Flashcards in Back Problems Deck (26)
What is kyphosis?
Increased thoracic curvature of the spine
What is Sherurmann's disease?
A form of adolescent kyphosis where the epiphyseal growth plates of the vertebral bodies are affected in one or more of the thoracic vertebra leading to wedging and an exaggerated kyphosis
What is lordosis?
Where anterior rotation of the pelvis leads to an increased lumbar curvature
How may psoas muscle dysfunction lead to a lordosis?
If there is chronic psoas shortening and weakness this will lead to an increased lumbar lordosis as the thorax-lumbar fascia and erector spinae muscles will also shorten.
What can lead to an increased lordosis?
Weakened trunk muscles, hips flexors or late pregnancy or obesity
What may cause flat back syndrome?
Ankylosing spondylitis, degenerative discs and spinal fusion
What is flat back syndrome?
Where the pelvis tilts backwards and pulls the lumbar spine flat
What are the symptoms/complications of flat back syndrome?
As a result of the pulling of the lumbar spine, there is tight musculature between the ribs leading to shallow breathing, tight hamstrings and weak hip flexors.
What is scoliosis?
Abnormal lateral curvature of the spine (usually with rotation of the vertebrae)
What five things seen on a plain radiograph of the spine may indicate a degenerative disorder?
• Osteophytes (syndesmophytes)
• Loss of disc height
• Loss or increase in curves
• Spinal stenosis
• Ossification of vertebral ligaments
What type of joint is the intervertebral joint?
Symphysis joint (fibrocartilaginous)
What are the two layers of the intervertebral disc?
Annulus fibrosis (outside) and nucleus purposes (inner portion)
Describe the composition of the nucleus pulposus
Mainly water with proteoglycans, it is avascular
Describe the composition of the annulus fibrosis
Consists of alternating layers of type 1 collagen and the outer third is innervated
What collagen is present in the annulus fibrosis of intervertebral discs?
Type 1 collagen
What is a herniated disc and where does it most commonly occur?
Where the nucleus purposes seeps out of the intervertebral disc and irritates or compresses the spinal nerve root. This is most common at L4/L5 or L5/S1
What is cauda equina syndrome?
A serious neurological condition that can result from impingement from a herniated disc on the cauda equina region of the spinal cord which can lead to reduced sensation or no sensation below this. There may be bone or bladder disturbance also.
What are the zygapophysial joints in the spine?
The facet joints between the vertebral spines
What type of joint is present between the C1/C2 vertebra?
Pivot joint (atlas on axis)
What conditions may cause there to be vertebral-basilar artery insufficiency to supply the spine?
Osteoarthritis or degenerative disc disease
What is diffuse idiopathic skeletal hyperostosis?
Involves ossification/calcification of the anterior longitudinal ligament with or without osteophytes. The disc height is maintained and this condition does NOT involve the sacroiliac joint. Affects 50-75 year olds
Which joint does diffuse idiopathic hyperostosis NOT affect?
Which ligament is ossified in diffuse idiopathic skeletal hyperostosis?
Anterior longitudinal ligament
What is ankylosing spondylitis?
A chronic inflammatory disorder mainly affecting the axial skeleton. It involves narrowing and hardening (sclerosis) of both sacroiliac joints with bone formation across the anterior and lateral margins of the intervertebral discs leading to fusion of the vertebrae.
What is the genetic component that may lead to ankylosing spondylitis?
HLA-B27 (a receptor which influences the composition of endogenous gut flora) which can lead to a leaky gut which allows more substances to pass through the barrier and trigger inflammatory reactions.