L12 Clinical Anatomy of Back

Question 1

degenerative bone and joint disease (DJD - degenerative joint disease)

Answer 1

• blanket term → the diseases are usually multifactorial
• possible mechanical origins: trauma (recently or from years ago), poor alignmeng (from overuse or underuse - synovial joint problems)
• e.g. osteoarthritis
• possible metabolic origins: poor nutrition, genetic predisposition (osteoporosis)

Question 2

progression of synovial joint disintegration

Answer 2

1. normal synovial joint: has bony ends with articular cartilage on ends - articular cartilage is like glass → smooth and reflective
   
   • subchondral bone looks fairly even
   • cartilage appear invisible on X-Ray
2. early degeneration: roughening of surface → friction causes surface fibrillation (roughening of superficial part of cartilage)
   
   • cartilage is poorer at force bearing → more force to subchondral bone = increase of poor quality and fragile sclerotic bone
3. ​advanced degeneration: from lack of use
   
   • cartilage begins to shred and subchondral bone becomes more sclerotic
   • parts of articular cartilage can get caught in joint - pain may now be felt
   • osteophyte formation in margins of the joint + very thick and inflammed synovial membrane
4. end-stage degeneration: no more movement - no more cartilage
   
   • bone on bone = eburnated bone = cyst formation

Question 3

subchondral bone

Answer 3

bone directly under cartilage

Question 4

regional anaesthesia

Answer 4

• in local area (anatomically guided - dermatome knowledge)
• diminish sensation (for pain relief or specific surgical procedure)
• stick needles into back for anaesthesia
  
  • usually an ultrasound is used for accuracy
    
    • ultrasounds are highly interpretive and requires practice to be read well

Question 5

purposes of surgical repair

Answer 5

• remove damaged tissue
• restore function
• reduce pain
• improve quality of life

Question 6

What occurs with osteoporotic failure?

Answer 6

vertebral body collapse - aka spinal collapse… kinda

Question 7

What does it mean to preload a muscle?

Answer 7

• muscles tense in anticipation of movement