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Orthopedics > Lumbar, Thoracic, Cervical Spine (Exam 3) > Flashcards

Lumbar, Thoracic, Cervical Spine (Exam 3) Flashcards

1
Q

Second leading cause of all MD visits in U.S.

A

Lumbar Spine Problems

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2
Q

Lordotic Curve

A

Concave Posteriorly

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3
Q

Outer wall composed of concentric rings of fibrocartilage.

A

Annulus

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4
Q

Gelatinous center.

A

Nucleus Pulposus

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5
Q

Contains nucleus. Provides stability. Enhances movement b/w vertebral bodies. Shock absorption.

A

Annulus

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6
Q

Transmit forces. Equalizes stress. Promotes movement.

A

Nucleus Pulposus

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7
Q

Movement of spine from flexion to extension the nucleus moves _______.

A

Anteriorly

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8
Q

Movement of spine from extension to flexion the nucleus moves ______.

A

Posteriorly

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9
Q

Injury from sudden violent force or repeated stress.

A

Ligament Sprains

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10
Q

Limited ability to heal and repair itself due to not having an intense vascular response to injury.

A

Vertebral Disk Injuries

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11
Q

More common posteriorly. Due to weaker and narrower posterior longitudinal ligament (PLL).

A

Protrusions/Herniations

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12
Q

Nucleus bulges against intact annulus.

A

Disk Protrusion

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13
Q

Nucleus extend through annulus but nuclear material remains confined by PLL.

A

Extruded Disk

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14
Q

Nucleus is free within the canal.

A

Sequestrated Disk

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15
Q

More common in young to middle-aged adults.

A

Herniated Nucleus Pulposus (HNP)

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16
Q

Not as common in older individuals due to changes with aging such as decreased water content and increased collagen.

A

HNP

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17
Q

Symptoms are experienced further down the arm/leg.

A

Peripheralization

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18
Q

Radiating pain originating from the spine and referred distally is made to move away from the periphery and toward the mid-line of the spine.

A

Centralization

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19
Q

With a _____ shift, extension may increase pain, unless it is reduced prior to performing extension.

A

Lateral

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20
Q

Reduce pain. Protect affected area from unwanted stress and forces while encouraging and promoting movement. Increase muscle strength, endurance, and flexibility. Counsel patient concerning correct body mechanics.

A

General Objectives of HNP

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21
Q

Nucleases is reduced to a more anterior position and away from impingement.

A

Prone Extension Progression

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22
Q

Prone Extension Progression Steps

A

Prone on pillow. Prone. Prone with pillow under chest. Prone on elbows. Prone press-ups. Press-ups with overpressure.

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23
Q

Proper body mechanics. Sitting with lumbar roll. Avoid flexion positions.

A

Maintain neutral lordotic posture.

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24
Q

Goal is to relieve pain and inflammation. Doesn’t fix the problem.

A

Epidural steroid injection.

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25
Q

Remove the nonviable portion of the disk, thus decompressing the nerve root that is affected. Examples: Laminectomy, discectomy, fusion.

A

Surgical Intervention

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26
Q

Men twice as common as women. Late middle age and older.

A

Spinal Stenosis

27
Q

Due to degenerative arthritic changes that encroach on canal, producing nerve root impingement.

A

Spinal Stenosis

28
Q

Common with extension. Especially walking. Radicular ache into thighs and calves. Paresthesias into LE. Feels better with walking in flexion with cart, walker.

A

Spinal Stenosis Symptoms

29
Q

Treatment of Spinal Stenosis

A

Avoid extension. Patient education on body mechanics and posture. General conditioning. Flexion exercises (William’s Flexion). Posterior pelvic tilt, knee to chest, and partial sit-ups.

30
Q

Osteophytes formation at the superior and inferior margins of vertebral bodies.

A

Spondylosis

31
Q

Bony defect in the pars interarticularis of the posterior spine.

A

SpondyLOLsis

32
Q

Collar on “Scotty Dog”

A

SpondyLOLsis

33
Q

Forward slippage of one superior vertebra over inferior vertebra (usually L4-L5, L5-SI) due to instability caused by defect in pars interarticularis.

A

SpondyLOListhesis

34
Q

Grade I of Slippage

A

0-25%

35
Q

Grade II of Slippage

A

25-50%

36
Q

Grade III Slippage

A

50-75%

37
Q

Grade IV Slippage

A

75-100%

38
Q

Force producing fracture such as compression, flexion-rotation.

A

Lumbar Spine Fractures

39
Q

Elderly persons many thoracic and high lumbar fractures due to _____.

A

Osteoporosis

40
Q

Osteoporosis causes anterior wedging and creates kyphotic curve.

A

Thoracic Kyphosis

41
Q

Any lateral curvature of the spine.

A

Scoliosis

42
Q

Usually idiopathic.

A

75-85%

43
Q

Can also result from neuromuscular causes, degenerative disease, osteoporosis, trauma, and post surgical factors.

A

Scoliosis Causes

44
Q

Irreversible lateral curve with fixed rotation of vertebrae. Curve is not reversed by moving or changing position.

A

Structural Scoliosis

45
Q

Reversible curve. Lateral curve dissipates with positional changes.

A

Nonstructural Scoliosis

46
Q

Common among athletes and with MVA’s.

A

Muscle Strains

47
Q

Muscles commonly involved in muscle sprains/strains.

A

SCM, traps, scalene, erectors, rhomboids, and levator scapulae.

48
Q

Mechanisms of Injury Muscle Sprains/Strains

A

Hyperflexion, rotation, lateral flexion (of head and C-spine).

49
Q

Chronic degenerative disk from wear and tear on WB structure of the C-Spine.

A

Cervical Spondylosis

50
Q

Most common in 40’s, 50’s. Men > Women. C5-C6, C6-C7 most common segments.

A

Cervical Spondylosis

51
Q

Compression of vascular or neurologic tissues as they exit the superior triangle opening of thorax. Compressed subclavian artery/vein, brachial plexus.

A

Thoracic Outlet Syndrome (TOS)

52
Q

Cervical rib, shortened or hypertrophied anterior scalene, maluninon of clavicle, sublimed 1st thoracic rib.

A

Causes of Compression TOS

53
Q

Chronic inflammatory auto-immune disease. Most common in Males.

A

Ankylosing Spondylitis

54
Q

Average at age 23 (20-40). Early symptoms are pain and stiffness. Eventually spinal joints fuse together.

A

Ankylosing Spondylitis

55
Q

Outer 2/3 of annulus innervated by _______.

A

Sinuvertebral Nerve

56
Q

Reduce inflammation, restore function, and protect affected area.

A

Treatment goals for muscle strains.

57
Q

Initial care for muscle strains.

A

Modalities, NSAIDS, protection.

58
Q

After acute healing for muscle strains.

A

Submax isometrics, stretching.

59
Q

Sub acute muscle strains.

A

Extensor exercises, abdominal stabilization exercises.

60
Q

Bed Exercises Post-Op

A

Ankle pumps, quad sets, glut sets, proper breathing. Avoid valsalva maneuver.

61
Q

Progression Post-Op

A

Extension (active), avoid flexion, pelvic tilts, ROM.

62
Q

Before general conditioning program.

A

Increased motion, controlled pain, improved endurance, strength.

63
Q

Stretching of PLL, muscle fatigue, postural syndromes, and neurological syndromes.

A

Pain of thoracic kyphosis is caused by.

64
Q

Posterior pevlic tilt, knee to chest, partial sit-ups.

A

Flexion Exercises (William’s Flexion) Treatment for Spinal Stenosis

Orthopedics (17 decks)

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