neck and back lecture Flashcards
muscular innervations to test
C5- C8, L3-S1
spine is divided into
C7, T12, L5/6, S5
90% of head motion is where
C1,2
nerve roots exit ____ (below/above) their corresponding pedicle
below
cauda equina syndrome
compression of the entire spinal canal and all nerve roots, cuts off sensation and movement (tail of horse)
cauda equina symptoms
saddle anesthesia, urinary retention, urinary and bowel incontinence, diminished patellar and achilles reflexes, low back pain
cauda equina examination
rectal exam for tone
perianal for saddle sensation
cauda equina potential complications
paralysis, permanent incontinence of bowel or bladder, uterine prolapse, sexual dysfunction
cauda equina treatment
immediate surgical consult and decompression
back pain/strain/sprain cause
overuse (including obesity)
acute injury
back pain/strain/sprain treatment
rest
pain control
muscle relaxation
PT vs Chriopractic care
herniated nucleus pulposis (disc herniation)
a bulge from the intervertebral disc that compresses a nerve root or roots
referred to as sciatica
herniated nucleus pulposis (disc herniation) examination
Spurling’s maneuver
herniated nucleus pulposis (disc herniation) treatment
oral steroids
epidural steroids
cervical or lumbar micro-discectomy surgery
cervical myelopathy causes
cervical cord compression from any source
can lead to neck and arm pain, upper or lower extremity numbness
incoordination (hallmark) person appears drunk with stumbling gait
cervical myelopathy examination
hyperreflexia
clonus
hoffman’s sign
spondyl
change in the vertebrae
spondylosis
disc degeneration
spondylolisthesis
one vertebrae slipping forward over the one below
spondylitis
vertebral inflammation. often means ankylosing spondylitis
spondylolysis
refers to a pars defect
ankylosing spondylitis
inflammation in joints and ligaments of spine. bamboo spine appearance (late finding)
HLA-B27 gene
ankylosing spondylitis symptoms/presentation
complains of low back pain, SI joint pain, stiffness. symptoms are worse with rest.
+ shobers test
ankylosing spondylitis s/s
weight loss/fatigue, costochondritis, endhesitis, heart block
ankylosing spondylitis treatment
NSAIDS, steroids, anti TNF factor, smoking cessation
Surgery for deformity or fractures
spinal stenosis
tightening of the space where the spine lives
trigger: leaning forward on shopping cart for pain relief
spinal stenosis presentation
non-specific weakness to legs, numbness to legs, difficulty walking
spinal stenosis examination
cannot stand upright, cannot extend lumbar spine, reflexes usually intact and no hyper reflexia
compression fracture
small breaks or cracks in vertebrae
#1 risk factor = osteoporosis
compression fracture treatment
rest
TSLO brace
pain medication as needed
vertebroplasty
kyphoplasty
spinous process fracture treatment
conservative
pars defect
overuse or fracture of pars interarticularis
can progress to spondylolisthesis
pars defect treatment
symptomatic
pain control with caution on narcotics
physical therapy
kyphosis etiology
osteoporosis and multiple compression fx’s
postural
associated with ehlers danlos syndrome and marfan’s
scoliosis treatment
physical activity
postural training
bracing to prevent progression
surgery is severe pain
scoliosis
sideways curvature of spine
kyphosis
excessive curve of spine resulting in an abnormal rounding of the upper back
