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61 Cards in this Set
- Front
- Back
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What vertebrae does the spinal cord extend to?
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L1-L2
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Which vertebrae are lordotic?
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cervical and lumbar vertebrae
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Which vertebrae are kyphotic?
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thoracic and sacral vertebrae
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How many spinal nerves are there?
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31 pairs of spinal nerves
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Describe a Jefferson fracture
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• an axial load compression fracture of the anterior and posterior arches of C1
• an unstable fracture • lateral masses of C1 lying lateral to the lateral masses of C2 (results as a spread of the ring of C1) |
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Where are there no intervertebral discs?
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• between C1 and C2
• sacrum |
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Upon flexion of the neck, which spinous process is felt on the posterior part of the neck?
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C7
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Generally, what do the 8 cervical nerves control?
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• C1: Head and neck
• C2: Head and neck • C3: Diaphragm • C4: Upper body muscles (e.g. Deltoids, Biceps) • C5: Wrist extensors • C6: Wrist extensors • C7: Triceps • C8: Hands |
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What are physical exam findings of an upper motor neuron lesion?
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• hyperreflexia
• muscle spasticity • spasms |
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What are physical exam findings of lower motor neuron lesion?
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• decreased DTRs
• flaccid muscle tone • flaccid paralysis |
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Intervertebral discs make up what percentages of the spinal column's length?
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25%
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True/False: Intervertebral disc have their own blood supply
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• Intervertebral discs are not vascular and depend on the end plates to diffuse needed nutrients
• The correct answer is: False |
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What are the 2 parts of the intervertebral disc?
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• annulus fibrosus - outer part
• nucleus pulposus - inner part |
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What are the 3 important ligaments of the spine and where are they located?
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• ligamentum flavum : forms over the dura mater, inside the spinal canal
• posterior longitudinal ligament: runs in the spinal canal but posterior to the vertebra body • anterior longitudinal ligament: runs up and down the spine; attaches to the front of each vertebra |
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What is the conus medullaris?
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the area of the spinal cord below T12 and L1 where the cord transitions in to the cauda equina
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What is the longest and largest nerve in the body?
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sciatic nerve (measures ¾ inch in diameter)
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What is sciatica?
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• injury or inflammation of the sciatic nerve
• can cause intense pain along any part of the sciatica nerve pathway (from the buttocks to the toes) |
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What are symptoms of sciatica?
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• loss of reflexes
• numbness • severe pain • weakness |
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What are conditions that can cause sciatica?
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• bulging or herniated disc
• DJD • Isthmic Spondylolisthesis • spinal stenosis • tumor (rare), |
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What is Piriformis Syndrome?
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caused by entrapment of the sciatic nerve as it exits the greater sciatic notch in the gluteal region
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What is a sensory march?
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• pain, that starts in the legs, and moves upward to the buttocks
OR • pain the begins higher in the body and moves downward • seen in cervical spinal stenosis |
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What are treatment options for spinal stenosis?
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• NSAIDs
• corticosteroid injections • rest or restricted activity • physical therapy • surgical |
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What is spondylolysis?
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a defect in the parts interarticularis
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What is the most common vertebra involved in spondylolysis?
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L5
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What is foot drop?
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• an abnormal neuromuscular disorder that affects the patient's ability to raise their foot at the ankle
• inability to dorsiflex (point toe to the body) • patients exhibit Steppage Gait or Footdrop Gait |
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What are causes of foot drop?
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• peroneal nerve injury (ex. herniation, trauma, spondylolisthesis, etc.)
• ALS • MS • Parkinson's |
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What occurs when you have a herniated disc?
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• the nucleus pulposus breaks through the anulus fibrosis of an intervertebral disc
• usually occurs in the L4-L5 and L5-S1 region |
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What is the test to evaluate for herniated disc?
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• the straight-leg raise test (or Lasegue Test)
• the patient lies down, the knee is extended and the hip is flexed • pain at 15° is a positive straight-leg raise test |
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What causes Cauda Equina Syndrome?
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occurs from a central disc herniation compressing the cauda equina
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What are some symptoms of Cauda Equina Syndrome?
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• bilateral leg pain
• loss of perianal sensation • paralysis of the bladder • weakness of the anal sphincter |
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What is whiplash?
