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CABS - MSK > pathophysiology of the spine > Flashcards

pathophysiology of the spine Flashcards

1
Q

how many bones make up the cervical spine

A

7`

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2
Q

how many bones make up the thoracic spine

A

12

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3
Q

how many bones make up the lumbar spine

A

5

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4
Q

what are the same about the spine

A

the body
foramen
processes (transverse or spinal)
articular processes (spine to spine or spine to ribs)
pedicle (attaches the foramen to the body)

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5
Q

what is the atlas

A

C1

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6
Q

what is the axis

A

C2

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7
Q

what is important about the cervical vertebrae

A

most mobile
smallest, oval body
largest vertebral foramen
there are 7
bifid or forked spinous process in C2 to C6
C7 prominens

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8
Q

what is important about the thoracic vertebrae

A

heart shaped body
larger than C-spine body
12 total

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9
Q

what is important about the lumbar vertebrae

A

largest body
kidney shaped body
5 total
more mobile than thoracic spine

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10
Q

what are the difference between the different vertebrae

A

body shape
transforse foramen
facets for ribs
spinous process

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11
Q

where is hematopoiesis ongoing

A

vertebrae, ribs, sternum and pelvis

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12
Q

what are the two parts of the discs

A

annulus fibrosus and nucleus pulposus

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13
Q

what part of the disc contains more water

A

nucleus pulposus

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14
Q

What are the intervertebral liagments

A

ligamenta flava
posterior longitudinal ligamen
interspinous ligaments
supraspinous ligement
anterior longitudinal ligament

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15
Q

what is the densest fibrous tissue in the spine

A

ligamenta flava

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16
Q

where are the transverse foramen found

A

within the C-spine

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17
Q

what goes through the transverse foramen

A

vertebral nerves and vasculature

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18
Q

what is the MOA of whiplash

A

acceleration/deceleration with sudden hyperextension

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19
Q

what ligament is most likely strained in whiplash

A

alar ligement (on C1)

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20
Q

what is a muscle spasm

A

involuntary, painful contraction of the muscle

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21
Q

what are the ABC

A

airway
breathing
circulation

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22
Q

what motor function test is used for C5

A

elbow flexion

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23
Q

what motor function test is used for C6

A

wrist extension

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24
Q

what motor function test is used for C7

A

wrist flexion, finger extension

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25
Q

what motor function test is used for C8

A

finger flexion

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26
Q

what motor function test is used for T1

A

finger abduction

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27
Q

what tendon reflexes are used for C5

A

biceps

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28
Q

what tendon reflexes are used for C6

A

brachioradialis

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29
Q

what tendon reflexes are used for C7

A

tricep

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30
Q

what tendon reflexes are used for L3,4

A

quadricepts

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31
Q

what tendon reflexes are used for L5,S1

A

achilles tendon

32
Q

what cerivical fractures are considered unstable

A

type 2 and 3 odontoid fractures, teardrop subaxial fracture, and hangmans

33
Q

what is a spinous process avulsion called

A

Clay shovelers fracture

34
Q

what rotates around the odontoid

A

atlas

35
Q

what causes tear drop fracutres

A

extreme extension

36
Q

what is disrupted in tear drop fracutres

A

anterior longitudinal ligaments and avulses a section of the anteroinferior

37
Q

what is a traumatic spondylolisthesis

A

hangmans fracture

38
Q

What is hunchback/dowager’s hump

A

cervical kyphosis

39
Q

what causes cervical kyphosis

A

poor posutre
degenerative disc disease - progressive degenerations
congenital causes, trauma, iatrogenic(ex. surgical), ankylosing spondylitis

