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PHTH 511 > Spinal conditions > Flashcards

Spinal conditions Flashcards

1
Q

What do degenerative conditions include?

A
  1. Stenosis

2. Spondylosis

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2
Q

What do instability conditions include?

A
  1. Spondylolysis

2. Spondylolisthesis

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3
Q

What do bone health conditions include?

A
  1. Osteoporosis

2. Pagets

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4
Q

What do developmental conditions include?

A

Scoliosis

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5
Q

What do traumatic conditions include?

A
  1. Acute disc

2. Whiplash

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6
Q

What is included in a spinal segment ?

A

2 vertebrae and corresponding disc

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7
Q

Each segment contributes to overall ______ and _______.

A

mobility; stability

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8
Q

The different angulation of disc layers is especially important in withstanding _______ forces.

A

rotary

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9
Q

Rotary forces include what other two types of forces?

A
  1. Compression

2. Shear

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10
Q

Anything that could decrease space in the intervertebral foramen could compress the _______
nerve.

A

spinal

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11
Q

What are 3 examples of conditions that might decrease the intervertebral space?

A
  1. Disc degeneration
  2. Spinal infection
  3. Osteophyte
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12
Q

What is the main function of the intervertebral disc?

A

To act as a mechanical spacer

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13
Q

What types of forces does the intervertebral disc provide resistance against?

A
  1. compression
  2. shear
  3. torque (rotary)
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14
Q

Loss of disc height can lead to nerve _______ and/or _______ changes to the joints.

A

compression; degenerative

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15
Q

The facet joint ______ to allow segmental movement.

A

glides

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16
Q

What two movements load up the facet joints?

A
  1. Extension

2. Hyperextension

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17
Q

Overloading the facet joint can lead to what 3 things?

A
  1. Bony hypertrophy
  2. Osteoarthritis (spondylosis)
  3. Osteophyte formation
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18
Q

The facet joints glide ____ when flexion, and glide _____ when extending.

A

up; down

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19
Q

If the facet joint is inflamed, ______ will be more painful.

A

extension

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20
Q

_______ increases the space in the IV foramen.

A

flexion

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21
Q

What is the main function of the IV foramen?

A

maintain space for the nerve root

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22
Q

Spondylosis is also known as spine _______.

A

arthritis

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23
Q

What are some signs and symptoms of spondylosis?

A
  • morning stiffness
  • improves with mobility
  • pain at EOD
  • aggravated by prolonged positioning in either standing or sitting
  • X-Ray will present degenerative changes which may include osteophytes
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24
Q

What are the two types of stenosis?

A
  1. Central

2. Lateral

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25
Q

What are the clinical presentations of stenosis?

A
  1. LBP, maybe with bilateral or unilateral leg pain
  2. Aggravated by extension
  3. Eased by flexion and sitting down
  4. Usually older age group
  5. Associated with degenerative changes
  6. Can be progressive
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26
Q

Stress in the pars interarticularis may lead to what?

A

spondylolysis

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27
Q

Does spondylolysis lead to change in the anterior region?

A

NO

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28
Q

Does spondylolisthesis lead to change in the anterior region?

A

YES

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29
Q

A spondylolisthesis is a full fracture though what?

A

pars interarticularis

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30
Q

Where does a spondylolysis usually occur?

A

at L5

31
Q

Spondylolysis has a “______” effect on facet joints of hyperextension

A

nutcracker

32
Q

Spondylolysis is most common in what population?

A

adolescents, gymnasts, figure skaters, and football players

33
Q

_______ can lead to spondylolisthesis

A

spondylolysis

34
Q

___________ = anterior slippage of one vertebrae on the other.

A

spondylolisthesis

35
Q

What is a grade 1 spondylolisthesis?

A

< 25% slippage

36
Q

What is a grade 2 spondylolisthesis?

A

25-50% slippage

37
Q

Why does spondylolisthesis usually occur at the level of L4 and L5?

A

Anatomical reasons

38
Q

What are 2 common treatments for people with spondylolisthesis?

A
  1. Lengthen hamstring

2. Strengthen core

39
Q

Whether a fracture through the pars is unilateral or bilateral depends on the ________ pattern.

