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71 Cards in this Set
- Front
- Back
how many cerivcal vertebrae are there?
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7
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C1 is also called the ?
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atlas
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C2 is also called the ?
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axis
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What is the main purpose of the atlas?
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to support the head
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does the atlas have a vertebral body?
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no
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the atlas rotates on the ?
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axis
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the atlas has how many articulating surfaces?
-5 -4 -3 -2 |
5
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the axis has the __ which articulates with the atlas.
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dens
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the axis has a __ spine
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bifid
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the axis has the odontoid process and __ articulating surfaces.
-7 -6 -5 |
6
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what are the 2 parts of the intervertebral disc?
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outer=annulus fibrosis
inner=nucleus pulposus |
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what are the layers of the meninges?
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dura mater
arachnoid mater pia mater |
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cervical spine nerves exit __their vertebral bodies.
-above -at -below |
above
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__ is excellent for detecting degenerative disease affecting the discs.
-mri -ct -u/s |
mri
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when doing a rectal what 3 things are you evaluating?
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peri-anal sensation
rectal tone bear down/contraction |
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what are the 3 pathologic reflex responses?
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hyperreflexia
clonus>4 beats babinski |
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a slow or clumsy grip and release test is consistent with what problem?
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cervical cord compression
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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?
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cervical myelopathy and finger escape sign
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if tapping on the distal brachioradialis produces hyperactive finger flexion...what is it called?
-inverted radial reflex -hoffman's reflex |
inverted radial reflex
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snapping of the long finger down quickly that causes contraction of the thumb and index finger is called?
-inverted radial reflex -hoffman's reflex |
hoffman's reflex-upper motor neuron lesion
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how many lumbar vertebrae are there?
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5
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what is the configuration of the lumbar vertebrae?
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lordotic configuration
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what is the purpose of the vertebral bodies?
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bears compressive weight
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what is the purpose of the intervertebral discs?
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distributes loads imposed on lumbar spine
restrains excessive motion |
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herniated nucleus pulposus occurs most commonly in what decades of life?
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3rd and 4th
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what is a herniated disc?
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herniation of the nucleus pulposus thru fibers of the annulus fibrosus
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what occurs within the disc with herniation?
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disk loses water
annular tearing myxomatous changes |
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where is the most common spot for a disc herniation?
-L2L3 -L3L4 -L4L5 |
L4-L5
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what is the anatomy of disc herniation?
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compresses the roots of the spinal nerve, nerve emerges thru upper part of foramen, lies against body of vertebrae above it.
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in a disc herniation of L5, what nerve is being compressed?
-L4 -L5 -S1 |
S1
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if a pt. has S1 nerve symptom distribution..what disc is herniated?
-L4 -L5 -S1 |
L5
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if a disc is protruding, which spinal ligament is messed with and how?
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PLL is intact
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if a disc is extruded what is messed with?
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PLL is ruptured
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if a disc is sequestered what is messed with?
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PLL is "free" in the canal
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what are important questions you want to ask when evaluating someones hx of injury?
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how did it happen
location of pain character of pain postural changes effect of increased intrathecal pressure |
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_ pain worsens with movement.
-nocturnal pain -mechanical pain -morning pain |
mechanical pain
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nocturnal pain is typically r/t?
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tumor or infection
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standing worsens __ claudication.
-muscular -neurogenic -radicular |
neurogenic
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morning pain that improves thruout the day is?
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spondyloarthropathy
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how do you test lasegue's monuever?
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ipsilateral straight leg raise
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which is more specific ipsilateral leg raise, or contralateral leg raise.?
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contralateral leg raise
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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 |
same side with disc herniation
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T/F
pt's usually do not experience pain and numbness together. |
true; they don't
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what is the goal in pts with chronic LBP?
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maximize fxn of the lumbosacral spine
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what is appropriate treatment of LBP?
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PT
NSAID's muscle relaxers ice |
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cauda equina dysfunction
progressive neuro deficits epidural abcess fx with neuro deficits and epidural hemorrhage...are all...? |
absolute surgical indications
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severe pain after conservative course..moderate motor weakness..recurring sciatic episodes..are signs of __ surgical indications.
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relative
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do pt's with disc disease generally have n/t or not?
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not
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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? |
degenerative disc disease
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__ is a collection of peripheral nerves L1 to S5 in a common dural sac
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cauda equina
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what is the other name for cauda equina?
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horse tail
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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 |
cauda equina syndrome
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where does the spinal cord terminate?
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between T12 adn L2
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what is the other name for the caudal end of the spinal cord?
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conus medullaris
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what is the most common cause of cauda equina syndrome?
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herniated lumbar disc
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what is the thin, nonneuronal filament attached to the coccyx?
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filum terminale
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neurogenic bladder dysfcn is essential element of __that results in urinary retention or incontinence.
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CES
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what are the s/s of CES?
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bladder dysfcn (required)
LBP groin, perineal pain b/l sciatica lower extremity weakness dec. or absent reflexes |
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what dermatomes are affected in CES?
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S2-S4 saddle anesthesia...posterior thigh, perineal and perianal region
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will the rectal tone be normal in a pt with CES?
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no, it will be decreased tone
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what is the bulbocavernosus reflex?
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apply traction on a foley catheter or pressure to the penis or clitoris and there will be contraction of the anus.
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what is the tx of CES?
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surgical exploration adn decompression of compressive lesions
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what decades of life do you commonly see CES?
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5th 6th
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dural sac compression is also called?
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central spinal stenosis
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compression of the nerve root in lateral recess is called?
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lateral spinal stenosis
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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 |
dehydrated disc
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what are the most common complaints in spinal stenosis?
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pain in back, butt, lower extremetries
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spinal stenosis pain is excerbated by?
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standing, walking, or exercise standing up
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if a pt's symptoms are relieved rapidly by sitting down or leaning forward (like over shopping cart) this is indicative of?
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neurogenic claudication
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__ is a condition in which part or all of a vertebrae slip on another?
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spondylolysthesis/spondylolysis
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where is the most common site for sponds?
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L5
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