Clinical correlations of Back disorders Flashcards Preview

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Flashcards in Clinical correlations of Back disorders Deck (45):
1

Scoliosis

Primary and secondary curves

most likely occurring in prepubescent girls

causes:
-wedged vertebrae
-shorter leg
-neuromuscular disease
-post menopausal women

2

harrington rods

surgical rods used to correct scoliosis

3

impact of scoliosis

may affect breathing
abdominal organs
intervertebral discs

4

Cervical spine compression/burst fracture

all pressure onto a certain vertebral body causing the whole vertebral body to shatter

5

vertebroplasty

using polymer injection into vertebral body to "pump" it back up

can't do this if there is a disk that is blown out
MUST HAVE INTEGRITY of IV DISK

6

Pathological fracture

fracture due to underlying disease (such as osteoporosis)

Metastases to bone from:
Breast
Ovary
Prostate
Hodgkin’s lymphoma

7

osteoporosis

Lack of dense matrix in trabecular bone

in progressive stage of osteoporosis vertebrae can become biconcave, flat, wedge, planar

ALSO their spine becomes kyphotic
b/c when you get compression fractures from stepping off a curve they are going to have an anterior compression fracture

8

Metastases to bone

go through vertebral venous plexus***

no valves so meaning pressure changes in abdomen/thorax leads blood to wherever it wants to go that is why there is usually spread of cancer to spine!

9

function of vertebral venous plexus during inspiration and expiration

in normal inspiration--> pressure is reduced, blood splits its way back into the thorax by passing into intervertebral plexus

during expiration, pressure is high, little blood comes in, larger amount of blood goes into vertebral venous plexus

forced expiration pressure is Really high, blood mainly flows into vertebral venous plexus

10

what is the most commononly fractured/dislocated vertebrae?

C6
simply b/c of space in this area

11

Jefferson (Burst) fracture of CV1

fracture of the anterior and posterior arch of the atlas

12

Hangman's fracture

C2/C3 spondylolysthesis

so fracture of the pars interarticularis

13

fracture of the dens (cv2-axis)

can walk around and not know this has happened


transverse ligament of the atlas intact

can lead to vascular necrosis b/c lose blood supply to the dens

14

disarticulation of the dens

CV1/CV2

the atlas is collaring the dens so compressing the spinal cord!! very bad--> if you survive this you are quadriplegic

tear transverse ligament of the atlas***

15

rupture of the alar ligament the "owl" ligament

Pre load the alar ligament (so the head is already flexed) and then turn and then it will rupture

(think of a football player whose head is in a turn)

16

spondyloysis

unilateral fracture of the pars interarticularis

sitting right at the lamina so much closer to the lamina than the pedicle

17

spodylolisthesis

bilateral fracture

tend to have these in areas where there are high mobility (cervical and lumbar)

most common at L5 and S1 b/c it is at an angle that wants to slide forward

as it slides forward it stretches the nerves of the cauda equina (if in the lumbar region)

18

grading spondylolisthesis

grade 1 slides a little bit

grade 4 just getting ready to fall off

19

Batson's plexus

inside and outside vertebral column

those plexus inside are immune to pressures that the outside venous plexuses are NOT immune to

so when there are changes in pressure in the abdomen and thorax the outer vertebral plexuses are the ones that are being drained in to...

20

Spina bifid occulta

happens at L5-S1 more than anywhere else

defect of lamina

can be overlayed with a fat pad, or tuft of hair

21

in order to see the dens...

go through the mouth

22

Case 26 year old male hurt neck while water skiing ...

vertical fracture of the dens??


no it is spina bifida of the atlas!! incomplete fusion of lamina

23

how many views are needed to confirm diagnosis

2

24

cervical spondylosis

degenerative changes between the body and the disk

25

spinal stenosis

in the intervertebral canal (spinal cord) (can be caused by growth of articular processes/facets)

OR

intervertebral foramen at the spinal nerve (degenerative disk)

these both will give you different symptoms

26

spinal stenosis in vertebral canal

upper motor neurons lesions

27

spinal stenosis in intervertebral foramen

lower motor neurons lesions

28

osteoarthritis (effects vertebral bodies and facet joints)

degeneration of disks and disk spaces

extension of the vertebral column

spinal column doesn't move as well

also have involvement of zygopophyseal joints
can cause pressure on spinal nerves --> leads to radiculopathy --> lower motor neuron lesions

29

what indicates osteophytic vertebrae

narrowed vertebral foramen

biconcave "Lip" of body

30

laminectomy

to fix spinal stenosis

31

foraminotomy

opening intervertebral foramen

take off portion of lamina

32

posterior longitudinal ligamen

serrated to keep IV disk in place

33

Mild hyperextension

Whiplash

can cause tear in the anterior longitudinal ligament

avulsion fracture

worse case scenario--> tear the disk, lose integrity, now have to fuse vertebrae

34

whiplash muscle spasms

pull the cervical column into a more kyphotic curve

35

ankylosing spondylitis

"bamboo" spine

spine is fused due to inflammation of synovial joints and ligaments

X-ray shows inflammation and calcium formation

36

Disk pathologies

degenerated

bulging

herniated- happens more in cervical and lumbar (L4-L5, L5-S1)

thinning

disc degeneration with osteophyte formation

37

posterior herniation

towards the cauda

effects a much larger span of nerves

38

posterolateral herniation

goes toward spinal nerve

39

stages of intervertebral disk herniation

disc degeneration
prolapse
extrusion
sequestration

40

acute pain of herniation

tear of the IV

41

chronic pain

disk pushing on the nerve and mechanically stimulating it over time

42

ischemic paralysis of the spinal cord

lose segmental arteries

loss of blood supply to vertebrae

43

lumbar puncture

.

44

epidural (transsacral)

.

45

Tension headache

greater occipital nerve is entrapped in muscles and fascial layers

so if you are constantly using these muscles (trapeziums, semispinalis) then this nerve will be impinged/compressed and cause headache