pathophysiology of the spine

Question 1

how many bones make up the cervical spine

Answer 1

7`

Question 2

how many bones make up the thoracic spine

Answer 2

12

Question 3

how many bones make up the lumbar spine

Answer 3

5

Question 4

what are the same about the spine

Answer 4

the body
foramen
processes (transverse or spinal)
articular processes (spine to spine or spine to ribs)
pedicle (attaches the foramen to the body)

Question 5

what is the atlas

Answer 5

C1

Question 6

what is the axis

Answer 6

C2

Question 7

what is important about the cervical vertebrae

Answer 7

most mobile
smallest, oval body
largest vertebral foramen
there are 7
bifid or forked spinous process in C2 to C6
C7 prominens

Question 8

what is important about the thoracic vertebrae

Answer 8

heart shaped body
larger than C-spine body
12 total

Question 9

what is important about the lumbar vertebrae

Answer 9

largest body
kidney shaped body
5 total
more mobile than thoracic spine

Question 10

what are the difference between the different vertebrae

Answer 10

body shape
transforse foramen
facets for ribs
spinous process

Question 11

where is hematopoiesis ongoing

Answer 11

vertebrae, ribs, sternum and pelvis

Question 12

what are the two parts of the discs

Answer 12

annulus fibrosus and nucleus pulposus

Question 13

what part of the disc contains more water

Answer 13

nucleus pulposus

Question 14

What are the intervertebral liagments

Answer 14

ligamenta flava
posterior longitudinal ligamen
interspinous ligaments
supraspinous ligement
anterior longitudinal ligament

Question 15

what is the densest fibrous tissue in the spine

Answer 15

ligamenta flava

Question 16

where are the transverse foramen found

Answer 16

within the C-spine

Question 17

what goes through the transverse foramen

Answer 17

vertebral nerves and vasculature

Question 18

what is the MOA of whiplash

Answer 18

acceleration/deceleration with sudden hyperextension

Question 19

what ligament is most likely strained in whiplash

Answer 19

alar ligement (on C1)

Question 20

what is a muscle spasm

Answer 20

involuntary, painful contraction of the muscle

Question 21

what are the ABC

Answer 21

airway
breathing
circulation

Question 22

what motor function test is used for C5

Answer 22

elbow flexion

Question 23

what motor function test is used for C6

Answer 23

wrist extension

Question 24

what motor function test is used for C7

Answer 24

wrist flexion, finger extension

Question 25

what motor function test is used for C8

Answer 25

finger flexion

Question 26

what motor function test is used for T1

Answer 26

finger abduction

Question 27

what tendon reflexes are used for C5

Answer 27

biceps

Question 28

what tendon reflexes are used for C6

Answer 28

brachioradialis

Question 29

what tendon reflexes are used for C7

Answer 29

tricep

Question 30

what tendon reflexes are used for L3,4

Answer 30

quadricepts

Question 31

what tendon reflexes are used for L5,S1

Answer 31

achilles tendon

Question 32

what cerivical fractures are considered unstable

Answer 32

type 2 and 3 odontoid fractures, teardrop subaxial fracture, and hangmans

Question 33

what is a spinous process avulsion called

Answer 33

Clay shovelers fracture

Question 34

what rotates around the odontoid

Answer 34

atlas

Question 35

what causes tear drop fracutres

Answer 35

extreme extension

Question 36

what is disrupted in tear drop fracutres

Answer 36

anterior longitudinal ligaments and avulses a section of the anteroinferior

Question 37

what is a traumatic spondylolisthesis

Answer 37

hangmans fracture

Question 38

What is hunchback/dowager's hump

Answer 38

cervical kyphosis

Question 39

what causes cervical kyphosis

Answer 39

poor posutre degenerative disc disease - progressive degenerations congenital causes, trauma, iatrogenic(ex. surgical), ankylosing spondylitis

