The spine and the vertebral column Flashcards
Functions of the spine
- Supports body and head
- Protects spinal cord
- Distribution route for nerves
- Attaches ribs, muscles and pelvic girdle
- Movement
What is important to remember about the cervical spine?
7 cervical vertebra but 8 cervical roots - first above c1 and last below c7
Where does the spinal column end?
L1/2
Where do you perform a lumbar puncture?
L4/5
Why does damage to the p/s pathway lead to incontinence?
Associated with S2-4 which control sphincter
Embryology of spine
- Neural tube develops early on in the form of somites
- As fetus develops, somites increase in number
- 28 days: fetus looks like it has spinal cord
- Central canal forms when the spinal cord develops
- Central cord syndrome: central canal is too big and becomes fluid-filed - cape like loss of pain and temperature sensation
What is spinal bifida?
Incomplete vertebral arch - channel is open
Which compound is useful for neural tube development?
Folate
Meningocele
Sack of spinal fluid pokes through spine
Myelomeningocele
Portion of spine or spinal nerves is exposed
What is syringomelia?
Fluid filled abscess arises in spinal cord which gets bigger and bigger
Tx syringomelia
Catheter drainage and lower CSF pressure
ASIA scale
A is complete loss of motor function, E is normal
What is scoliosis?
Lateral curves
What is kyphosis?
Slouched shoulders - enhanced thoracic kyphosis
Dropped head spine
Weakness of neck extensor muscles (MND, myasthenia graves, myopathy)
Treat by using brace to hold head up
Back pain red flags
- History of malignancy
- Unexplained weight loss
- Fever
- Immunocompromised
- IV drug use
- Saddle anaesthesia
- Sphincter dysfunction
- Progressive neurological deficit
- Nocturnal pain
Ankylosing spondylitis
Inflammation of the spine
Ankylosing spondylitis sx
Back pain and stiffness
Tiredness
Discitis
Inflammation between spinal discs
Discitis sx
Posture changes
Stiffness in back
Fever
Abdomen pain
Herniation
Portion of nucleus pushes through cracks in annulus
Herniation sx
If your herniated disk is in your lower back, you’ll typically feel the most pain in your buttocks, thigh and calf. You might have pain in part of the foot, as well. If your herniated disk is in your neck, you’ll typically feel the most pain in your shoulder and arm
Numbness
Tingling
Weakness
Spondylosis
Age-related wear and tear of the vertebrae in the neck
Lumbago
General lower back pain
Spondolisthesis
Vertebra slips out of position, commonly in lower back
DEXA scan numbers and osteoporosis
above 1SD is normal, between -1 and -2.5 is osteopenia and below -2.5 is osteoporosis
Osteoporosis
Demineralisation and abnormal bone density
r/f for osteoporosis
steroid use, low BMI, heavy smoker and drinker
Osteoporosis sx
Back pain, caused by a fractured or collapsed vertebra.
Loss of height over time.
A stooped posture.
A bone that breaks much more easily than expected.
Treatment osteoporosis
avoid risk factors, vitD and calcium replacement, osteoclast inhibition (olendronate), SERMs (raloxifene), rank receptor inhibition (denosumab)
AIDP
Acute inflammatory demyelinating poly-radiculopathy (Guillon barre)
What is Guillon Barre ?
Immune system attacking PNS
MND sx
Weakness in legs/ankles
Slurred speech
Muscle cramps
Guillon Barre sx
weakness, sensory loss, reflex loss, autonomic failure, respiratory failure
Guillon Barre ix
nerve conduction studies (demyelination), lumbar puncture (high protein), vital capacity, ECG, blood tests (campylobacter ABs)
Guillon Barre tx
immunomodulation, prevent complications (plasma exchange, not steroids), supportive care on ITU
