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Y2 MSK > The Spine and Back Pain > Flashcards

The Spine and Back Pain Flashcards

1
Q

how many vertebrae are there

A

33

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2
Q

how many cervical, thoracic, lumbar, sacral and fused coccygeal vertebrae are these

A

7, 12, 5, 5, 4

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3
Q

describe the curvatures of the spine

A

cervical lordosis
thoracic kyphosis
lumbar lordosis
coccygeal kyphosis

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4
Q

what are the parts of the body of a vertebra

A

outer annulus fibrosis, inner nucleolus pulposus

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5
Q

what are the atypical vertebrae

A

c1, c2, c7

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6
Q

what is atypical about c1

A

“atlas” no vertebral body for head rotation

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7
Q

what is atypical about c2

A

“axis” has a dens

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8
Q

what is atypical about c7

A

“vertebrae prominens” small foramina transveraria, non-bifid for vertebral artery passage

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9
Q

what is the cauda equina and what vertebral level is it

A

L1 spinal cord ends

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10
Q

where do sensory neurons originate

A

dorsally

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11
Q

where do motor neurons originate

A

anteriorly from dorsal horn

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12
Q

what are mixed spinal nerves formed of

A

anterior & posterior roots

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13
Q

what is spondylosis

A

group term for degeneration of the spine

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14
Q

what is spondylolysis

A

stress #/defect in pars interarticularis of vertebrae at L5

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15
Q

what is spondylolisthesis

A

1 vertebra slips forward on another

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16
Q

what vertebrae are affected by spondylolithesis

A

L4/5 or L5/S1

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17
Q

what plane is a gibbus viewed in

A

saggital

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18
Q

what are the red flags of back pain

A 
PH carcinoma
cauda equina synd
morning stiff
immunocompromised
non-mechanical
6 wk
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19
Q

what ages are is back pain more worrying

A

acute <20/>55

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20
Q

what area of the spine is back pain more worrying in

A

thoracic

21
Q

what is the commonest cause of back pain

A

mechanical

22
Q

what is the management of mechanical back pain

A

NSAID/PT/chiro

23
Q

how long does mechanical back pain usually take to heal

A

6wk

24
Q

what type of back pain is OA

A

mechanical

25
Q

how to differentiate mechanical back pain

A

worse on activity, relief on rest

26
Q

which vertebrae are affected by osteoporosis/spondylosis

A

L4/5/S1

27
Q

how to distinguish back OP

A

pain relief on extension

28
Q

what test can be done to diagnose/treat back OP

A

facet joint injection under fluoroscopy

29
Q

what is the presentation of a lumbar disc prolapse

A

episodic back pain, then dominating dermatomal leg pain

30
Q

what ages are affected by lumbar disc prolapses

A

30s-50s

31
Q

what is the presentation of sciatica

A

dermatomal tingling/burning pain in lower leg +- bum

32
Q

what is the pathology of sciatica

A

nucleus pulposus herniates to spinal canal; compresses L4/L5/S1, radiates on sciatic nerve

33
Q

what is the initial management of sciatca

A

PT/analgesia/NSAID +- muscle relaxant diazepam

34
Q

when to refer sciatica

A

if >3 months

35
Q

what is done for sciatica after referral

A

MRI to decide if surgery is appropriate

36
Q

what surgeries can be done for sciatica

A

discectomy or decompression

37
Q

what is the pathology of spinal stenosis

A

osteophytes, hypertrophied ligamentum flavum & bulging discs < cauda equina space; compress nerve

38
Q

what are risk factors for spinal stenosis

A

(>50 obese male

39
Q

what is the presentation of spinal stenosis

A

neurogenic claudication, burning leg pain walking downhill, relief up hill/ flexing/ cycling

40
Q

what is the management of spinal stenosis

A

sometimes decompression is appropriate

41
Q

when to MRI back pain from primary care

A

sciatica >3mth, spinal claudication

42
Q

problem with MRIs for back pain

A

many false +ves

43
Q

how long does spinal shock last

A

24hr

44
Q

presentation of neurogenic shock

A

temporary paralysis, hypotension, bradycardia

45
Q

cause of a vertebral crush/wedge fracture

A

OP

46
Q

management of a vertebral crush/wedge fracture

A

conservative or balloon vertebroplasty

47
Q

describe discogenic pain

A

deep central lower back, worse end of day/flex/activity

48
Q

gold standard investigation of back pain

A

MRI

49
Q

investigation of spinal fracture

A

CT

Y2 MSK (20 decks)

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