Chapter 4: Back and Embryology Flashcards
(241 cards)
1
Q
What is the period of time called when all three germ layers are present?
A
gastrulation
2
Q
What are the three primary germ layers?
A
ectoderm, endoderm, mesoderm
3
Q
What are the two initial germ layers?
A
hypoblast: cells that develop in the first weekepiblast: cells that develop in the second week
4
Q
Where do the head and brain eventually develop?
A
the primitive groove
5
Q
What do neural crest cells develop into?
A
ganglia, medulla, facial bones
6
Q
What do somites develop into?
A
vertebrae
7
Q
What’s the importance of the notochord?
A
initiates neuralation (the development of neural tissue)
8
Q
What germ layer does the spinal cord develop from?
A
ectoderm
9
Q
What do the parietal and visceral mesoderm layers differentiate into?
A
layers surrounding the heart and lung
10
Q
What serves as a rigid axis for the embryo?
A
notochord
11
Q
In what week does the development of upper and lower limb buds occur?
A
4th week
12
Q
The upper limb undergoes what rotation? Lower limb? Where are their extensors found?
A
upper = external rotation; extensors are posteriorlower = internal rotation: extensors are anterior
13
Q
What exact germ layer are the somites formed from?
A
pariaxial mesoderm
14
Q
What all do the somites form? Where are they found on an embryo?
A
skull, dermis, vertebral bodies, skeletal muscle; found on the dorsal surface of the embryo
15
Q
At what week are all three germ layers present?
A
3rd week
16
Q
What rises up to create the neural groove and later the neural tube?
A
ectoderm
17
Q
How many somites are there for each portion of the body? (occipital, cervical, thoracic, etc.)
A
4 occipital8 cervical12 thoracic5 lumbar5 sacral8-10 coccygeal
18
Q
Which areas of the somites fuse together?
A
sacrum, coccyx, and occipital bones all fuse respectively
19
Q
The embryo is the size of the tip of an eraser at the end of which week?
A
week 3
20
Q
Explain the differences between the superior half of the somite and the inferior half; which structures are formed in each?
A
superior: less dense, so spinal nerves and IVD developed hereinferior: more dense, so bony vertebrae are formed
21
Q
When is the heart bulge first visable?
A
4th week
22
Q
How do the disks form?
A
notochord pinches off, gets squeezed out and forms the nucleus puposis and anulus fibrosis.
23
Q
T/F: The notochord is still present at birth.
A
true
24
Q
What structure forms the IVD?
A
notochord
25
Why/how does the notochord get squeezed?
Because the somites are developing, so the notochord has is squeezed and becomes the IVD
26
What does the somitic mesenchyme consist of?
cranial, less dense portion (nerves and IVD)caudal, more dense portion (vertebrae)
27
T/F: You can tell what day of development the embryo is on by counting the number of somites.
true
28
In what week is the spine in place?
5th week
29
What happens in spinal stenosis? Why does this occur?
Both the vertebral foramen and the intervertebral foramen have the potential to narrow; happens naturally with age, but could also be genetics or poor posture
30
What causes spina bifida? Why does this range in severity?
- the neural groove not fully closing to form the neural tube causes spina bifida- but this can range in severity: if only the bony structure is impaired the spinal cord/meninges are fine. If the tube is more deformed and the spinal cord/meninges are impaired, then you have lots of developmental delays and disabilities
31
The muscles of the trunk are formed from what germ layer?
paraxial mesoderm
32
All of the skeleton except for the skull is formed from what germ layer?
paraxial mesoderm
33
The urogenital system is formed from what germ layer?
intermediate mesoderm
34
What are the three primary centers of ossification?
one in each neural arch, and one in the centrum (body)
35
What is the direction of ossification throughout the vertebral column?
develop in cervical/thoracic first, then move more cervical, then go down to thoracic/lumbar
36
When do these primary ossification sites form on the vertebrae?
4th-12th week gestation
37
T/F: The improper lining up of the joints (ie. superior and articular facets) can be a source of back pain.
true
38
What parts of the body does the intermediate mesoderm form?
kidneys and relating ducts, reproductive organs
39
What are the two distinctions of lateral plate mesoderm?
