spine disorders Flashcards
parts of cerbral spine
atlanto axial joint - c1-c2
subaxial spine - c3 -c6
transitional vertebra - c7
what are the feuares of hte cerbal spine vereterbae
bifid spine process
hook like processes
what is the uncovertebarla joint
joint betwen the uncinate proces and supeor vertbrea
features of the thoracic spine
herat shape body
small cicurar cnacel
attachment of the ribs
fetures of lumbar spine
massive kidney shaped body
horizual penciesl
what are hte 3 partss of th esacurm
1 - lateral zone
2 - intermeidate zone
3 - medial zone
what is the lateral zone crosses by
sympatheic trunk, lumosacarl turnk and obturator nerve
what are the parts of the spine body
anterior - antiero half of annulus fisure and mian antioer part of verla body
middle - between spianl cord and antiero colurm
postier - anything form the spinal cord an dback
what is the nerve in the byceps reflex
c5 - c6
nerves in supinaroy reflex
c6 - c7
nerves in the tricepts reflex
c7 - c8
nerves in the creamasteric reflex
l2 - l3
nerves in the knee jerk reflex
l3 - l4
nerves in ankle jerk reflex
s1/s2
what is the fucniton of the dorasl columb tract
fine tough, joint poisions, virbaion, proprioception
fucntion of lateral and anterior spinothalic tract
pain, temp and light touch
cause of spina bifiid
fialre to close of the spine around the menigines
risk factors for spina bifida
low foliac levles in early pregancy
family history of birth defects
diabetes
obesity
anti seizure medicaton
what is spina bid oculat
clsoed spian bdif but msing bones in postre spianl cord
may presnet with hari over area
what is the sign of spia bifida
bakc pain, lower limb motro defects
sensory defects
sphinceir distuance
back defories and lower limb deforaotesn
back swelling
difference beetween myelomenigocele and meningocele spinal bifiaia
myningocye, this is wher the mengine is exente but there re no nerves in the ara
myelomeninglce - you have nerve in the spianl bfifida sac
how to differenciate between meningocele and myelomeningocle
in myelmeningocle - the sac covering is more membrenous and left skin like
it is trnasopquae instead of translucent
neurological deficient may be pernet
there is normally double inconent instead of spincters bing in tack
there is hydocelpathi in most cases
how quickly should a spina bifida be closecd
within 24 hrs
what treatmetn may be necsesas is mylomenicgose is presents
a vp shunt to relive hydrocephalus
what is teathered spinal cord syndrome
wher there is an inllastic anchori of the causeal spial cord by an abnormal fatt ilum termiale
symtoms of teatherd spinal cord
neurologic, urological or orthopaedic symptoms
types of spinal infections
pyogenic vertebral osteomylelitis and biscitis
granulomatous infection
epidular infections
post operative infections
where deos pyogenic vertable osteomyelits nromally curr
in the lumbar spine
what is the bactia in pyogeneic vertbral osteomyleltis
staphyloccous aureus and streptococus
symptoms and signs of pyogenic vertbral osteomyelits
axial pain
fever
neruological symtoms including - radicular numbness, muscle wasting,
labs for pyogenic vertebral osteomyelitis
wbc, esr , crp , blood cultures, urinalass
neruologcla imaging
xray, ct, mri
treatment for pyogenic vertebral osteomytiesi
broad specute iv antibtics for 6- 8 weeks
what percent of spinal surgery get post operative infeiton
12 %
how to prevnte post op spinal infections
prophaltic antibitoies
intraoperative antibiotics
treatmetn for post operative spinla infections
irragation and beridmetn of hte area
iv antibiotics for minimum of 6 weeks, then switch to oral medicton
imaging for spinal cord tumours
x ray or ct, mri is gold standard
treamte for spinal cord tumours
surgical excision, biopys, radio and chemo
where can spinal hematomas occur
subdrual , epidural , subarachnoid, intramedular haemoroage
where can subarachnoid hematorms spread to
the entire length of teh spinal columb
cuaes of spinal haemotomaws
anticoagulation therpayr, vasuclar malformatins
truamaa
most cuases no obvious causes
symptoms of spinal haematomas
intese pain at the area
motor weakness
sensroy and reflex deficits
acute bowel and bladder dysfunction
what are the symtoms to subarachonii haemotsa similar to
