T Spine/L Spine Mechanics Flashcards
What is the orientation of the superior articulating facet of the Cervical vertebrae?
Backwards
Upwards
Medial
What is the orientation of the superior articulating facets on the thoracic vertebrae?
Backwards
Upwards
Lateral
What is the orientation of the superior articulating facets of the lumbar vertebrae?
Backwards
Medial
What do you call the tissue that runs along the anterolateral aspects of the vertebral bodies?
Anterior Longitudinal Ligament
What do you call the tissue running along the posterolateral aspects of the vertebral bodies?
Posterior longitudinal ligament
What do you call the tissue connecting laminae if adjacent vertebrae?
Ligamentum Flava
What do you call the tissue connecting the transverse processes of adjacent vertebrae?
Intertransverse ligaments
What do you call the tissue connecting spinous processes of adjacent vertebrae?
Interspinous Ligaments
Explain the rule of threes
T1-3 transverse processes are found on the same level as their corresponding spinous processes
T4-6 transverse processes are found half a step up to the previous thoracic spinous process in relation it’s corresponding spinous process
T7-9 transverse processes are found a full step up, aligned with the previous thoracic spinous in relation to its corresponding spinous process
T10 transverse processes are aligned with its own spinous process
T11 transverse processes are aligned a half step above
T12 transverse processes are aligned a full step above
What are the actions of the Rotatores Muscles, and specifically what section do they act on?
Bilaterally: extension of thoracic spine
Unilaterally: rotation of thoracic vertebrae to opposite side
What are the actions of the multifidus Muscles, and specifically what section do they act on?
Bilaterally: extension of spine
Unilaterally: flexes to same side, rotates to opposite side
Multifidus spans cervical, thoracic, and lumbar segments of the spine
What are the actions of the Semispinalis Muscles, and specifically what section do they act on?
Bilaterally: extends the cervical, thoracic and head
Unilaterally: bends head, cervical, thoracic spine to same side, rotates to opposite side
What are the three spinal land marks?
Spine of the scapula -> T3 spinous process/T3 transverse processes
Inferior Angle of the Scapula -> T7 spinous process/T8 transverse processes
Iliac Crest -> L4 vertebra
What direction does the spine bend in dextroscoliosis?
Right
Make sure to pay attention whether you’re looking at an anterior or posterior view
What direction does the spine curve in a levoscoliosis?
Left
Make sure to pay attention whether you’re looking at an anterior or posterior view
How do you monitor scoliosis based on its severity?
<25 degrees: conservative, monitor with frequent radiograph imaging
25-45 degrees: non operative bracing
> 45 degrees: Surgical fusion
At what angles do complications appear?
> 50 degrees shows respiratory complications
> 75 degrees shows cardiac complications
What is radiculopathy?
Pinched nerve
Pain with Dermatomal distribution
Neurological function may be impaired: lower extremity weakness and diminished reflexes
Typically may be acute, can become chronic
Work up: straight leg test (patient raises leg while lying down with knee extended, test is positive if pain appears between 15-30 degrees of movement) and MRI
How do the symptoms of radiculopathy differs from L4/L5 disc and L5/S1 disc?
L4/L5 disc: weakness with dorsiflexion, difficulty walking on heel
L5/S1: weakness with plantarflexion, difficulty walking on toes, gastrocnemius and soleus atrophy, ankle jerk diminished or absent (calcaneal reflex)
What is spinal stenosis?
Bone growth that narrows spinal canal
Bilateral lower limb pain
Neurogenic Claudication (pain with walking)
Neurologic function may be impaired (lower extremity weakness and absent or diminished reflexes)
Typically chronic
Work up: straight leg test (patient raises leg while lying down with knee extended, test is positive if pain appears between 15-30 degrees of movement) and MRI
What is cauda equina syndrome?
When the nerves below the spinal cord (cauda equina) are damaged - typically by a herniated disc
Impaired neurologic function: Sadal anesthesia (numb butt), lower extremity weakness, absent or diminished reflexes, and urinary retention
Emergency, usually traumatic
Work-up: MRI
What is spina bifida occulta?
Failure of neural tube to close without herniation, sometimes tuft of hair is present on mid back at site of defect.
What is meningocele?
Failure of neural tube closure, but herniation is present with protrusion of meninges. No spinal cord tissue in the hernia.
What is myelomeningocele?
Failure of neural tube closure with hernia with protrusion of both meninges and spinal cord through the Defect
What is sacralization?
Sacralization is when one or both of the transverse processes of L5 fuse with S1
What is lumbarization?
When S1 fails to fuse with the rest of the sacrum
What is spondylosis?
The general wear of the spinal column
Spinal osteoarthritis
Bony spurs can form - abnormal growths on the spinal column
What is spondylolysis?
Defect or stress fracture of the vertebral arch
What is Spondylolesthesis?
Slipping of one vertebra on another
