Prolapsed Disc

Question 1

Part of disc displaced in prolapsed disc

Answer 1

Nucleus purposes displaced

Question 2

What leads to annulus fibrous tear

Answer 2

• mechanical compression by n. polposus

- + inflam markers

Question 3

Most and least common affected spines

Answer 3

• most —> lumbar

- least —> T

Question 4

Describe the character and radiation of pain in prolapsed disc

Answer 4

• burning/stinging

- lower extremity

Question 5

Area of sensory loss in L3 compression

Answer 5

Anterior thigh

Question 6

Area of sensory loss in L4 compression

Answer 6

Anterior aspect of knee

Question 7

Area of sensory loss in L5 compression

Answer 7

Foot dorsum

Question 8

Area of sensory loss in S1 compression

Answer 8

Posterolateral leg & lateral foot

Question 9

L3/4 compression weakens which group muscles

Answer 9

Quads

Question 10

L5 compression leads to weakness in

Answer 10

Foot and big tow dorsiflexion

Question 11

S1 compression leads to weakness of which foot movement

Answer 11

Plantarflexion

Question 12

Reduced knee reflex is a sign of compression of

Answer 12

L3-4

Question 13

Reflexes are intact in compression of

Answer 13

L5

Question 14

Reduced ankle flexion is found in compression of

Answer 14

S1

Question 15

Positive femoral stretch test is a sign of compression of

Answer 15

L3-4

Question 16

Positive sciatic nerve stretch test is a sign of compression of

Answer 16

L5/S1

Question 17

1st line meds

Answer 17

• NSAIDs + physical therapy
• oral steroids
• low dose benzodiazepines

Question 18

2nd line meds

Answer 18

• translaminar epidural injections

- selective nerve root blocks