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Clin Med II - Exam 2 > Beloy - Spine > Flashcards

Beloy - Spine Flashcards

1
Q

a fracture near the transverse foramen is concerning for

A

injury/dissection of vertebral artery

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2
Q

if there is any injury or dissection of the vertebral artery, the pt gets put on

A

asa

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3
Q

toracic vertebrae have no

A

transverse foramen

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4
Q

most back pain is from issues with

A

articular facets and associated ligaments/nerves

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5
Q

C5

A

anterolateral shoulder

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6
Q

C6

A

tumb

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7
Q

C7

A

middle finger

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8
Q

C8

A

little finger

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9
Q

T1

A

medial arm

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10
Q

T3

A

3rd, 4th interspace

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11
Q

T4

A

nipple line, 4th, 5th interspace

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12
Q

T6

A

xiphoid process

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13
Q

T10

A

umbilicus

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14
Q

T12

A

pubis

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15
Q

L2

A

medial thigh

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16
Q

L3

A

medial knee

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17
Q

L4

A

medial ankle, great toe

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18
Q

L5

A

dorsum of the foot

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19
Q

S1

A

lateral foot

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20
Q

S2

A

posteromedial thigh

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21
Q

S3

A

4,5 - perianal area

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22
Q

C spine nerves exit

A

above corresponding vertebrae

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23
Q

thoracic and lumbar vertebrae exit the spinal cord

A

below the corresponding vertebrae

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24
Q

pain in the back of the head corresponds with

A

C1 or C2

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25
Q

pain in L5 corresponds with

A

pain in the big toe → evaluate L5/S1 joint space

26
Q

never reduce spinal pressure by more than

A

20 mL/hr

usually take between 5-10mL/hr

27
Q

what does PQRST stand for

A

provoking/palliative

quality

radiation

severity

time

28
Q

nerve pain is usually described as

A

burning/stabbing

29
Q

tx for back pain with no motor deficit/UMN findings is treated

A

conservatively → given 5-6 weeks to heal

30
Q

what are the steps in spine evaluation post trauma

A
  1. palpate entire spine with collar on
  2. if not pain → take collar off and do full exam
  3. if pain → MRI
31
Q

85% of the time, a positive hoffman’s sign indicates

A

cervical spine injury → UMN abnormality → MRI

32
Q

0/5 muscle paralysis on a motor exam means

A

muscle paralysis/flaccid tone

33
Q

what 3 reflex abnormalities indicate UMN/cervical spine dysfxn

A

hoffman’s

clonus

babinski

34
Q

straight leg raise tests which disc

A

L4/5

or

L5/S1

35
Q

SI joint __ during pregnancy

A

stretches

36
Q

what is a double crush

A

involves 2 sites of compression → ex carpal tunnel plus neck pain

37
Q

what test helps distinguish peripheral pain vs spinal nerve pain

A

EMG (Electromyography)

38
Q

c-spine instability is defined as __ mm of motion

A

2-3

39
Q

criteria to order an MRI for neck pain

A
  1. instability noted on xrays
  2. weakness
  3. signs/symptoms of cord compression → dropping things, gait instability, incontinent
  4. no improvement w. conservative care after 6-8 weeks
40
Q

what are red flags in spine pain

A
  1. arm weakness
  2. no improvement w. conservative cair after 6-8 weeks
  3. s/s of compression
  4. cervical instability on xrays
  5. severe stenosis on MRI
41
Q

signs of dysfxn/paralysis

A
  1. gait instability
  2. weakness, incoordination
  3. bowel.bladder incontinence
  4. burning on bilateral hands
42
Q

signs of myelopathy

A
  1. hoffman’s sign
  2. babinski
  3. 2-3 beats of sustained clonus
  4. 3-4+ reflexes
43
Q

back pain is the __ most common reason for physician visits

A

third

44
Q

chronic back pain is defined as lasting

A

3 months or more

45
Q

90% of herniated discs occur in either

A

L4/L5

L5/S1

46
Q

what is the classic presentation of neurogenic claudication

A

pain when walking or standing

47
Q

what is the scotty dog a sign of

A

spondylolysis

48
Q

what tx’s are considered before surgery

A
  1. PT
  2. weight control
  3. steroid injections
  4. anti-inflammatory drugs
  5. rehab
  6. limited activity
49
Q

what are the two types of steroid injxns

A

epidural

facet

50
Q

in terms of tx, cauda equina is a

A

surgical emergency

51
Q

what are 3 symptoms of cauda equina

A
  1. urinary and/or fecal retention/incontinence
  2. saddle anesthesia
  3. leg weaknes
52
Q

atlanto-occipital dislocations are automatically considered

A

unstable

53
Q

what is the tx for atlanto-occipital dislocation

A

internal fixation

arthrodesis

54
Q

all type III atlas/jefferson fx’s are considered

A

unstable

55
Q

burst fractures cause concern for

A

neurologica dysfxn → fragment may go into spinal cord

56
Q

what are the most commonly injured vertebrae

A

C5-C7

C1-C2

T12-L1

57
Q

disc replacements/motion preservation do not help with

A

back/neck pain → can make pain worse

58
Q

what are the first 2 steps in tx for a compression fx

A
  1. xray
  2. then MRI or bone scan
59
Q

compression fractures can take __ weeks to heal

A

6-8

60
Q

what are the tx steps for discitis

A
  1. MRI to see discitis and osteomyelitis
  2. blood cultures
  3. abx x 6-8 weeks
  4. follow w. CBC, ESR, CRP
61
Q

what is the tx for cervical compression fx

A

cervical fusion

62
Q

is weakness enough to do an MRI

A

yes!

Clin Med II - Exam 2 (14 decks)

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