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a nonmedical term to describe hyperextension injury to the neck resulting from an indirect force, sually a rear-end automobile collision
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What is the treatment for neck sprain/strain?
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• NSAIDS
• muscle relaxers • narcotics |
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What is scoliosis?
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lateral curvature of the spine
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What is the treatment of scoliosis?
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• treatment is dependant on the degree of curvature
• 10-15° » follow-up in 6 months • 15-20° » serial xrays every 3-4 months • >20° » ortho referral for possible bracing |
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What spinal deformity is often associated with respiratory distress?
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kyphosis
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What is Kyphosis?
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enhanced convex curvature of thoracic spine (hunchback)
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What is Pott's Disease?
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when TB of the spine causing progressive scoliosis
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What is the treatment for kyphosis?
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• 45-60º curve: observe 3-4 months w/ physical therapy
• > 60º curve or persistent pain: brace; possible surgery |
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What is Ankylosing Spondylitis?
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• inflammation with progressive fusion of the vertebrae
• a chronic, multisystem inflammatory disorder of the sacroilliac (SI) joints |
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Describe a wedge fracture
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a compression fracture in which a vertebra is crushed only in the front part of the spine, causing a wedge shape
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Describe a burst fracture
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the vertebra is crushed in all directions
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What are some characteristics of a Chance Fracture?
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• seen in passengers restrained by lap belts
• commonly found in the upper lumbar spine • represents a pure bony injury extending from posterior to anterior (through the spinous process, pedicles, and vertebral body) |
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What would a high cervical lesion affect?
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A lesion on C3-C5 would affect all arm muscles and ventilation
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What would a midcervical lesion affect?
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would affect extension but not flexion at elbow
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What would a low cervical lesion affect?
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affects hand muscle function but may preserve elbow flexion and extension
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What are some characteristics of partial spinal cord injury?
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• may be seen with acute neck extension
• typically get central spinal cord syndrome or anterior spinal artery syndrome |
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How does an injury to the corticospinal tract present?
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• produces an ipsilateral upper motor neuron lesions
• results in: - increased deep tendon reflexes - spasticity - weakness - a positive Babinski sign |
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What is negative Babinski sign and a positive Babinski sign?
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• negative = toes curl down
• positive = toes fan out |
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How does an injury to the dorsal column present?
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loss of ipsilateral light touch sensation and proprioception
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How does an injury to the spinothalamic tract present?
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contralateral pain and temperature sensory losses
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How does an injury to the nerve roots present?
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• produces ipsilateral lower motor neuron lesions and radiculopathy
• results in decreased deep tendon reflexes, weakness, and sensory loss in that nerve distribution |
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What are characteristics of spinal shock?
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• warm, pink, dry skin
• adequate urine output • relative bradycardia • signs of autonomic dysfunction (ex. ileus, urinary retention, fecal incontinence, priapism) |
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When are extension and flexion radiographs done?
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• if xray is normal, but the patient still complains of pain
• checks for cervical spine stability |
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What are the Nexus C-spine rules?
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plain film Xray of the spine when one of the following is present:
• midline pain or bony tenderness, crepitus, or step-off • presence of distracting injuries • altered mental status (including intoxication) • compliant of paresthesia or numbness; neurologic deficit |
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Describe a Hangman's fracture
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an unstable fracture of the pedicles of the posterior arch of C2 caused by extension and distraction injury
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Describe an extension "teardrop" fracture
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an unstable fracture where the anterior longitudinal ligament avulses the anterior-inferior corner of the vertebral body
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What is a clay shoveler's fracture?
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• an oblique fracture of the lower cervical spinous process (usually C7)
• results from hyperflexion |
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What are characteristics of anterior cord syndrome?
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• involves the loss of motor function, pain, temperature sensation distal to the level of injury
• preservation of light touch, vibration, and proprioception |
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What are some characteristics of central cord syndrome?
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What is the Brown-Sequard syndrome?
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What is the Brown-Sequard syndrome?
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• most often results from penetrating trauma
• caused by a hemisetion of the spinal cord • loss of ipsilateral motor function, proprioception, light touch sensation, and loss of contralateral pain and temperature sensation |
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What should you be consider in a patient older than 55 y/o with non-traumatic back pain?
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always consider abdominal aortic aneurysm (AAA)
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