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2nd Year - MSK > Spinal orthopaedics 1 - Clinically relevant anatomy of the spine > Flashcards

Spinal orthopaedics 1 - Clinically relevant anatomy of the spine Flashcards

1
Q

what is mechanical back pain?

A

Back pain related to joints, ligament and muscles with no sinister features

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2
Q

What is spondylosis?

A

Degeneration of intervertebral discs (lose water content with age = less cushioning and increased pressure on facet joints) leading to secondary OA

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3
Q

What is a radiculopathy?

A

One or more nerves are compressed/ irritated = does not work properly

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4
Q

What is spondylolisthesis?

A

Vertebrae bone slips out of position

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5
Q

Benign tumour seen on the spine?

A

Osteoid osteoma

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6
Q

Malignant tumours seen in the spine? (2)

A

Metastatic disease

Multiple myeloma

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7
Q

How many vertebrae are there?

A

33

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8
Q

5 sections of the spine?

A 
Cervical
Thoracic
Lumbar
Sacral (fused)
Coccygeal (fused)
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9
Q

How many cervical vertebrae?

A

7

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10
Q

How many thoracic vertebrae?

A

12

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11
Q

How many lumbar vertebrae?

A

5

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12
Q

How many sacral vertebrae?

A

5

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13
Q

How many coccygeal vertebrae?

A

4

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14
Q

Which 2 areas of the spine are naturally lordotic?

A

Cervical and lumbar

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15
Q

Which 2 areas of the spine are naturally kyphotic?

A

Thoracic and sacral

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16
Q

Name of C1?

A

Atlas

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17
Q

Name of C2?

A

Axis

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18
Q

Name of C7?

A

Vertebra prominens

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19
Q

How is vertebra prominens (C7) different?

A

Larger and longer spinous process

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20
Q

Name of centre of vertebral disc?

A

Nucleus pulposus

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21
Q

Name of periphery of vertebral disc?

A

Anulus fibrosus

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22
Q

What type of joints are intervertebral joints?

A

Secondary cartilagenous (made from fibrocartilage)

23
Q

Why is lumbar rotation less than thoracic rotation?

A

Due to more vertically orientated facet joins

24
Q

Why does the cervical spine allow the greatest amount of movement?

A

Due to more horizontal facet joints

25
Q

Other name for facet joint?

A

Apophyseal joint

26
Q

What is spondylosis often used synonymously for?

A

OA

27
Q

Give 2 treatments for facet joint OA at one level of the spine?

A

Facet joint injections under fluoroscopy

Localised fusion

28
Q

What is a disc bulge?

A

Disc is compressed evenly leading to it bulging out equally on all sides

29
Q

2 other names for disc herniation?

A

Prolapsed or slipped disc

30
Q

What does disc herniation involve?

A

Tearing of the cartilage rings

31
Q

2 types of disc herniation/ slip/ prolapse?

A

Protrusion (only a few cartilage rings are torn = no leakage of entire)
Extrusion (all rings in a small area are torn = jelly like material flows out of a disc)

32
Q

At what level is disc bulge/ prolapse most likely to occur?

A

L4/5 and L5/S1

33
Q

Why is MRI not diagnostic of a disc bulge/ prolapse?

A

Many people will have these but be asymptomatic

34
Q

Do motor neurones originate anteriorly or dorsally?

Where are their bodies located?

A

Anteriorly

Anterior grey horn

35
Q

Do sensory neurones originate anteriorly or dorsally?

Where are their bodies located?

A

Dorsally

dorsal root ganglion

36
Q

What is the name for the bundle of nerves at the lower end of the spinal column/ distal continuation of nerves after the spinal cord?

A

Cauda equina

37
Q

At what vertebral level does the spinal cord end?

A

L1

38
Q

Where does the upper motor neurone synapse to the lower motor neurone?

A

In the spinal cord

39
Q

Does the following symptoms/ signs signal an upper or lower motor neurone pathology? - weakness, spasticity, increased tone, hyperreflexia

A

Upper

40
Q

Does the following symptoms/ signs signal an upper or lower motor neurone pathology? - weakness, flaccidity, loss of reflexes

A

Lower

41
Q

What is the name of the membranous sheath of dura matter that surrounds the spinal cord and the cauda equina?

A

Thecal sac

42
Q

What are the 2 nerve roots that are susceptible to being compressed? e.g. in disc prolapse

A

Transversing
Exiting (outside thecal sac passing under the pedicle)
Transversing (anteriorly in the thecal sac, preparing to the next exiting nerve root)

43
Q

What does compression of a nerve root cause?

A

Radiculopathy

44
Q

Name of the sensory distribution of a nerve root?

A

Dermatome

45
Q

Name for the group of muscles that a single nerve root supplies?

A

Myotome

46
Q

Name for the ligaments of the spine?

A

Ligamentum flavum

47
Q

What is myelopathy another name for?

A

Spinal cord compression e.g. tumour, disc prolapse

48
Q

Signs of myelopathy? (3)

A

Upper motor neurone signs
Patient will walk with a large gait
Babinski sign

49
Q

Describe babinski sign?

A

When plantar of foot is scratched, the big toe will go up rather than down

50
Q

3 erector spinae muscles?

A

Iliocosalis
Longissimus thoracis
spinalis thoracis

51
Q

Name the 5 ligaments of the spinal column?

A 
Anterior longitudinal ligament
Posterior longitudinal ligmanet
ligamentum falvum
supraspinous ligmanet
interspinous ligament
52
Q

At what level are lumbar punctures or spinal anaesthesia given?

A

Posterior iliac crest (L4)

Posterior superior iliac spine (S2)

53
Q

When is spinal discectomy or decompression good?

A

Sciatica/ leg pain which doesn’t settle within 3 months with conservative management

2nd Year - MSK (23 decks)

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