Brainscape's Knowledge GenomeTM

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


See full index

Year 3 MSK (JK) > Spinal symposium > Flashcards

Spinal symposium Flashcards

1
Q

State whether the cervical, thoracic and lumbar spine have kyphosis or lordosis

A

c and L = lordosis

T = kyphosis

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

|n what plane is the spine straight?

A

coronal

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

If the spine is not straight in coronal what does this mean?

A

scoliosis

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

3 erector spinae muscles

A

illiocostalis
longissimus
spinalis

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

Epidemiology of spinal cord injuries

A

1000/year in UK with most being male
20-29 years
50 000 in UK with paralysis

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

Causes of spinal cord injuries

A

falls - RTA - tumour - infection - sport

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

Complete SCI

A

no motor or sensory function distal to lesion

no anal squeeze, sacral sensation or chance of recovery

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

What ASIA grade is complete SCI?

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Incomplete SCI

A

some function present below site of injury

more favourable prognosis

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

Why may you not be able to determine acutely if it is incomplete or complete SCI?

A

spinal shock

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

ASIA grade and description

A

A- complete, no sensory or motor in S4-5
B- incomplete, no motor in S4-5
C- incomplete, motor below level - muscles <3 power
D - incomplete, motor below level - muscles >3
E- normal sensory and motor

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

Quadriplegia/tetraplegia

A

partial or total loss of use of all 4 limbs and trunk

loss of motor/sensory function in cervical region

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

What happens in tetraplegia

A

cervical fracture - phrenic nerve (diaphragm)

resp failure and spasticity

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

spasticity in tetraplegia

A

increased muscle tone
UMN lesion - spinal cord and above
lesions above L1

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

Paraplegia

A

partial or total loss of use of lower limbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of paraplegia

A 
impairment or loss of sensory/motor in T/L/S
arm function spared
possible impairment in trunk 
bladder/bowel function 
spasticity in spinal cord injured
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

aetiology of paraplegia

A

thoracic or lumbar fractures

associated chest or abdominal injuries

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

Central cord syndrome - briefly describe

A

older patients eg arthritic neck, hyperextension injury
arm>leg weakness, perianal sensation and lower extremity power preserved
low velocity fall

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

anterior cord syndrome - briefly describe

A

hyperflexion injury, anterior compression fracture

injured anterior spinal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

anterior cord syndrome symptoms

A

profound weakness

fine touch and proprioception preserved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Causes of Brown-Sequard syndrome

A

penetrating injuries eg gunshot/stab wound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Brown-Sequard syndrome?

A

hemi-section of cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

symptoms in Brown-Sequard syndrome and tracts affected

A

paralysis on affected side - corticospinal
loss of proprioception and local fine discrimination - dorsal
pain and temp loss on opposite side below lesion - spinothalamic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Managing SCI - broad

A

prevent 2 insult
ABCD
ATLS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

ABCD - explain

A

A - c spine control
B - ventilation, O2, associated chest injury
C - IV fluids, neurogenic shock? low BP and HR, vasopressors
D - neurological function, PR and perianal, log roll

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Spinal shock

A

transient depression of cord function below injury level
flaccid paralysis and areflexia
several hours –> days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

neurogenic shock

A

hypotension and bradycardia
hypothermia
injuries above T6 - 2 to sympathetic outflow disruption

28
Q

imaging in SCI

A

x-ray
CT - bone
MRI - neurological defecit or child

29
Q

Surgical fixation in SCI

A

unstable fractures

from posterior aspect - pedicle screws

30
Q

Long term management of SCI

A

physio/OT
spinal cord injury unit
psychological, sexual and urological counselling

31
Q

Lumbar disc prolapse - lateral and central

A

lateral - compressed nerve root

central - compressed roots within cauda equina

32
Q

intervertebral discs joint type

A

secondary cartilaginous

33
Q

What is the largest avascular structure in the body?

