H & P Spinal Disorders

Front 1

how many cerivcal vertebrae are there?

Back 1

7

Front 2

C1 is also called the ?

Back 2

atlas

Front 3

C2 is also called the ?

Back 3

axis

Front 4

What is the main purpose of the atlas?

Back 4

to support the head

Front 5

does the atlas have a vertebral body?

Back 5

no

Front 6

the atlas rotates on the ?

Back 6

axis

Front 7

the atlas has how many articulating surfaces?

-5
-4
-3
-2

Back 7

5

Front 8

the axis has the __ which articulates with the atlas.

Back 8

dens

Front 9

the axis has a __ spine

Back 9

bifid

Front 10

the axis has the odontoid process and __ articulating surfaces.

-7
-6
-5

Back 10

6

Front 11

what are the 2 parts of the intervertebral disc?

Back 11

outer=annulus fibrosis

inner=nucleus pulposus

Front 12

what are the layers of the meninges?

Back 12

dura mater
arachnoid mater
pia mater

Front 13

cervical spine nerves exit __their vertebral bodies.

-above
-at
-below

Back 13

above

Front 14

__ is excellent for detecting degenerative disease affecting the discs.

-mri
-ct
-u/s

Back 14

mri

Front 15

when doing a rectal what 3 things are you evaluating?

Back 15

peri-anal sensation
rectal tone
bear down/contraction

Front 16

what are the 3 pathologic reflex responses?

Back 16

hyperreflexia
clonus>4 beats
babinski

Front 17

a slow or clumsy grip and release test is consistent with what problem?

Back 17

cervical cord compression

Front 18

a pt is asked to hold fingers extended and adducted for 60 seconds, if two ulnar digits drift into abduciton and flexion..what is the pathology and what is the test called?

Back 18

cervical myelopathy and finger escape sign

Front 19

if tapping on the distal brachioradialis produces hyperactive finger flexion...what is it called?

-inverted radial reflex
-hoffman's reflex

Back 19

inverted radial reflex

Front 20

snapping of the long finger down quickly that causes contraction of the thumb and index finger is called?

-inverted radial reflex
-hoffman's reflex

Back 20

hoffman's reflex-upper motor neuron lesion

Front 21

how many lumbar vertebrae are there?

Back 21

5

Front 22

what is the configuration of the lumbar vertebrae?

Back 22

lordotic configuration

Front 23

what is the purpose of the vertebral bodies?

Back 23

bears compressive weight

Front 24

what is the purpose of the intervertebral discs?

Back 24

distributes loads imposed on lumbar spine

restrains excessive motion

Front 25

herniated nucleus pulposus occurs most commonly in what decades of life?

Back 25

3rd and 4th

Front 26

what is a herniated disc?

Back 26

herniation of the nucleus pulposus thru fibers of the annulus fibrosus

Front 27

what occurs within the disc with herniation?

Back 27

disk loses water
annular tearing
myxomatous changes

Front 28

where is the most common spot for a disc herniation?

-L2L3
-L3L4
-L4L5

Back 28

L4-L5

Front 29

what is the anatomy of disc herniation?

Back 29

compresses the roots of the spinal nerve, nerve emerges thru upper part of foramen, lies against body of vertebrae above it.

Front 30

in a disc herniation of L5, what nerve is being compressed?

-L4
-L5
-S1

Back 30

S1

Front 31

if a pt. has S1 nerve symptom distribution..what disc is herniated?

-L4
-L5
-S1

Back 31

L5

Front 32

if a disc is protruding, which spinal ligament is messed with and how?

Back 32

PLL is intact

Front 33

if a disc is extruded what is messed with?

Back 33

PLL is ruptured

Front 34

if a disc is sequestered what is messed with?

Back 34

PLL is "free" in the canal

Front 35

what are important questions you want to ask when evaluating someones hx of injury?

Back 35

how did it happen
location of pain
character of pain
postural changes
effect of increased intrathecal pressure

Front 36

_ pain worsens with movement.

-nocturnal pain
-mechanical pain
-morning pain

Back 36

mechanical pain

Front 37

nocturnal pain is typically r/t?

Back 37

tumor or infection

Front 38

standing worsens __ claudication.

