Clinical Correlations of the Back Flashcards
scoliosis
most common spinal deformity
can be due to short leg
also can be due to spina bifida, muscular dystrophy and even osteoporosis
congenital scoliosis
wedge-shaped hemivertebrae
curves of scoliosis?
primary and secondary
spinous process toward center of curve
nerve spacing is narrower inside curve
treatment of scoliosis?
bracing or internal fixation
traumatic compression fx?
body weight rapid deceleration
or rapid load bearing
associated conditions with compression fractures?
osteoporotic weakened trabeculae or neoplastic cancer (via Batson’s plexus) that weakens bone
what vertebrae are more likely to be dislocated?
cervical
**bc of reduced mass and articular facet orientation
harrington rods
used to surgically repair a scoliotic curve
jefferson fracture
burst fracture of atlas
fx of anterior and posterior arches
hangman’s fracture
pars interarticularis of axis (CV2) fracture
-disrupts C2/C3 IV disc
basically a spondylolysthesis
what do you need to do with blow out disc?
need to fuse them
most common dislocation in cervical region?
CV6
its where you run out of room and pressure hits there
complete fracture of dens?
avascular necrosis can result
pathologic fracture
due to some current medical problem
ex/ osteoporosis or metastesis
rupture of transverse ligament of atlas?
allows atlas to move in AP direction and can pinch on the spinal cord
breast ovary prostate hodgkins lymphmoa
batson’s plexus
down syndrome?
missing a transverse ligament of atlas
-increased susceptibility to atlanto-axial subluxation
hung facet
overlapped facets
cannot self reduce
which is more delicate CV1 or CV2
CV1 (atlas) because it has no body
fracture of dens
can go unnoticed if the transverse ligament of atlas is still intact
rupture of alar ligaments?
can lead to increased rotation of skull laterally
can be caused by increased with rotation of skull when it is in flexion
spondylolysis
fracture of pars interarticularis
spondylolisthesis
bilateral spondylolysis
vertebrae slide forward
most common site - LV5 on SV1
spina bifida occulta
neural arch defects at LV5 or SV1 predominantly
-tuft of hair often indicates area of defect
can be complete or partial
how many pictures to confirm diagnosis?
2!
spinal stenosis
narrowing spinal canal
-also in IV foramen
will give you different symptoms
laminectomy
surgical removal of spinal processes and adjacent lamina
foraminotomy
surgical enlargement of IV foramen to relieve pressure on spinal nerves
spondylosis
degeneration of vertebrae body and IV discs
water content of cartilage decreases with age
degeneration leads to inflammation and osteophyte formation
osteophyte
bone spur
what can result from spondylosis
narrowed IV foramen
-can lead to radiculopathy
osteoarthritis of what joints?
zygapophyseal joints
- same pathology of spondylosis
- further narrowing of IV foramen
radicular pain
from nerve root impingement as well as inflammation
thecal sac
inside dura
what ligament injuries are worse?
hyperextension
-can tear anterior longitudinal spinal ligament
whiplash
ankylosing spondylitis
fusion of spine due to inflammation of synovial joints
usually 3rd and 4th decade of life
bamboo spine
radiologic landmark of ankylosing spondylitis
HLA B-27
genetic protein marker associated with ankylosing spondylitis
cause of herniated disk?
sudden hyperflexion
pain from tear of annulus
acute pain
pain from disk herniation over time
chronic pain
compression of nerve root
paraplegia
impairment in motor or sensory function of the lower extremities
parasthesia
numbness/tingling
lumbar puncture
passes through ligamentum flavum
-removeal of CSF
passes through dura and arachnoid to subarachnoid space (CSF)
location of lumbar puncture ?
LV3/4 LV4/5
-spinal cord ends LV1-2
**neonate - LV4-5
caudal epidural anasthesia
needle passes through sacral hiatus to surround the cauda equina
relieves pelvic pain without affecting motor control
no change in motor control bc it originates higher in spinal cord**
