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B5W2 > EXAMINATION OF THE SPINE AND SENSORY TESTING > Flashcards

EXAMINATION OF THE SPINE AND SENSORY TESTING Flashcards

1
Q

what are the functions of intervertebral discs?

A

they allow cushioning which is important for movement in bipedal organisms and shock absorption

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2
Q

describe the structure of vertebra?

A

it is formed of a vertebral body and a vertebral arch

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3
Q

what is the basic structure of the vertebral arch?

A

it has transverse processes, pedicles, superior articular processes, lamina and a spinous process

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4
Q

what is the function of the intervertebral foramen?

A

where the spinal nerve can leave the spinal cord

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5
Q

what is the function of the body of the vertebra?

A

its large to bear weight

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6
Q

what is the function of the arch of the vertebra?

A

to provide a point of origin and insertion for muscles and ligaments as well as some protection for the spinal cord

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7
Q

what is the function of the spinous and transverse processes on the vertebra?

A

a point of attachment for muscles

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8
Q

what is the zygo-apophyseal joint?

A

synovial joints that provide stability of the spine, control of movement and protection of the intervertebral discs. The articular facets are covered with articular cartilage and the joints are surrounded by a fibrous capsule and lined with synovium.

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9
Q

what is C1 called? what is the joint called that attaches it to the occipitis of the skull?
what is the prime function of this joint?

A

atlas
Atlanta-occipital joint
to allow flexion and extension so we have good mobility in the head and neck

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10
Q

what shape is the atlas (C1)?

A

a ring shape with no body or spinous processes

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11
Q

what is C2 called? what is the joint called between C1 and C2?

A

axis

antlanto-axial joint

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12
Q

how is C2 structured differently to other cervical vertebra?

A

it has a dens (odontoid process) which extends superiorly from the anterior portion of the vertebra and articulates with the anterior arch of the atlas, creating the atlanto-axial joint- allows rotation of neck

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13
Q

what is the function of the transverse foramen?

A

to transport the vertebral artery, vein and sympathetic nerves

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14
Q

how many cervical vertebra do we have?

A

7

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15
Q

give a brief outline of the structure of cervical vertebra?

A

small vertebral bodies with large arches and horizontal facets to allow for rotation of the neck. has a bifid spine.

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16
Q

how many thoracic vertebra so we have?

A

12

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17
Q

how is the structure of thoracic vertebra different to cervical vertebra?

A

larger heart shaped body, longer spinous and transverse processes. (these longer spinous processes slope posteriorly and overlap the vertebra below).
smaller circular vertebral foramen. vertical articulations making the spine less mobile.

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18
Q

why do vertebra get larger as we move down the spine?

A

as the weight increases and it shows the importance of muscles in the back

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19
Q

why is it important that the thoracic vertebra is less mobile than the cervical vertebra?

A

as it offers mechanical stability for the respiratory cycle

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20
Q

what is the function of the superior, inferior and transverse costal facets in thoracic vertebra?

A

to articulate with the pair of ribs

21
Q

how many lumbar veterbra do we have?

A

5

22
Q

describe the structure of the lumbar vertebra

A

large kidney shaped body, midsized triangular vertebral foramen, facets in medial and lateral directions, short spinous process

23
Q

which lumbar vertebra is the biggest?

A

L5

24
Q

describe mobility of the lumbar spine?

A

more range of motion than the thoracic spine, but less than the cervical. Lumbar facet joints enable significant flexion and extension movement, but limits rotation

25
Q

what is the sacrum composed of?

what is its function?

A

5 fused vertebra that form a thin wedge-shaped bone

to transfer body weight to pelvis and offers protection to the sacral plexus.

26
Q

what is the sacral hiatus?

A

a posterior, caudal opening at the 5th sacral vertebra

27
Q

why does the sacrum have 4 pairs of sacral foramen?

A

so the sacral nerves and blood vessels pass through.

28
Q

describe the structure of the coccyx?

A

C01 is unfused by Co2-4 are fused. it lacks pedicles, laminae, spines, vertebral arches and vertebral canals.

29
Q

what is cauda equine syndrome?

