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Medical Sciences B > Dorsopathies > Flashcards

Dorsopathies Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the deforming dorsopathies? ( 7 )

A
  • Hyperkyphosis
  • Hyperlordosis
  • Scoliosis
  • Spondylolysis
  • Spondylolisthesis
  • Torticollis
  • Spinal osteochondrosis
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2
Q

What are causes of hyperkyphosis?

A
  • degeneration of IVDs
  • failed normal development
  • week longitudinal back muscles
  • compression fractures
  • Scheuermann’s disease
  • ankylosing spondylitis
  • DISH
  • hemivertebra
  • posture
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3
Q

What is Scheuermann’s disease?

A
  • developmental disorder of the spine
  • Calvé disease / juvenile osteochondrosis of the spine
  • abnormal growth of thoracic spine
  • hyperkyphosis
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4
Q

What is a swayback?

A

Hyperlordosis

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5
Q

What are causes of hyperlordosis?

A
  • increased abdominal weight (pregnant or obese)
  • weak lumbar spine flexors (iliac, psoas)
  • compensatory to kyphosis or scoliosis
  • posture (gymnast, high heels)
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6
Q

Where is a scoliosis most likely?

A

Thoracolumbar region

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7
Q

What actions differentiate a structural from non-structural scoliosis?

A
  • flexion
  • lateral flexion
  • lying prone
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8
Q

What are the causes of a structural scoliosis?

A
  • idiopathic
  • congenital
  • neuromuscular, neuropathic, myopathic (eg. poliomyelitis, cerebral palsy, neurofibromatosis)
  • infection, radiation, trauma
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9
Q

What are the causes of a non-structural scoliosis?

A
  • leg-length discrepancy

* antalgique posture

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10
Q

What is the definition of a spondylolysis?

A

Defect (uni or bilateral) of the pars interarticularis

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11
Q

What is the definition of a spondylolisthesis?

A

Anterior slip of one vert on another, with or without pars defect

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12
Q

What are the causes of spondylolisthesis?

A
  • congenital
  • degenerative
  • trauma
  • post-surgical
  • secondary to bone disease
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13
Q

How does a spondylolisthesis cause pain?

A 
By consequence of the slip:
• facet syndromes
• anular tears
• sacroiliac syndrome
• nerve root compression
• spinal stenosis causing neurogenic claudication
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14
Q

What is a torticollis?

A
  • twisting and abnormal position of the head due to abnormal contraction of cervical muscles
  • with or without pain referral to supra-scapular region
  • sudden and severe pain
  • congenital or acquired
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15
Q

What are the spondylopathies? ( 8 )

A
  • Ankylosing spondylitis
  • Sacroiliitis
  • Vertebrae or disc infection
  • Spondylosis
  • Spinal stenosis
  • Anterior spinal and vertebral artery compression syndromes
  • DISH
  • OPLL
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16
Q

What is ankylosis?

A

abnormal stiffening and immobility of a joint due to fusion of the bones

17
Q

What is ankylosing spondylitis?

A
  • chronic progressive arthritis with eventual ankylosis
  • sacroiliac and spine (axial skeleton)
  • bilateral
  • men x10
  • onset at 15-35yrs
  • familial, HLA-B27 antigen
  • chronic aching and stiffness
18
Q

What is DISH?

A
  • Diffuse idiopathic skeletal hyperostosis
  • generalized spinal and extra spinal disorder
  • ligamentous calcification and ossification
  • broad spectrum presentation
19
Q

What is Forrestier’s disease?

A

DISH

20
Q

What is are the clinical features of DISH?

A
  • complaints similar to DJD
  • morning stiffness, low msk pain
  • ALL
  • lost cervical and lumbar lordosis, increased thoracic kyphosis
  • localized pain, swelling, ossific masses (Achilles and quad tendon)
  • dysphagia (20%)
  • diabetes mellitus (20%)
21
Q

What is OPLL?

A
  • abnormal ossification of PLL
  • results in compression myelopathy of spinal cord
  • cervical most common, thoracic is least
  • insidious onset
  • motor and sensory loss mostly in legs
  • sometimes msk-like pain in spine
22
Q

What is true sciatica?

A

Pain in lower limb along the course of the sciatic nerve, radiating from the buttock does the back of the thigh and leg

23
Q

What is the pathophysiology of sciatica?

A
  • consequence of irritation, pressure, compression, stretching, entrapment of sciatic nerve or its roots
  • L4, L5, S1, S3
  • caused by muscle pathology or SI joint disorders
24
Q

What is are intervertebral disc disorders?

A
  • disorders of degradation of annulus fibrosis and nuclear pulposis
  • affected by repetitive microtrauma, macrotrauma, or aging
  • Bulge, protrusion, herniation, sequestration
25
Q

What is dessication?

A
  • effect of aging

* replacement of hydrophilic glycosaminoglycans within nucleus pulposus with fibrocartilage

26
Q

Annular fissure

A

deficiency of one or more layers of annulus fibrosus

27
Q

What is the difference between bulge and herniation?

A

Circumferential projection of annulus outside of the vertebral body surface area

Bulge: more than half
Herniation: less than half

28
Q

What is the difference between IVD protrusion and extrusion?

A

Protrusion:
• local bulge of annulus
• annulus is torn from centre to periphery

Extrusion:
• nucleus pulposus migrates through the torn annulus

29
Q

What is sequestration?

A
  • discontinuity of the nucleus pulpous

* free fragment can now travel within subarachnoid space

30
Q

What causes radiculopathy?

A

impingement of nerve roots

31
Q

What causes myelopathy?

A

impingement of spinal cord

32
Q

What is spinal stenosis?

A
  • constriction of spinal canal by bony or soft tissue intrusions
  • central stenosis or lateral recess stenosis
  • causes neurogenic claudication
  • back pain, radicular uni/bilateral pain, gait problems, paraesthesia, numbness
33
Q

What is neurogenic claudication?

A
  • relative ischaemia created by spinal stenosis

* further aggravated by increased oxygen consumption in those nerves

34
Q

What are the causes of spinal stenosis?

A
  • osteophytes
  • Pagets disease
  • neoplasm
35
Q

What are the causes of sciatica?

A
  • spondylolisthesis
  • pregnancy
  • piriformis irritation
  • calcification of OPLL
  • deformity of ligamentous flavum
  • trauma
  • osteophytes
  • abscess or tumour in spinal canal
36
Q

What are causes of torticolis?

A
  • congenital muscle deformity
  • poor sleep posture
  • fever
  • cold
  • muscle spasm
  • trauma
37
Q

How do DISH and OPLL compare?

A

Differences:
• ALL vs PLL
• dysphagia vs sensory, motor, incontinence

Same:
• degenerative
• >60, men
• comorbid with diabetes mellitus

38
Q

How does ankylosing spondylitis compare to DISH and OPLL?

A 
Same:
• degenerative
• chronic and progressive
• generalized spinal or extraspinal
• asymptomatic or variable
• men
Different in ankylosing:
• inflammatory arthritis
• SI ascending to spine
• positive for HLA-B27 antigen
• 15-30yrs
• affects eyes, lungs

Medical Sciences B (23 decks)

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