Flashcards in 6. Spine Deck (92)
# of spinal nerves?
8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
% people with low back pain sometime in life
Definition of acute low back pain
Nonsurgical tx for spinal stenosis
2. Analgesics (acetaminophen)
3. Steroid injections (inflammation)
4. Anesthetic nerve blocks
5. Restricted activity
7. Back brace
Irritation of LMN from mechanical/chemical insult to nerve root at single spinal level.
Burning pain/numbness with weakness/loss of reflex in corresponding nerve distribution
>1 nerve root compression
Straight leg raise test (for disc herniation)
If cervical disk herniation at C4-C5, which nerve root will be affected?
(lower nerve root)
Increased pain along nerve distribution from cervical extension with axial compression/rotation of head (decrease size of neural foramen)
LMN symptoms in upper extremity (loss of manual dexterity/muscular atrophy), from chronic pressure on cervical spinal cord from degenerative process.
+ neck pain, stiffness, clonus, hoffman/babinski signs
Red flags in spinal eval
Fever, pain in recumbent position, weight loss, B&B dysfunction, trauma, hx cancer, saddle anesthesia, failure to respond to tx
Measures movement of lumbar spine
10cm proximal and 5cm distal to line between posterior superior iliac spine in midline - at least >5cm in extension
Malnourished patient with symmetric paresthesias in feet/hand and poor proprioception
Lateral recess stenosis, SLR negative or positive?
GBS and SLR?
SLR often positive in GBS
back pain, radiculopathic symptoms + SLR, and hx of viral event
Patrick test for lower extremities (FABER test for flexion, abduction, and external rotation)
Arthritis of hip
1. figure 4 of hip
2. pressure on tested knee
look for pain (anterior hip capsule)
SLR nerve root
L5 and S1
Types of nerves in dorsal ramus of nerve root
Dorsal portion of trunk carrying visceral motor, somatic motor and sensory to/from skin and back muscles
Types of nerves in ventral ramus of nerve root
Visceral motor, somatic motor and sensory to/from ventrolateral body surface, body wall and limbs
Lateral recess stenosis and herniated lumbar disk pain with sitting
LRS: relieved by sitting
HLD: exacerbated by sitting
Why C5 radiculopathy can follow anterior/posterior decompression even after no obvious complication
C5 radiculopathy (deltoid weakness) from traction of nerve root from posterior migration of cord (shortest length from foramen to muscle ending)
Paget disease: urinary metabolite
Spinal tract for lower limb subconscious proprioception
Intercristal line on AP and lateral x-ray
Confirms location of L5 and L4-L5 disk
Electric sensation running down back
MS, cervical myelopathy, subacute combined degeneration
Compressive lesion of craniocervical border - nystagmus?
Cape-like sensory deficit
Central cord lesion damaging second seonsory neuron crossing to join lateral spinothalamic tract