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spine disorders Flashcards

1
Q

parts of cerbral spine

A

atlanto axial joint - c1-c2
subaxial spine - c3 -c6
transitional vertebra - c7

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2
Q

what are the feuares of hte cerbal spine vereterbae

A

bifid spine process
hook like processes

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3
Q

what is the uncovertebarla joint

A

joint betwen the uncinate proces and supeor vertbrea

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4
Q

features of the thoracic spine

A

herat shape body
small cicurar cnacel
attachment of the ribs

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5
Q

fetures of lumbar spine

A

massive kidney shaped body
horizual penciesl

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6
Q

what are hte 3 partss of th esacurm

A

1 - lateral zone
2 - intermeidate zone
3 - medial zone

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7
Q

what is the lateral zone crosses by

A

sympatheic trunk, lumosacarl turnk and obturator nerve

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8
Q

what are the parts of the spine body

A

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

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9
Q

what is the nerve in the byceps reflex

A

c5 - c6

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10
Q

nerves in supinaroy reflex

A

c6 - c7

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11
Q

nerves in the tricepts reflex

A

c7 - c8

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12
Q

nerves in the creamasteric reflex

A

l2 - l3

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13
Q

nerves in the knee jerk reflex

A

l3 - l4

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14
Q

nerves in ankle jerk reflex

A

s1/s2

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15
Q

what is the fucniton of the dorasl columb tract

A

fine tough, joint poisions, virbaion, proprioception

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16
Q

fucntion of lateral and anterior spinothalic tract

A

pain, temp and light touch

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17
Q

cause of spina bifiid

A

fialre to close of the spine around the menigines

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18
Q

risk factors for spina bifida

A

low foliac levles in early pregancy
family history of birth defects
diabetes
obesity
anti seizure medicaton

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19
Q

what is spina bid oculat

A

clsoed spian bdif but msing bones in postre spianl cord
may presnet with hari over area

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20
Q

what is the sign of spia bifida

A

bakc pain, lower limb motro defects
sensory defects
sphinceir distuance
back defories and lower limb deforaotesn
back swelling

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21
Q

difference beetween myelomenigocele and meningocele spinal bifiaia

A

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

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22
Q

how to differenciate between meningocele and myelomeningocle

A

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

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23
Q

how quickly should a spina bifida be closecd

A

within 24 hrs

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24
Q

what treatmetn may be necsesas is mylomenicgose is presents

A

a vp shunt to relive hydrocephalus

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25
Q

what is teathered spinal cord syndrome

A

wher there is an inllastic anchori of the causeal spial cord by an abnormal fatt ilum termiale

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26
Q

symtoms of teatherd spinal cord

A

neurologic, urological or orthopaedic symptoms

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27
Q

types of spinal infections

A

pyogenic vertebral osteomylelitis and biscitis
granulomatous infection
epidular infections
post operative infections

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28
Q

where deos pyogenic vertable osteomyelits nromally curr

A

in the lumbar spine

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29
Q

what is the bactia in pyogeneic vertbral osteomyleltis

A

staphyloccous aureus and streptococus

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30
Q

symptoms and signs of pyogenic vertbral osteomyelits

A

axial pain
fever
neruological symtoms including - radicular numbness, muscle wasting,

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31
Q

labs for pyogenic vertebral osteomyelitis

A

wbc, esr , crp , blood cultures, urinalass

32
Q

neruologcla imaging

A

xray, ct, mri

33
Q

treatment for pyogenic vertebral osteomytiesi

A

broad specute iv antibtics for 6- 8 weeks

34
Q

what percent of spinal surgery get post operative infeiton

A

12 %

35
Q

how to prevnte post op spinal infections

A

prophaltic antibitoies
intraoperative antibiotics

36
Q

treatmetn for post operative spinla infections

A

irragation and beridmetn of hte area
iv antibiotics for minimum of 6 weeks, then switch to oral medicton

37
Q

imaging for spinal cord tumours

A

x ray or ct, mri is gold standard

38
Q

treamte for spinal cord tumours

A

surgical excision, biopys, radio and chemo

39
Q

where can spinal hematomas occur

A

subdrual , epidural , subarachnoid, intramedular haemoroage

40
Q

where can subarachnoid hematorms spread to

A

the entire length of teh spinal columb

41
Q

cuaes of spinal haemotomaws

A

anticoagulation therpayr, vasuclar malformatins
truamaa
most cuases no obvious causes

