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LOCO 2 > The vertebral column and common back problems > Flashcards

The vertebral column and common back problems Flashcards

1
Q

Why do abnormal curves happen?

A

Due to developmental abnormalities or pathological conditions (missing half vertebrae and osteoporosis)

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2
Q

What is kyphosis

A

Humpback

Excessive thoracic kyphosis

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3
Q

Why does kyphosis happen

A

Erosion/ fracture of anterior part of one or more vertebrae

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4
Q

What are the aims of kyphoplasty

A

Effective at providing pain relief

Preventing further collapse

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5
Q

What is adolescent kyphosis also known as

A

Sheuermanns disease

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6
Q

What happens in adolescent kyphosis

A
  • Epiphyseal growth plates of vertebral bodies more affected in one or more thoracic vertebrae
  • Causes wedging of bone and kyphosis
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7
Q

Symptoms of adolescent kyphosis

A

Pain, difficult breathing

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8
Q

What % of children are affected by adolescent kyphosis

A

1%

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9
Q

How is adolscent kyphosis treated

A

Brace

Surgery for curves >60 degrees

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10
Q

What is lordosis

A

Hollow back/ sway back

Anterior rotation of the pelvic produces increased lumbar curvature

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11
Q

When can lordosis occur (3)

A
  • Late pregnancy
  • Obesity
  • Weak hip flexor
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12
Q

Symptoms of lordosis

A

Back ache

Sciatica

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13
Q

Shortness and weakening of which muscle is associated with lordosis

A

Psoas

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14
Q

Describe how shortening/ tightening of the psoas can lead to lordosis

A
  • Alterations in body mechanics alignment resulting in excessive and inappropriate muscle exertion
  • Increase in normal forward curve or hollow is most common postural defect
  • Muscles in lower back shortern and tighten (thoracolumbar fascia and erector spinae muscles)
  • Hamstrong and gluteal muscles tightened and often hypertonic
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15
Q

What is flat back syndrome

A

Tight musculature between ribs makes breathing shallow
Hamstrings are tight
Hip flexors weak
Pelvis tilts backwards, pulling column flat

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16
Q

What are the 3 consequences of flat back syndrome

A
  • Ankylosing spondylitis
  • Degeneratiev disc
  • Spinal fusion
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17
Q

What is scoliosis

A

Abnormal lateral curvature of the back

18
Q

What % of the population have scoliosis? What group is it most commonly seen in

A

3%

Girls around puberty

19
Q

What does scoliosis result from

A
  • Developmental defects
  • Asymmetric muscle strength
  • Poor posure
  • Idiopathic
20
Q

Between what degrees of curvature can a brace be used for scoliosis

A

20-40

21
Q

What are the options for scoliosis curves of >50 degrees

A

Vertebral fusion

Harrington rods

22
Q

What should you look for when considering age related degenerative spine disorders (5)

A
  • Osteophytes
  • Loss of disc height
  • Loss/ increase in curves
  • Spinal steonosis
  • Ossification of vertebral ligaments
23
Q

What kind of joint in an IV disc

A

Cartilaginous

24
Q

What is the make up of the nucleus pulposus

A

70-90% water
Proteoglycans
(avascuclar and aneural)

25
Q

Describe the structure of the annulus fibrosus

A

alternating layers of type 1 collagen
outer 1/3 innervated
firmly attached to outer margin of vertebral body

26
Q

Which disc is most commonly herniated

A

L4/5

L5/S1

27
Q

Why do herniated/ prolapsed discs cause pain

A

Nucleus pulposus irritates compresses spinal nerve root

28
Q

What are the symptoms of cauda equina syndrome

A 
Low back pain
Unilateral/ bilateral sciatica
Saddle or perineal hypothesia
Bowel bladder disturbances
Motor and sensory deficit
Reduced or absent lower extremity reflexes
29
Q

Treatment for cauda equina syndrome

A

Laminectomy or discetomy

30
Q

What are the acute complications of a burst disc

A

Compression of the spinal cord or nerve roots

Instability

31
Q

What are the late complications of a burst disc

A

Haematoma

Necrosis

32
Q

Where do osteophytes develop around as we age

A

Margins of the vertebral body

Zygrapophysial joints

33
Q

What is a vascular consequence of OA/ degenerative disc disease

A

vertebral-basilar artery insufficiency

34
Q

What is diffuse idiopathic skeletal hyperostosis

A

Ossification of anterior longitudinal ligament with or without osteophytes

35
Q

Is disc height maintained in diffuse idiopathi skeletal hyperostosis

A

Yes

36
Q

Is the sacroiliac joint involved in diffuse idiopathic skeletal hyperostosis

A

Nah

37
Q

What is ankylosing spondylitis

A

Chronic inflammatory disease mainly involving axial skeleton

38
Q

What are the features of ankylosing spondylitis

A
  • Narrowing and sclerosis of both sacroiliac joints
  • Slerosis and ankylosis of vertebral bodies with no loss of disc space
  • Bone formation extends across anterior and lateral margins of IV discs
39
Q

What gene is related to ankylosing spondylitis

A

HLA-B27

40
Q

What is enthescopathy

A

Attachments of tendons and ligaments into bone

41
Q

Describe the relationship between anklylosing spondylitis and the gut

A
  • HLA B27 influences composition of the endogenous gut flora
  • B27 predisposes to leaky gut
  • Leaky gut allows substances trigger cascades of inflammatory reactions

LOCO 2 (25 decks)

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