meningitis
imaging for spinal hameot
mri - gold standard - it can show where the clot is
s
acutre, hyperacute and subacute
hyperacute - less than 24 hours
acute - less than 3 days
sub acute - more than 3 days
treament of spinal haematoms
surgial decpomersion is neruoglocial defects
laminectomy - go though the vertebrae backbone
Cuda equina syndrome
compression and inflaton of the lower lumbar an dsacral nerves route in the spianl cord
cuases of cauda equina syndorme
trauma
haemorrage
inflatomation
infections - spinal epidurla abces
degerantive spinae deiase
tumours
signs of cudaa equina syndrome
leg pain, weak ness and anestheis,
saddle anaethsi
bladder, bowel and sexual dysfunction
decraed anal tone
abscels of ankle reflex
types of cauda equina syndrome
incomplete - loss of urgency or decread urinary sensation withough incotneer or retetsion
complete - urinary and bowel retention or incontinence
imaign for cuada eqiarna syndomre
mri
treatement for cuada equi synoem
surgical decompressoin
which verebrae are assocaed with teh highes risk of mortaily for spiane trauam
thoses which are higher up, cervial
main cuse of spine trauam
rtc
what is the priamry sci effect
damage to the cel bodies and neronal prcoes death
damage to the spinal axons
what is the effect of secondary spinal cord injury
inflmation
vascualr evenetison - including damge to epithl cell and local blood vessels
comprimaino to blood supply in the area
neruoglocial defects including bradycardia, hypotension and cord tissue ischma
break down of the blood spinal cord barrier
leads to demylaiton and scar formation
what is spinal cord shock
wher there is loss of neruoglcia fucniotn belwo the level of the spianl cord injury
signs of spianl cord shock
hypotension
flaccid paraslis and areflexia - loss of relfexes
how long does spnal cord shock last
72 horus - 1 week
cause of spinal cord shock
loss of symathiec funion
loss of vasular tone belwo level of injury
venous pooing due to lss of skelaat mules
hypovleoms - due to loss of blood volume with wounds
effect of comprel spinal cord synoem
losso of all motor and sensory fucntion bellow the level of the injyr
types of incomplte spinal cord syndorme
central cord synome
browns sequard syndomre - hemisection of cord
anterior cord syndomre
posterior cord sydnorme
what area is damaged in ctnrel cord synorem
primary the greay matter
cuase of cntrel cord synomfe
hyperextion injry in older paitens
signs of centrla cord syndorme
weaknes in bowth ul and lower limb
loss of sensation below the injury
loss of urine reteions
causes of antieroe cord syndorme
there is an infact in teh artery that supplies the anteiro spinal cord
presentaiton of antiero cord synome
loss of movemtn in libs
loss of sense belwo leisn
loss of pain and temp - due to spinothalimc tract , but prestaion of two pint disciton, deep resatre
what is the spinal tract that is damaged and spared in antiaor cord injuyq
spinothalmic tract damaged
dorsal columb spared
what is seen in brown sequard syndrome
loss of joint and position sense on the ipsilateral side
parayslies below the lesiosn onsame side
cotralater los of pain and temp
whene should early decompesion be used for spinal cord injeyr
if ther is progessive neruolocial deteriaion
incomplte spinal cord injry
how to occipital condle fractres present
loss of concious
craniocervicla pain
sometimes lower crainl nerve deficits - 9-12
where does atlanto occipital disoltiaon mainly occur
in childern - due to smaller occipalt condlyes and soft tissue laxity
due to hyperextension, distractionand rotation
effect of the atlanto occipital dislcotaion
instant death
cna service with neruoloicla deficito ie. lwoer crial nerve palsy
types of throaco lumbar infjeyr
compression, burst, seat belt, fracutre/ disolction
effect of zone 1, 2 and 3 injaryesi in the sacla spine
zone 1 - can cuase l5 route issues or ciatic nerve
l2 - often neruoglci deficit, does not involve spicter
zone 3 - high rate of neroloic defei, also bladder and bowel dysfuction
what types of spinal cord fractures need surgeyr
occiptial condley avulison fractuers,
atlanto occipilta dislton
more than 5mm c1/c2
neruolgoical deficits
biomechanicl instabily
non union after 12 weeks of immobilization