A

rare and severe type of spinal stenosis where all of the nerves in the lower back suddenly become severely compressed. e.g. disc herniation that pushes on cauda equina

30
Q

which regions of the spine are most prone to damage from wear and tare? why?

A

the lumbar and sacral spines as this is where most of the weight bearing is.

31
Q

what are symptoms of cauda equine syndrome?

A

back pain, bladder and bowel dysfunction, perineal numbness, new sexual dysfunction, progressive leg weakness

32
Q

what are the 4 major nerve plexuses?

A

cervical, brachial, lumbar, and sacral plexuses.

33
Q

what does the lumbar plexus innervate?

A

skin and muscles of the abdominal wall, thigh, and external genitalia.

34
Q

what does the sacral plexus innervate?

A

the posterior thigh, most of the lower leg, the entire foot, and part of the pelvis

35
Q

what is a Radiculopathy?

A

pinching of a nerve root in the spinal column- often caused by herniation of a intervertebral disc to the side and pushes on a spinal nerve.

36
Q

which discs are most likely to herniate? which nerve is this?

A

L5/S1- sciatic nerve

37
Q

what are the 4 natural curves of the spine?

A

cervical lordosis, thoracic kyphosis, lumbar lordosis, sacral kyphosis

38
Q

describe the examination of the spinal cord process

A

take a history about characteristics of pain, change in movement, stiffness, neurological changes, alterations in bowel/bladder function
look for normal curvature of spine
feel for tenderness and abnormal alignment of spinal processes
measure patient’s active movements
nerve stretch tests

39
Q

what are the 2 main nerves that come out of the lumbar plexus?

A

sciatic (L5-S2)

fermoral (L2-L4)

40
Q

why do we carry out nerve stretch tests?

A

as pain from a compressed or inflamed nerve root is made worse by stretching it

41
Q

how do you carry out a sciatic nerve stretch test?

A

get patient into a neutral position on back
Straight leg raise- increases pressure over sciatic nerve
Dorsiflexion of foot- makes it worse again
Knee flexion- should relieve pain
Knee extension- should worsens it

42
Q

how do you carry out a femoral nerve stretch test?

A

patient In a neutral position on their front
Knee flexion- should causes pain in back
Hip extension- should exacerbate pain further

43
Q

how do you assess the PNS?

A

assess sensation with sensation and vibration testing of dermatomes
assess motor function i.e. muscle power and proprioception
assess reflexes
assess vascular, skin and pulse changes

44
Q

what are dermatomes?

A

regions of skin innervated by specific spinal nerve roots

45
Q

where do we test C3-C8?

A 
C3- upper neck
C4- shoulder tip
C5- over deltoid
C6- tip of thumb
C7- tip of middle finger
C8- tip of little finger
46
Q

where do we test T1-T12?

A

T1- medial border of elbow
T2- medial side of upper arm
T3- chest area above nipple
T4- nipple area
T5- 5th intercostal space
T6- horizontal level of diploid process
T7-horizontal level at 1/4 the distance between the level of the xiphoid process and the level of the umbilicus.
T8- horizontal level 1/2 the distance between the level of the xiphoid process and the level of the umbilicus.
T9- horizontal level at 3/4 the distance between the level of the xiphoid process and the level of the umbilicus.
T10- umbilicus area
T11- horizontal level midway between the level of the umbilicus and the inguinal ligament.
T12- the intersection of the midclavicular line and the midpoint of the inguinal ligament

47
Q

where do we test for L1-5?

A

L1: the inguinal region and the very top of the medial thigh.
L2: the middle and lateral aspect of the anterior thigh.
L3: the medial epicondyle of the femur.
L4: the medial malleolus.
L5: the dorsum of the foot at the third metatarsophalangeal joint

48
Q

where do we test for S1-4/5

A

S1: the lateral aspect of the calcaneus.
S2: at the midpoint of the popliteal fossa.
S3: at the horizontal gluteal crease
S4/5: the perianal area.

49
Q

how do we carry out a dermatome test?

A

Light touch is done with their eyes closed and touching them with a cotton bud.
Pain and temperature are tested separately with a neurotip- compare whether they can feel the sharp or blunt end.

B5W2 (10 decks)

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