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BPK 241 > Week 5 [not including lab] > Flashcards

Week 5 [not including lab] Flashcards

1
Q

List the number of vertebrae in the spine and in each section

A 
33 total: 
7 cervical
12 thoracic
5 lumbar
5 sacral (fused)
4 coccyx
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2
Q

What is the importance of the spinal vertebrae?

A

structure helps to distribute force

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3
Q

What does the lateral (transverse) process articulate with?

A

ribs

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4
Q

Explain the differences between the cervical, thoracic and lumbar spine?

A
  • cervical spine: facets are oriented more horizontally to allow for larger range of motion; allows for flexion, extension, rotation, and lateral flexion
  • thoracic spine: articular facets are oriented more vertically; allows for flexion, extension, and rotation; little lateral flexion because of ribs
  • lumbar spine: articular facets are oriented in the sagittal plane; allows for lots of flexion and extension but little rotation
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5
Q

Give the function of the intervertebral discs

A
  • stability

- cushioning

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6
Q

How many facet joints are on each vertebrae?

A

4

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7
Q

Explain the structure of the nucleus pulposus

A
  • nucleus pulposus has a high water content because it is made up of hydrophilic material
  • ^proteoglycan fibre is main component (then collagen and water)
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8
Q

Explain the structure of the annulus fibres

A
  • arranged in 15-25 concentric layers (“annulus” like from yearly growth of tree rings)
  • fibres are angled and angle changes with alternate layers to allow for a strong configuration
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9
Q

What is it meant when it is said that the disc nucleus pulposus behaves hydrostatically?

A
  • centre of the disc (nucleus pulposus) is like a liquid
  • liquids are incompressible
  • an applied load creates outward (radial) pressure in all directions inside the disc
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10
Q

Why is sitting more physically demanding on the annulus fibrosis than standing?

A
  • sitting rotates the pelvis posterior
  • we lose the lordotic curve in our back
  • ends up resulting in greater compressive forces in the discs
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11
Q

What parts of the spine are responsible for:

  • flexion and extension
  • lateral flexion
  • rotation
A
  • flexion and extension: cervical, thoracic, lumbar
  • lateral flexion: cervical, thoracic, lumbar
  • rotation: cervical and thoracic only
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12
Q

What is the transversospinalis responsible for?

A
  • mostly stabilization
  • lateral flexion
  • extension
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13
Q

Fill in the blank: when one side of the transversospinalis contracts, it can cause ____________

A

contralateral rotation

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14
Q

Where do the spinal nerves come from?

A

intervertebral foramen

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15
Q

Explain the connection of number of nerve roots and vertebrae

A
    • number of nerve roots match up with number of vertebrae EXCEPT in cervical spine (has 8 nerve roots)
  • because first cervical nerve root comes out between skull and above C1
  • 8th cervical nerve root comes out between C7 and T1
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16
Q

Where does the spinal cord end?

A

spinal cord ends at L1 and below that its just nerve roots that come out

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17
Q

Where do the sciatic nerves originate?

A

L4, L5, S1, S2, S3

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18
Q

Define: sciatica

A

sciatic nerve discomfort

19
Q

Define: dermatome

A

dermatome is an area of skin in which sensory nerves derive from a single spinal nerve root

20
Q

What are some general causes for spinal injuries?

A
  • congenital predispositions
  • previous trauma
  • mechanical factors (previous trauma like lifting and bending, obesity)
  • acute or repetitive trauma
21
Q

What are some general effects of spinal injuries?

A
  • pain, tenderness, spasm, restricted ROM

- neurological symptoms: weakness, numbness, sciatica (radiating pain), absent deep tendon reflexes

22
Q

Spinal strains and sprains

  • cause
  • symptoms
A 
cause
- twisting, lifting (reoccurrence is common)
symptoms
- pain and tenderness
- muscle spasm (delayed onset)
- restricted ROM
- increased warmth
- N.B.: if any neurological SSx is present, assume fracture, dislocation, or disc injury (stabilize and transport to hospital)
23
Q

Spinal strains and sprains

- treatment

A
  • Rest – supine – no more than 2 days
  • NSAID
  • cold therapy at first
  • Heat therapy later
  • Physiotherapy or massage Tx
  • Comprehensive, supervised rehabilitation program
  • Flexibility
  • Strengthening § Task-specific
  • Correct predisposing factors
  • Gradual return to activity
24
Q

Explain lumbar disc herniation and the four stages

A
  • Nucleus pulposus breaks through annulus fibrosis
  • usually occurs at the L4L5 and L5S1 levels

stages:
- protrusion
- prolapsed
- extrusion
- sequestered

25
Q

What ages are you vulnerable for lumbar disc herniation

A
  • vulnerable between ages 30 to 50 as elasticity and water content of the nucleus pulposus decreases with age
26
Q

