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CSI > CSI 13 > Flashcards

CSI 13 Flashcards

1
Q

Common causes of back pain (4)

A

pulled muscle (strain).
slipped disc
sciatica
ankylosing spondylitis

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2
Q

Medication for back apin

A

ibuprofen (NSAID) not paracetemol on its own

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3
Q

when to see a gp (4)

A

back pain does not improve after treating it at home for a few weeks
the pain is stopping you doing your day-to-day activities
the pain is severe or getting worse over time
you’re worried about the pain or you’re struggling to cope

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4
Q

10 red flags

A

a high temp
lump that has changed shape
lost weight
tingling around genitals/ both legs
loss of bowel/bladder control (peeing and pooping) NOT constipation)
chest pain
swelling in back
worse at night/cannot sleep
after a serious accident worse on sneezing, coughing
top of back between shoulders

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5
Q

lumbago meaning?

A

lower back pain

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6
Q

treatments for back pain prescribed by GP?(3)

A

painkillers (nsaids)
CBT
PT

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7
Q

3 common & 3 uncommon causes of lower back apin

A
  • pulled muscle
  • herniated disc
  • compression fracture
  • Malignancy
  • Cauda equina
  • osteomyelitis
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8
Q

vertebral causes of back pain

A

Compression fracture
spondylolysis
osteomyelitis

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9
Q

muscles causes of back pain

A

pulled muscle

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10
Q

spinal cord problems

A

compression
malignancy

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11
Q

nerve problems with back pain

A

CES
herniated nuclues

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12
Q

3 pathways of nuerones, what they do and if they switch

A

senation : dorsal column pathway (fine touch, proprioception, vibration) and spinothalamic pathway (pain, temp, crude touch)
Motor: corticospinal

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13
Q

spinothalamic pathway

A

left mechanorceeptor -> dorsal horn -> (reticular formen if dull pain) ->somatosensory cortex. sharp pain is faster

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14
Q

Somatotrophy

A

hemisphere of brain: lateral to medial.
(tongue most lateral)face,hand,arm, hip (most superior), leg, toe ,genital (most inside )

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15
Q

contralateral arrangement

A

DC: swaps in medulla, ipsilateral up SC the switch
ST: swaps in spinal cord, contralateral up SC switched already

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16
Q

convergence theory

A

visceral nuerones converge with somatic nureones. eg heart pain is felt in skin of chest

17
Q

3 differentials in case

A

radiculopathy
CES
Mechanical back pain

18
Q

mechanical back pain?

A

Caused by abnormal stress and strain on muscles of the vertebral column​

Triggered by certain movements/ positions, comes and goes​

19
Q

Radiculopathy

A

A nerve root is pinched as it leaves, usually unilateral

20
Q

CES

A

Lumbosacral nerve roots are severely compressed​

Usually bilateral

21
Q

differences between radiculopathy and CES?

A

CES usually L4-S2 while radiculopathy is higher up, this is usually because radiculopathy compression is on nerve roots (less protected -> lateral compression. medial compression doesnt do much because of disc vertebrae) medial/central compression in cauda quina causes Lower motor nuerone nueropathy usually by prolapsing disc

22
Q

6 Symptoms of cauda equina

A
  • bilateral sciatica
  • sadle paraesthesia (genital, butt, inner thigh)
  • difficulty initiating micturition (filled bladder)
  • erectile dysfunction
  • motor weakness (dorsiflexion, extension + elevation of knee joint)
  • anal laxity
23
Q

define sciatica and explain why bilateral sciatica comes about?

A

nerve pain in leg from compressed sciatic nerve
formed from L4 TO S3. disc herniation causes CES pulposus displaced. spinal nerves from both sides affected

24
Q

what plexuses supply lower extremeties

A

umbar and sacral plexuses

25
Q

nerve roots S234 (3P’s)

A

Poo/Pee/Penis (erection)

26
Q

Sympathetic vs parasympathetic activations

A

parasym (S2-4) allows you to pee, sym **(L1-2) **doesnt. So when only sym is activated it causes urinary retention

27
Q

where does CES occur?

A

L3-S2

28
Q

Parsympathetic/ Sympathetic nervous system! What nerve comes out of sacral region parasym?

A

splanchnic

29
Q

What investigations?

A

MRI spine + try to treat within 48 hours

30
Q
A
31
Q

At what vertebrae level does the spinal cord end?

A

L1

32
Q

What are rare causes of CES?

A

INFECTION OR TUMOUR

33
Q

when are a-delta fibres used as opposed to c fibres??

A

a delta - SHARP pain- FAST (myleinated)
c fibres - DULL pain- SLOW

34
Q

parasym + sym jobs in micturition

A
  • detrusor muscle contracts (p)
  • internal urinary sphincter relaxes (p)
35
Q

Criteria for a successful claim

A
  • below a reasonable standard, caused a loss/damage “causation”.
36
Q

dorsal column route

A

mechanoreceptor-> medulla -> thalamus-> top part of brain (somatotrophy)

37
Q

most common places to get CES?

A

L4/L5 L5/S1

CSI (2 decks)

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