THEORY WEEK 2 FINISHED Flashcards
Radiculopathy
The irritation of a nerve root
Myelopathy
The irritation of the spinal cord
Radiating pain
Nerve along the nerve root
Referred pain
Musculoskeletal structure that causes somatic referred pain, its not along a specific nerve root, to do with embryology and how you were formed.
Annulus fibrosis makes up how much of the disc?
Outer 1/3
Which parts of the disc have nerve supply?
Only the outer 1/3
What is the role of the nucleus pulpous and the annulus fibrosis?
Provide strong attachment sites between the vertebral bodies 20-25% of height of the vertebral column Shock absorption Nucleus provides flexibility Separate the vertebra
Describe the annulus fibrosis:
Obliquely oriented alternating collagen fibres
Describe the nucleus pulpous:
Avascular, composed of hydrophilic proteoglycan = semi fluid filled.
What are the 4 forms of disc injury in order of least bad to most bad?
Disc degeneration
Disc bulge
Disc prolapse
Sequestration
What is an annular tear?
Fibres of the annulus portion are torn
What is a disc bulge?
Nucleus has moved into a weakened area of the annulus but contained within the disc
What is disc prolapse?
The nucleus has moved outside the annulus though a tear. Nucleus is still attached to the disc
What is a disc sequestration?
Same as the prolapse, but part of the extruded nucleus has broken off from the nucleus.
Internal disc derangement
Terms used to describe degenerated discs without any visible external deformity. May have presence of small micro tears.
Why is disc prolapse less likely in older age groups?
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.
What is the peak age of onset for disc injuries?
20-45
What is the % of disc bulges of L/S or L4/L5?
> 95%
What is the aetiology of disc injuries?
Degenerative/ micro trauma injury
Repetitive lifting, twisting, bending
Genetics
Possible to occur from acute trauma to the spine e.g. falling off ladder
What is cauda equina syndrome? What does it result in? Why is it a medical emergency?
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.
What are some causes of caudal equine syndrome?
Trauma - fracture Disc prolapse/sequestration Spinal stenosis Neoplasm Inflammatory arthridity Abscess Lumbar HVLA?! Iatrogenic - lumbar puncture, hardware
