Khanna Spine Flashcards
Patellar reflex?
What is L5 reflex?
- L4 patellar reflex
Dermatome L1/2/3 Prox/middle/distal thigh
There is NO L5 nerve root
What is the best to determine PVNS versus synovial chondromatosis?
Gradient echo MR
To evaluate for non-displaced occult fracture of femoral neck?
STIR sequence of MRI
Tumors respect the disk because?
They do NOT have hyallluranidase- cannot digest the disk- infection can
SLACLine
Sympathetic chain, longus coli, atery, cervical nerve root, lateral masse (anterior to posterior)
Horners syndrome injury
- Inferior ganlgion of sympathetic chain
Carotid sheath contents and relationship
Artery (most anteior and medial, IJ, vagus N.
What is at risk with the C1-2 transarticular screw?
C2 nerve root
- Posterior arch of C1 (1.5 cm worry about VA, 2.5cm until you HIT VArtery
Which side does the artery of Adamkiewize arise from?
Lower thoracic spine , LEFT side
ALIF risks L/4/5 or L5S1
- L4/5 ililumbar vein
L5/S1- symphatetic chain
Also genitofemoral nerve
Powers ratio
BC/AB- only good for ANTERIOR AOdislocation
Type II Odontoid
Displacement>angulation Odontoid screw(only 1) OR PSF C1/2
Type II Odontoid
Displacement>angulation Odontoid screw(only 1) OR PSF C1/2
What is a hangmans fracture?
Is a fracture between the anterior and posterior elements of C2
- Type I- no angulation/translation
- Type II- angulation and translation- closed, traction, extension
IIA- need COMPRESSION HALO
III- vertical fracture with unilateral or bilateral facet dislocations (highest neuro compromise)
What levels increase risk of dysphagia in ACDF?
the Higher you GO, higher dysphagia
- Lower you GO higher risk of RLN injury
- More levels, higher airway comp, higher non-union
Rheumatoid Spine
- ligament instability, pannus formation
- neurocompromise
Rheumatoid spine
Autoimmune response, ligaments are getting lex, pannus formation
- <135 cervicomedullary angle
- subaxial subluxation
- AA instability
- basilar invagination
AA instability(first)–>then leads to late stage subaxial subluxation
IF you have a burst fracture WITH a lamina fracture what approach?
you will have to go from the bac due to high association with injury dural tears
GSW to spine?
Hollow organ injury- possible surgical intervention
No hollow- observe
If bullet IN canal at t10 or ABOV you LEAVE IT (ODD)
Treatment for neurgenic shock?
Hypotensive and bradycardia
Fluids THEN pressors
Which of the chord syndroms has the worst prognosis?
Anteiror cord
- Best prognosis is BS
