Spinal Symposium

Question 1

how are thoracic and lumbar nerves numbered

Answer 1

nerve numbered same as the vertebrae above it

Question 2

how many thoracic nerves are there

Answer 2

12

Question 3

how many cervical nerves are there

Answer 3

8

Question 4

how many cervical vertebrae are there

Answer 4

7

Question 5

how are cervical vertebrae number

Answer 5

nerve number same as one below it - means that there is a C8 nerve below C7

Question 6

3 muscles that make up erector spinae

Answer 6

iliacostalis, longissimus and spinalis thoracis

Question 7

what is the most medial muscle of erector spinae

Answer 7

spinalis

Question 8

spine segment that is lordotic

Answer 8

lumbar and cervical

Question 9

what is a dermatome

Answer 9

area of skin supplied by a spinal nerve

Question 10

what is a myotome

Answer 10

group of muscles supplied by a spinal nerve

Question 11

what is the myotome of C7

Answer 11

elbow extensors

Question 12

what is the myotome of C5

Answer 12

shoulder abduction

Question 13

spinal nerve of big toe extension

Answer 13

L5

Question 14

spinal nerve of ankle dorsiflexion

Answer 14

L4

Question 15

complete injuries have no _______ above/below traum

Answer 15

no function below trauma

Question 16

application of ABCD in spinal fracture

Answer 16

Airway - C spine control
Breathing - ventilation and O2
Circulation - consider neuro/spinal shock, control BP
Disability - asses neuro function (perianal sensation) and log roll method

Question 17

features of neurogenic shock

Answer 17

bradycardic, hypotensive, hypothermic

Question 18

features of spinal shock

Answer 18

flaccid paralysis and areflexia

Question 19

neurogenic shock occurs msotly in injuries above/below T6

Answer 19

above

Question 20

what is the largest avascular structure in the body

Answer 20

intervertebral disc

Question 21

structure of intervertebral disc

Answer 21

annulus fibrous (tough outer layer) and nucleus pulposus (gelatinous core)

Question 22

degenerative changes to the intervertebral disc

Answer 22

• water content decreases with age
• disc space narrows with age
• degeneration is aggravated by smoking

Question 23

what kinds of movements cause intervertebral disc to tear

Answer 23

rotation and twisting

Question 24

give 5 causes of lower back pain

Answer 24

nerve root compression
cancer metastases
osteomyelitis
paget's disease
facet joint arthritis

Question 25

true/false - obesity increase the risk of developing lower back pain

Answer 25

true

Question 26

red flag symptoms that indicate cauda equina syndrome

Answer 26

saddle numbness or paraesthesia
faecal/bladder incontinence
neurological deficit in lower limbs

Question 27

red flag symptoms of a spinal fracture in a back pain history

Answer 27

sudden central severe pain relieved by lying down
major trauma
minor trauma in osteroporosis
point tenderness over vertebrae

Question 28

what cancers commonly metastasise to bone

Answer 28

prostate, breast and lung

Question 29

what type of joint is an intervertebral disc

Answer 29

secondary cartilagionous (symphysis)

Question 30

what fibres run cross-hatched in the annulus fibrosis

Answer 30

collagen fibres

Question 31

a lateral disc herniation will compress ______

Answer 31

the nerve root

Question 32

a central disc herniation will compress _______

Answer 32

the spinal cord

Question 33

what is the most common direction of an intervertebral disc herniation

Answer 33

postero-lateral

Question 34

presentation of intervertebral disc herniation

Answer 34

back pain and nerve root impingement (pain in limb/radicular distribution)

Question 35

management for intervertbral disc herniation

Answer 35

analgesia and physiotherapy
most will settle down themselves after 3 months
otherwise surgery (discectomy)

Question 36

what is cauda equina syndrome

Answer 36

compression of the cauda equina (L1 ish onwards)

Question 37

causes of cauda equna syndrome

Answer 37

tumour, abscess, trauma, lumbar disc herniation, ankylosing spondilitis and spondylolisthesis

Question 38

what is spondylolithesis

Answer 38

vertebral displacement by trauma, surgery of degeneration. Most commonly anteriorly

Question 39

triad of cauda equina presentation

Answer 39

1. saddle numbness or paraesthesia
2. loss of bladder of bowel control
3. sciatic pain

Question 40

immediate management of traumatic cauda equina syndrome

Answer 40

immobilise spine

surgery to decompress within 48 hours

Question 41

treatment for cauda equina in ankylosing spondilitis

Answer 41

anti-inflammatories and corticosteroids