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Imaging II > Lumbar Spine II > Flashcards

Lumbar Spine II Flashcards

1
Q

Classification of spinal stenosis

A
  1. central spinal canal
  2. intervertebral foreman
  3. subarticular or lateral recesses
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2
Q

What portion of the population may have asymptomatic spinal stenosis under the age of 40?

A

1/4

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3
Q

When does spinal stenosis first appear and who is it most likely to affect?

A

40-50 years old

men

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4
Q

What region is spinal stenosis most common in?

A

cervical and lumbar spinal regions

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5
Q

Where is central canal narrowing most prevalent

A

L4

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6
Q

Normal AP diameter of spinal canal adult men C3-C5:

A

17-18mm

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7
Q

Normal AP diameter of spinal canal adult men C5-C7:

A

12-14mm

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8
Q

Normal AP diameter of spinal canal adult men thoracic spine:

A

12-14 mm

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9
Q

Normal AP diameter of spinal canal adult men lumbar spine

A

15-27mm

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10
Q

What is the most serious complication of c-spine spinal stenosis?

A

central cord syndrome

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11
Q

What kind of injury is central cord syndrome associated with?

A

hyperextension

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12
Q

What is cervical spinal stenosis associated with?

A

Long tract and radicular signs
Headaches
Pain
Radiating electric-like shock sensations elicited with cervical spine flexion

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13
Q

What can concurrent cervical and lumbar spinal stenosis can present with?

A

Gait disturbance
Myelopathy
Radiculopathy

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14
Q

What does lumbar spine stenosis present with?

A

Diffuse unilateral or bilateral LBP and/or LE pain
Numbness
Weakness

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15
Q

What does lumbar extension do?

A

narrows canals and exacerbates symptoms

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16
Q

What does lumbar flexion do?

A

opens available space and provides some relief

17
Q

Simian stance:

A

trunk, hip, and knee flexion

18
Q

What is neurogenic claudication?

A

congestion of blood vessels at stenotic level

19
Q

What does neurogenic claudication inhibit?

A

nerve conduction and results in poorly defined leg pain, numbness, and weakness

20
Q

What exacerbates neurogenic claudication?

A

standing and spinal extension

21
Q

What exacerbates vascular claudication?

A

exercise and improved with standing

22
Q

What aggravates disk herniation?

A

sitting, flexion, lifting, and Valsalva maneuvers and often relieved with walking

23
Q

What imaging technique is widely used for evaluation of spinal stenosis?

A

CT

24
Q

How is mild and moderate spinal stenosis managed?

A

Analgesic medications
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Epidural steroid injections
PT for strengthening and flexibility exercises

25
Q

What is an intervertebral disk herniation (IVDH)?

A

extension of NP through AF and beyond adjacent vertebral margins

26
Q

Who is IVDH most common among?

A

25-45
men
smoke or obese or exposed to vehicular vibration

27
Q

Where is IVDH most common?

A

lumbar spine

L4-L5

28
Q

Where is cervical spine IDVH most common?

A

C5-C6

radiculopathy

29
Q

What symptoms do intraspinal disk herniations cause?

A

LBP and referred or radicular pain

30
Q

Intraspinal disk herniation symptoms are exacerbated how?

A

active flexion, prolonged sitting, and Valsalva maneuvers

31
Q

Conservative treatment of IVDH:

A

PT
Analgesics
Short-term bedrest
Restricted activities

32
Q

Hallmarks of DJD at SIJ:

A

Decreased joint space
Subchondral sclerosis
Osteophyte formation at joint margins

33
Q

Ankylosing spondylitis:

A

chronic, progressive inflammatory arthritis characterized by joint sclerosis and ligamentous ossification

34
Q

How does ankylosing spondylitis manifest first?

A

in stiffness of SIJs and later extends to lumbar and thoracic spines

35
Q

Who is affected by ankylosing spondylitis?

A

men (7 times more than women)

onset in 20s

36
Q

Radiological evidence of ankylosing spondylitis first seen:

A

abnormal narrowing of upper half of SIJs

Imaging II (10 decks)

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