Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Med I > the spine > Flashcards

the spine Flashcards

1
Q

how many vertebrae are there?

A
  • 33 total
  • C7
  • T12
  • L5
  • S5
  • Coccyx 4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how many spinal nerves are at each level?

A
  • C8
  • T12
  • L5
  • S5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

T4 dermatome

A
  • nipple line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T10 dermatome

A
  • belly button
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

L4 dermatome

A
  • toes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

S1 dermatome

A
  • Achilles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what does AP view of c spine assess

A
  • alignment

- rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does lateral view of c spine assess

A
  • alignment
  • subluxation
  • sponlyolysthesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does odontoid view of c spine assess

A
  • used in trauma for C1- C2 clear space around odontoid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does oblique view of c spine assess

A
  • facet joints for spondylolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does fuchs view of c spine assess

A
  • modified odontoid through soft tissue of neck
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does swimmers view of c spine assess

A
  • C6 C7 visualization in larger person

- arm close to cassett

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

odontoid fx

A
  • aka peg or dens fx
  • fx through odontoid process of C2
  • most common fx of upper c spine
  • mechanism variable but often d/t flexion loading
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Associated injuries of odontoid fx

A
  • atlas fx

- transverse ligament rupture- considered unstable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

conservative tx for odontoid fx

A
  • halo brace X 3 months

- will do well if pt is younger, small displacement, or dx early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

operative tx for odontoid fx

A
  • posterior atlantoaxial arthrodesis with wire and bone graft
  • anterior screw fixation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

cervical spondylosis

A
  • combo of DDD and osteophyte formation
  • common at C5-6* or C6-7
  • DD and facet arthropathy -> radiculopathy
  • often have associated disc herniation
  • graded as levels 1-4
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

imaging for cervical spondylosis

A
  • plain films to assess for alignment, disc space narrowing, anatomical anomalies
  • MRI best but ONLY for interventional purposes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

treatment for cervical spondylosis

A
  • pain control- no narcs
  • high dose steroids with taper
  • PT
  • light activity
  • epidural steroid inj
  • surgery - discectomy and fusion of affected vertebrae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

herniated nucleus pulposis (HNP) in c spine

A
  • neck pain that radiates or causes numbness
  • radicular pain with compression of neural structures
  • extremity weakness or numbness
  • varying level of pain
  • worse with flex/ ext
  • often stiff and uncomfortable
  • positive spurling’s sign
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hangman’s fracture

A
  • noose placed with knot towards side of neck
  • virtually never seen in suicide
  • d/t hyperextension and distraction
  • involves pars interarticularis of C2 bilaterally
22
Q

clinical presentation of hangman’s fx

A
  • often from post- traumatic neck pain after high velocity hyperextension (MVA)
  • neurologic impairment not usually seen
23
Q

radiographic findings for hangman’s fx

A
  • bilat lamina and pedicle fx at C2
  • associated anterolisthesis of C2 on C3
  • ext of fx to transverse foramina- possible vertebral a injury
  • CT best imaging modality
24
Q

tx of hangman’s fx

A
  • ABCs
  • maintain c spine precautions
  • treat other injuries
  • early consult to spine/neuro
  • hard collar first then soft collar
  • ORIF
  • halo brace
25
Q

jefferson fx

A
  • burst fx of C1 through anterior and posterior arches
  • d/t axial loading which causes occipital condyles to be driven into lateral masses of C1
  • i.e. diving head first into shallow pool
  • not normally assoc with neuro deficits
  • often associated with other C spine injuries and C2 fx
  • possible vertebral artery injury
26
Q

imaging of jefferson fx

A
  • xray shows asymmetry in odontoid view with displacement of lateral masses away from dens
  • significant displacement (>6 mm)= ligament injury
  • CT to assess fx
  • MRI if fx not seen and to eval ligament injury
27
Q

treatment for jefferson fx

A
  • if no transverse atlantal ligament injury then can tx with hard collar immobilization
  • if ligament injury it is considered unstable -> halo immobilization, posterior C1-2 lateral mass internal fixation, transoral internal fixation
28
Q