A

loading

40
Q

What is a grade 3 spondylolisthesis?

A

50-75% slippage

41
Q

What is a grade 4 spondylolisthesis?

A

> 75% slippage

42
Q

What are clinical presentations of spondylolisthesis?

A
  1. Step deformity palpable
  2. Aggravated by extension
  3. Eased by flexion
  4. Responds to posture and core stabilization and avoiding hyperextension
  5. Can be progressive but generally good clinical outcome
43
Q

What are 2 main differences between spondylolysis and stenosis?

A
  1. Age (stenosis = older adults)

2. Spondylolysis may present on X-Ray

44
Q

What 3 things are critical to bone health?

A
  1. Calcium
  2. Vitamin D
  3. Weight bearing exercises
45
Q

1 in __ women and at least 1 in __ men over the age of 50 have osteoporosis

A

4;8

46
Q

1 in ___ women and 1 in ___ men will break a bone due to osteoporosis

A

3;5

47
Q

Why is osteoporosis often secondary to other conditions such as cancer, IBS, medication and gastric surgery?

A

Because absorption of nutrients is effected

48
Q

What area is especially vulnerable to spontaneous fractures when the patient has OP?

A

T spine

49
Q

Osteoporosis is known as a _______ disease.

A

silent

50
Q

_________ is common in people who have chronic LBP.

A

osteoporosis

51
Q

In ________ disease, bone is replaced faster than normal, but it is weaker.

A

pagets

52
Q

______ disease has a familial tendency

A

pagets

53
Q

What regions does pagets disease most frequently effect?

A
  1. skull
  2. pelvis
  3. spine
54
Q

When is pagets disease usually noticed?

A

> 40, males > females

55
Q

How is pagets disease usually diagnosed?

A

blood work and X-Rays

56
Q

What are possible treatments for pagets disease?

A
  1. Oral or injectable bisphonates

2. calcitonin

57
Q

What are the 3 main classifications of scoliosis?

A
  1. Congenital
  2. Idiopathic
  3. Neuromuscular
58
Q

What type of scoliosis is most common?

A

Idiopathic

59
Q

_______ scoliosis is secondary to other conditions such as cerebral palsy and spina bifida.

A

neuromuscular

60
Q

_______ scoliosis is associated with vertebral deformities

A

congenital

61
Q

When is scoliosis usually noted?

A

in growth spurt before puberty

62
Q

Clinically, how does scoliosis present?

A

rib hump on forward bend and asymmetrical waist and shoulders

63
Q

Is there a more severe progression of scoliosis in girls or boys?

A

girls

64
Q

In ______, individual assessment is required to assess which tissues are affected.

A

WAD

65
Q

A classification system for WAD is used by who?

A

3rd party payers such as ICBC

66
Q

What is a grade 1 WAD?

A

Neck pain and stiffness, tenderness and no physical signs

67
Q

What is a grade 2 WAD?

A

Neck complaint and MCK signs (decreased RO M and tenderness)

68
Q

What is a grade 3 WAD?

A

Neck complaint and neurological signs (weakness, decreased sensation and decreased reflex)

69
Q

What is a grade 4 WAD?

A

neck complaint and fracture or dislocation

70
Q

What are clinical presentations of disc pathology?

A
  1. LBP, leg pain (maybe)
  2. Aggravated by cough or sneeze
  3. Worse with flexion activities
  4. Better wit extension activities
71
Q

Disc pathology generally has functional healing (T/F)

A

TRUE

72
Q

What are 5 characteristics of postural back pain?

A
  1. Prolonged poor postures
  2. Ligament creep and hysteresis
  3. Deep core muscle inhibition
  4. Postural muscle imbalance
  5. Esp. treatable and responsive to exercise and postural management
73
Q

What are 3 indications for medical co-management?

A
  1. Any of the conditions requiring medication for bone health
  2. Where medical management of pain is required (WAD, acute disc)
  3. Where further investigations (X-Ray, MRI) is required
74
Q

in what cases might further medical investigation be needed?

A

Spondylolisthesis, stenosis and scoliosis

PHTH 511 (1 decks)

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