A

intervertebral disc

34
Q

2 components of intervertebral disc

A

tough outer layer = annulus fibrosus

gelatinous core = nucleus pulposus

35
Q

injuries to annulus fibrosus and nucleus pulposus

A

AF - may tear and NP prolapse

36
Q

What ligaments attach discs to vertebral bodies?

A

ALL and PLL

37
Q

Significance of collagen orientation inn AN. Fib,

A

run obliquely - resist rotational movements

38
Q

what makes up the nucleus pulposus?

A

80% water, collagen and proteoglycans

39
Q

What direction are disc prolapses usually?

A

postero-lateral

40
Q

Normal ageing process of discs

A

lower water content, disc space narrowing and degenerative changes in facet
aggravated by smoking etc

41
Q

Pathological process of discs

A

tear AN.F and prolapse N.P
osteophytes compress nerve roots
central spinal stenosis
abnormal movements eg spondylosis/spondylolisthesis

42
Q

Nerve root pain

A

fairly common - limb pain worse than back pain

pain in nerve root distribution

43
Q

Managing nerve root pain

A

90% settle in 3 months
physio and strong analgesia
refer after 12 weeks –> MRI

44
Q

disc problems - bulge

A

common, asymptomatic?

45
Q

disc problem - protrusion

A

annulus weakened but still intact

46
Q

disc problem - extrusion

A

through annulus but in continuity

47
Q

disc problem - sequestration

A

dessicated disc material free in canal

48
Q

cervical disc prolapse

A

C5/6

49
Q

Thoracic disc prolapse

A

<1%

most in T11/12

50
Q

Lumbar disc prolapse

A

L4/5 then L5/S1 then L3/4

51
Q

Why are most lumbar disc prolapses posterolateral?

A

PLL is weakest

52
Q

Prolapsed disc - give nerve root, sensory loss, motor weakness and reflex change
A - L5/S1
B - L4/5
C - L3/4

A

A - S1, little toe and sole of foot, plantarflex - ankle jerk
B - L5, great toe and 1st web space, EHL
C - L4, medial aspect of lower leg, quads, knee jerk

53
Q

Managing cauda equina syndrome

A

SURGICAL EMERGENCY

admission, urgent MRI and op in 48 hrs

54
Q

What can be the result of sacral nerve compression?

A

permanent bladder and anal sphincter dysfunction and incontinence

55
Q

Aetiology of cauda equina syndrome

A

central lumbar disc prolapse - tumours - trauma - spinal stenosis - epidural abscess - iatrogenic

56
Q

Clinical features of cauda equina syndrome

A

injury or precipitating event
locate symptoms - bilat buttock and leg pain, dysaesthesia and weakness
badder or bowel dysfunction - overflow incontinence
PR exam - saddle anaesthesia, loss of anal tone and reflex

57
Q

Who should you have a high index of suspicion for cauda equina syndrome?

A

spinal post op with leg pain and urinary retention

58
Q

Radiography in cauda equina syndrome

A

MRI (if CI use lumbar CT myelogram)

59
Q

Cervical and lumbar spondylosis

A

common, degenerative change at facet, disc, ligament

if severe can compress whole cord causing myelopathy

60
Q

Facet joint type and what movements are allowed

A

true synovial - flex and extension

61
Q

What movements do discs allow?

A

between vertebrae

62
Q

5 ligaments related to vertebral column

A 
ALL
PLL
Ligamentum flavum 
interspinous and supraspinous 
intratransverse
63
Q

Lumbar spondylosis

A

OA of facet and disc joints

64
Q

Spinal claudication

A 
bilateral 
sensory dysaesthesia 
weakness?
several mins to ease 
worse walking downhill
65
Q

Treatment for lateral recess stenosis and foraminal stenosis

A

non-op
nerve root injection
epidural
surgery

66
Q

treating central stenosis

A

non op
epidural steroid injection
surgery

67
Q

treating spondylolisthesis

A

conservative

surgery if persistent root pain or nerve root entrapment

Year 3 MSK (JK) (30 decks)

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