Question 40

what are the long term complications of cervical kyphosis

Answer 40

trouble swallowing or breathing

Question 41

what are the types of scoliosis

Answer 41

idiopathic congenital neuromuscular pathologic

Question 42

what is the degree of curvature for scoliosis

Answer 42

>10 degrees using the cobb angle

Question 43

what is the presentation of scoliosis

Answer 43

shoulder or hips are uneven ribs may be more prominent on one side head tilts

Question 44

what type of condition is juvenile scoliosis

Answer 44

inherited condition passed along X chromosomes

Question 45

what does thoracic lordosis lead to

Answer 45

pulmonary dysfunction

Question 46

what are different types of thoracic fractures

Answer 46

compression burst chance translational fractures - dislocations transverse process

Question 47

what is another name for a compression fracture in the spine

Answer 47

wedge fracture

Question 48

what is the most common thoracic fracture

Answer 48

compression fracture

Question 49

what is the MOA for burst fractures

Answer 49

axial load injury that causes the bone to "burst" comminuted fracture and multiple fragments going in different directions

Question 50

what is a chance fracture also known as

Answer 50

anterior compression with associated transverse fracture

Question 51

what is the MOA for chance fractures

Answer 51

flexion-distraction injury, typically associated with lap belts

Question 52

where are chance fractures most common

Answer 52

T11-L2 (lap belt fractures)

Question 53

translational fracture- dislocation

Answer 53

high mechanism of injury that often have neurologic deficits Requires OR

Question 54

What is the MOA for transverse-process fractures

Answer 54

rotation extreme lateral flexion - stable fracture

Question 55

where do the nerve roots exit the spine in the lumbar spine

Answer 55

under the corresponding vertebrae

Question 56

where do the nerve roots exit the spine in the cervical spine

Answer 56

above the corresponding vertebrae

Question 57

what type of pain suggests nerve involvement in lumbar injuries

Answer 57

leg pains - numbness, tingling/parasethesias, weakness, gait abnormalities

Question 58

what are your paraspinals responsible for

Answer 58

extension, rotation, and lateral bending

Question 59

what is the latissimus dorsi responsible for

Answer 59

shoulder adduction, medial rotation, extension

Question 60

what determines a lumbar strain/sprain

Answer 60

non radiculopathy, positional, worse with activity, relieved with rest, muscle spasms, stiffness and nonspecific low back pain

Question 61

what is lumbar DDD

Answer 61

loss of disc hydration at normal age-ralted change mechanical stress, decreased nutrients (vascularity), normal cell senescence (including repair), genetics

Question 62

what is primarily proceeded by DDD

Answer 62

Lumbar spinal stenosis

Question 63

what is the hallmark of lumbar spinal stenosis

Answer 63

neurogenic claudication - easy fatiguability

Question 64

what is a herniated nucleus pulposus

Answer 64

herniated disc

Question 65

what is the MOA for herniated discs

Answer 65

mechanical disruption, tears in annulus, Wear and tear with aging, trauma to normal disc

Question 66

where are herniated discs most likely to happen

Answer 66

in the lumbar spine L4,5 and L5, S1

Question 67

what is the most common direction of herniation

Answer 67

posteriolateral

Question 68

what is sciatica

Answer 68

radiculopathy of the sciatic nerve includes portions from L4-S3 nerve roots (buttocks, posterior thigh, most of the calf and foot)

Question 69

what is the presentation of sciatica

Answer 69

burning pain in the buttock and posterior thigh pain in the calf and foot numbness and parasethesias in the LE weakness is less common

Question 70

what is spondyloysis

Answer 70

acquired defect in the Pars interarticularis (stress fracture)

Question 71

what is spondylolisthesis

Answer 71

the aprs defect leads to malaligment - anterior translation of a vertebral segment

Question 72

where is cauda equina located

Answer 72

where L1-S5 nerve roots traverse the spinal cord before exiting

Question 73

what is cauda equina

Answer 73

canal compression in the area of the cauda equina acts as a lower motor neuron lesion (peripheral), NOT and upper motor neuron one

Question 74

what is the presentation of cauda equina

Answer 74

unilateral or bilateral LE pains sensory or motor changes in the LE bowel/bladder dysfunction - retention (overflow incontinence) Saddle anesthesia - numbness/tinging in perineum

Question 75

where is the primary location for traumatic fractures

Answer 75

thoracolumbar junction

Question 76

what type of fractures are secondary to osteoporosis

Answer 76

lumbar spine fractures