Exam Final Flashcards
When Giles performed his study on the IVFs where did he measure the IVF?
On the medial border(which was smaller) and the nerve root-ganglion complex(which was larger)
When Crelin measured the IVFs in his study where did he measure?
Measured the lateral border of the IVF relative to the exiting spinal nerve
In regards to nerve impingement and IVF space what are the 3 main points that differ between crelin and giles?
Crelin-measured lateral border, x-section of nerve to IVF left 5-6x reserve space, distance of nerve to IVF never less thn 4mm
Giles- measured entire length of the interpedicular canal zone, x-section was a smaller reserve(3.3-4.6x), distance of nerve to IVF 0.4-0.9mm
What was Giles conclusion to his measurements revealing much smaller clearances?
“compressive irritation…may arise, especially should there be intervertebral disc and/or osteophytic projection into the intervertebral canals.”
Are subluxations likely to cause severe compression signs?
Very unlikely
A patient with nerve root compression(severe or mild) is this likely to do to a subluxation?
Neither are likely to be due to subluxations…keep looking for diagnoses
Is radiating pain due to irritated nerve roots?
Usually not and nerve tension tests with be negative
What is radiating pain usually due to?
Somatic referred phenomenon from irritated joint structures
What is palmers “too much nerve energy”?
May be increased action potentials from the irritated joints irritating the CNS
What are the symptoms of nerve root irritation?
Patients with dermatomal pain/paresthesia and positive nerve tension test
When thinking of nerve root irritation what are the first things that you should be thinking of?
chemical/mechanical irritation from- disc herniation osteophytes, stenosis, and tumors
When should subluxations and NR irritation be considered?
if other more probable diagnoses do not seem likely and subluxations are present, the the radicular syndrome may be associated with the subluxation
What are possible ways that a subluxation could cause NR irritation?
The joint dysfuntion may be associated with chemical irritatns from the discv,, from local inflammation(H+ ions), or nerve root adhesion
What is the differential diagnosis for radicular from deep referred pain? symptoms(from history)
Radicular- Dermatomal pain Pain may be sharp or electrical Dermatomal paresthesia Reports of subjective numbness or weakness Deep referred- Diffuse pain less likely to cross the knee(elbow)
What is the DDX radicular from referred? signs(from physical)
Radicular-
Positive tension tests suggest NR irritation
Neurological deficits suggest compression/cell damage
Deep referred-
Negative tension tests
No neuro defiits
