Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Ortho AM > Spine and back > Flashcards

Spine and back Flashcards

1
Q

What are the indications for imaging in non specific back pain?

A

Likely pathology e.g. malignancy

Result of imaging likely to change management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What imaging is used for back pain?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the management of non specific back pain?

A

Encourage self management
1st line= NSAIDs- co-prescribe PPI if >45
Exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is myelopathy?

A

Compression of spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are common causes of myelopathy?

A

Spondylosis

Spinal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the most common area for myelopathy

A

CErvical spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the presentation of myelopathy?

A

UMN signs

Back pain > limb pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What investigation is done fr myelopathy?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is radiculopathy?

A

Compression of nerve root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the presentation of radiculopathy?

A

Limb pain>back pain
Root tension- using muscles supplied exacerbates pain
Root compression- weakness and changes in sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the management of radiculopathy?

A

Analgesia and physio

Referral if persistent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is spinal stenosis?

A

Central canal of spinal cord narrowed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can cause spinal stenosis?

A

Degenerative= most common
Tumour
Disc prolapse
Congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the presentation of lumbar spinal stenosis?

A 
Back pain
Neuropathic pain of legs- better when leaning forward or walking uphill
Weakness and numbness
Gradual onset
Severe= incntinence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the investigation of spinal stenosis?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the management of lumbar spinal stenosis?

A

Laminectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the most common cervical stenosis?

A

Degenerative cervcal myelopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the risk factors for degenerative cervical myelopathy?

A

Smoking
Occupation
FH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the presentation of degenerative cervical myelopathy?

A 
Pain in neck and all 4 limbs 
Loss of dexterity, weakness, gait imbalance 
Numbness, paraestoesia 
Severe= incontinence 
Hoffman's sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Hoffman’s sign?

A

Flick 1 finger and other fingers will move in response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What investigation is done for cervical degenerative myelopathy?

A

MRI= disc degeneration, ligament hypertrophy, spinal cord change

22
Q

What is the management of degenerative cervical myelopathy?

A

Urgent referral for assessment

Decompressive surgery

23
Q

What is spondylosis?

A

Degenerative changes of spine, essentially OA

Very common

24
Q

What is disc prolapse?

A

Tearing of annulus fibrosis, causing nucleus pulposis to protrude, compression the cord or nerve root

25
What are th types of disc prolapse?
Bulge= common, majority asymptomatic Protrusion Extrusion Sequestration= desiccated disc material free in canal
26
Where is disc prolapse common?
C5/6 T11/12 L4/5 S1
27
What is the presentation of disc prolapse?
Asymptomatic Often produces clear dermatomal pattern CEntral= myelopathy Lateral= radiculopathy
28
What is the management of disc prolapse?
Analgesia, physiotherapy | Persistent= refer for MRI
29
Who are the most spinal cord injuries seen in?
Males > females | 20-29yo
30
What are the common causes of spinal cord injury?
``` Trauma- most comon= fall, RTC, sports Degenerative orthopaedic Spinal cord infarct Transverse myelitis Thoracoadbsominal aortic aneurysm ```
31
What is the classification used for spinal cord injury?
ASIA
32
What are the ASIA classifications?
``` A= no sensory/motor in S4/5 B= sensory but no motor below neurological level C= Motor function preserved below level but grade <3 D= Motor function preserved below level and grade >3 E= normal ```
33
What are some patterns of spinal cord injury?
``` Quadraplegia Paraplegia Central cord syndrome Anterior crd syndrome Brown-Sequard syndrome ```
34
What is quadriplegia?
Loss of motor/sensory function in cervical segments of spinal cord Partial or total loss of use of all 4 limbs and trunk- spastic weakness in all limbs Resp failure if above C5
35
What is paraplegia?
Impaired or loss of motor/sensory function in T/L or S spine Partial or total loss of use of lower limbs, arms spared but trunk may be involved Spastic weakness if Above L1 Bladder and bowel can be affected
36
What is central cord syndrome?
Hypertextension injury to neck where cervical tracts are more involved
37
What is the presentation of central cord syndrome?
Older patient | Weakness of arms, with perianal and lower extremities power preserved
38
What is anterior cord syndrome?
Hyperflexion injury causes anterior compression fracture and damaged anterior spinal artery
39
What is the presentation of anterior cord syndrome?
Profound weakness | Vibratory sense, fine discrimination ad proprioception preserved
40
What is Brown-Sequard syndrome?
Paralysis and loss of proprioception and fine discrimination ipsilateral below lesion Loss of pain and temperature sensation on contralateral below lesion
41
What causes Brown-Sequard?
Hemisection of cord, out often due to penetrating injury
42
What are the types of shock affecting the spine?
Neurogenic shock | Spinal shock
43
What is neurogenic shock?
Injury above T6 causing disruption to sympathetic outflow --> hypotension, bradycardia and hypothermia
44
What is spinal shock?
Transient depression of cord function below level of injury Flaccid paralysis and areflexia Can last hours to days
45
What is the urgent management of spinal cord injury?
ABCD | Imaging- MRI and XR
46
What is the long term management of spinal cord injury?
``` Spinal cord injury unit Physio OT Psych Urological and sexual counselling ```
47
What is the management of unstable spinal fractures?
Usually pedicle screws from posterior
48
What is cauda equina syndrome?
Compression of caudal equina
49
What can cause cauda equina?
``` Central lumbar disc prolaps= most common Tumours Trauma Spinal stenosis Infection Iatrogenic- epidural, spinal surgery ```
50
What is the presentation of cauda equina?
Bilateral buttock and leg pain Varying dysaethesia and weakness Saddle anaesthesia Urinary retention +/- incontinence
51
What is the management of cauda equina?
Urgent MRI | Operation within 48 hours of onset
52
What are some complications of cauda equina?
Delay= permanent bladder and anal sphincter dysfunction | ~30% never go back to "normal"

Ortho AM (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions