Spine Flashcards
oppenheim reflex
UMN test
- rub tibial crest proximal to distal
- Normal: Toes PF
- Abnoraml: DF and splay
Cremasteric reflex
T12-L1
- stroek medial thigh proximal to distal
normal: upward scrotum - abnormal: nothing
anal wink refoex
S2-4
-stroke skin around anus
-sphincter contracts
bulbocavernosus
S3-4
squeeze penis or clitoris or tug bladder catheter
normal: anal sphicnter contract
PLC components
supraspinous ligament
interspinous ligament
ligamentum flavum
facet joint capsules
sagital balance paramters
C Lordosis = 20-40
T kyphosis = 20-50
lumbar lordsosis = 20-80
normal alignment
the vertical axis
- center of C2 to the anterior border of T7
- to middle of the T12/L1 disc
- to posterior to the L3 vertebral body
- posterosuperieor corner of the sacrum.
negative balance (axis post to sacrum = hyperlordosis)
Cspine facet plane and function
plane: 0 coronal and 45 sagittal superiomedial
function: F/E, lateral flex, rotaiton
T spine plane and function
plane: 20 coronoal and 55 sagittal (facet in coronal plane)
limited f/e
l spine plane and function
50 coronal and 90 sagittal (facets sagittalplane)
f/x, minimal rotaiton
C2 vialb eof rpedicle screw?
yes; same as c7
C3-6 use lateral mass
Tspine pedicale diamter
2x as thick medially as distally
T4 narrowest & shortest pedicale diamter
T12 usually larger pedicle than L1
pedicle length changes
lenght decrease T1-4, but increase further distal
pedicle ange T spine
15 degree cephalad
neutral in Lspine
pedicle angulation
angulate more medial moving distally
L1 = 10
L5 = 30
On average, thoracic pedicle diameter is maximal at T1 and T12, and gradually “dips” to its smallest diameter at the T4 to T6 region.
T6 is smallest diamter
coronal plane imablance adult deformity
> 10 degree from vertical
sagittal plane imalance
XR imbalance >5 cm
ALL attachemtns
axis: anterior body
atlas: anterior arch
foramen magnum: inferior edge
terminates as anterior atlanto-occipital membrane
techtorial membrane is extension of what
PLL
primary stabilizer of occiput-C1 articulation and limits extension
cruciate ligament xomplex
transverse atlantal ligament (TAL): runs between lateral masses of atlas posteiror to dens
-primary stbilzier of atlantoaxial motion, minimizing flexion, translation but allows rotation
alar ligaments
dorsolateral dens to inferomedial occipital condyle
vertebral artery course
92% patients- passess anteriorly to TP of C7
enter transverse forament at c6
course obliquely and medially on superior aspect of posterior arch C1 before entering forament magnum to format basilar artery
