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Ortho > Cervical & Thoracic Spine > Flashcards

Cervical & Thoracic Spine Flashcards

1
Q

What sections of the spine are mobile?

A

Cervical

Lumbar

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2
Q

Where are pain fibers located?

A 
Annulus fibrosis
Joint: uncovertebral, facet
Ligaments
Periosteum
Muscle/Fascia
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3
Q

Radicular Pain

A

Nerve root mediated
Dermatomal pain, numbness, paresthesia
Associated with weakness, hyporeflexia

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4
Q

Reasons for Radicular Pain

A

Compression
Chemical
Inflammatory

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5
Q

Define Referred Pain

A

Axial or external pain localized to a site remote from location of nocioceptors

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6
Q

Describe Referred Pain

A

Dull, achy, non-dermatomal pain

Associated with axial pain

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7
Q

How do intervertebral discs get their nutrition?

A

Childhood: annular arteries
Adolescence: diffusion

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8
Q

Normal Aging of Discs

A

Occurs at different rates
Disc dehydration, narrowing
Increase strain on annulus: diffuse bulging, annular tears, focal disc herniation
Stress transfers to uncovertebral & facet joints

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9
Q

Causes of Axial Pain

A

Facet, uncovertebral joint arthritis
Loss of lordosis (muscular)
Instability

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10
Q

Define Radiculopathy

A

Pressure related nerve root dysfunction

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11
Q

Causes of Radiculopathy

A

Disc herniation

Uncovertebral, facet joint spurs

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12
Q

Define Myelopathy

A

Pressure related spinal cord dysfunction

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13
Q

Causes of Myelopathy

A

Large disc herniation
Spurs
Congenitally narrow canal

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14
Q

Describe Structural Axial Pain

A

Dull
Achy
Paraspinal

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15
Q

Describe Referred Axial Pain

A

Sharp
Stabbing
Intrascapular

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16
Q

Describe Radicular Extremity Pain

A

Dermatomal
Sharp
Temperature
Wet/dry

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17
Q

Describe Appendicular Extremity Pain

A

Non-dermatomal

Joint/bone/muscle localized

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18
Q

Muscles to Check for C5

A

Deltoid

External rotators

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19
Q

Muscles to Check for C6

A

Wrist extension
Pronator teres
Biceps

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20
Q

Muscles to Check for C7

A

Triceps

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21
Q

Muscles to Check for C8

A

Finger flexors

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22
Q

How to Test for Sensory

A

Light touch
Pin prick
Temperature

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23
Q

DTR for C5

A

Biceps

24
Q

DTR for C6

A

Brachioradialis

25
Q

DTR for C7

A

Triceps

26
Q

Reason for Hyporeflexia

A

Radiculopathy

27
Q

Reason for Hyperreflexia

A

Myelopathy

28
Q

C5 Motor, Reflex, Sensation

A

M: deltoid, biceps
R: biceps
S: Lateral upper arm

29
Q

C6 Motor, Reflex, Sensation

A

M: wrist extensors, pronator teres
R: brachioradialis
S: lateral forearm, digit 1 & 2

30
Q

C7 Motor, Reflex, Sensation

A

M: triceps, finger extensors, wrist flexors
R: triceps
S: middle finger, back of upper arm

31
Q

C8 Motor, Reflex, Sensation

A

M: finger flexion, interossei muscles
R: none
S: medial forearm, digits 4 & 5

32
Q

T1 Motor, Reflex, Sensation

A

M: interossei muscles
R: none
Sensation: distal, medial upper arm

33
Q

Long Tract Signs

A 
Hyperreflexia
Clonus
Increased resting tone
Gait, coordination, rectal tone
Hoffmans (UE)
Babinski (LE)
34
Q

Provocative Tests for the Cervical Spine

A

Spurling’s
Reverse Spurling’s
L’Hermitte

35
Q

Differential Diagnosis of Axial Pain

A 
Bone: fracture, instability
Disc: degeneration, herniation
Joint: arthritis, instability
Soft tissue: sprain, fibromyalgia
Tumor/infection: primary, metastatic
Inflammatory: RA
36
Q

Diagnostic Tests for Bone Pain

A

X-ray

Bone scan

37
Q

Diagnostic Tests for Disc Disease

A

MRI
Myelo CT
Discography

38
Q

Diagnostic Tests for Joint Pain

A

Bone scan
Flexion/extension x-rays
Facet injection

39
Q

Diagnostic Tests for Soft Tissue Pain

A

MRI

Diagnosis of exclusion

40
Q

Diagnostic Tests for Tumor or Infection

A

Labs
Bone scan
MRI
CT

41
Q

Diagnostic Test for Inflammatory Conditions

A

Labs

42
Q

Non-Operative Treatment for Axial Pain

A 
PT
NSAIDs
Narcotics?
MR
Education
Activity modification
Reassurance
Pain management
43
Q

Pain Management Options for Axial Pain

A

Injection

Radiofrequency ablation

44
Q

Operative Treatment for Axial Pain

A

Fusion

45
Q

Differential Diagnosis for Extremity pain

A

Radiculopathy
Myelopathy
Peripheral nerves
Joints

46
Q

Radiculopathy Differential Diagnosis for Extremity Pain

A 
Herniated disc
Spondylosis
Instability
Tumor
Infection
Fracture
47
Q

Myelopathy Differential Diagnosis for Extremity Pain

A 
Herniated disc
Stenosis
Instability
Cord lesions
Medical
Trauma
Tumor
Syrinx: CSF & cord completely fill spinal canal
CNS
48
Q

Peripheral Nerve Differential Diagnosis of Extremity Pain

A

Entrapment
Neuropathy
Plexopathy
Chronic radiculopathy pain syndrome

49
Q

Joint Differential Diagnosis of Extremity Pain

A

Rotator cuff

Tennis elbow

50
Q

Diagnostic Tests for Radiculopathy Extremity Pain

A

MRI
Myelo/CT
EMG
SNRB: selective nerve regional block

51
Q

Diagnostic Tests for Myelopathy Extremity Pain

A

MRI
Myelo/CT
SSEP

52
Q

Diagnostic Test for Peripheral Nerve Extremity Pain

A

NCV

53
Q

Diagnostic Evaluation for Joint Extremity pain

A

Ortho eval

54
Q

Non-Operative Treatment of Extremity Pain

A 
NSAIDs
Narcotics?
Steroid injection
Traction
Collar
Myelopathy: urgent workup
55
Q

Operative Treatment of Extremity Pain

A

Decompression +/- fusion

Ortho (22 decks)

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