Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MB2 Rheumatology and Orthopaedics > Spinal > Flashcards

Spinal Flashcards

1
Q

typical presentation of simple backache

A

age 20-55
lumbosacral, buttocks, thighs
mechanical pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe sciatica

A 
nerve root pain 
shooting pain radiating down leg and toes 
unilateral 
paraesthesia 
numbness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

desbribe the hallmark of cauda equina

A

saddle anaesthesia
difficulty micturition
lost anal tone/faecal continence
progressive motor weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

back pain red flags

A 
<20 >55
severe night pain 
neurological change 
unexplained weight loss
systemically unwell
immunosuppressed, PWID, HIV. TB
Thoracic pain 
trauma
previous cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

true/false - with mechanical back pain you should stop all exercise and rest

A

false - dont exercise intensely but dont stop all exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

lifestyle advice to patient with mechanical back pain?

A

keep moving
stay at work if you can
restrict exercise but dont cut it out
weight control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

describe how referred leg pain would feel

A

dull achy
poorly localised to buttock/thigh
above knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where may referred back pain be from?

A 
kidneys 
colon
uterine/ovarian 
pancreas 
gallbladder
PUD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what pathologies might cause a possible spinal pathology

A

primary/secondary tumour
inflammatory disease
fracture
infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what conditions may cause nerve root problems

A

disc prolapse

spinal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the most common back pain and what causes it

A

mechanical

no underlying cause besides possibly degenerative disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how does degenerative disc disease lead to nerve root pain?

A

disc degenerates leading to nerve becoming pinched as it leaves the spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is spondylolysis

A

defect/fracture in pars interarticularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is spondylosthesis

A

total displacement of pars interarticularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

yellow flags for chronic back pain

A 
low mood 
high levels pain/disability
believing activity is harmful
low education 
obesity 
problem with claims 
job dissatisfaction 
heavy lifting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is mechanical back pain?

A

recurrent relapsing and remitting back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is spondylosis

A

intervertebral discs lose water so less cushioning and increased pressure on facet joints leading to secondary OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

when would surgery be indicated for mechanical back pain

A

severe unrelenting disease that only affects one spinal level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

an acute disc tear causes what kind of pain?

A

nerve root pain - shooting pain with altered sensation and unilateral reduced power

20
Q

how may OA cause nerve root pain

A

osteophyte formation may impinge on nerve roots

21
Q

pathophysiology of spinal stenosis

A

spondylosis, bulging discs, bulging ligamentuum flavum or osteophytosis reduce space for cauda equina so multiple nerve roots become compressed

22
Q

how is spinal stenosis claudication different from PVD

A

pain is burning not cramping
pedal pulses preserved
distance is inconsistent
no pain uphill

23
Q

true/false - PR exam in suspected cauda equina is voluntary

A

false - it is negligent not to do one

24
Q

severe crush fractures in the vertebral body that are not traumatic may be?

A

osteoporotic

25
Q

what risks are associated with <20 in back pain

A

primary tumour or infection

spondylolisthesis

26
Q

what risks are associated with >55/60 in back pain

A

arthritis/osteoporotic crush fracture

neoplasia and metastatic disease

27
Q

what risks are associated more with back pain that is worse at night?

A

tumour/infection

28
Q

what risks are associated with back pain with systemic upset

A

tumour/infection

29
Q

what cervical instaility does downs syndrome carry

A

atlanto-axial subluxation with potential cord compression

30
Q

what cervical instability does RA carry

A

atlanto-axial subluxation due to destroyed joint between atlas and dens
ruptured transverse ligament

31
Q

criteria for clinically clearing C spine?

A 
GCS 15 with no alcohol intoxication 
no obvious significant head injury
no hx lost consciousness 
no midline tenderness on palpation c spine 
no pain on gentle active movement
32
Q

if the C spine cannot be clinically cleared what happens

A

c spine must be radiologically cleared with AP/lateral and odontoid peg views

33
Q

above what level can a C spine fracture be fatal and why

A

C3 as C3,4,5 innervate diaphragm

34
Q

management of C spine fracture?

A

stable - in a collar

unstable - surgical stabilisation and external fixation with halo vest

35
Q

management of C spine dislocation/subluxation?

A

reduction and halo vest or operative stabilisation

36
Q

what type of thoracolumbar fractures are seen in the elderly and how are they managed

A

osteoporotic wedge fracture

symptomatic management

37
Q

cause of thoracolumbar fractures in non-elderly patient

A

RTA, high energy fall from height

38
Q

how are stable thoracic/lumbar fractures managed

A

back brace to prevent kyphosis and flexion

plaster jacket for lumbar to protect lordosis

39
Q

indication for spinal surgery following thoracolumbar fracture

A

neuro deficit
unstable injury
lost vertebral height
displacement

40
Q

what types of injuries can cause spinal cord injury

A

laceration
compression
stretch
contusion

41
Q

what is spinal shock

A

lost sensation and motor function and lost reflexes below level of injury
usually resolves within 24 hours with return of reflex

42
Q

what reflex is absent in spinal shock and its return signifies its end

A

bulbocavernosus

reflex contraction of anal sphincter with squeeze of glans, tapping mons pubis or pulling catheter

43
Q

what is neurogenic shock and how is it managed

A

temp shutdown of sympathetic outflow leading to bradycardia and hypotension usually 24-48 hours
priapism
IV fluids, vasopressors and atropine

44
Q

what is complete spinal cord injury

A

no sensory or voluntary movement below level of injury
reflexes should return
classed by level at which there is partial function but has poor prognosis

45
Q

what is an incomplete spinal injury

A

some neuro function distal to injury, greater the function the better the prognosis
sacral sparing, perianal sensation, big toe flexion and anal contraction signifies incomplete

46
Q

true/false - in a patient with known spinal injury and hypotension the most likely cause is neurogenic shock

A

false - neurogenic shock is a possibility but hypovolaemic shock is most likely

MB2 Rheumatology and Orthopaedics (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions