Spinal Symposium Flashcards
how are thoracic and lumbar nerves numbered
nerve numbered same as the vertebrae above it
how many thoracic nerves are there
12
how many cervical nerves are there
8
how many cervical vertebrae are there
7
how are cervical vertebrae number
nerve number same as one below it - means that there is a C8 nerve below C7
3 muscles that make up erector spinae
iliacostalis, longissimus and spinalis thoracis
what is the most medial muscle of erector spinae
spinalis
spine segment that is lordotic
lumbar and cervical
what is a dermatome
area of skin supplied by a spinal nerve
what is a myotome
group of muscles supplied by a spinal nerve
what is the myotome of C7
elbow extensors
what is the myotome of C5
shoulder abduction
spinal nerve of big toe extension
L5
spinal nerve of ankle dorsiflexion
L4
complete injuries have no _______ above/below traum
no function below trauma
application of ABCD in spinal fracture
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
features of neurogenic shock
bradycardic, hypotensive, hypothermic
features of spinal shock
flaccid paralysis and areflexia
neurogenic shock occurs msotly in injuries above/below T6
above
what is the largest avascular structure in the body
intervertebral disc
structure of intervertebral disc
annulus fibrous (tough outer layer) and nucleus pulposus (gelatinous core)
degenerative changes to the intervertebral disc
- water content decreases with age
- disc space narrows with age
- degeneration is aggravated by smoking
what kinds of movements cause intervertebral disc to tear
rotation and twisting
give 5 causes of lower back pain
nerve root compression cancer metastases osteomyelitis paget's disease facet joint arthritis
true/false - obesity increase the risk of developing lower back pain
true
red flag symptoms that indicate cauda equina syndrome
saddle numbness or paraesthesia
faecal/bladder incontinence
neurological deficit in lower limbs
red flag symptoms of a spinal fracture in a back pain history
sudden central severe pain relieved by lying down
major trauma
minor trauma in osteroporosis
point tenderness over vertebrae
what cancers commonly metastasise to bone
prostate, breast and lung
what type of joint is an intervertebral disc
secondary cartilagionous (symphysis)
what fibres run cross-hatched in the annulus fibrosis
collagen fibres
a lateral disc herniation will compress ______
the nerve root
a central disc herniation will compress _______
the spinal cord
what is the most common direction of an intervertebral disc herniation
postero-lateral
presentation of intervertebral disc herniation
back pain and nerve root impingement (pain in limb/radicular distribution)
management for intervertbral disc herniation
analgesia and physiotherapy most will settle down themselves after 3 months otherwise surgery (discectomy)
what is cauda equina syndrome
compression of the cauda equina (L1 ish onwards)
causes of cauda equna syndrome
tumour, abscess, trauma, lumbar disc herniation, ankylosing spondilitis and spondylolisthesis
what is spondylolithesis
vertebral displacement by trauma, surgery of degeneration. Most commonly anteriorly
triad of cauda equina presentation
- saddle numbness or paraesthesia
- loss of bladder of bowel control
- sciatic pain
immediate management of traumatic cauda equina syndrome
immobilise spine
surgery to decompress within 48 hours
treatment for cauda equina in ankylosing spondilitis
anti-inflammatories and corticosteroids
