Beloy - Spine Flashcards
(62 cards)
1
Q
a fracture near the transverse foramen is concerning for
A
injury/dissection of vertebral artery
2
Q
if there is any injury or dissection of the vertebral artery, the pt gets put on
A
asa
3
Q
toracic vertebrae have no
A
transverse foramen
4
Q
most back pain is from issues with
A
articular facets and associated ligaments/nerves
5
Q
C5
A
anterolateral shoulder
6
Q
C6
A
tumb
7
Q
C7
A
middle finger
8
Q
C8
A
little finger
9
Q
T1
A
medial arm
10
Q
T3
A
3rd, 4th interspace
11
Q
T4
A
nipple line, 4th, 5th interspace
12
Q
T6
A
xiphoid process
13
Q
T10
A
umbilicus
14
Q
T12
A
pubis
15
Q
L2
A
medial thigh
16
Q
L3
A
medial knee
17
Q
L4
A
medial ankle, great toe
18
Q
L5
A
dorsum of the foot
19
Q
S1
A
lateral foot
20
Q
S2
A
posteromedial thigh
21
Q
S3
A
4,5 - perianal area
22
Q
C spine nerves exit
A
above corresponding vertebrae
23
Q
thoracic and lumbar vertebrae exit the spinal cord
A
below the corresponding vertebrae
24
Q
pain in the back of the head corresponds with
A
C1 or C2
25
pain in L5 corresponds with
pain in the big toe → evaluate L5/S1 joint space
26
never reduce spinal pressure by more than
20 mL/hr
usually take between 5-10mL/hr
27
what does PQRST stand for
provoking/palliative
quality
radiation
severity
time
28
nerve pain is usually described as
burning/stabbing
29
tx for back pain with no motor deficit/UMN findings is treated
conservatively → given 5-6 weeks to heal
30
what are the steps in spine evaluation post trauma
1. palpate entire spine with collar on
2. if not pain → take collar off and do full exam
3. if pain → MRI
31
85% of the time, a positive hoffman's sign indicates
cervical spine injury → UMN abnormality → MRI
32
0/5 muscle paralysis on a motor exam means
muscle paralysis/flaccid tone
33
what 3 reflex abnormalities indicate UMN/cervical spine dysfxn
hoffman's
clonus
babinski
34
straight leg raise tests which disc
L4/5
or
L5/S1
35
SI joint __ during pregnancy
stretches
36
what is a double crush
involves 2 sites of compression → ex carpal tunnel plus neck pain
37
what test helps distinguish peripheral pain vs spinal nerve pain
EMG (Electromyography)
38
c-spine instability is defined as __ mm of motion
2-3
39
criteria to order an MRI for neck pain
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
what are red flags in spine pain
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
signs of dysfxn/paralysis
1. gait instability
2. weakness, incoordination
3. bowel.bladder incontinence
4. burning on bilateral hands
42
signs of myelopathy
1. hoffman's sign
2. babinski
3. 2-3 beats of sustained clonus
4. 3-4+ reflexes
43
back pain is the __ most common reason for physician visits
third
44
chronic back pain is defined as lasting
3 months or more
45
90% of herniated discs occur in either
L4/L5
L5/S1
46
what is the classic presentation of neurogenic claudication
pain when walking or standing
47
what is the scotty dog a sign of
spondylolysis
48
what tx's are considered before surgery
1. PT
2. weight control
3. steroid injections
4. anti-inflammatory drugs
5. rehab
6. limited activity
49
what are the two types of steroid injxns
epidural
facet
50
in terms of tx, cauda equina is a
surgical emergency
51
what are 3 symptoms of cauda equina
1. urinary and/or fecal retention/incontinence
2. saddle anesthesia
3. leg weaknes
52
atlanto-occipital dislocations are automatically considered
unstable
53
what is the tx for atlanto-occipital dislocation
internal fixation
arthrodesis
54
all type III atlas/jefferson fx's are considered
unstable
55
burst fractures cause concern for
neurologica dysfxn → fragment may go into spinal cord
56
what are the most commonly injured vertebrae
C5-C7
C1-C2
T12-L1
57
disc replacements/motion preservation do not help with
back/neck pain → can make pain worse
58
what are the first 2 steps in tx for a compression fx
1. xray
2. then MRI or bone scan
59
compression fractures can take __ weeks to heal
6-8
60
what are the tx steps for discitis
1. MRI to see discitis and osteomyelitis
2. blood cultures
3. abx x 6-8 weeks
4. follow w. CBC, ESR, CRP
61
what is the tx for cervical compression fx
cervical fusion
62
is weakness enough to do an MRI
yes!