1) somatic (parietal mesoderm)2) splanchnic (visceral mesoderm)
40
At what age do the primary centers of ossification unite and fuse?
by 3-5 years old
41
What does the paraxial mesoderm form?
somites, skeleton, muscles of the extremity and trunk, vertebral column, dermatomes, and dermis
42
Where are myotomes and dermatomes first formed?
on the somites
43
What germ layer forms the liver and pancreas? (GI tract)
endoderm
44
What germ layer forms appendicular skeleton?
mesoderm
45
What germ layer forms the neural tube?
ectoderm
46
What germ layer forms the hair, sebaceous glands, and sweat glands?
ectoderm
47
What germ layer forms the heart?
mesoderm
48
What germ layer forms the dermatomes?
mesoderm, because they're from somites
49
What germ layer forms the spinal cord and brain?
ectoderm
50
What week does neuralation take place?
week 4
51
What week do somites start to form?
week 4
52
What are spinal ganglion?
- clusters of dorsal sensory nerves, usually in the IVF- cell bodies of the dorsal roots
53
What are the 3 meninges?
pia, dura, arachnoid
54
What's worse, a severed dermatome or peripheral nerve?
dermatome: lose input to all those regions
55
A patient reports severe whiplash coming in from an accident. Before treating, what should you make sure isn't torn?
alar and transverse ligaments
56
What is the fine filament of connective tissue at the end of the conus medularis? What's it for?
filum terminale, an extension of the pia that anchors the spinal cord to the coccyx
57
How far does the conus medularis extend to?
L1-L2
58
What does the notochord develop from?
The primitive node
59
What is the primitive streak?
indentation along the surface of the embryo; on caudal end is the primitive node
60
The vertebral artery becomes what artery when it goes up to the head?
basilar artery
61
What does the basilar artery supply?
the posterior half of the brain
62
Why is the proximal part of the vertebral artery prone to compression?
due to the longus colli and scalene muscles
63
Why do the transverse processes of C2-C6 cause the vertebral artery to be prone to compression?
compression from osteophytes and subluxed facet joints
64
What is an osteophyte?
a bone spur, indicating degeneration of the spine; common with age
65
Why is the suboccipital region prone to compression with the vertebral artery?
prone to compression from cervical rotation
66
What area of the vertebral artery trail is prone to plaque and stenosis build up?
intercranial portion
67
How many zygapophyseal joints are in the cervical spine?
14
68
How many uncovertebral joints are in the c-spine?
10
69
What is unique about the zygaphophyseal joint?
- each dorsal rami innervates two adjacent joints, so each joint has two dorsal rami innervating it-It has dual innervation; one from the sinovertebral artery and one from the medial branch of dorsal rami. This gives the joint ability to be a spot of pain
70
Which muscles attach to the nuchal ligament?
rhomboid minor, trapezius, serratus posterior superior, splenious
71
What ligament limits flexion in the C-spine and assists in posture?
ligamentum nuchae
72
Which vertebrae has a "vertebrae prominens"
C7
73
Which area of the vertebral artery is prone to compression via bone spurs or subluxed facet joints?
transverse C2-C6 portion
74
Where are the facet joints most likely to dislocate?
In C-spine b/c they're more horizontal; allows for greater range of motion but more likely for dislocation
75
What is unique about the joints of luschka? How do they form?
- it's "not a real joint" b/c it's not present at birth- forms from the weight of the C-spine being distributed
76
Where can there be plaque build up and stenosis along the vertebral artery pathway?
intercranial portion
77
Which part of the vertebral artery is prone to compression via the surrounding muscles, like scalene and longus colli?
proximal portion
78
What joint allows rotation of C-spine?
atlantoaxial joint
79
T/F: There is no spinous process on C1.
true
80
What direction are the zygapophyseal joints facing in the C-spine?
anterior and inferior, vs posterior and superior like most other areas of the spine
81
What do articular pillars do?
- help with stability of C-spine; they're the column arrangements of the facet joints, junction of the pedicle and the lamina- this is what you palpate when you feel the C-spine usually
82
Do the uncinate joints have synovial membranes?
yes
83
What's the role of the uncovertebral joint? (4)
1) limits lateral flexion of c-spine2) guides cervical flexion/extention3) prevents posterior translation of neighboring verts4) supports the IVD
84
Which portion of the spine forms the kyphotic curve?
thoracic spine
85
What forms the IVD?
notochord
86
What are the 5 secondary sites of ossification?
- Two on the annular epiphysis (body), one anterior and one posterior- two on the tips of the transverse processes- one on the tip of the spinous process
87
What structure initiates the development of neural tissue?
Notochord
88
Where does the notochord develop?
