Clinical anatomy of the spine and some syndromes Flashcards Preview

Musculoskeletal > Clinical anatomy of the spine and some syndromes > Flashcards

Flashcards in Clinical anatomy of the spine and some syndromes Deck (24)
Loading flashcards...
1
Q

Describe the composition of the intervertebral disc?

A

Outer annulos fibrosa. Made out of fibrous tissue in layers.
In nucleus pulposa- gelitanous substance.

2
Q

Affect of ageing on the intervertebral discs

A

as you get older, the water content in the intervertebral discs decreases. This makes it saggier and therefore is not as good at supporting the spine.

3
Q

How is movement of the spine brought about?

A

Each segment offers only a small amount of movement- but collectively they offer a great amount of movement.

4
Q

Spondylosis

A

Decrease in water content of the intervertebral disc which leads to overloading of the facet joints. Pain becomes worse with extension- therefore people tend to be hunched over.

5
Q

Treatment of spondylosis

A

Facet joint injection- steroids and local anaesthetic under flouroscopy.

6
Q

Osteoarthritis in the spine

A

If in only one or two segments can be treated with spinal fusion. However if multi-level- won’t be effective.

7
Q

Where is acute disc prolapse likely to occur?

A

L4/L5 and L5/S1

8
Q

How do people cause prolapsed discs?

A

They lift heavy objects causing a sudden tear in the annulus fibrosa.

9
Q

How do people with prolapsed discs characteristically present?

A

Pain on coughing- due to coughing squashing the spine.

10
Q

What is the cauda equina?

A

Means the horses tail. The spinal cord is called this when it reaches L1.

11
Q

Where does the spinal cord run?

A

Inside a thecal sac inside the vertebral foramen. The roots then exit via the intervertebral foramen.

12
Q

Exiting root

A

The nerve root passes out of the thecal sac under the pedicle of that vertebrae and exits

13
Q

Transverse root

A

Remains anterior in the thecal sac until at the vertebra below and then crosses the disc and exits through that vertebrae’s exiting root.

14
Q

Which nerve root is more likely to be damaged in a prolapsed disc?

A

The transverse nerve root is more likely to be damaged because it crosses over the disc to the vertebrae below. The exiting root would only be damaged if it were a far lateral prolapse.

15
Q

What symptoms does compression of the lumbar nerve roots cause?

A

Radiculopathy- pain down the sensory distribution (dermatome) of the nerve roots
In the lower leg known as sciatica

16
Q

Sciatica

A

L4, L5 and S1 nerve roots contribute to the sciatic nerve (along with S2 and S3). Radiation of pain down the sensory division of the sciatic nerve is sciatica.

17
Q

Spinal stenosis

A

Nerve root compression by hypertrophic ligaments and osteophytes.

18
Q

Presentation of spinal stenosis

A

Burning leg pain on walking- neuropathic claudication. Differs to cardiogenic claudication because it occurs at variable distances and is better going uphill due to the spine not being compressed.

19
Q

Treatment of spinal stenosis

A

Surgery to remove osteophytes.

20
Q

Spinal cord compression

A

Myelopathy- weakness and hyperspasisity. Causes upper neuron signs. It could be due to tumours or disc prolapses.

21
Q

How to test for myelopathy

A

Scratch the bottom of the foot- normally the big toe would move down, in this it moves up.

22
Q

Cauda Equina Syndrome

A

Compression of all lumbar and sacral nerve roots affecting the bladder and bowel as well as the lower limb.
It is a medical emergency

23
Q

Presentation of cauda equina syndrome

A

Could present differently- incontinence, urinary retention, numbness at the tail end (saddle anaesthesia), loss of anal tone.

24
Q

Ligaments of the spine

A

Anterior longitudinal ligament- infront of the vertebral body.
Posterior longitudinal ligament- behind vertebral body before vertebral foramen.
Interspinous ligament- between spinous processes
Supraspinous ligament- on the outside of the spinous process.
Ligamentum flavum- right next to the vertebral foramen- more superficial.