Anatomy - Verterbal Column - Lower Back Flashcards Preview

Block 2 - MSK > Anatomy - Verterbal Column - Lower Back > Flashcards

Flashcards in Anatomy - Verterbal Column - Lower Back Deck (10):
1

Spondylogenic referred pain

- origin: structures other than nerve roots
- cause: infflammatin, mechanical cpmpression, mechanical strain
- Clinical feature: Deep dull aching pain
- usually not past knee
- no neurological sign

2

Radicular referred pain

- origin: nerve roots, DRG
- cause: tension, mechanical compression, ischemia, chemical irritation
- referral along dermatome
- neurological sign

3

Lateral recess stenosis

= narrowing at IVF
- will relieve their symptoms by flexion of lumbar spine

4

Lumbar vertebral canal

Boundaries:
- anterior: vertebral bodies and discs
- Lateral: pedicles and intervertebral foramina
- Posterior: lamina and ligamenta flava

Contents: spinal cord and nerve roots, CSF in subarachnoid space, epidural space

5

Spondylolisthesis

- at L5/S1
- secondary to spindylosis
- bilateral fracture and vertebral body slips forward

6

Lumbar Disc herniations

- 95% of lumbar disc herniation occur at L4/5 and L5/S1, most are posterolateral
- posterolateral: may impige on dura and nerve roots that are moving laterally towards IVF
- posterior: may impige on centrally-located sacral nerve roots (cauda equina syndrome)
- ventral nerve root compression: weakness/flaccid paralysis
- dorsal nerve root compression: sensory deficit/anethesis

7

Test for myotomes and dermatomes
L2
L3
L4
L5
S1

L2: hip flexion
L3: Knee extension/ knee jerk
L4: foot inversion/ knee jerk
L5: great toe extension
S1: Ankle plantarflexion: foot eversin

8

Straight leg raise

- reproduce pain in leg
- stretches the sciatic nerve and its associated rami and roots

Test for malingering: leg is lowered slightly to point of no pain then ankle is dorsiflexed -> restretches sciatic nerve and its associates rami and roots

9

Position to reduce load on lumbar disc

- Supine
- avoidance of low back flexion
- hips flexed
- knees flexed

10

Central stenosis of vertebral canal

- narrowing of vertebral canal
- compresses dural sac and its contents
- causes: congenital, arthropathy, disc bulge/herniation, ligamentum flavum thickening/buckling or combination
- lumbar stenosis may cause neurogenic claudication: pain and weakness in leg, stoop to continue walking