In the primitive node
89
What are the primary curvatures of the spine?
thoracic and sacral; concave anterior
90
What are the secondary curvatures of the spine?
cervical and lumbar; concave posterior
91
What helps the spine to handle compressive forces?
the curvatures of the spine
92
Where does the transverse ligament of the atlas attach?
between the bodies of the lateral masses of C1
93
Where does the alar ligament attach?
From the sides of the dens to the foramen magnum
94
T/F: T-spine is pretty unstable because of all the rib attachments
false; very stable so not much herniation of disks
95
Does the spinal cord get larger or smaller as it travels to the lumbar region?
Larger
96
What movements do the lumbar vertebrae favor?
extension/flexion, very little rotation in this area
97
What movements are permitted in the zygapophyseal joints?
gliding
98
What is the pars interarticularis?
collar on the dog; between the junction of the lamina and IAP
99
What is spondylosis?
general wear and tear on the spine related to aging; can be a source of pain
100
The zygapophyseal joint has what kind of receptors in it?
mechano and proprioceptors to tell it where it is in space, as well as pain receptors
101
What are the vertebral endplates?
thin cartilage that lies above and below vertebrae; gives nutrition to the vertebral body
102
T/F: Vertebral endplates are bone.
false; they're permeable in the central portion where diffusion of blood and nutrients takes place
103
Why are the vertebral endplates prone to injury?
Osteophytes build up; when the vertebral endplates break down, this decreases diffusion, causing the vertebra and the disk to break down as well
104
What is the annulus fibrosis?
the collagen that wraps around the nucleus pulposa
105
Why is the annulus fibrosis like an onion?
It has 12-15 outer rings of collagen, providing strong reinforcement for the nucleus pulposa
106
What do the fibers of Sharpey do? (periosteal fibers)
attaches the outer ring of the annulus fibrosis to the vertebral body
107
T/F: There are IVD's throughout the entire spine.
False, there is no disk between C1 and C2, or btwn the sacrum and coccyx
108
Where are the IVD's the thickest?
In the cervical and lumbar portions of the spine
109
T/F: The IVDs make up a third of the height of the spinal column
true
110
What is likely the largest avascular structure in the body?
the intervertebral disk, especially in the middle
111
As we age, what happens to the IVD?
loses the ability to take in water as well
112
In what direction does disk herniation most usually occur?
posteriolaterally
113
What nerves would a central nerve herniation affect if it was at L3?
All the nerves inferior to the herniation, including cauda equina and bowel/bladder nerves
114
Which ligament limits hyperextension? From where to where does it run?
anterior longitudinal ligament; runs from sacrum to foramen magnum
115
At what level does the techtorial membrane start?
C2, runs to foramen magnum
116
T/F: The techtorial membrane supports the dens and axis.
true
117
What is the primary action of the atlanto-axial joint? What structure allows this action to happen?
rotation because of the dens, mainly in the median atlanto-axial joint (pivot joint)
118
What are the main motions of the atlanto-occipital joint?
flexion and extension, little side bending
119
Why do disks tend to bulge out posteriolaterally?
the posterior longitudinal ligament is rather weak, allowing the disk to bulge out that way
120
What ligament is an extension of the posterior longitudinal ligament?
techtorial membrane
121
The vertebral artery can pass through a hole in which ligament?
posterior longitudinal ligament
122
T/F: The atlanto-occipital joint has pain receptors, therefore can be a site of pain.
true
123
Layer these ligaments from superficial to deep: alar, posterior longitudinal, cruciate.
Superficial to deep: posterior longitudinal -> cruciate -> alar
124
What three ligaments make up the cruciate ligament?
superior longitudinal ligament, transverse ligament, inferior longitudinal ligament
125
What ligament is also called the "check" ligament? Why is this?
alar; limits the amount of rotation occuring at C1-C2
126
A patient presents with whiplash. What joint was probably most affected?
atlanto-occipital
127
If one side of the head has more rotation than the other, what could this possibly tell you?
the alar ligament may have been comprimised
128
What two populations are prone to having lax ligaments?
rheumatoid arthritis and down's syndrome
129
If the transverse ligament is lax, what could potentially happen?
The dens now has more range of motion, so it could move posteriorly and compress the spinal cord
130
What are the "rules of three"?
