Back Clinical Notes

Question 1

Jefferson fracture

Burst fracture

Answer 1

fracture of both arches of the atlas secondary to a blow to the top of the head; does not typically injure the spinal cord

Question 2

hangman’s fracture

Answer 2

fracture of the vertebral arch of the axis secondary to hyperextension of the head on the neck

Question 3

fracture of the odontoid process

Answer 3

may occur after a horizontal blow to the head

• if it breaks at its base it will not heal
• if it breaks inferior to the base it is more likely to heal

Question 4

spina bifida occulta

Answer 4

development abnormality in which the veterbral lamina fail to fuse and close off the verterbral canal

• commonly occurs at L5 and S1
• tuft of hair present

Question 5

spina bifida cystica

Answer 5

when spina bifida occulta incorporates the neural tissue and the meninges

Question 6

why does it require less force to dislocate the cervical vertebrae

Answer 6

the articulating facets of the cervical vertebrae are more horizontal than the other vertebrae so it requires less force

Question 7

spondylosis

Answer 7

degenerative joint disease which involves calcification of the edges of the vertebral body
- causes localized pain and stiffness

Question 8

Spondylolysis

Answer 8

separation of the vertebral arch from the vertebral body

Question 9

Spondylolisthesis

Answer 9

Anterior displacement of the Vertebral Body on the Inferior Vertebral Segment
- can occur secondary to spondylolysis

Question 10

lumbar spinal stenosis

Answer 10

narrowing of the lumbar vertebral foramen; may cause compression of one or more spinal nerve roots

Question 11

lumbar puncture

Answer 11

needle inserted at L3/L4 or L4/L5 vertebae at the level of the iliac crest; needle passes through ligamentum flavum and “pops” as it passed into the lumbar cistern through the spinal dura and arachnoid mater

Question 12

sacrilization of L5 vertebra

Answer 12

partial or complete incorporation of the L5 vertebral segment into the sacrum

Question 13

lumbarization of S1 vertebra

Answer 13

separation of S1 vertebra from the sacrum

Question 14

coccygodynia

Answer 14

follows coccygeal trauma

Question 15

kyphosis

Answer 15

exaggerated curving of thoracic vertebral column resulting in “hunchback”

Question 16

lordosis

Answer 16

exaggerated curving of the lumbar vertebral column results in “sway back”

Question 17

scoliosis

Answer 17

lateral curving of the spine either to the right or left

Question 18

whiplash

Answer 18

results in excessive stretching and even tearing of the anterior longitudinal ligament

Question 19

treatment for fracture of the vertebral column

Answer 19

patient should be kept in hyperextension at all times; the pull of the anterior longitudinal ligament will help realign fragments of bone and keep further injury to the spinal cord from occurring

Question 20

disc herniation

Answer 20

nucleus pulposis herniates through the annulus fibrosis; the resultant bulge compresses spinal nerve roots, the cauda equina, and spinal nerves in the vertebra canal and interverterbal foramina

Question 21

where is disc herniation most common and why

Answer 21

L4/L5 and L5/S1

- the discs are much larger and more mobile

Question 22

back sprain

Answer 22

injury to ligamentous attachments between bone

- usually the result of inadequate stretching before activity

Question 23

back strain

Answer 23

excessive stretching and sometimes tearing of muscle fibers produced by an overly strong muscular contraction

Question 24

back spasm

Answer 24

muscle tissue spasms (involuntarily contracts) in response to injury and inflammation as a protective measure

Question 25

transection of spinal cord at C1-C3

Answer 25

no function below the head; respirator necessary for life (cannot breath on own)

Question 26

transection of spinal cord at C4-C5

Answer 26

no function of any limbs; able to breath on own

Question 27

transection of spinal cord at C6-C8

Answer 27

loss of hand and variable upper limb function; may be able to propel a wheelchair

Question 28

transection of spinal cord at T1-T9

Answer 28

paralysis of both lower limbs

Question 29

transection of spinal cord T10-L1

Answer 29

some thigh muscle function; may allow walking with long leg braces

Question 30

transection of spinal cord L2-L3

Answer 30

most lower limb functions present, may be able to walk with short leg braces

Question 31

muscular back pain is often the result of

Answer 31

spasm in muscular tissue producing ischemia

Question 32

back joint pain is usually the result of

Answer 32

osteoarthritis or disease arthritis

Question 33

fibroskeletal back pain is usually the result of

Answer 33

fractures and dislocation of ligamentous structures