-muscular
-neurogenic
-radicular

Back 38

neurogenic

Front 39

morning pain that improves thruout the day is?

Back 39

spondyloarthropathy

Front 40

how do you test lasegue's monuever?

Back 40

ipsilateral straight leg raise

Front 41

which is more specific ipsilateral leg raise, or contralateral leg raise.?

Back 41

contralateral leg raise

Front 42

a pt with disc herniation will have pain with contralateral leg raise...

-on the same side as disc herniation
-on the opposite side of disc herniation

Back 42

same side with disc herniation

Front 43

T/F

pt's usually do not experience pain and numbness together.

Back 43

true; they don't

Front 44

what is the goal in pts with chronic LBP?

Back 44

maximize fxn of the lumbosacral spine

Front 45

what is appropriate treatment of LBP?

Back 45

PT
NSAID's
muscle relaxers
ice

Front 46

cauda equina dysfunction
progressive neuro deficits
epidural abcess
fx with neuro deficits and
epidural hemorrhage...are all...?

Back 46

absolute surgical indications

Front 47

severe pain after conservative course..moderate motor weakness..recurring sciatic episodes..are signs of __ surgical indications.

Back 47

relative

Front 48

do pt's with disc disease generally have n/t or not?

Back 48

not

Front 49

pt's who c/o...
-worse pain with movements that stress disc
-back pain worse than leg pain
-worse with flexion, better with extension
-MRI shows loss of hydration of disk and endplate changes...

what is this?

Back 49

degenerative disc disease

Front 50

__ is a collection of peripheral nerves L1 to S5 in a common dural sac

Back 50

cauda equina

Front 51

what is the other name for cauda equina?

Back 51

horse tail

Front 52

B/B dysfcn
saddle anesthesia
varying degrees of loss of lower extremity sensory and motor fcn
most common cause is herniated lumbar disc..is...

-ruptured disc
-cauda equina syndrome
-hemiplegia

Back 52

cauda equina syndrome

Front 53

where does the spinal cord terminate?

Back 53

between T12 adn L2

Front 54

what is the other name for the caudal end of the spinal cord?

Back 54

conus medullaris

Front 55

what is the most common cause of cauda equina syndrome?

Back 55

herniated lumbar disc

Front 56

what is the thin, nonneuronal filament attached to the coccyx?

Back 56

filum terminale

Front 57

neurogenic bladder dysfcn is essential element of __that results in urinary retention or incontinence.

Back 57

CES

Front 58

what are the s/s of CES?

Back 58

bladder dysfcn (required)
LBP
groin, perineal pain
b/l sciatica
lower extremity weakness
dec. or absent reflexes

Front 59

what dermatomes are affected in CES?

Back 59

S2-S4 saddle anesthesia...posterior thigh, perineal and perianal region

Front 60

will the rectal tone be normal in a pt with CES?

Back 60

no, it will be decreased tone

Front 61

what is the bulbocavernosus reflex?

Back 61

apply traction on a foley catheter or pressure to the penis or clitoris and there will be contraction of the anus.

Front 62

what is the tx of CES?

Back 62

surgical exploration adn decompression of compressive lesions

Front 63

what decades of life do you commonly see CES?

Back 63

5th 6th

Front 64

dural sac compression is also called?

Back 64

central spinal stenosis

Front 65

compression of the nerve root in lateral recess is called?

Back 65

lateral spinal stenosis

Front 66

if a pt has a loss of disc height and has bulging of annulus fibrosis and ligamentum flavum into the canal they have?

-bulging disc
-ruptured disc
-dehydrated disc

Back 66

dehydrated disc

Front 67

what are the most common complaints in spinal stenosis?

Back 67

pain in back, butt, lower extremetries

Front 68

spinal stenosis pain is excerbated by?

Back 68

standing, walking, or exercise standing up

Front 69

if a pt's symptoms are relieved rapidly by sitting down or leaning forward (like over shopping cart) this is indicative of?

Back 69

neurogenic claudication

Front 70

__ is a condition in which part or all of a vertebrae slip on another?

Back 70

spondylolysthesis/spondylolysis

Front 71

where is the most common site for sponds?

Back 71

L5