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Ortho > Spine > Flashcards

Spine Flashcards

1
Q

What is the normal range of lumbar lordosis in the sagittal plane?

A

60 degrees, range 20-80 degrees

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2
Q

Which part of the spine has the largest vertebral bodies?

A

The lumbar spine

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3
Q

What supplies blood to lumbar vertebral bodies?

A

Segmental arteries

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4
Q

What is complete spinal cord injury?

A

Where there is no motor or sensory function below the level of injury

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5
Q

How long does spinal shock typically last?

A

24-72 hours

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6
Q

What happens during spinal shock?

A

No motor, sensory or autonomic function

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7
Q

What signifies the end of spinal shock?

A

The return of the bulbocavernosus reflex (innervated by sacral roots)- the most distal reflex

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8
Q

What is the bulbocavernosus reflex?

A

Checked by squeezing the glans penis or clitoris or tugging a urinary catheter which elicits contraction of the anal sphincter

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9
Q

What is the bulbocavernosus reflex?

A

Checked by squeezing the glans penis or clitoris or tugging a urinary catheter which elicits contraction of the anal sphincter

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10
Q

What is incomplete spinal cord injury?

A

When spinal cord function is noted after spinal shock has ended and may manifest as sacral sparing or any distal sensory or motor function

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11
Q

What is the name for the articulation with the ribs on thoracic vertebrae?

A

Superior and inferior articular facets

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12
Q

What is the name for the part of the neural arch between the spinous process and the transverse process?

A

The lamina

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13
Q

What is the name for the part of the neural arch between the transverse body and the pedicle?

A

The pedicles- these connect the rest of the arch to the body

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14
Q

Why is the vertical extent of the pedicle less than that of the body?

A

Creates room for the spinal nerve to come out through the intervertebral foramen

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15
Q

What is found at the junction of the lamina and pedicle?

A

The superior and inferior articular processes

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16
Q

What determines the movement possible between adjacent vertebrae?

A

the direction of the facets

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17
Q

How many parts does a vertebra ossify from?

A

Three; the centrum and right and left halves of the neural arch and these are the morphological parts of a vertebra

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18
Q

What is an easy way to distinguish a cervical vertebrae?

A

A foramen in the transverse process- called the vertebrarterial foramen

19
Q

What are some radiological signs of cervical spine instability?

A

Interruption of cervical lordosis, interlaminar space widening, disc space reduction, avulsion of body fragment, spinous process malalignment

20
Q

What should be the first imaging step of the C-spine in major trauma?

A

CT

21
Q

What’s the first line of imaging in C-spine minor trauma?

A

XR

22
Q

What should you do if clinically you are suspicious of C-spine fracture or on the fence in the setting of minor trauma with negative XR?

A

MRI

23
Q

What is MRI helpful for in the setting of minor C-spine trauma?

A

Hidden fractures and fracture dating, spinal cord, ligaments and discs, muscle involvement

24
Q

If XR is positive in the setting of minor trauma of C-spine what is the next step?

A

CT to assess the fracture in more detail, assess for fragment displacement, microfracture and to assess the posterior elements

25
Q

What’s the risk of false negative with XR in minor trauma?

A

Low

26
Q

What’s the risk of false negative with XR in major trauma?

A

High

27
Q

What are the risks of false negative with CT in trauma?

A

Low for minor trauma and very low for major trauma

28
Q

What do you look for on C-spine AP XR in setting of trauma?

A

C3-T1 shape and alignment, alignment of the spinous processes

29
Q

What do you look for on C-Spine lateral XR in setting of trauma?

A

From C1-T1: check the lines, prevertebral soft tissues

30
Q

What do you look for with the transoral view XR of the C-spine in trauma?

A

Symmetry check- checking position of dens between the lateral masses of the atlas and symmetry of the joints between C1 and C2

31
Q

What can you see with a Swimmer’s view?

A

C6-T3

32
Q

What do you use dynamic studies of the C-spine for in the setting of trauma?

A

Checking for instability

33
Q

What are the components of vertebral alignment that you’re checking for on C-spine lateral XR?

A

Anterior profile, posterior profile, the spinolaminar line, and the posterior spinous line

34
Q

What is a Swimmer’s view?

A

Used when you can’t see C7-T1 on a standard view. Lateral XR taken supine with pt’s arm above their head

35
Q

What do the costal elements develop into in the thoracic region?

A

The ribs which articulate with the neural arch by synovial joints

36
Q

What do the costal elements form in the cervical vertebrae?

A

The foramen in the transverse process. Anterior and posterior tubercles and intervening costal or intertubercular lamellar

37
Q

What is a cervical rib?

A

Elongation of the costal element of the C7 vertebra. Can be bony or fibrous passing from C7 to the first rib

38
Q

What type of cervical rib tends to be more irritating, bony or fibrous?

A

Fibrous

39
Q

What structures does a cervical rib put pressure on?

A

subclavian artery and lowest root (T1) of the brachial plexus

40
Q

When do symptoms from a cervical rib tend to appear?

A

Around puberty where the neck elongates and the shoulders droop

41
Q

What do the costal elements form in the lumbar vertebrae?

A

Transverse processes

42
Q

What grooves the lumbar transverse process?

A

The posterior ramus of the spinal nerve

43
Q

What lies above the groove in the transverse process of lumbar vertebrae?

A

The mamillary process (behind the superior articular facet

44
Q

Which has the better long term outcome haemorrhagic or non-haemorrhagic spinal cord injury?

A

Non-haemorrhagic- 69% had return of leg function va 8%

Ortho (11 decks)

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