1. the dens takes up 1/3 of the space
2. the chord takes up 1/3 of the space
3. empty space takes up 1/3 of the space
131
What is the hangman's fracture?
disruption of the pars of C2, severe hyperextension
132
What happens if the alar ligament is ruptured?
excessive head rotation
133
Rupture of the transverse ligament results in what dislocation?
dislocation of the atlas from the axis
134
What is a fracture of the atlas called?
Jefferson's fracture (think diving injury)
135
T/F: The posterior longitudinal ligament can become a source of pain.
true; innervated by the sinovertebral nerve which has pain receptors
136
What ligament limits excessive flexion?
posterior longitudinal ligament
137
The ligamentum flavum is made of what kind of tissue, (which is different than the other ligaments)?
elastin tissue makes up the ligamentum flavum, allowing it to move in almost any way, vs. collagen tissue for the other ligaments
138
What two nerves make up the dual innervation of the ligamentum flavum?
sinuvertebral nerve and medial branch of dorsal rami (same as facet joint, which means it's a site of pain)
139
What ligament is important in counteracting the anterior translation of C1?
transverse ligament
140
Which fracture, Jefferson's or hangman's, has the greater potential to injure the chord?
hangman's
141
T/F: The chord grows faster than the vertebrae at birth.
false, verts grow faster and chord ends at L2
142
What is the cauda equina?
lumbar/sacral nerves going down to sacral foramina
143
Name each portion for the three erector spinae muscles.
iliocostalis: lumbar, thoracic, cervical portions
longissimus: thoracic, cervical, capitus portions
spinalis: thoracic, cervical, capitus portions
144
What's the distal attachment for spinalis?
spinous processes of upper thoracic region to cranium
145
Distal attachment for iliocostalis?
ribs and cervical transverse processes
146
What muscles are in the transversospinalis group?
semispinalis, rotators, levatores costarum, interspinales, intertransversarii, multifidus
147
What information do ventral roots carry?
motor, go away from the cord
148
What information do dorsal rami carry?
both sensory and motor
149
What info do dorsal roots carry?
sensory, go toward the cord
150
Which muscle may play a role in chronic neck pain? And how?
semispinalis cervicis; may have fatty infiltration and become underutilized and atrophy
- not totally sure which comes first, the neck pain or the atrophy
151
Why can the multifidus be a modulator for pain in the cervical area?
Because it inserts right near/on the facet joints (articular processes), so if the muscle is inflammed, the facet joint can be painful
152
Which muscle is the first to react in cases of loud noise or horizontal acceleration?
multifidus; this means may be the first muscle reacting to whiplash
153
What changes in anatomy occur with neck pain?
- decreased CSA in both multifidus and semispinalis cervicis
| - atrophy in deep muscles but more activity in superficial extensor muscles (this is bad, you need a balance)
154
What are "slow twitch" muscles good for?
posture and proprioception, stabilization
155
In which areas are there spinal cord enlargements?
cervical (C4-T1) and lumbar (L2-S3) , because there's so many nerves needed to supply the upper and lower extremities
156
The denticulate ligaments hold the pia mater to what?
the dura mater
157
When a spinal nerve pierces through the dura and through the IVF, what is it now called?
dorsal/ventral rami
158
What are the flattened extensions of the pia that anchor the cord to the dura?
denticulate ligaments
159
What's the lumbar cistern and what does it contain?
(aka dural sac) continuation of subarachnoid space where there's no cord, just cauda equina, filum terminale, and CSF
160
T/F: You can take CSF from the lumbar cistern.
true b/c it's low enough that it won't affect the cord
161
At which level do spinal nerves begin to exit below the vertebrae?
C8, which exits below C7
162
The muscles in the suboccipital region act on what joint?
atlantoaxial joint
163
What are the two major joints of the neck/head?
atlantoaxial and atlantooccipital
164
The back is mostly innervated by what nerves?
dorsal rami
165
Shorter segment muscles are primarily used for what?
stabilization
166
What portions of the occipital nerve are cutaneous?
greater and lesser occipital nerves; suboccipital does the triangle
167
What is the function of the meninges?
protecting the cord
168
What's in the subarachnoid space?
