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Ortho > Lecture Exam 4 > Flashcards

Lecture Exam 4 Flashcards

1
Q

facet joints in the cervical spine are in what plane?

A

all 3 (triplanar)

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2
Q

facet joints in the thoracic spine are in what plane?

A

frontal

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3
Q

facet joints in the lumbar spine are in what plane?

A

sagittal (with some curvature in frontal)

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4
Q

describe the annulus fibrosis & nucleus pulposus

A

these 2 parts compose the lumbar disk

  • annulus fibrosis: allows for mobility & minor shock absorption
  • nucleus pulposus: composed of a gel that provides shock absorption
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5
Q

mechanical compression or inflammation of a nerve root that cause neurologic symptoms in the LE

A

radiculopathy

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6
Q

which position puts 100% pressure on the discs?

A

standing

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7
Q

which position puts 150% pressure on the discs?

A

standing with forward bending

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8
Q

which position puts 25% pressure on the discs?

A

supine

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9
Q

which position puts 75% pressure on the discs?

A

side-lying

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10
Q

which position puts 35% pressure on the discs?

A

supine with both knees flexed

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11
Q

which position puts 275% pressure on the discs?

A

bending forward in sitting & lifting

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12
Q

what are the global muscles?

A

muscles of the lumbar spine

Rectus Abdominis
External & Internal Oblique
Quadratus Lumborum
Erector Spinae

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13
Q

what are the core muscles?

A

Transverse Abdominis
Multifidus
Deep portion of the Quadratus Lumborum

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14
Q

what is being described?

  • occurs along the iliac crest (due to falls or repeating loading with lifting/twisting)
  • can also be due to faulty standing posture, stretching beyond limits, or a forceful contraction
A

muscle strains of the lumbar spine

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15
Q

disc injuries are best described by what term?

A

Herniated Nucleus Pulposus (HNP)

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16
Q

any change in the shape of the annulus that causes it to bulge beyond normal perimeter

A

disc herniation

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17
Q

what mechanism of injury is being described?

  • fatigue & breakdown
  • traumatic rupture (one time event or on a part that has had gradual breakdown of annular rings)
  • degeneration (due to):
    • fibrous changes in nucleus
    • loss of organization of rings of annulus fibrosis
    • less water content in nucleus
A

disc herniation/IV injury

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18
Q

what are the 4 categories of HNP?

A

disc protrusion
prolapse
extrusion
sequestration

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19
Q

nucleus bulges against an intact annulus

A

disc protrusion/herniation

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20
Q

rupture of the nuclear material into the vertebral canal

A

prolapse

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21
Q

nuclear material is beyond the PLL or above & below the disc space as seen with MRI

A

extrusion

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22
Q

extruded nucleus is free from the disc & moved away from the prolapsed area

A

sequestration

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23
Q
  • pain: acute or changes with activity/movements
    • may prefer standing/walking
    • may see lateral shift of spine
    • limited fwd bending & extension
    • pain with SLR between 30-60 degrees
  • inflammation
  • motor weakness (neurological)
  • dermatomal changes (neurological)
  • variability of symptoms (posterior, posterolateral, anterior)

these are s/s of what type of pathology?

A

disc pathology

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24
Q

what are the most common areas for s/s with lumbar disc pathologies?

A

L4, L5
L5, S1

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25
Q

repeating a movement/being in certain positions causes symptoms to increase or be experienced further down the leg

A

peripheralization

26
Q

repeating a movement/being in certain positions causes pain that is referred distally to move toward the midline

A

centralization

27
Q

if there is a lateral shift of the spinal column, backward bending (decreases; increases) pain?

A

increases

28
Q

if lateral shift of the spinal column is corrected, backward bending (decreases; increases) pain?

A

decreases/centralizes

29
Q

narrowing of the spinal canal, nerve root, or foramen which causes pressure on the spinal canal/nerve roots & leads to symptoms

A

spinal stenosis

30
Q

with spinal stenosis, patients usually c/o of symptoms with (flexion/extension) of the spine?

