Intervertebral / Herniated Disks Flashcards
What is the primary cause of a herniated disk?
Trauma - incorrect lifting
Describe the pathophysiology of a herniated disk (2)
- Protrusion of nucleus pulposus
- Pressure on spinal cord
What is an intervertebral disk?
Cartilaginous plate - serves as a cushion between each vertebrae
What are the most common sites of a herniated disk? (4)
- L4 - L5
- L5 - S1
- C5 - C6
- C6 - C7
Herniated disks rarely occur in the ______ region
Thoracic
What are the general manifestations of a herniated disk? (4)
- Pain
- Paresthesia
- Fasciculation
- Decreased ROM
What is the primary diagnostic test used for the diagnosis of a herniated disk?
MRI
Describe the function of an MRI in the diagnosis of a herniated disk
Localization of small disk herniations
What alternative diagnostic tests are used for the diagnosis of a herniated disk if an MRI is not consistent with patient symptoms? (3)
- CT
- EMG
- Myelography
Describe the function of a myelography in the diagnosis of a herniated disk
Uses contrast dye to visualize abnormalities in the spinal cord / nerve roots
Describe the general nursing interventions associated with herniated disk treatment (2)
- 1 - 2 days of bedrest
- William’s position
Describe William’s position
Semi-fowlers with knees flexed
Describe medications associated with herniated disk treatment (4)
- NSAIDs
- Analgesics
- Corticosteroids
- Muscle relaxants - Flexeril
Surgical treatment for a herniated disk is used when there is ______
Progressive neurological dysfunction
What is the goal of surgical management for a herniated disk?
Relieve pressure on nerve roots
What are the causes of cervical disk herniation? (3)
- Aging
- Spondylosis
- Occupational stressors
Cervical disk herniation may lead to …
Lesions damaging the spinal cord
Describe the location of pain associated with cervical disk herniation (3)
- Neck
- Upper extremities
- Shoulders / scapulae
Pain associated with cervical disk herniation is sometimes mistaken for ______
Chest pain
Describe the medical management associated with cervical disk herniation (2)
- Cervical collar
- Ice followed by hot moist compress
Describe the frequency of hot moist compress use for treatment of a herniated disk
10 - 20 minutes - several times / day
What are the manifestations of lumbar disk herniation? (4)
- Sciatica
- Lower back pain
- Postural deformity
- Pain during straight leg test
Lumbar disk herniation pain is aggravated with actions that …
Increase intra-spinal fluid pressure
Describe some examples of actions that increase intra-spinal fluid pressure (4)
- Sneezing / coughing
- Straining
- Bending
- Lifting
Describe the straight leg test
Raising a leg into the straight position while laying in the supine position
Describe the medical management associated with lumbar disk herniation (2)
- Physical therapy
- Ice followed by hot moist compress
Describe the surgical management associated with lumbar disk herniation (2)
- Microdiskectomy
- Lumbar disk excision
What are the complications associated with surgical treatment of lumbar disk herniation? (3)
- Arachnoiditis
- Urinary retention
- Scarring around spinal nerves
______ may continue despite surgical management
Sciatica
What nursing method is used in pre-operative care for a patient with a herniated disk?
- The 3 Bs:
- Blood
- Bone
- Brace
Describe “blood” regarding pre-operative herniated disk care
Donation of a patient’s own blood
Describe “bone” regarding pre-operative herniated disk care
Donation of a patient’s own bone OR a bone graft from a donor
Describe “brace” regarding pre-operative herniated disk care (4)
- TLSO braces
- Provide support
- Prevent twisting
- Fitted to the individual patient
Autograft donor site pain may be present for ______
2 - 3 years
Describe post-operative nursing interventions associated with a herniated disk (3)
- Logroll every 2 hours
- Neurological assessment
- Measure JP / Hemovac drainage
Describe correct positioning post-op herniated disk when out of bed (2)
- Back straight
- Feet on the floor
