute pain of herniation

A

tear of the IV

41
Q

chronic pain

A

disk pushing on the nerve and mechanically stimulating it over time

42
Q

ischemic paralysis of the spinal cord

A

lose segmental arteries

loss of blood supply to vertebrae

43
Q

lumbar puncture

A

.

44
Q

epidural (transsacral)

A

.

45
Q

Tension headache

A

greater occipital nerve is entrapped in muscles and fascial layers

so if you are constantly using these muscles (trapeziums, semispinalis) then this nerve will be impinged/compressed and cause headache

MSK exam 1 AP (7 decks)

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