40
Q

what are the long term complications of cervical kyphosis

A

trouble swallowing or breathing

41
Q

what are the types of scoliosis

A

idiopathic
congenital
neuromuscular
pathologic

42
Q

what is the degree of curvature for scoliosis

A

> 10 degrees using the cobb angle

43
Q

what is the presentation of scoliosis

A

shoulder or hips are uneven
ribs may be more prominent on one side
head tilts

44
Q

what type of condition is juvenile scoliosis

A

inherited condition passed along X chromosomes

45
Q

what does thoracic lordosis lead to

A

pulmonary dysfunction

46
Q

what are different types of thoracic fractures

A

compression
burst
chance
translational fractures - dislocations
transverse process

47
Q

what is another name for a compression fracture in the spine

A

wedge fracture

48
Q

what is the most common thoracic fracture

A

compression fracture

49
Q

what is the MOA for burst fractures

A

axial load injury that causes the bone to “burst”
comminuted fracture and multiple fragments going in different directions

50
Q

what is a chance fracture also known as

A

anterior compression with associated transverse fracture

51
Q

what is the MOA for chance fractures

A

flexion-distraction injury, typically associated with lap belts

52
Q

where are chance fractures most common

A

T11-L2 (lap belt fractures)

53
Q

translational fracture- dislocation

A

high mechanism of injury that often have neurologic deficits

Requires OR

54
Q

What is the MOA for transverse-process fractures

A

rotation extreme lateral flexion - stable fracture

55
Q

where do the nerve roots exit the spine in the lumbar spine

A

under the corresponding vertebrae

56
Q

where do the nerve roots exit the spine in the cervical spine

A

above the corresponding vertebrae

57
Q

what type of pain suggests nerve involvement in lumbar injuries

A

leg pains - numbness, tingling/parasethesias, weakness, gait abnormalities

58
Q

what are your paraspinals responsible for

A

extension, rotation, and lateral bending

59
Q

what is the latissimus dorsi responsible for

A

shoulder adduction, medial rotation, extension

60
Q

what determines a lumbar strain/sprain

A

non radiculopathy, positional, worse with activity, relieved with rest, muscle spasms, stiffness and nonspecific low back pain

61
Q

what is lumbar DDD

A

loss of disc hydration at normal age-ralted change
mechanical stress, decreased nutrients (vascularity), normal cell senescence (including repair), genetics

62
Q

what is primarily proceeded by DDD

A

Lumbar spinal stenosis

63
Q

what is the hallmark of lumbar spinal stenosis

A

neurogenic claudication - easy fatiguability

64
Q

what is a herniated nucleus pulposus

A

herniated disc

65
Q

what is the MOA for herniated discs

A

mechanical disruption, tears in annulus, Wear and tear with aging, trauma to normal disc

66
Q

where are herniated discs most likely to happen

A

in the lumbar spine L4,5 and L5, S1

67
Q

what is the most common direction of herniation

A

posteriolateral

68
Q

what is sciatica

A

radiculopathy of the sciatic nerve includes portions from L4-S3 nerve roots

(buttocks, posterior thigh, most of the calf and foot)

69
Q

what is the presentation of sciatica

A

burning pain in the buttock and posterior thigh
pain in the calf and foot
numbness and parasethesias in the LE
weakness is less common

70
Q

what is spondyloysis

A

acquired defect in the Pars interarticularis (stress fracture)

71
Q

what is spondylolisthesis

A

the aprs defect leads to malaligment - anterior translation of a vertebral segment

72
Q

where is cauda equina located

A

where L1-S5 nerve roots traverse the spinal cord before exiting

73
Q

what is cauda equina

A

canal compression in the area of the cauda equina acts as a lower motor neuron lesion (peripheral), NOT and upper motor neuron one

74
Q

what is the presentation of cauda equina

A

unilateral or bilateral LE pains
sensory or motor changes in the LE
bowel/bladder dysfunction - retention (overflow incontinence)
Saddle anesthesia - numbness/tinging in perineum

75
Q

where is the primary location for traumatic fractures

A

thoracolumbar junction

76
Q

what type of fractures are secondary to osteoporosis

A

lumbar spine fractures

CABS - MSK (12 decks)

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