HERNIATED DISCS & SPINAL CORD

Question 1

Describe how Spinal nerves are named in different regions of the vertebral column.

Answer 1

At the cervical level, spinal nerves are named on the vertebra BELOW them. At thoracic levels and below, nerves are named on the vertebra ABOVE them.

Question 2

The nerve between vertebra L3 and L4 is ______. The nerve between vertebra C5 and C6 is ________.

Answer 2

L3 spinal nerve

C6 spinal nerve

Question 3

Describe the structure and function of IV discs

Answer 3

Composed of inner gel-like, nucleus propulsus and the outer annulus fibrosis. Compression of the disc can occur from sitting/standing too long and elongation occurs from stretching when sleeping as water moves back into the discs. They function to cushion the vertebrae and enable mobility of vertebral column.

Question 4

In what direction is the greatest potential for a herniated nucleus propulsus? What symptoms does it result in?

Answer 4

Herniation sites tend to occur posterior laterally due to a small posterior longitudinal ligament. Pain and deficiency in motor symptoms can occur if spinal roots are compressed.

Question 5

If a herniated nucleus propulsus occurs between L1 and L2 vertebra, the ____ spinal nerve is impinged. If between C4 and C5 vertebra, the ____ spinal nerve is impinged.

Answer 5

L2 spinal nerve;

C5 spinal nerve

Question 6

Describe what occurs in a central stenosis of the spinal cord.

Answer 6

The spinal nerves at the level of herniation and below are affected.

Question 7

Describe Osteophytic encroachment

Answer 7

Osteophytes (bone spurs) directly compress the spinal nerves or indirectly do so by compressing the IV disks to cause impingement

Question 8

Describe how someone can locate the level of a compressed spinal nerve from symptoms.

Answer 8

Work backwards from affected dermatome or myotome and refer it back to the level of a compressed nerve.

Question 9

Spina bifida

Answer 9

Failure of vertebral arch to form correctly

Question 10

Spina bifida cystica

Answer 10

Failure of one or more neural arches to fuse completely,
cyst-like sac protrudes out of spine
Mnemonic: “Mew-two’s tail”

Question 11

Spina bifida occulta

Answer 11

A congenital anomaly that features a tuft of hair (and sometimes a dimple) overlying the affected skin on the lower back
Mnemonic: “Goku’s cult of Saiyans”

Question 12

Meningomyelocele

Answer 12

Tether cord syndrome;

Protrusion of spinal cord through the meninges

Question 13

Lordosis

Answer 13

Abnormally exaggerated lumbar vertebral curvature;

Mnemonic: “Praising pregnant women”

Question 14

Kyphosis

Answer 14

Abnormal curvature of the thoracic vertebrae

“Hunchback syndrome”

Question 15

Describe the region of the L5 dermatome.

Answer 15

Runs down the lateral side of thigh and spirals around to the anterior leg, then to the dorsum of the foot.

Question 16

Describe the S1/2 dermatome.

Answer 16

Dermatome at the back leg and thigh;

Originates close to the level of the center of gravity

Question 17

Describe the region of the T10 dermatome.

Answer 17

Dermatome that wraps along the belly button from ventral to dorsal sides of body

Question 18

What dermatome wraps along the medial side of the foot and over the knee?

Answer 18

L4 Dermatome

Question 19

The spinal nerve damaged always corresponds to the _______ level of the disc that is herniated. Provide an example.

Answer 19

Lower level:
HNP between C4 and C5 = C5 spinal nerve affected;
HNP between T3 and T4 = T4 spinal nerve affected

Question 20

What ligament resists extension of the back, such as by stretching backwards with arms overhead and feet planted?

Answer 20

Anterior longitudinal ligament

“Stretch occurs away from where ligament is attached to spine”

Question 21

What naturally resists flexion at the vertebral column?

Answer 21

The posterior longitudinal ligament and Ligamentum flavum resists flexion of the spine.

Question 22

What vertebral level does the dural sac and subarachnoid space end?

Answer 22

S2 vertebra level

Question 23

The patella reflex involves what two dermatome levels?

Answer 23

L3/L4

“Kick the door”

Question 24

Describe the pathway a needle takes for a lumbar puncture.

Answer 24

Passes spinous processes > interspinous ligament > ligamentum flavum > epidural venous plexus > dura mater > arachnoid mater > subarachnoid

Question 25

How would a herniated nucleus propulsus between C6 and C7 spinal vertebra present in a patient?

Answer 25

Pain of C7 dermatome and muscle weakness of the distal forearm muscles.