Clinical Notes of the Back

Question 1

What is a Jefferson/burst fracture?

Answer 1

a blow to the top of the head from a falling object or accident can fracture both arches of the Atlas. will not typically injure spinal cord unless Transverse L of Atlas is ruptured

Question 2

What is a Hangman’s fracture?

Answer 2

a fracture of Axis usually by hyperextension of the head on the neck.

Question 3

A horizontal blow to the head can cause a fracture where in the Axis?

Answer 3

Odontoid process

Question 4

What is spina bifida occulta?

Answer 4

a developmental abnormality in which the vertebral lamina fail to fuse and close off the vertebral canal. usually occurs at L5 and SI.

Question 5

What is spina bifida cystica?

Answer 5

if spina bifida occulta incorporates into neural tissue and meninges

Question 6

Why is it easier to dislocate cervical vertebrae?

Answer 6

Because the articulating facets of cervical vertebrae are more horizontal than the other vertibrae. but because of the large vertebral foramen, this does not usually lead to spinal cord injury.

Question 7

What is spondylosis?

Answer 7

a degenerative joint disease which involves calcification of the edges of the vertebral body and can cause localized pain and stiffness.

Question 8

what is spondylolysis?

Answer 8

separation of the vertebral arch from the vertebral body

Question 9

what is spondylolisthesis?

Answer 9

anterior displacement of the vertebral body on the inferior vertebral segment. can occur secondarily to spondylolysis

Question 10

What is lumbar spinal stenosis?

Answer 10

a narrowing of the lumbar vertebral foramen. it can compress spinal nerve roots

Question 11

What is a lumbar puncture and where is the needle inserted?

Answer 11

it is a diagnostic procedure for evaluating a variety of central nervous system disorders. a needle is inserted between either L3/L4 or L4/L5 at the level of the iliac crests

Question 12

What is sacrilization/hemisacrilization?

Answer 12

the complete or partial incorporation of the L5 vertebral segment into the sacrum

Question 13

What is Lumbarization?

Answer 13

the separation of the S1 vertebra from the sacrum. S1 becomes L6

Question 14

What is Coccygodynia?

Answer 14

a condition that causes pain in the tailbone usually follows coccygeal trauma (dislocation or fracture)

Question 15

What is a back sprain?

Answer 15

an injury to the ligamentous attachments between bone because of inadequate stretching

Question 16

What is a back strain?

Answer 16

tearing of muscle fibers produced by an overly strong muscle contraction

Question 17

Why should a patient be kept in hyperextension after a fracture of the vertebral column?

Answer 17

because the anterior longitudinal ligament can help realign fragments of bone and keep further injury of the spinal cord from occurring

Question 18

What is herniation?

Answer 18

a bulging of the nucleus pulposes and annulus fibrosis posterolaterally (the annulus fibrosis receives no support from the anterior and posterior longitudinal ligaments)

Question 19

Where is herniation most common?

Answer 19

L4/L5 and L5/S1

Question 20

What is the second number rule?

Answer 20

for the cervical and lumbar regions, the vertebral level at which the prolapse occurs will affect the spinal nerve with the second number designation (a prolapse at c5/c6 will affect spinal nerve 6)

Question 21

What are the three most common back pain causes?

Answer 21

muscular, joint and fibroskeletal pain