Clinical Conditions Of The Cervical + Thoracic Spine Flashcards

1
Q

What is cervical spondylosis?

A

Osteoarthritis of IV joints

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2
Q

What is the typical triad presentation of cervical spondylosis?

A

Loss of disc height
Osteophytes
Facet joint space osteoarthritis

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3
Q

What is a spinal radiculopathy?

A

Pressure on the spinal nerve due to narrowing of IV foramen
Osteophytes in foramen

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4
Q

Symptoms of spinal radiculopathy

A

Paraesthesia - in dermatome
Pain - radiates from root to dermatome e
Myotomal motor weakness

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5
Q

What is spinal myelopathy?

A

Pressure on spinal cord due to stenosis of spinal canal
Oesteophytes in vertebral canal

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6
Q

Symptoms of spinal myelopathy

A

Global muscle weakness
Gait dysfunction
Loss of balance
Loss of bowel + bladder control

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7
Q

Effect of myelopathy in upper cervical lesions

A

Decreased dexterity
Dysdiadocokinesia - impaired ability to perform rapid alternating movements

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8
Q

Effect of myelopathy in lower cervical lesions

A
  • Spacsticity - increase muscle tone
  • Loss of proprioception of legs - loss of awareness of position + movement of body (legs feel heavy)
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9
Q

What is a Jefferson’s fracture?

A

Fracture of the anterior + posterior arches of the C1 vertebra

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10
Q

Mechanism of Jefferson’s fracture
Examples

A

Axial loading
e.g. diving into shallow water, impacting head from hall or crash

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11
Q

Why does a Jefferson’s fracture present with pain but no neurological signs?

A

Fracture bursts open
Decreased likelihood of impingement of spinal cord

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12
Q

What is a Hangman’s fracture?

A

Fracture of C2 vertebra through pars interarticularis

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13
Q

Mechanism of hangman’s fracture
Example

A

Hyperextension of head on neck
e.g. RTC

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14
Q

Mechanism of fracture of odontoid process
Examples

A

Hyperflexion e.g. blow to back of head
Hyperextension e.g. falling + impact on forehead

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15
Q

Outline a whiplash injury

A

Forceful hyperextension + hyperflexion of injury to cervical spine&raquo_space; tearing of cervical muscles and ligaments

Muscles contract to splint injured muscles > spasm > pain and stiffness

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16
Q

What nerve is compressed in cervical IV disc prolapse?

A

Exiting root

17
Q

Causes of thoracic cord compression

A

Vertebral fracture > fragments in spinal cord
Tumours in spinal canal

18
Q

What are the routes that pathogens can reach bones and tissues of the spine?

A
  • Haematogenous
  • spread from adjacent soft tissue infection
  • direct inoculation during invasive spinal procedure
    e.g. lumbar puncture, epidural
19
Q

What is spondylodiscitis/discitis?

A

Infection of IV disc

20
Q

How does spondylodiscitis occur?

A

IV disc is avascular so not via blood
Enters due to necrosis of bone due to ischaemia > direct spread of organisms