Clinical Correlations of the Back

Question 1

scoliosis

Answer 1

most common spinal deformity
can be due to short leg
also can be due to spina bifida, muscular dystrophy and even osteoporosis

Question 2

congenital scoliosis

Answer 2

wedge-shaped hemivertebrae

Question 3

curves of scoliosis?

Answer 3

primary and secondary

spinous process toward center of curve

nerve spacing is narrower inside curve

Question 4

treatment of scoliosis?

Answer 4

bracing or internal fixation

Question 5

traumatic compression fx?

Answer 5

body weight rapid deceleration

or rapid load bearing

Question 6

associated conditions with compression fractures?

Answer 6

osteoporotic weakened trabeculae or neoplastic cancer (via Batson’s plexus) that weakens bone

Question 7

what vertebrae are more likely to be dislocated?

Answer 7

cervical

**bc of reduced mass and articular facet orientation

Question 8

harrington rods

Answer 8

used to surgically repair a scoliotic curve

Question 9

jefferson fracture

Answer 9

burst fracture of atlas

fx of anterior and posterior arches

Question 10

hangman’s fracture

Answer 10

pars interarticularis of axis (CV2) fracture
-disrupts C2/C3 IV disc

basically a spondylolysthesis

Question 11

what do you need to do with blow out disc?

Answer 11

need to fuse them

Question 12

most common dislocation in cervical region?

Answer 12

CV6

its where you run out of room and pressure hits there

Question 13

complete fracture of dens?

Answer 13

avascular necrosis can result

Question 14

pathologic fracture

Answer 14

due to some current medical problem

ex/ osteoporosis or metastesis

Question 15

rupture of transverse ligament of atlas?

Answer 15

allows atlas to move in AP direction and can pinch on the spinal cord

Question 16

breast ovary prostate hodgkins lymphmoa

Answer 16

batson’s plexus

Question 17

down syndrome?

Answer 17

missing a transverse ligament of atlas

-increased susceptibility to atlanto-axial subluxation

Question 18

hung facet

Answer 18

overlapped facets

cannot self reduce

Question 19

which is more delicate CV1 or CV2

Answer 19

CV1 (atlas) because it has no body

Question 20

fracture of dens

Answer 20

can go unnoticed if the transverse ligament of atlas is still intact

Question 21

rupture of alar ligaments?

Answer 21

can lead to increased rotation of skull laterally

can be caused by increased with rotation of skull when it is in flexion

Question 22

spondylolysis

Answer 22

fracture of pars interarticularis

Question 23

spondylolisthesis

Answer 23

bilateral spondylolysis

vertebrae slide forward

most common site - LV5 on SV1

Question 24

spina bifida occulta

Answer 24

neural arch defects at LV5 or SV1 predominantly
-tuft of hair often indicates area of defect

can be complete or partial

Question 25

how many pictures to confirm diagnosis?

Answer 25

2!

Question 26

spinal stenosis

Answer 26

narrowing spinal canal -also in IV foramen will give you different symptoms

Question 27

laminectomy

Answer 27

surgical removal of spinal processes and adjacent lamina

Question 28

foraminotomy

Answer 28

surgical enlargement of IV foramen to relieve pressure on spinal nerves

Question 29

spondylosis

Answer 29

degeneration of vertebrae body and IV discs water content of cartilage decreases with age degeneration leads to inflammation and osteophyte formation

Question 30

osteophyte

Answer 30

bone spur

Question 31

what can result from spondylosis

Answer 31

narrowed IV foramen | -can lead to radiculopathy

Question 32

osteoarthritis of what joints?

Answer 32

zygapophyseal joints - same pathology of spondylosis - further narrowing of IV foramen

Question 33

radicular pain

Answer 33

from nerve root impingement as well as inflammation

Question 34

thecal sac

Answer 34

inside dura

Question 35

what ligament injuries are worse?

Answer 35

hyperextension -can tear anterior longitudinal spinal ligament whiplash

Question 36

ankylosing spondylitis

Answer 36

fusion of spine due to inflammation of synovial joints usually 3rd and 4th decade of life

Question 37

bamboo spine

Answer 37

radiologic landmark of ankylosing spondylitis

Question 38

HLA B-27

Answer 38

genetic protein marker associated with ankylosing spondylitis

Question 39

cause of herniated disk?

Answer 39

sudden hyperflexion

Question 40

pain from tear of annulus

Answer 40

acute pain

Question 41

pain from disk herniation over time

Answer 41

chronic pain compression of nerve root

Question 42

paraplegia

Answer 42

impairment in motor or sensory function of the lower extremities

Question 43

parasthesia

Answer 43

numbness/tingling

Question 44

lumbar puncture

Answer 44

passes through ligamentum flavum -removeal of CSF passes through dura and arachnoid to subarachnoid space (CSF)

Question 45

location of lumbar puncture ?

Answer 45

LV3/4 LV4/5 -spinal cord ends LV1-2 **neonate - LV4-5

Question 46

caudal epidural anasthesia

Answer 46

needle passes through sacral hiatus to surround the cauda equina relieves pelvic pain without affecting motor control no change in motor control bc it originates higher in spinal cord**