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כאב גב > Test 1 > Flashcards

Test 1 Flashcards

0
Q

SCI age

A

most 16-30 yrs: participate in high risk activities
median age 26 yrs

avg age 41

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1
Q

SCI cause

A

*MVA most common 44% (motorcycle only 7%, die)
Falls 18%
Violence 16%
Sporting, mostly diving 12.7%

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2
Q

SCI gender

A

Male: Female ration is 4:1

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3
Q

SCI Ethnicity

A

73.9 Caucasian

caucasian (MVA) > AA (violence) > Hispanic (violence)

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4
Q

leading cause SCI below 45yrs, above 45 yrs

A

below 45: MVA

above 45: falls

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5
Q

When is SCI most common

A

July
Saturday
Daytime hours

alcohol or substance abuse plays a role in 17-49% of cases

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6
Q

epidemiology

tetra vs paraplegia/ complete vs incomplete SCI common

A

Incomplete Tetraplegia (quad): 29.5%—arms, legs, trunk

Complete Paraplegia 27.9%

Incomplete paraplegia: 21.3%

complete tetraplegia (quad): 18.5%

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7
Q

epidemiology

most frequent level SCI

A

C5

then: C4, C6, T12

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8
Q

what % of pts SCI have complete neuro recovery by discharge?

A

<1%

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9
Q

what are the most vulnerable areas of the spine levels in SCI?

A

C5-C7

T4-T7

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10
Q

What ASIA level most likely to be employed?

A

D

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11
Q

Who is most likely to return to work post SCI? What kind of work?

A

ASIA D
work fulltime
if return in one yr its the same job

more likely to return to work: younger, male, white, more educated, higher IQ

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13
Q

Rehab

A

the restoration through personal health services of handicapped individuals to their fullest physical, mental, social, and economic usefulness of which they are capable

including ordinary tx and tx in special rehab

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14
Q 
Vertebral Column 
# vertebrae
A 
7 cervical 
12 thoracic
5 Lumbar
sacrum and coccyx not considered vertebrae
31 spinal nerves 
21 vertebrae
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15
Q

Processes on vertebrae

A

7 proceses
4 articular
2 transverse
1 spinous

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16
Q

about the dis

A

central nucleus puplposes surrounded by annulus fibrosis
avascular: bld supply from peiphery adjacent blood vessels

mobility

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17
Q

what is for mobility and stability in spine

A

muscle attachements and ligaments for stability

articulation of facet joints and IV disc mobility

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18
Q

ALL

A

anterior longitudinal ligament

anterior vertebral body
atlas to sacrum
limits extension

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19
Q

PLL

A

posterior body within spinal canal from axis to sacrum, limits flexion

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20
Q

Ligamentum flavum

A

laminae of adjacent vertebrae,

upright head

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21
Q

ligamentum ncha

A

extend protub of skull to C7 for head upright

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22
Q

supraspinous infraspinous ligament

A

btwn spinous pocess

upright head

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23
Q

intertrnsverse ligament

A

ptween transverese process

limit lateral flexion of spine (rotation?)

24
Q

dura mater

A

envelopes roots, ganglia, nerves, dense fibrous tissue, little vascualr supply, protective function

if tumor problem

25
Q

arachnoid mater:

A

delicate, cobweblike fine elastic tissue in subarachnoid space

distribute CSF in CNS

26
Q

Pia Mater

A

adhere firmly to cord and help hold cord in place

27
Q

most imp structure between brain and body

A

spinal cord

28
Q

where is spinal cord

A

foramen of first magnum where it is continuous with medulla to level of the first or second lumbar vertebrae

29
Q

size of spinal cord

A

45 cm males
42 cm females
1.5 cm wide
weigh 30 grams–light

30
Q

where are the nerve roots

A

2 rows of nerve roots emerge from the cord on each of tis 2 sides, the nerve roots join distally to form 31 pairs of spinal nerves. there is one pair of roots per spinal segment, upper roots almost horizontal, others downward oblique

31
Q

ventral root

A

anterior, efferent
somatic = motor
have a visceral (sympathetic) portion

originate from ventral and lateral grey

32
Q

dorsal root

A

posterior, afferent root

33
Q

SAME

A

sensory afferent motor efferent

34
Q

DAVE

A

dorsal afferent ventral efferent

35
Q

how do dorsal and ventral combine

A

dorsal horn (sensory( and ventral horn (motor) come out of the central grey and join together to form the spinal nerve (31 pairs on each side)