what does AP view of lumbar spine assess

A
  • alignment and rotation
29
Q

what does lateral view of lumbar spine assess

A
  • alignment
  • subluxation
  • spondylolisthesis
30
Q

what does coned down (spot) view of lumbar spine assess

A
  • zooms in on L4 and L5
31
Q

what does oblique view of lumbar spine assess

A
  • articular facet
  • pars interarticularis
  • pedicles
32
Q

LBP

A
  • most common cause of disability in pts < 45
  • second most common cause for PCP visit
  • 80% resolves after 2 weeks
  • 90% resolves after 6 weeks
33
Q

si/sx of LBP

A
  • sudden vs gradual onset
  • usually around low back with radiation to buttocks
  • +/- radiation to LE and radicular sx
  • if radiates does it go past knee?
  • +/- LE weakness (usually d/t pain)
34
Q

physical exam for LBP

A
  • if pt is more comfortable standing then do most of PE while theyre standing
  • save maneuvers most likely to cause pain for last
  • caution of waddell’s signs- correlate to non-organic LBP
35
Q

what are Waddell’s signs?

A
  1. tenderness
  2. stimulation
  3. distraction
  4. regional
  5. overreaction
36
Q

treatment for LBP

A
  • pain control- no narcs
  • PT
  • light activity
37
Q

surgical indications for LBP

A
  • cauda equina syndrome- emergency
  • HNP not responding to conservative tx
  • cancer
  • infection
  • severe spinal deformity
38
Q

HNP of lumbar spine

A
  • LBP +/- radiation of pain and/or numbness
  • L4-5 and L5-S1 most often affected
  • pain with flexion or prolonged sitting
  • radicular pain with compression of neural structures
  • extremity weakness and pain
39
Q

PE of HNP in lumbar spine

A
  • pt may prefer to stand
  • LBP at level of affected disc is worse with activity
  • pain with flex or ext
  • check motor, sensory and reflexes
    • SLR on affected side, contralateral SLR is indicator for severe herniation
  • must r/o cauda equina
40
Q

sciatica

A
  • shock like pain radiating down posterior aspect of legs often below the knees
41
Q

imaging for HNP in lumbar spine

A
  • xrays to assess alignment, disc space narrowing, OA, anatomic anomalies
  • MRI best but ONLY for interventional purposes
42
Q

treatment of HNP in lumbar spine

A
  • pain control- limit narcs
  • high dose PO steroids
  • PT
  • light activity
  • epidural steroid injection
  • discectomy
43
Q

spondylolysis

A
  • defects in pars interarticularis of neural arch that connects superior and inferior articular facets
  • aka pars defect
  • more common in men
  • d/t stress fx or high energy trauma with hyperext of lumbar spine
  • 90% occur at L5
  • may be uni or bilat
44
Q

clinical presentation of spondylolysis

A
  • more in adolescent atheltic population- swimmers and gymnasts
  • commonly asymptomatic
  • if symptomatic have pain that is worse with ext and/or rotation of spine
  • scotty dog sign on oblique view
45
Q

treatment for spondylolysis

A
  • sx often resolve with conservative tx
  • bracing 6-8 months
  • surgical repair if not responding to bracing or L5 pars defect
46
Q

spondylolisthesis

A
  • displacement of vertebral body in relation to inferior vertebra
  • often at L5/S1* and L4/L5
  • anterolisthesis or retrolisthesis
  • graded by meyerding classification
47
Q

meyerding classification

A
  • grades spondylolisthesis
  • Grade I= < 25% displaced
  • grade II= 25-50% displaced
  • grade III= 50-75% displaced
  • grade IV= 75-100% displaced
  • grave V= spondyloptosis
48
Q

spinal stenosis

A
  • narrowing of spinal canal
  • mostly in older pts
  • d/t OA, HNP, hypertrophy of ligamentum flavum, or congenital
49
Q

clinical presentation of spinal stenosis

A
  • pain worse with exertion
  • reprod uni or bilat leg sx after walking several minutes
  • relieved by sitting- neurogenic claudication
  • pain usually worse when back ext to relieved by leaning forward
50
Q

PE of spinal stenosis

A
  • pt may prefer to sit
  • limited ext and may produce pain down legs
  • check motor, sensory, and reflexes
    • SLR on affected side, contralateral SLR is indicator for severe stenosis
  • need to r/o cauda equina
  • xray first then MRI only for interventional purpose
51
Q

treatment of spinal stenosis

A
  • pain control- limit narcs
  • PT
  • light activity
  • facet or epidural inj
  • surgery- spinal decompression, nerve root decompression, spinal fusion

Clin Med I (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions