Term
| Acute back pain is usually indicative of what kind of condition/injury? |
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Definition
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Term
| #1 cause of chronic back pain? |
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Definition
| degenerative dx of the spine |
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Term
| Nerve roots of C2-C7 exit the spine above/below their respective vertebrae? |
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Definition
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Term
Nerve roots of T1-Coc1 exit the spine above/below their respective vertebrae?
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Definition
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Term
| C8 nerve exits the spine at what location? |
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Definition
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Term
| What nerve root is affected with a lateral disc protrusion at the level of L4-L5? |
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Definition
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Term
| T/F: the sxs of causda equina syndrome tend to be mostly UMN in nature? |
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Definition
| False LMN - b/c the nerve root is part of the PNS |
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Term
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Definition
1. numbness localized to saddle area, possibly the glans penis or clitoris
2. asymmetrical
3. no sensory dissociation
4. loss of sensation in specific dermatomes in LE w/numbness and parathesia |
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Term
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Definition
| sharp, shooting, brief, increased with coughing or straining |
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Term
| Sxs of nerve or plexus pain |
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Definition
| -burning, "pins & needles", asleep, numb |
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Term
| Acute back pain < 6 weeks is usu d/t what? |
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Definition
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Term
| D/dx for subacute back pain |
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Definition
| osteomyelitis, neoplasm, sondylosis |
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Term
| What is the hallmark of spine pain d/t malignancy? |
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Definition
| pain at night that increases w/rest |
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Term
| If pt presents with incontinence or retention what 2 exams should are absolutely necessary? |
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Definition
| anal reflex and sacral dermatome |
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Term
| T/F: a proximal lesion of the spinal cord will present with spastic bladder & hyperreflexia. |
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Definition
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Term
| Types of gait abnormalities w/L5 weakness |
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Definition
1.walks w/foot slap d/t weakness of ant. tibialis muscle
2. contralateral pelivs drops during stance (trendelenburg gait) d/t weakness of gluteus medius that is controlled by L5
3. pts have difficulty walking on their heals
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Term
| S1 weakness pts have trouble walking on what? |
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Definition
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Term
| Pts w/LE pain list to what side w/standing or walking? |
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Definition
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Term
| If pt extends, rotates and bends neck laterally and pain increases it is d/t what? |
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Definition
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Term
| If pts spinal pain persists >6-7 wks what is protocol wrt diagnostic exams? |
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Definition
1. xray (r/o fx, neoplasm, congenital abnormalities, RA)
2. MRI |
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Term
| What is the best imaging technique to evaluate ALL conditions of the spine |
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Definition
| MRI. W/contrast it can distinguish btwn scar tissue from previous back surgeries and recurrent disc protrusion |
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Term
| Radiculopathy is a dx of what? |
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Definition
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Term
| The motor component of the spinal nerve is located in the... |
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Definition
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Term
| Most dxs of the spinal cord affect BOTH the ventral (motor) & dorsal (sensory) roots. What dx is the exception to this rule? |
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Definition
| herpes zoster (shingles) causes radiculitis of SENSORY root only. |
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Term
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Definition
1. pain or paresthesia in a sensory dermatome
2. weakness of the muscles innervated by the nerve root
3. reduced or absent DTRs mediated by that nerve root |
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Term
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Definition
1. sensory loss of lateral leg & big toe
2. motor weakness of foot & toe extensors
3. pts have trouble walking on heels |
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Term
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Definition
1. sensory loss of back of calf, lateral foot
2. motor weakness of plantar flexion of foot & toes
3. loss of ankle reflexes
4. pts have trouble walking on toes |
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Term
| Sciatica causes pain where? |
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Definition
In hip & butt that radiates down the posterolaterl aspect of the leg |
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Term
| Bed rest is recommended for pts with radiculopathy. How long should a pt rest for? |
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Definition
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Term
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Definition
1. PT (4-6 wks): exercise with use of heat, cold, U/S, massage
2. if secondary to occupation hazard train in use of ergonomics |
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Term
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Definition
Narrowing of spinal canal d/t:
1. congential defect
2. buldging discs
3. spondylolisthesis
4. degenerative OA |
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Term
| What is the patho of pain in spinal stenosis? |
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Definition
| Compression of nerve roots & vascular supply d/t decreased diameter of spinal canal & spinal foramina with standing & walking. |
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Term
| What makes the pain of spinal stenosis feel better? |
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Definition
| flexing the spine reduces the sxs (leaning on shopping cart) |
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Term
| What is the hallmark sign of spinal stenosis? |
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Definition
| neurogenic claudication: made worse with prolonged standing w/or w/o movement |
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Term
| What imaging technique confirms spinal stenosis diagnosis? |
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Definition
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Term
| Define cervical spondylosis |
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Definition
| degenerative changes of cervical spine often w/aging often causing neck pain or referred pain to the frontal/occipital regions of the cranium |
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Term
| What cervical nerve root is most often affected by herniated disc? |
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Definition
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Term
| Name three common complications of cervical spondylosis |
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Definition
1. HA
2. radiculopathy
3. myelopathy |
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Term
| What nerve root(s) are most often affected by cervical lordosis? |
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Definition
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Term
| Sxs of cervical spondylotic myelopathy |
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Definition
| stiff neck, arm pain, leg weakness, easy fatigability, numb& clumsy hands, spastic parapesis w/hyperactive reflexes |
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Term
| Non-surgical mgmt of cervical myelopathy |
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Definition
| soft-cervical collar, physiotherapy, NSAIDS*, close clinical f/u |
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Term
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Definition
| neck pain, HA, blurring of vision, dizziness, weakness, parashtesias, coginitive difficulty (d/t microvascular trauma), psychological sxs |
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Term
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Definition
| early mobilization (is better than rest!), NSAIDS |
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Term
| Indications for spinal surgery |
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Definition
1. compressive radiculopathy
2. myelopathy
3. spinal instability
4. increasing neurogenic deficit
5. incapacitating neurogenic claudication
6. imparied bladder/bowel fxn |
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Term
| Indications for ER spinal surgery |
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Definition
1. acute myelopathy
2. cauda equina syndrome
3. radiculopathy with motor deficit |
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Term
| Most important surgical outcome for spinal surgery |
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Definition
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Term
| Spinal surgery is not an exact science with improvement of sxs 50% of the time. What other fact should a patient be aware of prior to agreeing to surgery? |
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Definition
| That functional issues and peripheral pain NOT axial pain are relieved (if at all) with back surgery. |
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