Spine Problems Flashcards
What re the 6 RED FLAG symptoms in spinal injuries?
Under 20 or Over 55 Associated with systemic/neurological symptoms Persistant and serious suspected Nocturnal pain or worse in the morning Malignancy/HIV/Infection Acute onset in the elderly
What are the 3 areas of back pain?
Mechanical
Nerve root entrapment
Serious underling pathology
What are the 2 types of prolapsed IV disc?
Lateral = compression of the nerve root
Posterior central = entrapment of the spinal cord causing caudal eqina syndrome
What are the 4 most commonly affected areas?
C5/6 T11/12 L4/5
L5/S1
What are the symptoms of a nerve root entrapment?
Sciatica = pain in the buttock radiating down the leg
Loss of ankle reflex
Pain and muscle spasms
Sensory and or motor weakness
What is the treatment of a mild prolapsed IV disc?
Physiotherpay
Bed rest for 3 days
Strong analgesia
Most resolve
Apart from IV disc prolapse what can be the cause of caudal equina?
Tumour
Trauma
Spinal stenosis
What are the symptoms of CA syndrome?
Loss of sacral sensation Overflow incontinence Urinary retention Bowel dysfunction Loss of tone of sphinters Pain that radiates down the legs
What is the management of CA syndrome?
Surgery within 48hrs - removal of the disc
Urgent MRI/CT?lumbar myelogram
Where can a metastatic spinal tumour come from?
CNS tumour Breast Bone Prostate Lung Renal Primary sarcoma
What re the symptoms of a metastatic spinal tumour?
Parasthesia
Loss of anal tone
Pain
Sensory Changes
How can you diagnose a metastatic bone tumour?
X-ray
Can do CT/ MRI
What is the management of a metastatic bone tumour?
Immediate surgical resection
Chemo/radio
Find the primary
What is the definition of
Spondylolysis
Spondylolisthesis?
- This is a stress fracture in one of facet joins AKA Par Interarticularis
- Fracture leading to the asteroid slippage of a vertebrae leading to pain and injury
What are the common presenting symptoms of the 2 S’s?
Lower back pain Gradual onset Resticts daily living unilateral tenderness Sensory/ nerve damage
What are the managements of the S’s?
Rest, NSAID’s, brace and physio
Can do a fusion Sx
What is scoliosis?
This is the abnormal curate of the spine
What are the clinical findings in scoliosis?
They have asymmetry standing and the waist and shoulder are out of lone
What is the treatment of scoliosis?
Surgical correction
What is spinal stenosis
Abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots.
What are the 2 most common causes of a Spinal cord Injury?
Fall or RTA
What are the 3 effects of SCI?
Quadraplegia = all 4 limbs Paraplegia = 2 lower limbs Hemiplegia = down one side
What are the features of Brown Sequard Syndrome?
Paralysis on the affected side and loss of proprioception on he alternative side
What is a central cord syndrome?
Caused by a hyperextension injury, greater weakness of the arms than the legs
What is a anterior cord syndrome?
Hyperflexion injury causing profound weakness but the proprioception is preserved
What is a posterior cord syndrome?
RARE! Loss of proprioception but pain and temperature is preserved
What is the management of a spinal cord injury?
A - Secure the spine B -Ventilation and oxygenation C - IV fluids and consider neurogenic shock (hypotensive and bradycardia) D -assess the neurological function Spinal surgery, OT, physio
What do the following levels correspond to in terms of movements and movements and muscles: C5 C6 C7 C8 T1
Abduction = deltoid Elbow flexion = biceps Elbow extension = triceps Finger flexion = FDS FDP Finger abduction = interossei
What do the following levels correspond to in terms of movements and movements and muscles: L2 L3/4 L4 L5 S1
L2 = Hip flexion = Iliopsoas Knee extension = quads Ankle dorsiflexion = tibialis anterior Big toe extension = EHL Ankle plantar flexion = gastrocnemius