CSF
169
Where are cell bodies housed for the dorsal root system?
dorsal root ganglion
170
Where are cell bodies housed for the ventral root system?
anterior horn
171
What does the medial branch of the posterior ramus innervate?
the facet joint, ligamentum flavum, and other deep and medial spine muscles, like interspinalis, intertransversarii, multifidus
172
T/F: The sinuvertebral nerve carries parasympathetic information.
false, sympathetic (responses to threat, fight or flight)
173
The sinuvertebral nerve is a branch of what ramus?
anterior ramus
174
The posterior longitudinal ligament is innervated by what?
anterior rami, specifically the sinuvertebral nerve
175
Is the sinuvertebral nerve autonomic or somatic?
autonomic
176
Which branch of the posterior ramus innervates the longissimus and spinalis muscles?
intermediate branch
177
What does the lateral branch of the dorsal ramus innervate?
dermis and iliocostalis (ex.)
178
What innervates the outer layer of the annulus fibrosis?
sinuvertebral nerve
179
What are the three branches of the anterior ramus?
sinuvertebral nerve, skeletal branch, muscular branch
180
What innervates the anterior longitudinal ligament?
skeletal branch of ventral rami
181
What's another same for the sinuvertebral nerve?
recurrent meningial; comes off of ventral rami and goes back to spinal cord to meninges
182
What does the sinuvertebral nerve innervate?
IVD, posterior longitudinal ligament, parts of dura, annulus fibrosis
183
What is the blood supply to the cord?
- one anterior spinal artery and two posterior spinal arteries, which supply 2/3 of the way down
- redicular arteries supply the remaining 1/3
184
What the largest redicular artery?
great medullary artery
185
Which artery, anterior spinal or posterior spinal, supplies more of the 2/3rds?
anterior
186
T/F: The veins follow the arteries for the spine.
true
187
How can viruses spread in the cord?
there are no valves that stop flow in venous drainage, so viruses can travel to the brain
188
What is lumbarization?
6 lumbar vertebra instead of 5 (extra lumbar)
189
What is sacralization?
4 lumbar instead of 5, one joins the sacrum
190
What is hemivertebra?
half of vertebrae isn't developed
191
What is the Klippel-Feil anomaly?
vertebra (most times cervical) that are missing
192
What is a fracture in the pars interarticularis called?
spondylolysis
193
What is it called when there is a slippage of one vertebrae onto the one below?
spondylolistheses
194
Describe the different grades of spondylolistheses.
grade 1: 25% slippage
grade 2: 50%
grade 3: 75%
grade 4: 100% (severest)
195
What's a schmorl node?
endplate degenerating and creating an invagination of bony tissue in the vertebral body
196
What is the degeneration of bone due simply to aging called?
spondylosis
197
If there is a posteriomedial disk herniation at L3, what nerve(s) are affected?
L3-4
198
If there is a posteriolateral disk herniation at L5, which nerve(s) are affected?
L5 and one lower, so S1
199
T/F: Intervertebral disks get thinner as you age.
False, they actually get thicker; thinning is a sign of pathology
200
What gives the IVD a high fullness or turgor?
their water content in the nucleus puplosis; it's around 90% in young individuals
201
Why are IVD herniations mostly in the lumbar region?
Most flexion occurs here, and these are greater movements; IVD's are also largest here, with more ability to impinge a spinal nerve
202
An elderly patient comes in with an acute disk herniation. Why would you be skeptical of this diagnosis?
With aging, the nucleus becomes decreasingly dehydrated, even granular or solid. It's more likely that the nerve roots are compressed by increased ossification of the IVF as they exit
203
What differences in spinal anatomy occur with aging? (5)
1) Spondylosis, general wear and tear on the disk
2) osteophytes, bone spurs that indicate degeneration of the spine
3) nucleus pulposis can't uptake H20 as well, leaving it fibrous or even granular
4) stenosis: narrowing of the foramens in the spine (IVF, VF) which can compress structures running through them
5) zygapophyseal joint pain
204
At what level do 95% of lumbar herniations occur?
L4-L5 and L5-S1
205
Acute middle and low back pain presenting with muscle spasms may indicate what injury?
posteriolateral herniation
206
What is sciatica? What causes it?
sciatic is pain in the lower back and hip radiating down the back of the thigh, often caused by a herniated lumbar IV disk that compresses the L5/S1 component of the sciatic nerve
207
Why is sciatica so common?
the increasing size of the lumbar nerves coupled with the decreasing size of the IVF
208
How do you test to produce sciatic nerve pain?
flex the thigh with knee extended (straight leg raise test, stretches the sciatic nerve)
209
What violent movements can produce disk damage?
violent hyperextension (like in a head-on collision) or violent rotation (like in a golf swing)
210
Cervical IVD protrusions cause pain in what areas?
neck, shoulder, arm, and hand
211
T/F: The dens of C2 is stronger than the transverse ligament that holds it down.
false, transverse ligament is stronger
212
Why do we avoid movement in upper spinal cord injury patients?
