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Orthopaedics and Trauma > Spine > Flashcards

Spine Flashcards

1
Q

Features of back pain history

A

Axial vs radiating (e.g. shooting into leg)

Improved with rest?

Any sensation loss (radiculopathy)

Any gait instability (myelopathy)

Any red flags?

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2
Q

Spinal history red flags

A

Night pain, weight loss, Hx of cancer

Recent trauma

Saddle anaesthesia, bladder/bowel control loss, gait disturbance

Thoracic spine

Age <20 or >55

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3
Q

Management of spinal radiculopathy

A

Analgesia, physiotherapy

Laminectomy for resistant cases

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4
Q

Management of cauda equina

A

PR, full neuro exam

Post-voiding bladder ultrasound

Urgent MRI

Surgical decompression

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5
Q

Differential for glove/stocking distribution of sensory loss

A

DAMAGE

Diabetes

Alcohol

Metabolic

Autoimmune/vasculitis

Guillaine-Barre

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6
Q

Positive prognostic marker for cauda equina

A

Incomplete saddle anaesthesia (only half affected)

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7
Q

Spondylolysis vs spondylolisthesis

A

Spondylolysis: Fracture of vertebral isthmus (commonly L5), often asymptomatic and self-limiting

Spondylolisthesis: Slippage of vertebra on one below of intervertebral disc (15% progresssion from spondylolysis in young people, common with degeneratve change in elderly)

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8
Q

Spinal stenosis (i.e. neurogenic claudication) vs vascular claudication

A
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9
Q

Pathophysiology of spinal stenosiS

A

Degeneration of spine –> osteophyte formation –> reduction in canal space

Soft tissue/ligamentum flavum hypertrophy

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10
Q

What should bilateral carpal tunnel symptoms alert you to?

A

Cervical myelopathy!

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11
Q

Nexus guidelines for C-spine clearance

A

DC TIN

Distracting injury?

Altered consciousness?

Tenderness?

Intoxication?

Focal neurology?

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12
Q

Common organisms associated with MSK infection

A

Staph aureus, streptococcus, N. gonnorhoea for septic arthritis

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13
Q

Presentation of MSK infection

A

Joint pain +/- pseudoparalysis

Warmth, redness, swelling

Systemic response e.g. fever (swinging in abscess formation)

Elevated WCC, CRP, ESR

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14
Q

Aetiology of septic arthritis

A

Staph aureus, N. gonorrhoea

Haematogenous, direct, or osseous spread (from osteomyelitis)

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15
Q

Management of septic arthritis

A

Blood cultures

IV Abx (fluclox, cephalosporin)

Joint aspiration + lavage with saline (may require surgery in hip or if septation has occured)

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16
Q

Complications of septic arthritis

A

Cartilage damage –> early osteoarthritis

Septic shock

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17
Q

Copmlications of osteomyelitis

A

Commonly a disease of children –. growth arrest due to permanent bone damage

May be first presentation of diabetes –> check blood glucose!

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18
Q

Management of osteomyelitis

A

Blood cultures + blood glucose

IV abx

Surgical drainage if chronic/periosteal pus formation

Amputation if resistant to previous measures (chronic)

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19
Q

Lateral vs posterolateral disc herniation

A

Lateral: Nerve root above (e.g. L4 in L4-5 disc)

Posterolateral: Nerve root below (e.g. L5 in L4-L5 disc)

20
Q

C5 dermatome

A

Regiment badge

21
Q

C6 dermatome

A

Thumb

22
Q

C7 dermatome

A

Middle finger

23
Q

C8 dermatome

A

Little finger

24
Q

T1 dermatome

A

Medial elbow

25
Q

T5 dermatome

A

Nipple

26
Q

T10 dermatome

A

Umbilicus

27
Q

L3 dermatome

A

Medial thigh/knee

28
Q

L4 dermatome

A

Medial leg

29
Q

L5 dermatome

A

Dorsal surface of toes

30
Q

S1 dermatome

A

Plantar surface of heel

31
Q

C5 myotome

A

Shoulder abduction

32
Q

Elbow flexion root

A

C5-C6

33
Q

Elbow extension nerve root

A

C7

34
Q

Wrist extension nerve root

A

C6

35
Q

Finger extension nerve root

A

C7

36
Q

Finger flexion nerve root

A

C8 (median + ulnar)

37
Q

Finger abduction enrve root

A

T1

38
Q

Hip extension nerve root

A

L5/S1

39
Q

Hip flexion nerve root

A

L1-L2

40
Q

Knee flexion nerve root

A

S1

41
Q

Knee extension nerve root

A

L3/4

42
Q

Ankle dorsiflexion nerve root

A

L4-5

43
Q

Ankle plantarflexion nerve root

A

S1/S2

44
Q

Great toe extension

A

L5

45
Q

Ankle inversion nerve root

A

L4-L5

46
Q

Ankle eversion nerve root

A

L5/S1

Orthopaedics and Trauma (8 decks)

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