Explain this stage of lumbar disc herniation: disc protrusion

A
  • disc bulge

- cracks in annulus fibrosis begin to appear

27
Q

Explain this stage of lumbar disc herniation: prolapsed disc

A
  • nucleus pulposus moves completely through annulus fibrosus
28
Q

Explain this stage of lumbar disc herniation: extruded disc

A
  • nucleus pulposus moves into spinal canal, comes in contact with a nerve root
29
Q

Explain this stage of lumbar disc herniation: sequestered disc

A
  • portion of nucleus pulposus separates from disc and begins to migrate in spinal canal
30
Q

Explain the mechanism behind intervertebral disc disease

A
  • forward bending and twisting that places an abnormal strain on the lumbar region
  • Herniation or bulging of nucleus pulposus
  • Compression of nerve root(s) or spinal cord
  • Results in degeneration, tears, and cracks in the annulus fibrosis
  • all from faulty body mechanics or trauma
31
Q

Explain the symptoms behind intervertebral disc disease

A
  • sciatica: Sharp, centrally located pain that radiates unilaterally in a dermatomal pattern to the buttocks and down the back of the leg, or pain across the back
  • weakness in lower limbs
  • Symptoms are worse in the morning with axial loading such as when patient gets out of bed
  • Forward bending and sitting increase pain
  • Backward bending reduces pain
  • Valsalva increases pain (coughing, sneezing,)
  • diminished tendon reflexes
  • instability (muscle testing reveals weakness with bilateral differences)
  • osteoarthritis (osteophytes, stenosis)
32
Q

Define: osteophytes

A

bony lumps (bone spurs) that grow on the bones of the spine or around the joints

33
Q

Define: stenosis

A

narrowing of the spaces within your spine, which can put pressure on the nerves that travel through the spine

34
Q

Explain the treatments for intervertebral disc disease

A

Stay conservative if possible:

  • loosen tight muscles in areas of pain, and strengthen weak ones
  • in particular strengthen the core
  • Pain reducing modalities (ice, electrical stimulation)
  • Goal: reduce protrusion and restore normal posture
  • Manual traction combined with passive backward bending or extension
  • Postural self-correction exercises
  • For extruded or sequestraded disks you can only modulate pain with electrical stimulation
  • Flexion exercises and lying supine in a flexed position may help with comfort
  • Signs of nerve damage indicate surgery may be required to eliminate pain and disfunction

Surgery which is last resort:

  • discectomy: replacing a disc with an artificial one
  • laminectomy: remove part of lamina to give spinal cord more space
  • fusion: fuse 2 spinal segments (but this increases stress on spinal segments above and below the fusion which accelerates the degenerative changes in this area)
35
Q

Brachial plexus neuropraxia

  • Hx
  • symptoms
A

history

  • Stretching or compression of brachial plexus
  • Neck forced laterally

symptoms

  • Pain/numbness into fingers, burning, numbness, tingling from shoulder to hand
  • Lasts for several minutes
  • Athlete may return only if symptoms resolve
36
Q

Brachial plexus neuropraxia

- treatments

A
  • rest

- If symptoms not diminishing or resolving within a few minutes (or if worsening) send to hospital

37
Q

Spinal fractures

- causes

A
  • axial load (Cervical spine (head into boards at hockey, helmet to helmet in football); 4th, 5th, and 6th cervical vert most common)
  • hyperextension
38
Q

Spinal fractures

- symptoms

A
  • point tenderness, decreased ROM
  • pain in neck, chest, extremities
  • numbness/ weakness in trunk and limbs
39
Q

Spinal fractures

- treatment

A
  • stabilize, c-spine collar, spine board

- if unconscious, assume c-spine injury

40
Q

What are some tips on management of back injuries

A
  • key is balance: keep demands within functional capacity and expectations with realistic goals

Mainstays

  • time (rest, healing)
  • cold, heat, NSAIDs, braces
  • physiotherapy, massage therapy, chiropractic
  • rehabilitation (indefinite)
  • correct predisposing factors
  • may need to change job or sport
41
Q

Fill in the blank: Studies found that intervertebral pressure decreased by ____ when the spine was in supine position and by ____ when compared to side lying (compared to standing)

A
  • 75%

- 25%

42
Q

Fill in the blank: Pressure increased ___ while patient was sitting, ___ when standing and slightly bent forward, by ___ while patient was sitting slightly bent forward, ___ when patient was standing bent far forward, and ___ when patient was sitting bent well forward

A
  • 33%
  • 33%
  • 45%
  • 52%
  • 63%
43
Q

contralateral vs ipsilateral

A
  • contralateral: relating to or denoting the side of the body opposite to that on which a particular structure or condition occurs.
  • ipsilateral: belonging to or occurring on the same side of the body.

BPK 241 (7 decks)

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