If the antlantoaxial joint is subluxed or dislocated (from an injury or inflammation), sudden movements can cause posterior displacement of the dens or anterior movement of C1 and impinge the cord. You just may not know it yet because of the slight empty space between the dens and spinal cord
213
A patient presents with greater cranial rotation to the right. On what side do you expect the alar ligament to be torn, and how much % greater rotation would you approximately find?
30% greater rotation on the left side
214
A offensive lineman football player presents with a cervical injury. What injury could you suspect, given the motions he undergoes?
cervical flexion and rotation can rupture one or both alar ligaments, so check to make sure both are in place
215
What are the five structures that can be sources of back pain?
1) fibroskeletal structures: periosteum, ligaments, and anuli fibrosi of IV discs
2) meninges (rare)
3) synovial joints: capsules of zygapophyseal joints
4) muscles: intrinsic muscles of back
5) nervous tissue: spinal nerves/roots exiting the IVF
216
When someone has referred low back pain, what is usually the source?
compression/irritation of nerve roots, perceived as coming from the cutaneous/subcutaneous area; can be accompanied by low back pain
217
What is usually the source of localized low back pain?
Perceived as coming from the low back, so it's generally muscular, joint, or fibroskeletal pain
218
Lordosis is often associated with what musculoskeletal issues?
weak trunk muscles, especially anteriolateral abdominals
219
Why does kyphosis occur?
erosion of the anterior part of one or more vertebrae (osteoporosis)
220
What can be done to prevent many back strains and sprains, which are causes of low back pain?
warming up, stretching, and exercising the anterolateral abdominal wall, especially the transverse abdominis
221
A patient says he becomes dizzy when looking behind him when he's backing up his car. What could be the problem?
The vertebral artery may be affected; blood flow isn't getting to the head; think arteriosclerosis (hardening of arteries)
222
Which area of the spinal cord is at highest risk for compression by bone spurs?
L5: largest nerve roots and smallest IVF; bone spurs will impact very quickly
223
What does myelography allow you to see?
visualization of the spinal cord and nerve roots
224
What are the most affected areas from osteoporosis?
neck of the femur, bodies of vertebrae (thoracic especially), metacarpals, and radius
225
A surgeon needs to gain access to the spinal cord. What surgical procedure does she need to do?
laminectomy; also done to relieve pressure on the cord due to a tumor or herniated disk
226
T/F: A Jefferson fracture alone doesn't necessarily cause spinal cord injury.
true, more likely with the transverse ligament also torn
| Jefferson fractures posterior and/or anterior arches of C1
227
What is one of the most common injuries to C2?
fractures of the vertebral arch, caused from hyperextension of the head on the neck (vs. head and neck in whiplash)
228
A patient presents with hyperextension of the head on the neck, what injury could you find?
a fracture of the vertebral arch of C2 in the pars interarticularis
229
T/F: Fractures of the dens are common axis injuries.
true, 40-50%
230
What can cause thoracic outlet syndrome?
the supernumerary rib elevating and putting pressure on the subclavian or inferior trunk of brachial plexus
231
Where can you inject caudal epidural anesthesia?
in the sacral hiatus
232
Why is there slight height loss that accompanies aging?
there's a decrease in bone density, especially centrally in the body. So, the vertebral bodies become concave
233
What's the difference between back sprain and back strain?
both result from excessively strong contractions involving movements of the vertebral column
• SPRAIN is with only the ligaments are involved
• STRAIN is with the stretching/slight tearing of muscle fibers
234
Lumbar punctures are performed with the patient in what position?
lying on the side with the back and hips flexed to stretch the ligamentum flavum
235
With a spinal cord injury at C1-C3 level, what happens?
no function below head, ventilator needed for respiration
236
SCI at C4-5, what's the result?
quadriplegia
237
SCI at T1-T9, what's the result?
paraplegia, amount of trunk control varies with height of lesion
238
Can you walk with an SCI at L2-L3?
yes, short leg braces may be required
239
With an SCI at C4-C5, can the individual self feed?
no
240
With an SCI at C6-C8, can the individual propel in a wheelchair?
potentially yes
241
With an SCI at T1, will the individual be able to self propel in a wheelchair?
yes
