THEORY WEEK 2 FINISHED

Question 1

Radiculopathy

Answer 1

The irritation of a nerve root

Question 2

Myelopathy

Answer 2

The irritation of the spinal cord

Question 3

Radiating pain

Answer 3

Nerve along the nerve root

Question 4

Referred pain

Answer 4

Musculoskeletal structure that causes somatic referred pain, its not along a specific nerve root, to do with embryology and how you were formed.

Question 5

Annulus fibrosis makes up how much of the disc?

Answer 5

Outer 1/3

Question 6

Which parts of the disc have nerve supply?

Answer 6

Only the outer 1/3

Question 7

What is the role of the nucleus pulpous and the annulus fibrosis?

Answer 7

Provide strong attachment sites between the vertebral bodies
20-25% of height of the vertebral column
Shock absorption
Nucleus provides flexibility
Separate the vertebra

Question 8

Describe the annulus fibrosis:

Answer 8

Obliquely oriented alternating collagen fibres

Question 9

Describe the nucleus pulpous:

Answer 9

Avascular, composed of hydrophilic proteoglycan = semi fluid filled.

Question 10

What are the 4 forms of disc injury in order of least bad to most bad?

Answer 10

Disc degeneration
Disc bulge
Disc prolapse
Sequestration

Question 11

What is an annular tear?

Answer 11

Fibres of the annulus portion are torn

Question 12

What is a disc bulge?

Answer 12

Nucleus has moved into a weakened area of the annulus but contained within the disc

Question 13

What is disc prolapse?

Answer 13

The nucleus has moved outside the annulus though a tear. Nucleus is still attached to the disc

Question 14

What is a disc sequestration?

Answer 14

Same as the prolapse, but part of the extruded nucleus has broken off from the nucleus.

Question 15

Internal disc derangement

Answer 15

Terms used to describe degenerated discs without any visible external deformity. May have presence of small micro tears.

Question 16

Why is disc prolapse less likely in older age groups?

Answer 16

Because as the person ages the water from the disc dries up and the annulus fibrosis hardens and becomes less flexible. Because it is so hard and stiff it is harder to split.

Question 17

What is the peak age of onset for disc injuries?

Answer 17

20-45

Question 18

What is the % of disc bulges of L/S or L4/L5?

Answer 18

> 95%

Question 19

What is the aetiology of disc injuries?

Answer 19

Degenerative/ micro trauma injury
Repetitive lifting, twisting, bending
Genetics
Possible to occur from acute trauma to the spine e.g. falling off ladder

Question 20

What is cauda equina syndrome? What does it result in? Why is it a medical emergency?

Answer 20

Is a lower motor neurone lesion
Saddle region anaesthesia/paraesthesia
\+/- urinary retention
\+/-faecal incontinence
\+/- lower limb nerve root signs and symptoms may be bilateral

If this is not treated within a few hours the above symptoms could become permanent e.g. faecal incontinence.

Question 21

What are some causes of caudal equine syndrome?

Answer 21

Trauma - fracture
Disc prolapse/sequestration
Spinal stenosis
Neoplasm
Inflammatory arthridity
Abscess
Lumbar HVLA?!
Iatrogenic - lumbar puncture, hardware