42
Q

symptoms of spinal haematomas

A

intese pain at the area
motor weakness
sensroy and reflex deficits
acute bowel and bladder dysfunction

43
Q

what are the symtoms to subarachonii haemotsa similar to

A

meningitis

44
Q

imaging for spinal hameot

A

mri - gold standard - it can show where the clot is
s

45
Q

acutre, hyperacute and subacute

A

hyperacute - less than 24 hours
acute - less than 3 days
sub acute - more than 3 days

46
Q

treament of spinal haematoms

A

surgial decpomersion is neruoglocial defects
laminectomy - go though the vertebrae backbone

47
Q

Cuda equina syndrome

A

compression and inflaton of the lower lumbar an dsacral nerves route in the spianl cord

48
Q

cuases of cauda equina syndorme

A

trauma
haemorrage
inflatomation
infections - spinal epidurla abces
degerantive spinae deiase
tumours

49
Q

signs of cudaa equina syndrome

A

leg pain, weak ness and anestheis,
saddle anaethsi
bladder, bowel and sexual dysfunction
decraed anal tone
abscels of ankle reflex

50
Q

types of cauda equina syndrome

A

incomplete - loss of urgency or decread urinary sensation withough incotneer or retetsion
complete - urinary and bowel retention or incontinence

51
Q

imaign for cuada eqiarna syndomre

A

mri

52
Q

treatement for cuada equi synoem

A

surgical decompressoin

53
Q

which verebrae are assocaed with teh highes risk of mortaily for spiane trauam

A

thoses which are higher up, cervial

54
Q

main cuse of spine trauam

A

rtc

55
Q

what is the priamry sci effect

A

damage to the cel bodies and neronal prcoes death
damage to the spinal axons

56
Q

what is the effect of secondary spinal cord injury

A

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

57
Q

what is spinal cord shock

A

wher there is loss of neruoglcia fucniotn belwo the level of the spianl cord injury

58
Q

signs of spianl cord shock

A

hypotension
flaccid paraslis and areflexia - loss of relfexes

59
Q

how long does spnal cord shock last

A

72 horus - 1 week

60
Q

cause of spinal cord shock

A

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

61
Q

effect of comprel spinal cord synoem

A

losso of all motor and sensory fucntion bellow the level of the injyr

62
Q

types of incomplte spinal cord syndorme

A

central cord synome
browns sequard syndomre - hemisection of cord
anterior cord syndomre
posterior cord sydnorme

63
Q

what area is damaged in ctnrel cord synorem

A

primary the greay matter

64
Q

cuase of cntrel cord synomfe

A

hyperextion injry in older paitens

65
Q

signs of centrla cord syndorme

A

weaknes in bowth ul and lower limb
loss of sensation below the injury
loss of urine reteions

66
Q

causes of antieroe cord syndorme

A

there is an infact in teh artery that supplies the anteiro spinal cord

67
Q

presentaiton of antiero cord synome

A

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

68
Q

what is the spinal tract that is damaged and spared in antiaor cord injuyq

A

spinothalmic tract damaged
dorsal columb spared

69
Q

what is seen in brown sequard syndrome

A

loss of joint and position sense on the ipsilateral side
parayslies below the lesiosn onsame side
cotralater los of pain and temp

70
Q

whene should early decompesion be used for spinal cord injeyr

A

if ther is progessive neruolocial deteriaion
incomplte spinal cord injry

71
Q

how to occipital condle fractres present

A

loss of concious
craniocervicla pain
sometimes lower crainl nerve deficits - 9-12

72
Q

where does atlanto occipital disoltiaon mainly occur

A

in childern - due to smaller occipalt condlyes and soft tissue laxity
due to hyperextension, distractionand rotation

73
Q

effect of the atlanto occipital dislcotaion

A

instant death
cna service with neruoloicla deficito ie. lwoer crial nerve palsy

74
Q

types of throaco lumbar infjeyr

A

compression, burst, seat belt, fracutre/ disolction

75
Q

effect of zone 1, 2 and 3 injaryesi in the sacla spine

A

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

76
Q

what types of spinal cord fractures need surgeyr

A

occiptial condley avulison fractuers,
atlanto occipilta dislton
more than 5mm c1/c2
neruolgoical deficits
biomechanicl instabily
non union after 12 weeks of immobilization

77
Q
A

CNS (27 decks)

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