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Spinal disorders Flashcards

1
Q

Kyphosis vs lordosis

A

Lordosis = amy lord sticking her bum out - kyphosis = rounding (huncback)

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2
Q

What travels through the transverse foramen?

A

vertebral arteries

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3
Q

wWhich cervical spine has no body?

A

C1

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4
Q

Cervial spine spinal provess is

A

bifid, except for C7 which is long and straight

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5
Q

Saggital diamiter of spinal canal

A

decreases the fursther dwn you go eg c3-6 is aorund 18mm, c7 is around 15mm

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6
Q

WHat is te uncinate process, what does it do, and what does it a landmar for?

A

in cervical spine, stops lateral flexion. Landmark for vertebral arteries

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7
Q

Spinous process C7

A

long and straight

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8
Q

Key features of thoracic

A

transverse processes for the ribs, heart shaped body, costal fascets, slanted spinous process

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9
Q

What are the 3 zones in the sacrum and what is the significance of this?

A

Lateral, intermediate, medial

Lateral = crossed by sympathetic trunk, lumbosacral trunk and obturator nerve

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10
Q

What does the anterior antlanto occipital membrane continue as?

A

anterior longitudinal ligament

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11
Q

What is the cruciate and transverse ligament?

A

transverse ligament keeps the dens inplace, and the cruiate ligament extends beyond that to top and below too.

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12
Q

What sis the apical ligament?

A

dens -> anterior part of the foramen magnum

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13
Q

What do the alar ligaments do?

A

limit head rotation (dens - > anterior part of FM)

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14
Q

What does the tetorial membrane continue down beyond c3 as?

A

Anterior longitudinal ligament

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15
Q

WHAT IS THE ATLANNTO-OCCIPITAL JOINT?

A

C1 -> occipital.

yes movements (flexion and extension) - condyloid joint

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16
Q

aTLANTO-AXIAL JOINT ALLOWS WHAT MOVEMENT? wHAT TYPE OF JOINT?

A

No, rotational movement. Synovial pivot

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17
Q

wHERE ARE THE VERTEBRAL DISCS?

A

From C2-3 to L5-S1

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18
Q

wHAT ARE THE COMPONENTS OF THE SPIINTERVERTEBRAL DISC?

A

Nucleus pulposus (middle) and anulus fibrosus.

(fibrocartilaginous - symphysis joint)

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19
Q

wHAT ARE THE 3 COUMNS OF RH SPINE AND WHAT ARE WITHN THEM?

A

Anterior (anterior longitudinal ligament, ant half of vertebral body)

middle (Posterior longitudinal ligament, post half body)

posterior (everything behind that!)

Spinal stability relies on at least 2/3 being intact

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20
Q

hOW ARE OUT 31 PAIRS OF SPINAL NERVES SPLIT UP?

A

8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal

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21
Q

wHICH SPINAL NERVE EXITS BETWEEN WHICH SPVERTEBRAL BDODIES?

A

cervicla becuase there is more nerves than bodies, starts above then works down. Then Thoracic and below exits below the level.

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22
Q

dERMATOMAL DISTRIBUTION: t4, t10, t12

A

T4 = nipple
T10 = belly button
T12 = mid inguinal ligament

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23
Q

Dermatomes: C6,7,8 L3, L5,S1

A

C6 = thumb
C7 = middle finger
C8 = little finger

L3 = inside knee
L5 = middle toe
S1 = lateral heel

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24
Q

Myotomes : C5,6,7,8,T1. L2,3,4,5,S1

A

C5 = biceps
C6 = wrist extension
C7 = tricepts
C8 = middle finger
T1 = little finger abduction

L2 = hip flection (illiopsoas)
L3 = knee extension
L4 = ankle dorsifelxion
L5 = big toe extension (dorsiflexion)
S1 = plantar flexion

