Exam 3 - Spine

Question 1

function of intervertebral discs

Answer 1

separate the vertebrae

absorb shock for the spine

Question 2

cause of intervertebral disc disease (IDD)

Answer 2

deterioration, herniation, other dysfunction of the ID

becomes bone on bone

Question 3

where is IDD most commonly seen

Answer 3

cervical spine but can affect thoracic and lumbar

Question 4

IDD can occur as a normal ___ process

Answer 4

aging

Question 5

degenerative disc disease changes can cause

Answer 5

OA
herniated disc
spinal stenosis

Question 6

results of nucleus pulposus pushing through crack in annulus fibrosis

Answer 6

herniated disc

Question 7

disc herniation commonly occurs

Answer 7

C5-6
C6-7
L4-5
L5-S1

*lumbar is most frequently affected

Question 8

L3-4 pain area

Answer 8

back to buttock to posterior thigh to inner calf

Question 9

L4-5 pain area

Answer 9

back to buttock to dorsum of foot and big toe

Question 10

L5-S1 pain area

Answer 10

back to buttock to sole of foot and heel

Question 11

space around the spinal cord narrows placing pressure on cord and nerves

Answer 11

spinal stenosis

Question 12

non-op pain therapy

Answer 12

meds
complementary alternatives
good body mechanisms
back strengthening exercises
restricted activity
ice, heat application
PT

Question 13

meds to reduce spinal pain

Answer 13

NSAIDS
muscle relaxants
anticonvulsants
antidepressants
epidural corticosteroid injections

Question 14

purpose of spinal surgery

Answer 14

take pressure off the nerve

Question 15

what is a laminectomy

Answer 15

removes lamina - back part of the vertebrae, covers spinal canal

Question 16

purpose fo laminectomy

Answer 16

relieve pressure on spinal cord or nerves

Question 17

laminectomy is usually out pt but may require a hospital day of what duration

Answer 17

1-3 days

Question 18

most common treatment for ruptured or herniated disc

Answer 18

discectomy

Question 19

performed for an unstable spine

Answer 19

spinal fusion

*adjacent vertebrae fused together with bone graft; metal, rods, plates, screws may be used

Question 20

how to reposition a pt after a laminectomy, discectomy, fusion

Answer 20

log roll

Question 21

pillow placement if supine after laminectomy , fusion, and disectomy

Answer 21

under knees

Question 22

pillow placement if lateral after laminectomy, fusion, and disectomy

Answer 22

between legs

Question 23

laminectomy postop assessments

Answer 23

neurological assessment
maintain proper spine alignment
limit lifting, bending, stooping for several months
back brace
monitor for complications
may return to work within a few week depending on job

Question 24

discectomy post op assessment

Answer 24

neurological assessment
maintain proper alignment
limit lifting, bending, stooping
back brace
monitor for complications
encourage walking
return to office 2-4 weeks
return to manual labor 4-8 weeks

Question 25

postop infusion assessment

Answer 25

neurological
maintain proper alignment
longer healing time
assess donor site (if present)
no twisting, bending, stooping, lifting
immobility at fusion site
do not sit or stand for long periods of time
rigid back brace
firm mattress or bed board

Question 26

preferred method of continuous pain management

Answer 26

PCA

Question 27

PO pain control

Answer 27

tylenol + codeine
hydrocodone
oxycodone
diazepam
pregabalin

Question 28

postop complications

Answer 28

CSF leak
neuro impairment
paralytic ileus
bladder impairment
bleeding

Question 29

CSF leak s/sx

Answer 29

severe HA, worsens with rising
clear, yellow drainage

*notify provider ASAP