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FINALS - ORTHO > spine > Flashcards

spine Flashcards

1
Q

bones of spinal column

A

7 cervical 12 thoracic 5 lumbar 5 sacral 4 coccyx

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2
Q

red flags lower back pain

A

<20 or >50, history malignany, night pain, trauma, systemic symptoms

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3
Q

invx for lower back pain

A

lumbar Xray // MRI if needed (for neurological or soft tissue)

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4
Q

mx mechanical lower back pain

A

NSAIDs, mobilise physio

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5
Q

what is radiculopathy

A

pinched nerve at spinal nerve root

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6
Q

symptoms radiculopathy

A

tingling, numbness, weakness, loss of sensation, pain on movement

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7
Q

what is spondylosis

A

loss of fluid from intervertebral discs

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8
Q

what causes spondylosis

A

OA

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9
Q

where does spondylosis usually occur in cervical and lumbar spine

A

C5-7 or L4/L5

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10
Q

symptoms cervical spondylosis

A

neck pain + stiffness which can radiate to shoulders // can have some radiculopathy + myelopathy

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11
Q

what is myelopathy

A

compression of spinal cord itself

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12
Q

what is spondylothesis + which part of spine

A

vertebra slips forward – L4/5 or L5/S1

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13
Q

what can cause an acute lumbar disc tear

A

usually heavy lifting

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14
Q

symptoms lumbar disc tear

A

pain, worse coughing

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15
Q

mx lumbar disc tear

A

analgesia and physio

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16
Q

what pattern of leg pain is seen with lower back prolapsed discs

A

dermatomal pain + neuro deficits // worse when sitting // usually worse than back pain

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17
Q

symptoms L3/4 prolapsed disc (4)

A

sensory loss over ant thigh (L3) or ant knee (L4) // weak quads // reduced knee reflex // positive femoral stretch test

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18
Q

symptoms L5 slipped disc

A

sensory loss dorsum foot // weak dorsiflexion // OK reflexes // positive sciatic stretch test

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19
Q

symptoms L1 nerve compression

A

sensorly loss posterolateral leg + foot // weak plantar flexon // reduce ankle reflex // positive sciatic stretch test

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20
Q

where does the sciatic nerve exit

A

L4,5 S1,2,3

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21
Q

symptoms sciatica

A

unilateral pain, sensory loss, numbness, tingling, weakness // radiating buttocks –> legs

22
Q

mx sciatica

A

analgesia, physio, NSAIDs // (maybe gabapentin duloxetine?)

23
Q

what invx should be done for sciatica after 4-6 weeks

A

MRI

24
Q

what is bony nerve root entrapment

A

OA –> osteophytes –> damage nerve roots

25
Q

mx bony nerve root entrapment

A

surgery for osteophyte trimming

26
Q

what can cause lumbar spinal stenosis

A

tumour, disc prolapse, spondylosis, osteophytes

27
Q

symptoms spinal stenosis (4)

A

similar to claudication (pain on walking, overweight, burning pain) // sitting better than standing // better to walk uphill // pedal pulses intact

28
Q

invx spinal stenosis

A

MRI

29
Q

mx spinal stenosis

A

surgical decompression eg laminectomy

30
Q

what is CES

A

damage to nerve roots that extend below spinal cord

31
Q

causes CES

A

disc prolapse (L4/5 or L5/S1) // tumours // abscess // trauma

32
Q

symptoms CES

A

low back pain // bilateral sciatica // saddle anaesthesia // reduced anal tone // urinary incontinence

33
Q

invx CES

A

MRI (+ PR)

34
Q

mx CES

A

surgical decompression

35
Q

what is meralgia paresthetica

A

entrapment of lateral cutaneous nerve of the thigh

36
Q

RF for meralgia paresthetica

A

30-40 // men // fat // obese // pregnant // trauma // recent surgery

37
Q

symptoms meralgia paresthetica

A

all side of thigh: burning, numb, ache, altered sensation // NO weakness

38
Q

invx meralgia paresthetica

A

ASIS pelvic compression test // USS // nerve conduction

39
Q

RF osteoporotic crush fracture

A

age (women 65, men 75) // history fractures // steroids // falls // secondary osteoporosis // low BMI // smoking and drinking

40
Q

symptoms osteoporotic crush fracture

A

back pain // breathing + GI problems (compression of organs) // loss of height // kyphosis

41
Q

invx osteoporotic crush fracture

A

1) Xray // CT or MRI

42
Q

invx to establish future risk of osteoporotic crush fractures

A

DEXA // FRAX criteria

43
Q

what is cervical spinal instability

A

atlanto-axial subluxation –> destruction of synovical joint

44
Q

symptoms cervical spinal instability

A

wide gait + weakness + increased tone

45
Q

what is spinal shock

A

physiological response to trauma –> complete sensory and motor loss below level of injury

46
Q

where does spinal shock usually occur

A

above T6

47
Q

what reflex can be done to test for spinal shock

A

squeeze gland of penis –> anal sphincter contraction

48
Q

how long until spinal shock usually resolves

A

24 hours

49
Q

what is neurogenic shock

A

spinal cord transection –> decreased symp or increased parasymp response

50
Q

how does neurogenic shock cause bradycardia and hypotension

A

reduced sympathetic response (or incrased para) so reduced vasoconstriction + HR

FINALS - ORTHO (13 decks)

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