Module 1: Unit 6

Question 1

What is the primary component of the nucleus purposes in intervertebral discs?

A. Fibrocartilage
B. Type II collagen and proteoglycans
C. Type I collagen
D. Elastin fibers

Answer 1

B

Question 2

How many discs are present in the average adult spine?

A. 26
B. 18
C. 23
D. 25

Answer 2

C

Question 3

What is the consequence of disc desiccation?

A. Enhanced shock adsorption
B. Altered biomechanics and stress
C. Increased disc hydration

Answer 3

B

Question 4

The annulus fibrosis is primarily made up of which type of collagen fibers?

A. Type II
B. Type VI
C. Type III
D. Type I

Answer 4

D

Question 5

A disc bulge typically involves:

A. More than 1/4 of the disc’s diameter
B. Less than 1/4 of the disc’s diameter
C. Complete rupture of the annulus
D. Separation of the nucleus pulposus

Answer 5

A

Question 6

What defines a sequestered disc fragment?

A. Nucleus pulposus extends through annulus fibers
B. Nucleus pulposus remains with the annulus
C. Annulus fibers tear circumferential
D. Nucleus pulposus separates from the parent disc

Answer 6

D

Question 7

What is an “annular fissure”?

Answer 7

A circumferential tear in the annulus fibrosus

Question 8

Which of the following disc herniating has the highest rate of spontaneous regression?

A. Extrusion
B. Protrusion
C. Sequestration
D. Disc bulge

Answer 8

C

Question 9

How many pairs of cervical curve roots are there?

A. 8
B. 10
C. 4
D. 9

Answer 9

A

Question 10

Where does the first intervertebral disk occur?

Answer 10

At C2-C3

Question 11

What two main parts make up the Intervertebral disk and what make up these parts?

Answer 11

Nucleus Pulposus: Made of type II collagen and proteoglycans *the proteoglycans attracts and retains water which maintains disc height and helps the disc to act as a shock absorber during compressive loading

Annulus Fibrosus: Type 1 collagen fibers arranged in lamellae organized in concentric rings surrounding the NP ^

Question 12

What substance helps maintain disk hydration?

A. Desiccation
B. Annulus Fibrosus
C. Blood bone marrow
D. Proteoglycans

Answer 12

D

Question 13

What happens if discs dry up?

Answer 13

Desiccate: to dry up thoroughly; dry up (this occurs naturally)
*think dehydrate

Question 14

What are the four types of annular tears? Explain each.

Answer 14

Degeneration: Pressure overtime is altering biomechanics and contributes to altered stress. This continues the cycle of degeneration.

Protrusion: Base of the herniation is wider than the outward extent *Annulus fibers are not completely torn

Extrusion: Nucleus pulpous extends through form annulus fibers *Outward extension is greater than the base of the herniation

Sequestration: Nucleus pulposus separates from the parent disc *may extend up or down within the central canal

Question 15

What is disc regression related to?

Answer 15

Dehydration process

Question 16

Why do disc herniation hurt? Explain some mechanisms as to why.

Answer 16

-Proteoglycan breakdown
-Loss of disc hydration
-Compromised biomechanical capabilities
-Structural damage
- Inability to resist tensile forces
*Endplate changes impair transport efficiency so neoinnercation and neovascularization take place *Disc herniation (mechanical pressure on nerve roots, chemical irritation by inflammatory mediators

Question 17

What is failed back syndrome?

Answer 17

Where a patient has gone through some form of back surgery resulting in the building up of scar tissues, nerve damage, or incomplete rehabilitation.

Question 18

How many cervical nerve roots are there?

Answer 18

8

C1-C8, starting above C1 and ending above T1 (C8 NR)

Question 19

Refer to slides 164 and 165 diagrams for reference of Cervical nerve roots and Lumbar Nerve root innervation*