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Flashcards in 6. Spine Deck (92)
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1

# of spinal nerves?

8 cervical, 12 thoracic, 5 lumbar, 5 sacral, 1 coccygeal
Total 31

2

% people with low back pain sometime in life

80%

3

Definition of acute low back pain

<6w

4

Nonsurgical tx for spinal stenosis

1. NSAIDS
2. Analgesics (acetaminophen)
3. Steroid injections (inflammation)
4. Anesthetic nerve blocks
5. Restricted activity
6. PT
7. Back brace

5

Radiculopathy

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

6

Polyradiculopathy

>1 nerve root compression

7

Lasegue sign

Straight leg raise test (for disc herniation)

8

If cervical disk herniation at C4-C5, which nerve root will be affected?

C5
(lower nerve root)

9

Spurling test

Increased pain along nerve distribution from cervical extension with axial compression/rotation of head (decrease size of neural foramen)

10

Cervical myelopathy

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

11

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

12

Schober test

Measures movement of lumbar spine
10cm proximal and 5cm distal to line between posterior superior iliac spine in midline - at least >5cm in extension

13

Malnourished patient with symmetric paresthesias in feet/hand and poor proprioception

B12

14

Knee reflex

L4

15

Achilles reflex

S1

16

Lateral recess stenosis, SLR negative or positive?

Negative

17

GBS and SLR?

SLR often positive in GBS
back pain, radiculopathic symptoms + SLR, and hx of viral event

18

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)

19

SLR nerve root

L5 and S1

20

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

21

Types of nerves in ventral ramus of nerve root

Visceral motor, somatic motor and sensory to/from ventrolateral body surface, body wall and limbs

22

Lateral recess stenosis and herniated lumbar disk pain with sitting

LRS: relieved by sitting
HLD: exacerbated by sitting

23

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)

24

Paget disease: urinary metabolite

hydroxyproline

25

Spinal tract for lower limb subconscious proprioception

Spinocerebellar

26

Intercristal line on AP and lateral x-ray

Confirms location of L5 and L4-L5 disk

27

L'Hermitte phenomenon

Electric sensation running down back
MS, cervical myelopathy, subacute combined degeneration

28

Compressive lesion of craniocervical border - nystagmus?

Downbeat

29

Cape-like sensory deficit

Central cord lesion damaging second seonsory neuron crossing to join lateral spinothalamic tract

30

How can C5-C6 disk cause C7 symptoms

Prefixed brachial plexus - normal levels of innervation abberrant by 1 level