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25
Reflexes spienal leevels; -Bicep Supoinator Tricep keneejerk, a nkle jerl. Which is firs to come back?
S1-2 = ankle jerk L3-4 = knee jerk C7-8 = triceps C5-6 = bicep C6-7 = Supinator
26
conus medularis ends : , adults, new born , foetus
New Born = L3 Foetus = S2 Adults -= L1/2
27
What is neurulation and how long does it take?
28 days after conception -folding of the neural fold to make the neural tube
28
What leads to spina bifida?
incomplete closure of he neural tube
29
What are the risk factors for spina bifida?
-TOO LITTLE FOLIC ACID -familiy history -obesity, diabetes -sodium valproate
30
What are the types of spina bifida?
spina bifida occulta - no out pouch, all intact, just missing say the spinous process meningocele - outpouch of the meninges - translucent, little/no neurological deficit) Myelomeningocele - outpouch of meninges AND spinal chord/nerves - membranous sac covering, neurologicla deficit, transopoaque.
31
How do we treat spina bifida?
Surgery within 24h.
32
What is a key complication of myelomeningocele?
HYDROCEPHALUS - V likely to have - must check!!
33
What is thethered cord syndrome?
Fibrous/ thickened/fatty filum terminale.
34
Signs and symptoms of tthered cord syndrome?
Neurological, urological, orthopeaedic
35
Pyogenic vertebral oseteomyelitis : presentatiuon, species, location, what o you need ot ask about
-axial pain, fever, neuro issues - numbess, muscle weakness. - Staphlycoccus Aureus mainly -recent travel/procedures
36
Investigation in pyogenic vertebral osteomyelitis
Blood cultures, MRI (ideally, if not then CT/XR) CRP, WBC, Erythrocyte sedimentation rate, Uninalysis
37
Good disc means? Bad disc menas?
Good disc = bad news (if disc isn't involved with symptoms, then it is likely to be a tumour) Bad disc = good news (more likely to be an infection)
38
How to treat pyogenic vertebral osteomyelitlts
IV antivbiotics 6-8 weeks. - more specific antibiotics when cultures return (!take cultures before antibiotics start!). -restrict spine movements -if needed - surgery
39
What are the indicators for surgery in Pyogenic vertebral oseomyelitis?
- medical management is failing -neurologicla deteriation -spinal deformity
40
Post op infectins ususally what kinda bact?
Ones that ususally live on your skin!
41
How do we prevent post-op infections?
Give antibiotics 60 minutes before the start of the op.
42
What are he 3 types f spinal cord tumours?
Extradural, intradural - intramedullary (within the actual spinal chord) and extramedullary (outside the spinal chord)
43
How do we investigate spinal chord tumours? How do we treat them?
Scans! Ideally MRI or if not hen CT/Xray Along with clinical findings
44
Spinal epidural compression, cauda equina and conus syndromes are emergencies/non emergncies?
EMERGENCY!
45
treatment of spinal haematomas
Surgical decompression if needed and correction of coagulopathy
46
Cauda equina incomplete vs complete and symptoms
Complete - you get the whole shebang inc. incontinance/bowl retention
47
Causa equina syndrome symptoms and treatment
Saddle anaethesia, bladder/bowl/sexual dysfunciton leg pain/weakness, no ankle reflex. Treatment = MRI
48
Primary Spinal Chord Injury (SCI) is due to what?
Trauma - 50% =rta
49
What are the 4 events in secondary SCI?
Inflammation, Vascular (ischaemic), Chronic - demylenation and scar formation
50
What is the bulbocavernous reflex?
Closure of anal sphincter on squeeze of penis/clitoris. It is the first reflex to come back following spinal shock.
51
What is spinal shock?
transient loss of neurological function below SCI Hypotension (SBP 80mmHg) 72h - 2 weeks
52
What can we tell after spinal shck ends?
the extent of the damage, if complete or incomplete damage
53
What is the most comon type of spinal chord tract?
Central Cord Syndrome - "vascular watershed zone"
54
What iare the sign/symptoms for central chord syndrome?
Urine retention, sensory loss below level of injury, motor loss -> upper limb more than lower limb, because upper limb are more medial in the corticopsinal tract, and lower limb are more lateral.
55
Anterior Cord Syndrome: what is it? What is it caused by? What does it present with?
When the front of the spinal chord is injured. Can be caused by occlusion of the anterior spinal artery or cord compression. Presents with loss of motor function - paraplegia or quadriplegia (higher than c7) pain/temp sensations lost, but 2 point discrimination, vibration, proprioception and pressure sensatsation preserved
56
What can show us c1 c2 in x ray?
Odontoid view
57
What are hte indications for early decompressin in patients with a spinal chord injury?
Neurological deterioration Incomplete spinal chord injury
58
Types of cerivcal spine injury :
*Occipital condyle fracture* -rare -unconcious, stable, pain, cranial nerves usually intact *Atlanto-occipital dislocation* -children, usually fatal or significant neuro deficit *Atlas fracture* -usually neurologically intact (space, and fracture explodes away) *Axis fracture* -odontoid peg/body/dens off body - hangmans fracture *Atlanto-axial instability* *Subaxial c spine*
59
How can we differentiate unilateral and bilateral dislocations?
Unilateral = displacement under 25% Bilateral = displacement over 50%
60
Thoraco lumbar spinal inuries: Distraction, Extenspoin, flexion and compression meanings
Distraction = stretched, extension = extension, flexion = flexion and compression = comperssion
61
Wht are hte 4 categories of thoraco-lumbar spinal injuries?
Compression, burst, seat belt, fracture-dislocaitons
62
Sacral spine fractures
Zone 1 (lateral) = l5/sciatic injury Zone 2 (intermedial) = neuro deficit (28%) but usually still have sphincter Zone 3 (medial) = most profound neuro defect. may inc bowel and bladder
63
Indications for surgery in spinal fractures?

Neuro 4 (8 decks)

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