Tspine main ones summarised Flashcards
Scoliosis
Apparent lateral curvature of the spine
Postural – conditions outside of the spine e.g. pelvic tilt or one leg shorter than the other
Structural – Vertebral rotation. SPs swing round towards the concavity of the curve and the transverse processes on the convexity rotate posteriorly.
Most cases have no obvious cause, some due to bony anomalies or connective tissue disorders
Most commonly begins in young people aged 10-18 - condition of development
Degenerative scoliosis - occurs later in life due to weakened structures
Idiopathic scoliosis - 80% of all cases, cause unknown - not linked to bad posture, exercise or diet etc
A possible obvious spinal deviation from midline, may be more apparent with P in flexion
Rib hump in thoracic curves
Asymmetrical prominence of one hip
Excessive kyphosis or lordosis
Risk factors to scoliosis
- the bones in the spine not forming properly in the womb – this is called congenital scoliosis and is present from birth
- an underlying nerve or muscle condition, such as cerebral palsy or muscular dystrophy – this is called neuromuscular scoliosis
- wear and tear of the spine with age – this is called degenerative scoliosis, which affects older adults
Spondylolisthesis
Vertebral displacement, forward slip of the vertebra
When normal mechanism of laminae and facets constituting a locking mechanism to keep each vertebra from moving forwards from the one below fails
Usually always between L4 and 5 or between L5 and the sacrum, due to:
Dysplasia of lumbar sacral facet joints – 20% of cases
Separation or stress fracture through neural arch – 50%
Osteoarthritic degeneration of facet joints causing them to loose normal stability – 25%
Destructive conditions such as fracture, tb and neoplasia – 5%
Women 3x more likely
Dysplastic spondylolisthesis seen in children
Lytic spondylolisthesis – most common and seen in adults
Degenerative spondylolisthesis – occurs in Ps over 40 with long standing backache due to facet joint arthritis
Intermittent back ache usual presenting symptom
Pain may be worse during exercise
A step can often be felt when running fingers down spine
Thoracic Outlet Syndrome
A group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed. This can cause shoulder and neck pain and numbness in your fingers. A diagnosis of exclusion
Can be arterial, venous or neurogenic.
Intercostal neuralgia
Any painful condition of the intercostal nerves
Presents as a band like pain wrapping across the chest in the dermatomal distribution.
Tietze Syndrome
Inflammation of the cartilage of one or more of the upper ribs (costochondral junction), specifically where the ribs attach to the sternum.
Precordial Catch Syndrome
Chest pain that occurs when nerves in the front of the chest are squeezed or aggravated.
Herpes Zoster
Viral infection that occurs with reactivation of the varicella-zoster virus (Chicken-pox).
Shingles
Most commonly have a rash in one or two adjacent dermatomes
* Not usually along P’s midline
* Painful, itchy, can be described as tingly
Costovertebral Joint syndrome
Joints between the vertebrae in the upper back and the ribs are called the costovertebral joints
Trunk and rib cage are rotated. This can overstretch the structures supporting the joint resulting in a costovertebral joint sprain.
- Pain made worse by deep breathing, coughing, or rotation movements
- Aching often felt between shoulder blades, towards one side of the Tspine
Post herpetic neuralgia
Pain in a dermatomal distribution which persists for three months or more after either onset or healing of the shingles rash.
Caused by herpes zoster-induced peripheral and central neuronal damage
Acute Pancreatitis
Sudden inflammation of the pancreas gland that begins in the cells in the pancreas that produce digestive enzymes.
