B6.032 - Preworks 1-3 Lower Back Paim Flashcards Preview

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Flashcards in B6.032 - Preworks 1-3 Lower Back Paim Deck (62):
1

number of cervical spine vertebrae

7

2

number of thoracic spine vertebrae

12

3

number of lumbar spine vertebrae

5

4

number of sacral vertebrae

5

5

parts of vertebrae

body and arch

6

what is the body of the vertebrae

has cortical and trabecular bone health of trabeculae is important

7

factors that can compromise trabeculae health

smoking obesity osteoporosis age lack of physical activity

8

Q image thumb

compression fracture 

9

Q image thumb

spondylolysis

partial or complete fracture of pars interarticularis

10

Q image thumb

spondylolithesis

pars interarticularis complete fracture where the vertebrae moves forward

 

11

describe the pain associated with compression fracture, spondylolysis or spondylolithesis

central back pain

point tenderness

requires plain radiograph

12

what are facet joints

synovial joints beteween the superior and inferior articular processes on each side of spine

hyaline cartilage, joint capsule, meniscoid

allow gliding motion

nerve innervation; medial branch

 

13

describe facet joint issues/pain

arthritis (DJD); meniscoid displacement causing facet lock 

sharp unilateral paraspinal pain 

no imaging is indicated

14

describe intervertebral joints

pseudo joints: discs and vertebral bodies

 

15

describe the disc of the spine

nucleus puplosis: deforms under pressure

annulus fibrosis: resists tensile forces

allow weight bearing and stability

nerve innervation: outer 1/3 annulus by sinuvertebral nerve

 

16

describe DDD pain

arthritis, disc herniation

back or back and leg pain

MRI indicated

17

describe ligaments of spine role

collectively stabilize vertebral colum and resist sagittal motion 

subject to injuriy and arthritic changes

18

describe ligament pain dx

central

no imaging necessary

19

describe superficial and deep muscles

superficia/interm - prime movers, increase activity in response to pain/injury

deep - stabilize each vertebral segment

decreases activity in response to pain/injury

20

describe the role of transverse abdomini

deepes of all abdominal muslce

attaches to thoracolumbar fascia, stabilizes spain

creates natural corset to stabilize spine

can be compromised

21

what can a spinal tumor cause

leg sx 

22

what can a spinal infection cause

severe back pain

23

what houses CSF

subarachnoid space, ends at L2 so an LP lower than L2 can get the fluid

24

what level is epidural given to 

subdural space

25

all 3 meninges surround nerver roots, why is this important

you can place tension on nerve root or dura matter to assess pain

26

what do the dorsal/ventral horns have extending from them

dorsal - sensory neurons

ventral - motor neurons

27

describe where nerves exit in each part of the spine

cervical - nerves exit above vertebral level till T1 (C8 exits below C7)

thoracic - nerves exit below

lumbar - nerves exit below

sacrum - nerves exit below

28

radicular sx

leg pain > back pain

pain (sharp pain distal to injury)

parasthesia

weakness

29

clinical exam for back pain

 neuro

electrophysiology

imaging

30

neuro exam 

myotomes - muscle motor roots (key muscle testing)

dermatomes - sensory, cutatenous light touch

reflexes - L3, L4, L5, S1, babinski

31

nerve root injury will result in what

sensory and motor changes in specific dermatome and myotomeand hypo reflexes

32

spinal cord injury will result in what

symptons of non dermatome and non myotome pattern of multiple segments and hyper reflexes

33

nerve root L1, L2

groin

anterior proximal thigh (hip flexion psoas)

34

nerve root L3, L4

L3 - medial aspect of distal thigh and knee, Knee extensions (quads)

L4 - lateral aspect of knee or medial distal leg, DF/Inv (ant tibialis)

reflex = patellar tendion

35

nerve root L5

dorsum of foot

toe extension (EHL and EDL)

proximal hamstring tendon reflex

36

S1

lateral foot

gastoroc/soleus

eversion (peroneals)

achilles tendon reflex

37

S2

medial aspect of heel 

toe flexion (FDL)

38

lumbar plexus

L2-L4

terminates into femoral n, obturator n, lateral femoral cutaneous

39

lumbar plexus provides motor and sensory contributions to what

anterior and medial compartments of the leg

40

lumbar plexus peripheral nerves for neuro exam

femoral (L1-L4)

obturator (L2-L4)

 

41

femoral sensory comp

medial side fo thigh and leg

42

motor and reflexes for femoral nerve

motor - hip flexion: iliacus, psoas, sartorius, pectineus, quadriceps

patellar reflex

43

sensory obturator comp

middle thigh on anterior aspect

44

obturator motor and reflex areas

hip add and ER: adductor brevis, adductor magnus, adductor longus, obturtor externus

no reflex

45

sacral plexus components

sciatic (L4-S3)

superficial peroneal (L4-S2)

Deep peroneal (L4-S2)

Tibial (L4-S3)

46

sciatic sensory

post thigh and leg, whole foot exept instep and medial malleolus 

47

sciatic motor

knee flexion: semitendinous, semimembraneosus, bicepts femoris and adductor magnus

48

sciatic reflex

medial hamstrings, achilles

49

superficial peroneal sensory

lateral calf and dorsum of foot

 

50

motor superficial peroneal

eversion of foot: peroneus longus, peroneus brevis

51

deep peroneal sensory

cleft between 1st and 2nd toe

 

52

motor of deep peroneal 

dorsiflexion of foot: tibialis anterior, EDL, EDB, EHL, peroneus tertius

53

tibial sensory

heel

54

tibial motor

plantarflex, adduction of foot: gastroc, soleus, plantaris, tibialsi posterior, FDL, FHL, abductor digiti minimi, flexor digiti minimi , lumbricales, interosseiu, adductor hallucis, abductor hallucis, flexor digitorum brevis. flexor hallucis brevis

55

reflex tibial 

achilles

56

sacral plexus overall provides what

L4-S4

sacral plexus provides motor and sensory contributions to gluteal and parts of pelvic region, posterior thigh, most of lower leg, entire foot

57

what can a tight piriformis do

cause compression of sciatic nerve and give posterior leg sx of pian and parasthesia

inn all 3 knee muscles

then branches into tibial and common peroneal nerve

58

what can be caused by prolonged crossing leg

common peroneal nerve neuropathy - foot drop

59

what can be caused by hip arthroplasty

sup gluteal nerve leadin gto pelvic drop opposite (trendelenburg gait)

60

injury to lateral femoral cutaneous neuropathy

inguinal area from wearing heavy belt or overweight

sensory loss to lateral thigh

61

discuss saphenous nerve entrapment

from medial knee injury/surgery leads to pain medial distal knee

62

sural nerve entrapment

from recurrent ankle problesm leading to pain post lateral lower 1/3 leg or lateral foot