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Ortho > Lecture Exam 4 > Flashcards

Lecture Exam 4 Flashcards

(60 cards)

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1
Q

facet joints in the cervical spine are in what plane?

A

all 3 (triplanar)

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2
Q

facet joints in the thoracic spine are in what plane?

A

frontal

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3
Q

facet joints in the lumbar spine are in what plane?

A

sagittal (with some curvature in frontal)

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4
Q

describe the annulus fibrosis & nucleus pulposus

A

these 2 parts compose the lumbar disk

  • annulus fibrosis: allows for mobility & minor shock absorption
  • nucleus pulposus: composed of a gel that provides shock absorption
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5
Q

mechanical compression or inflammation of a nerve root that cause neurologic symptoms in the LE

A

radiculopathy

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6
Q

which position puts 100% pressure on the discs?

A

standing

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7
Q

which position puts 150% pressure on the discs?

A

standing with forward bending

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8
Q

which position puts 25% pressure on the discs?

A

supine

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9
Q

which position puts 75% pressure on the discs?

A

side-lying

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10
Q

which position puts 35% pressure on the discs?

A

supine with both knees flexed

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11
Q

which position puts 275% pressure on the discs?

A

bending forward in sitting & lifting

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12
Q

what are the global muscles?

A

muscles of the lumbar spine

Rectus Abdominis
External & Internal Oblique
Quadratus Lumborum
Erector Spinae

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13
Q

what are the core muscles?

A

Transverse Abdominis
Multifidus
Deep portion of the Quadratus Lumborum

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14
Q

what is being described?

  • occurs along the iliac crest (due to falls or repeating loading with lifting/twisting)
  • can also be due to faulty standing posture, stretching beyond limits, or a forceful contraction
A

muscle strains of the lumbar spine

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15
Q

disc injuries are best described by what term?

A

Herniated Nucleus Pulposus (HNP)

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16
Q

any change in the shape of the annulus that causes it to bulge beyond normal perimeter

A

disc herniation

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17
Q

what mechanism of injury is being described?

  • fatigue & breakdown
  • traumatic rupture (one time event or on a part that has had gradual breakdown of annular rings)
  • degeneration (due to):
    • fibrous changes in nucleus
    • loss of organization of rings of annulus fibrosis
    • less water content in nucleus
A

disc herniation/IV injury

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18
Q

what are the 4 categories of HNP?

A

disc protrusion
prolapse
extrusion
sequestration

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19
Q

nucleus bulges against an intact annulus

A

disc protrusion/herniation

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20
Q

rupture of the nuclear material into the vertebral canal

A

prolapse

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21
Q

nuclear material is beyond the PLL or above & below the disc space as seen with MRI

A

extrusion

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22
Q

extruded nucleus is free from the disc & moved away from the prolapsed area

A

sequestration

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23
Q
  • pain: acute or changes with activity/movements
    • may prefer standing/walking
    • may see lateral shift of spine
    • limited fwd bending & extension
    • pain with SLR between 30-60 degrees
  • inflammation
  • motor weakness (neurological)
  • dermatomal changes (neurological)
  • variability of symptoms (posterior, posterolateral, anterior)

these are s/s of what type of pathology?

A

disc pathology

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24
Q

what are the most common areas for s/s with lumbar disc pathologies?

A

L4, L5
L5, S1

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25
repeating a movement/being in certain positions causes symptoms to increase or be experienced further down the leg
peripheralization
26
repeating a movement/being in certain positions causes pain that is referred distally to move toward the midline
centralization
27
if there is a lateral shift of the spinal column, backward bending (decreases; increases) pain?
increases
28
if lateral shift of the spinal column is corrected, backward bending (decreases; increases) pain?
decreases/centralizes
29
narrowing of the spinal canal, nerve root, or foramen which causes pressure on the spinal canal/nerve roots & leads to symptoms
spinal stenosis
30
with spinal stenosis, patients usually c/o of symptoms with (flexion/extension) of the spine?
extension
31
radicular ache to thigh paresthesias thigh loss of motor function these are s/s of what pathology?
spinal stenosis
32
- patients will find relief with flexed postures because it widens the IV foramina - position of comfort: supine with hips/knees flexed
flexion bias for spinal stenosis
33
bony defect in the Pars Interarticularis of the posterior elements of the spine
spondylosis
34
forward slippage of a superior vertebrae over an inferior one as a result of instability due to a bilateral defect in the Pars Interarticularis (5 classifications based on degree of slippage)
spondylolisthesis
35
insufficiency of the facet joints & disc complex
type 1 spondylolisthesis - congenital or dyspalsic
36
mechanical stress fracture at the Pars Interarticularis
type ll spondylolisthesis - isthmic (MOST COMMON)
37
associated with normal aging process; ligament laxity/slippage
type lll spondylolisthesis - degenerative
38
trauma from an acute fracture of the Pars Interarticularis
type lV spondylolisthesis - traumatic
39
tumors that affect the Pars Interarticularis
type V spondylolisthesis - pathologic
40
- umbrella term for age-related degeneration of the spine - OA of L-spine - bone spurs/osteophytes - DJD (Degenerative Joint Disease)
lumbar spondylosis
41
- due to trauma - due to compression fracture - lower thoracic/high lumbar is common with OP
lumbar spine fractures
42
composed of 7 segments with 8 pairs of nerve roots
cervical spine
43
purpose of the cervical spine is
mobility
44
- head rapidly moves into extension - head stopped by thorax if nothing else is there - compression of posterior structures - anterior structures are stretched
cervical extension injury
45
- head rapidly moves into flexion - head stopped by chin to chest - posterior structures are stretched
cervical flexion injury
46
acceleration/deceleration injuries flexion/extension injuries lateral flexion injuries
WAD (Whiplash Associated Disorder)
47
commonly involved muscles in cervical sprains/strains
sternocleidomastoid (SCM) scalene erectors rhomboids levator scapulae
48
disc extrusions in the c-spine are most common at which vertebrae?
C6, C7
49
- chronic DDD ("wear & tear") & is most common at C5, C6 & C6, C7 - average age of 40-50 - men> women
cervical spondylosis
50
with kyphosis of the thoracic spine, what muscles need to be stretched?
pecs anterior shoulder muscles
51
with kyphosis of the thoracic spine, which muscles should be strengthened
extensor muscles - scapular retractors - rhomboids - MT - erector spinae
52
- lateral curve changes with position changes - reversible
non-structural scoliosis
53
- non-reversible curve of the spine with fixed rotation of the vertebrae - lateral curve does not diminish with flexion of the spine - true scoliosis
structural scoliosis
54
*with structural scolisos* - ribs on convex side of curve will move in a posterior direction - ribs on concave side of curve will move in an anterior direction (will hollow)
rib hump
55
compression of vascular/neurological tissues as they exit the opening of the thorax
Thoracic Outlet Syndrome (TOS)
56
+ Adson's & +Roo's Test is a sign of
thoracic outlet syndrome
57
s/s of thoracic outlet syndrome
pain numbness tingling weakness skin temp changes
58
- rare condition - some form of anatomic abnormality that creates compression
neurogenic TOS
59
thoracic outlet syndrome is commonly misdiagnosed as
CTS
60
- no anatomical abnormalities - no abnormal EMG - no mm atrophy - faulty posture
nonspecific "symptomatic" neurogenic TOS

Ortho (5 decks)

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