spine clinical conditions Flashcards
What is the problem here?
L5-S1 disk is (black) DARK
this means its older and is loosing its water (black colour)
Identify the abnormality here
disk herniation at L4/5
Right sided disk prolapse
The women came back a few weeks later.. &..
(a small amount of impingment is shown) the prolapse can completely disapper, bc the disk matierial is VERY INFLAMMATORY & it gets broken down by the body.
What is sciatica?
describe the Sciatic nerve anatomy
Describe symptoms of Sciatica, how can u relive it?
Sitting will increase rhe pain bc u r compressing on the nerve further or stretching it further.
Coughing and sneezing can also increase the pain.
Standing up
what is the Natural History of Prolapsed Intervertebral Disc ?
- Occurs in 30 to 50 year olds
- Natural History = 90% resolve by 3 months
what is the Cauda Equina Syndrome?
how do these patients present?
how can we treat these symptoms
.Cauda equina syndrome (CES) is a rare but serious condition that describes extreme pressure and swelling of the nerves at the end of the spinal cord.
-Occurs in 30 – 50 year olds
Bilateral Sciatica
Perianal Numbness
Painless Retention of Urine-sacral nerve routes give us sphincter control, this is lost and we cant empty our bladder. (same with anal sphincter) >>SURGICAL EMERGENCY! TREAT WITHIN 48 HRS
*give them Laxatives
.Cauda equina: is a bundle of spinal nerves and spinal nerve roots which arise from conus medularis
What is lumbar canal Stenosis?
what can cause it? (3)
- seen in Elderly ppl due to:
1) disk buldge
2) artfhritis in the synovial facet joints, they expand due to the osteophytes and encroach into the canal (therby narrowing space available)
3) Ligamentum Flavum: Ages, stiffens and deposits of amyloids which causes it to EXPAND
What is Claudication? and what r the 2 types?
Pain in legs when walking
2 types:
- Neurogenic*> narrowing of nerve routes
- Vascular*> problem with circulation in legs
Spondylosis
Spondylolisthesis
spondylolysis
Spondylosis is a general term for degenerative osteoarthritic changes in the spine
Spondylolysis is a bony defect in the pars interarticularis of the vertebral arch
Spondylolisthesis refers to the anterior slippage of one vertebra over another
Name for C1 vertabra C2?
C1>> Atlas
C2>> Axis
what is spondylolysis
How does spondylolysis appear on xray?
looks like dog has got a collar around his neck.
“spotty dog”
Types of Sciatica
L4 Sciatica
Anterior thigh, Anterior knee
medial shin
• L5 Sciatica
• Lateral Thigh, lateral calf,
dorsum of foot
• S1 Sciatica •
Posterior Thigh, Posterior
Calf, Heel, Sole of Foot
what is scoilosis?
what can cause it?
is abnormal lateral curvature of the vertebral column.
- congenital,
- idiopathic (cause unknown)
- neuromuscular e.g. muscular dystrophy, spinal muscular atrophy, cerebral palsy, neurofibromatosis, spina bifida, spinal dysraphism (spinal cord malformation).
Cause of Kyphosis?
Scheuerman’s disease (wedge-shaped vertebrae) and osteoporotic vertebral compression fractures.
what is spina bifida?
Spina bifida is a condition where the spine does not develop properly, leaving a gap in the spine.
why does spina bifida occur?
During the first month of life, an embryo (developing baby) grows a structure called the neural tube that will eventually form the spine and nervous system.
When something goes wrong with this process, the result is called a “neural tube defect”.
Spina bifida is one type of neural tube defect.
Describe the anatomical abnormality in the bones of the vertebral column in spina bifida occulta.
The laminae of the lower lumbar vertebrae (most commonly L5 & S1) fail to fuse completely.
It is called ‘occulta’ as there is no physical disability so it is usually never detected.
What 3 types of spina bifida are there?
Spina bifida occulta= hidden
Meningocole= protrusion of meninges through vertebral cleft
Meningomyelocele= meninges protrude and spinal cord as well!
Describe the clinical feautres of the 3 types of Spina bifida
Spina bifida occulta= hairy, dimple, or birthmark
Meningocele=cysts-like structure
Meningomyelocele “can be open) = no skin shown
consequences of Meningomyelocele
Because spinal cord is pulled out as well, can cause spinal cord disfunction, brain stem is pulled downwards into the spinal canal at the base of the skull, obstructing the flow of the CSF and causing Hydrocephalus
-learning difficulties
-paralysis/ weakness of lowerlimbs
-fecal incontinence
a ababy with this type of spina bifida will have learning difficulties and hydrocephalus.
name it?
Meningomyelocele
what fracture is he most likely to get?
Jeffersons!
hangmans fracture
fracture of AXIS
What would be broken here in a hangmans fracture?
jefferson’s fracture
Jefferson fracture is the eponymous name given to a burst fracture of arches of C1 (atlas)
due to axial load! (diving in shallow water)
could be a three-part and two-part fractures
(thomas jefferson ripped is atlas into paieces)
What is Whiplash injury?
Whiplash injury
What structures r damaged in a whiplash injury?
Whiplash symptoms
Degenerative osteoarthritis of the intervertebral joints in the cervical spine.
name the disease
what could cause this?
Cervical spondylosis
dehydration of the discs w/ narrowing of the intervertebral spaces. There may be changes in the facet joints with osteophyte formation and this may put pressure on the nerve roots, causing motor and sensory disturbance.
during cervical Spondylosis
pressure on the Nerve ROOTS leads to ______
Pressure on the CORD leads to ________
Pressure on nerve roots leads to radiculopathy:
– Dermatomal sensory symptoms: paraesthesia, pain
– Myotomal motor weakness
Pressure on the cord leads to myelopathy (less common):
– Global weakness
– Gait dysfunction
– Loss of balance
– Loss of bladder and bowel control
Name the defect
Spondylolisthesis of Axis w/ disruption of the pars interarticularis! due to HANGMANS FRACTURE
C2 slipped jidam C3.
What will a patient complain of with a left sided C5/6 prolapsed disc? Which nerve is affected?
Explain the location of Pain, Motor weakness, Sensory
C6 (remember in cervcial they run ABOVE IT)
Location of :
Pain>> Biceps into thumb and index finger
Motor weakness >> Biceps and Wrist Extension
Sensory>> Numbness/ P&Ns Thumb and Index finger
What will a patient complain of w/ C7/T1 Prolapsed intervertebral disc ? Which Nerve Root is affected?
C8
Explain the defect
Thoracic cord compression at T10
what r 2 common causes of thoracic cord compression?
Fracture of vertebrae & tumors developing in the canal and compresses on spinal cord!
Thoracic cord compression at T10,
Explain the location of Pain, Motor weakness, Sensory
Thoracic cord compression at T5,
Explain the location of Pain, Motor weakness, Sensory
