PIVD ( PROLAPSED INTERVERTEBRAL DISC )

Question 1

DEFINITION

Answer 1

PROTRUSION OR EXRUSION OF NUCLEUS PULPOSUS THROUGH RENT IN ANNULUS FIBROSUS

Question 2

SEQUENCE OF CHANGES

Answer 2

NUCLEUS DEGENERATION
NUCLEUS DISPLACEMENT
NUCLEUS FIBROSIS

Question 3

IVD CONSISTS OF

Answer 3

CARTILAGE DISC
NUCLEUS PULPOSUS
ANNULUS FIBROSUS

Question 4

NUCLEUS DEGENERATION

Answer 4

SOFTENING OF NULEUS
WEAKENING OF POSTERIOR PART OF ANNULUS

Question 5

NUCLEUS DISPLACEMENT

Answer 5

DISC PROTRUSION = BULGING OF NUCLEUS THROUGH DEFECT IN ANNULUS
DISC EXTRUSION = NUCLEUS COMES OUT AND LIES BEHIND POSTERIOR LONGITUDINAL LIGAMENT . CONTACT NOT LOST WITH PARENT DISC
SEQUESTRATED DISC = NUCLEUS LOSES CONTACT WITH PARENT DISC

Question 6

STAGE OF FIBROSIS

Answer 6

RESIDUAL NUCLEUS BECOMES FIBROSED
EXTRUDED NUCLEUS FIBROSED AND CALCIFIED

Question 7

AGE

Answer 7

20 TO 40 YEARS

Question 8

SITE

Answer 8

L4 L5 AND C5 C6

Question 8

LIFESTYLE

Answer 8

SEDENTARY

Question 9

PRESENTING COMPLAINTS

Answer 9

LOW BACK PAIN WITH OR WITHOUT RADIATING TO BACK OF LEG
HISTORY OF TRAUMA OR LIFTING HEAVY OBJECT

Question 10

CLINICAL FEATURES

Answer 10

LOW BACKACHE
SCIATICA
NEUROLOGICAL SYMPTOMS

Question 11

LOW BACK ACHE

Answer 11

ACUTE = SEVERE WITH SPINE HELD RIGID BY MUSCLE SPASM
CHRONIC= DULL AND DIFFUSE , RELIEVED BY REST

Question 12

SCIATICA

Answer 12

IF COMPRESSION OF
L2 L3 NERVE ROOT = PAIN ON FRONT OF THIGH
L5 NERVE ROOT = PAIN ON ANTEROLATERAL ASPECT OF LEG AND ANKLE
S1 NERVE ROOT = PAIN ON POSTEROLATERAL ASPECT OF CALF AND ANKLE

Question 13

NEURLOGICAL SYMPTOMS

Answer 13

PARESTHESIA
NUMBNESS
WEAKNESS
CAUDA QUINA SYNDROME

Question 14

CAUDA EQUINA SYNDROME

Answer 14

BOWEL AND BLADDER INCONTINENCE
BILATERAL ANKLE JERK ABSENT
HYPOESTHESIA IN L5 TO S4 DERMATOME
IRREGULAR LMN PARALYSIS IN LOWER LIMB

Question 15

EXAMINATION

Answer 15

POSTURE
MOVEMENT
TENDERNESS
SLRT
LASEGUE TEST
NEUROLOGICAL EXAMINATION

Question 16

POSTURE

Answer 16

LUMBAR SPINE RRIGID WITH SCOLIOSIS

Question 17

MOVEMENT

Answer 17

FOREWARD BENDING RESTRICTED

Question 18

TENDERNESS

Answer 18

DIFFUSE IN LUMBOSACRAL REGION

Question 19

SLRT

Answer 19

POSITIVE SLRT AT 40 DEGREE OR LESS SUGGESTS NERVE ROOT COMPRESSION

Question 20

NEUROLOGICAL EXAMINATION

Answer 20

SEE PG 180 COMPREHENSIVE

Question 21

INVESTIGATION

Answer 21

X RAY = STRAIGHTENING OF AFFECTED SPINAL SEGMENT
MRI = INVESTIGATION OF CHOICE ; SHOWS NERVE ROOT AND DISC HERNIATION VERY CLEARLY
CT SCAN = HERNIATED MATERIAL IN SPINAL CORD , POST. BORDER OF DISC FLAT
MYELOGRAPHY ( NOT USED )
EMG

Question 22

TREATMENT

Answer 22

CONERVATIVE
OPERATIVE
PERCUTANEOUS DISECTOMY
CHEMONUCLEOLYSIS

Question 23

CONSERVATIVE

Answer 23

REST = COMPLETE BED REST FOR 2 TO 3 WEEKS
DRUGS = ANALGESICS AND MUSCLE RELAXANTS
HOT FOMENTATION
PHYSIOTHERAPY
TENS ( TRANSCUTANEOUS ELECTRIC NERVE STIMULATION )

Question 24

OPERATIVE

Answer 24

FENESTRATION
LAMINOTOMY
HEMI LAMINOTOMY
LAMINECTOMY