36
Q

T/F

where does damage to L5 vertebrae cause damage

A

spinal nerves come out straight around C3, as you go down the nerves travel a little further down each time, the cord ends at L1. damage to L5 vertebrae doesnt mean L5 damage

damage to L5 vertebrae doesnt mean L5 damage

37
Q

grey area

A

H shaped area containing cell bodies of neurons

initial axonal segments, terminals of axons that synapse with these neurons

38
Q

dorsal horn

A

sensory

39
Q

ventral horn

A

motor

40
Q

lateral horn

A

visceral

41
Q

spinal cord white matter

A

ascending and descending fibers

when fibers performing similar tracts are grouped together they are called tracts

myelenated = white

42
Q

what happens if posterior cord is damaged?

A

sensation loss

fasciulus gracilis, fasciculus cuneatue

you can have corticospinal sparing and save motor

you can stull have some sensory from lateral and ventral spinothalamic tracts

43
Q

lesion to most anterior SC

A

lose motor from ventral corticospinal tracts as well as sensory from the spinothalamic tracts

44
Q

anatommical relationships between the spinal cord and ventral vertebral column

A

Different growth rate of cord and spine. Cord segments are displaced upward from corresponding vertebrae, greater discrepancy occurs as you go down

use spinous processes, add 2 to the number of spinous processes and resulting number is that of underlying spinal cord segment, from C2-T10
Ex: SP C5 over cord segment C7
SP + 2 = # of the underlying segment

Because the cord is shorter than the vertebral column, nerve roots have to travel downwards (caudal), prior to exiting the vertebral canal

45
Q

Cord Segment–>Vertebral body–>spinous process

Vertebral C6

Vertebral T4

A

Cord Segment–>Vertebral body–>spinous process (don’t need to memorize this, use the rule): more discrepancy as you go down

  1. C8–> lower C6/upper C7–>C6
  2. T6–> lower T3/upper T4–>T3
  3. T12–>T9–>T8
  4. L5–> T11–>T10
  5. S–> T12/L1–>T12
46
Q

Vascular Supply to the Spinal Cord

A

the spinal cord is highly vascularized, it needs oxygen/nutrients and with loss of vascularization major damage will occur (trauma, spinal stroke loss of blood supply due to ischemia or hemorrhage)*vascularization is dense because it is important *without the vasculature have extensive cord damage

47
Q

Anterior spinal artery:

where is it

what does it supply

A

supplied by intracranial artery and vertebral artery
it is a single solitary trunk, along

anterior fissure to thoracic spine

and it gives rise to sulcal artery which will supply central cord

48
Q

lateral spinal artery:

where is it

what does it supply

A

single set of branches from the vertebral artery C2-T2

supplies lateral structures

49
Q

segmental radicular artery:

where is it

what does it supply

A

prolongation of anterior spinal artery below T4, intercostal artery from aorta, supply segment bridge to spinal cord

supply nerve root areas

50
Q

intercostal artery: from where

A

from aorta

51
Q

Vessel of Adamkieicz:

what does it supply

A

supplies the anterior spinal artery between T8-L4. Supplies thoracic, lumbar, and sacral areas,

52
Q

Terminal artery:

what does it supply

A

supplies filum terminale

53
Q

Posterior Spinal Artery:

what is it

what does it supply

A

supplies the posterior horns and posterior vertebral structures

descends as a pair (unlike the anterior) along the medial edge of the posterior roots,

54
Q

Centrifugal system

what does it supply

where is it

A

supply exclusively cord –supply grey matter of the cord

a. arise from the anterior spinal artery and supplies the central region of the cord—mostly grey matter
b. includes most of gray matter and ½ inner, posterior, lateral, and anterior white matter

55
Q

Centripetal system:

what does it supply?

A

supply exclusively cord –supply white matter of the cord
—–Supplies part of dorsal horns, posterior column, outer lateral and anterior column

Arise from the anterior and posterior spinal arteries and supplies the peripheral region of the cord. Anterior artery gives rise to pial arteries and travel circumferentially supplies periphery.

56
Q

Capillary Network:

more dense in grey or white matter?

A

more dense in the grey matter than in the white matter. This suggests that grey matter is more important needs more vascular supply, when there is ischemia to cord itself the grey matter cells die more quickly than the white matter cells

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