A

extension

31
Q

radicular ache to thigh
paresthesias thigh
loss of motor function

these are s/s of what pathology?

A

spinal stenosis

32
Q
  • patients will find relief with flexed postures because it widens the IV foramina
  • position of comfort: supine with hips/knees flexed
A

flexion bias for spinal stenosis

33
Q

bony defect in the Pars Interarticularis of the posterior elements of the spine

A

spondylosis

34
Q

forward slippage of a superior vertebrae over an inferior one as a result of instability due to a bilateral defect in the Pars Interarticularis (5 classifications based on degree of slippage)

A

spondylolisthesis

35
Q

insufficiency of the facet joints & disc complex

A

type 1 spondylolisthesis - congenital or dyspalsic

36
Q

mechanical stress fracture at the Pars Interarticularis

A

type ll spondylolisthesis - isthmic (MOST COMMON)

37
Q

associated with normal aging process; ligament laxity/slippage

A

type lll spondylolisthesis - degenerative

38
Q

trauma from an acute fracture of the Pars Interarticularis

A

type lV spondylolisthesis - traumatic

39
Q

tumors that affect the Pars Interarticularis

A

type V spondylolisthesis - pathologic

40
Q
  • umbrella term for age-related degeneration of the spine
    • OA of L-spine
    • bone spurs/osteophytes
    • DJD (Degenerative Joint Disease)
A

lumbar spondylosis

41
Q
  • due to trauma
  • due to compression fracture
  • lower thoracic/high lumbar is common with OP
A

lumbar spine fractures

42
Q

composed of 7 segments with 8 pairs of nerve roots

A

cervical spine

43
Q

purpose of the cervical spine is

A

mobility

44
Q
  • head rapidly moves into extension
  • head stopped by thorax if nothing else is there
  • compression of posterior structures
  • anterior structures are stretched
A

cervical extension injury

45
Q
  • head rapidly moves into flexion
  • head stopped by chin to chest
  • posterior structures are stretched
A

cervical flexion injury

46
Q

acceleration/deceleration injuries
flexion/extension injuries
lateral flexion injuries

A

WAD (Whiplash Associated Disorder)

47
Q

commonly involved muscles in cervical sprains/strains

A

sternocleidomastoid (SCM)
scalene
erectors
rhomboids
levator scapulae

48
Q

disc extrusions in the c-spine are most common at which vertebrae?

A

C6, C7

49
Q
  • chronic DDD (“wear & tear”) & is most common at C5, C6 & C6, C7
  • average age of 40-50
  • men> women
A

cervical spondylosis

50
Q

with kyphosis of the thoracic spine, what muscles need to be stretched?

A

pecs
anterior shoulder muscles

51
Q

with kyphosis of the thoracic spine, which muscles should be strengthened

A

extensor muscles

  • scapular retractors
  • rhomboids
  • MT
  • erector spinae
52
Q
  • lateral curve changes with position changes
  • reversible
A

non-structural scoliosis

53
Q
  • non-reversible curve of the spine with fixed rotation of the vertebrae
  • lateral curve does not diminish with flexion of the spine
  • true scoliosis
A

structural scoliosis

54
Q

with structural scolisos

  • ribs on convex side of curve will move in a posterior direction
  • ribs on concave side of curve will move in an anterior direction (will hollow)
A

rib hump

55
Q

compression of vascular/neurological tissues as they exit the opening of the thorax

A

Thoracic Outlet Syndrome (TOS)

56
Q

+ Adson’s & +Roo’s Test is a sign of

A

thoracic outlet syndrome

57
Q

s/s of thoracic outlet syndrome

A

pain
numbness
tingling
weakness
skin temp changes

58
Q
  • rare condition
  • some form of anatomic abnormality that creates compression
A

neurogenic TOS

59
Q

thoracic outlet syndrome is commonly misdiagnosed as

A

CTS

60
Q
  • no anatomical abnormalities
  • no abnormal EMG
  • no mm atrophy
  • faulty posture
A

nonspecific “symptomatic” neurogenic TOS

Ortho (5 decks)

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