neck and back lecture

Question 1

muscular innervations to test

Answer 1

C5- C8, L3-S1

Question 2

spine is divided into

Answer 2

C7, T12, L5/6, S5

Question 3

90% of head motion is where

Answer 3

C1,2

Question 4

nerve roots exit ____ (below/above) their corresponding pedicle

Answer 4

below

Question 5

cauda equina syndrome

Answer 5

compression of the entire spinal canal and all nerve roots, cuts off sensation and movement (tail of horse)

Question 6

cauda equina symptoms

Answer 6

saddle anesthesia, urinary retention, urinary and bowel incontinence, diminished patellar and achilles reflexes, low back pain

Question 7

cauda equina examination

Answer 7

rectal exam for tone
perianal for saddle sensation

Question 8

cauda equina potential complications

Answer 8

paralysis, permanent incontinence of bowel or bladder, uterine prolapse, sexual dysfunction

Question 9

cauda equina treatment

Answer 9

immediate surgical consult and decompression

Question 10

back pain/strain/sprain cause

Answer 10

overuse (including obesity)
acute injury

Question 11

back pain/strain/sprain treatment

Answer 11

rest
pain control
muscle relaxation
PT vs Chriopractic care

Question 12

herniated nucleus pulposis (disc herniation)

Answer 12

a bulge from the intervertebral disc that compresses a nerve root or roots
referred to as sciatica

Question 13

herniated nucleus pulposis (disc herniation) examination

Answer 13

Spurling’s maneuver

Question 14

herniated nucleus pulposis (disc herniation) treatment

Answer 14

oral steroids
epidural steroids
cervical or lumbar micro-discectomy surgery

Question 15

cervical myelopathy causes

Answer 15

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

Question 16

cervical myelopathy examination

Answer 16

hyperreflexia
clonus
hoffman’s sign

Question 17

spondyl

Answer 17

change in the vertebrae

Question 18

spondylosis

Answer 18

disc degeneration

Question 19

spondylolisthesis

Answer 19

one vertebrae slipping forward over the one below

Question 20

spondylitis

Answer 20

vertebral inflammation. often means ankylosing spondylitis

Question 21

spondylolysis

Answer 21

refers to a pars defect

Question 22

ankylosing spondylitis

Answer 22

inflammation in joints and ligaments of spine. bamboo spine appearance (late finding)
HLA-B27 gene

Question 23

ankylosing spondylitis symptoms/presentation

Answer 23

complains of low back pain, SI joint pain, stiffness. symptoms are worse with rest.
+ shobers test

Question 24

ankylosing spondylitis s/s

Answer 24

weight loss/fatigue, costochondritis, endhesitis, heart block

Question 25

ankylosing spondylitis treatment

Answer 25

NSAIDS, steroids, anti TNF factor, smoking cessation
Surgery for deformity or fractures

Question 26

spinal stenosis

Answer 26

tightening of the space where the spine lives
trigger: leaning forward on shopping cart for pain relief

Question 27

spinal stenosis presentation

Answer 27

non-specific weakness to legs, numbness to legs, difficulty walking

Question 28

spinal stenosis examination

Answer 28

cannot stand upright, cannot extend lumbar spine, reflexes usually intact and no hyper reflexia

Question 29

compression fracture

Answer 29

small breaks or cracks in vertebrae
#1 risk factor = osteoporosis

Question 30

compression fracture treatment

Answer 30

rest
TSLO brace
pain medication as needed
vertebroplasty
kyphoplasty

Question 31

spinous process fracture treatment

Answer 31

conservative

Question 32

pars defect

Answer 32

overuse or fracture of pars interarticularis
can progress to spondylolisthesis

Question 33

pars defect treatment

Answer 33

symptomatic
pain control with caution on narcotics
physical therapy

Question 34

kyphosis etiology

Answer 34

osteoporosis and multiple compression fx’s
postural
associated with ehlers danlos syndrome and marfan’s

Question 35

scoliosis treatment

Answer 35

physical activity
postural training
bracing to prevent progression
surgery is severe pain

Question 36

scoliosis

Answer 36

sideways curvature of spine

Question 37

kyphosis

Answer 37

excessive curve of spine resulting in an abnormal rounding of the upper back