The Spine - CH.25 Flashcards
(37 cards)
name the ligamentous structures that support the spine and name the direction it limits
anterior long. lig - hyperextension posterior long. lig - hyperflexion interspinous - hyperflexion supraspinous - hyper flexion ligamentum flavum - hyperflexion
an athlete sustains an injury to T11/12 which causes him to be paraplegic from the hip down whereas another person got the same injury but at L4/L5 but only has a disability with DF and great toe extension - everything else is okay - how is this happening?
cauda equina - end of spinal cord end at L1/2 level - anything above that severs the spinal cord (cuts the entire tail off)
whereas any injury below L3 will only damage the nn root but not the spinal cord itself
a patient comes in with an excessive amount of kyphosis at the thoracic and lumbar spine - what do you think could be happening?
scheurman’s disease
a patient comes in with pain and tightness at the neck - feels like a pinch in certain ranges of motion, you suspect a possible facet joint sprain at the cervical spine - what’s the first couple test you would do?
cervical neck instability - alar, sharp purser’s, tranverse ligament, VBI
must rule out all cervical instabilities before testing other neck ranges of motion
once cervical instabilities have been ruled out, what test would you use for a suspected facet joint sprain?
distraction - see if it eases up cervical compression spurlings quadrant test Jackson's? bakody's side - having forearm on head to take tension off the dura
what typical posture would you see in a patient who has a herniated disk?
they tend to side bend towards the same side as the herniation because it takes off the pressure if they were to side bend the other way
test for spondylolysis
stork test
(+) pain at lumbar - feeling of instability
what are the findings with 30/30-60/70-90 degrees with a straight leg raise
P @ 30: hip problems, potential lumbar problem
P @ 30-60: sciatic nn irritation - “laseauge’s sign” ***if max DF causes increase in symptoms - more likely L3/4 or S1/2
P @ 70-90: SI joint problem
demo the kernig’s test
test for nn irritation
demo the brudzink’s test
if patient flexes the neck and the knee reflexively bends, likely a nn irritation or tight fascia or sign of meningitis
what does the SI compression test, test for?
posterior SI lig
what’s the SI Distraction test, test for?
anterior SI lig
explain the prone knee flexion test and how is it confirmed?
one leg short = posterior rotation of SI joint of that same side
if they equal out at 90 of knee flex - then it’s a fa sho
test the cranial nerves
1-12 olfactory - smell optic - acuity oculomotor - tracking trochlear - convergence trigeminal - clench teeth abducens - lateral mvmnt of eye facial - facial expression vestibulocochlear - hearing glossopharyngeal (sensory of tongue, saying words) vagus (cah, gah) accessory (shrug) hypoglossal (shakira)
demo dermatomes, myotomes and deep tendon reflexes on your body
Babinski, Clonus, Hoffman’s sign?
do it on yourself
forceful DF - clonus
babinski - stroke foot and see if they extend toes (+)
hoffman’s - flick the middle finger and see if the index and thumb come together involuntarily (+)
you see a player about to spear head another athlete during a football game, what do you think could happen?
they go down what do you do?
axial load with slight flexion can cause a cervical fracture or dislocation (commonly at C4,5,6)
stabilize cpsine - call ambulance or get help, tx for shock but if not hold cspine until you can get a collar and board them for transport
what can you see to tell the difference b/w cervical fracture and cervical dislocation?
the head (in a dislocation) will be tilted to the same side as the dislocation
cervical dislocation are most common in what sport?
diving (flexion and rotation of head moi)
5 mechanisms in which the spinal cord can be damaged?
laceration
hemorrhage
contusion
cervical cord neuropraxia
spinal cord shock
injuries above or at this level of the csp is automatic death
c3
an athlete goes down on the field and doesn’t move - you get there and they’re still awake but they have N/T down their extremities B – after a couple of mins they feel completely fine other than just a sore neck? what condition do you think this is and how should you go about tx-ing it?
cervical cord neuropraxia
- tx as severe neck injury - go get imaging done to rule out fractures or instabilities
an athlete gets a blunt force to the head and neck - they become flaccid and then super spastic with no reflexes to hyperreflexive - what could be happening?
spinal cord shock
diff b/w complete and incomplete spinal cord shock?
complete - spinal cord completely gone and cut in 1/2 - anything below is not working
incomplete - certain parts of the spinal cord are injured
a patient with non-specific sensory loss, is quadraplegic, and no sexual function may have this condition?
central cord syndrome
