MSK extra from revision quizzes

Question 1

what are the stages of disk herniation?

Answer 1

Stage 1 is disc degeneration, chemical changes associated with aging which causes the disc to dehydrate and bulge.

Stage 2 is prolapse, protrusion of the nucleus pulposus within the annulus fibrosus, leading to slight impingement of the spinal canal.

Stage 3 is extrusion, where the nucleus polyposis breaks through the annulus fibrosus but is
still contained within the disc space.

4) sequestration, the nucleus pulposus separates from the main body of the disc and enters the spinal canal.

Question 2

what is a key feature of Canal filling herniation of intervertebral disks?

Answer 2

symptoms on BOTH sides > bilateral symptoms

whereas paracentric herniation will be on one side only

Question 3

what is a Comminuted Fracture?

Answer 3

a break or splinter of the bone into three or more fragments.

occur after high-impact trauma e.g. RTC
common in the elderly or those with low density bones (e.g in osteoporosis).

Question 4

types of fractures and their features?

Answer 4

Comminuted Fracture- break into 3 or more fragments (RTC)

Compression Fracture- occur in cancellous bone when an axial load compresses the bone beyond its limit. occur in the lumbar vertebrae

Greenstick Fracture- incomplete fractures. bone bends and crack. cortex on just one side fractures.

Linear Fracture- fracture line passes in parallel to the long axis of the bone

Spiral Fracture- a twist. see image.

oblique fracture- Like sawing a log in two at an angle (commonly confused with spiral fracture)

Question 5

where do the spinal nerves exit their corresponding vertebrae

Answer 5

All spinal nerves, except the cervical, exit the spine below their corresponding vertebrae

Question 6

What is derived from sclerotomes?

Answer 6

Sclerotomes give rise to vertebrae and ribs and are derived from somites.

Question 7

what is the difference between dermatome and peripheral nerve ?

Answer 7

A dermatome is an area of skin supplied by a single spinal nerve.

A peripheral nerve, however, often contains fibres from multiple spinal nerves.

so areas of skin that constitute the dermatomes often differ from those supplied by the peripheral nerves because of this. the spinal nerves are distributed via plexuses into multiple diff peripheral nerves.

Question 8

what is a motor unit?

Answer 8

motor unit is a single motor neuron and the skeletal muscle fibres it innervates.

Question 9

four factors that contribute to the stability and mobility of the vertebral column.

Answer 9

• The thickness and compressibility of the intervertebral discs
• The shape and orientation of the intervertebral facet joints
• The tone of the back muscles
• The resistance of the ligaments of the vertebral column.

Question 10

lumbar puncture between which spinous processes? and what is the anatomical landmark to find this?

Answer 10

L3 and L4

the supracristal plane> passes the highest points of the iliac crest and passes through the L4 spinous process.

Question 11

State five red flag symptoms of cauda equina syndrome.

Answer 11

Bilateral sciatica
Perianal numbness (saddle anaesthesia) Painless retention of urine
Urinary / faecal incontinence
Erectile dysfunction

Question 12

What is spondylolisthesis? What symptoms can it cause?

Answer 12

anterior displacement of the vertebra above on the vertebra below. slides forward out of place onto the vertebra below it.

symptoms:
Lower back pain
sciatica due to nerve root compression
neurogenic claudication (intermittent leg pain from impingement of the nerves emanating from the spinal cord)

Question 13

characteristic feature of thoracic vertebrae?

Answer 13

Thoracic vertebrae have long, slanted spinous processes.

circular vertebral foramen

Question 14

Whereabouts does the spinal cord terminate, and cauda equina begin?

Answer 14

L1 level.

Question 15

characteristic feature of all cervical vertebrae?

Answer 15

transverse foraminae which allow for the vertebral arteries.

Question 16

which parts have lordosis and which parts kyphosis?

Answer 16

Lordosis- anterior convexity. Cervical and Lumbar.
kyphosis- posterior convexity. thoracic and sacral.

(remember CTLS and the curves alternate so its L for lordosis L for lumbar then can work the rest out)

Question 17

what causes thoracic kyphosis to be more pronounced? its impact?

Answer 17

osteoporosis or wedge fractures

suffer from neck problems as have to hyperextend cervical spine.
respiratory problems and can’t ventilate adequately. predisposed to lower respiratory tract infections.

Question 18

which vertebrae has larger body and transverse processes? why?

Answer 18

L5

carries weight of entire upper body

Question 19

characteristic feature of all lumbar vertebrae?

Answer 19

triangular vertebral foramen

Question 20

what type of joint sits between vertebral bodies of lumbar spine?

Answer 20

cartilaginous > fibrocartilage forms the symphysis joint

Question 21

which connects the laminae of adjacent vertebrae?

Answer 21

ligamentum flava

Question 22

what is a facet joint?

Answer 22

formed by the articulation between articular processes. (at the back of each vertebra and connect adjacent vertebrae)

For each disc space, there are two facet joints and a disc.