Exam I Clinical Relevance Chart (back, thorax, upper limb)

Excess thoracic Kyphosis- what is it

Hump back, also known as dowager’s hump

Excess thoracic Kyphosis- caused by

osteoporosis

Excess thoracic Kyphosis- location

thoracis

Scoliosis- what is it

common deformity of vertebral column- crooked back

Scoliosis- common in

pubertal girls (large breasts)

Scoliosis- caused by

congenital, improper posture

Scoliosis- looks like

S or C shape

Spina bifida occulta- caused by

neural arches failing to fuse

Spina bifida occulta- how is it accquired?

congenital anomaly of vertebral column

Spina bifida occulta- symptoms

asymptomatic

Spina bifida occulta- location

L5 and/or S1

Spina bifida cystica- what is it?

herniation of the meninges and/or neural tissue

Spina bifida cystica- caused by

lack of folic acid

Spina bifida cystica- is it noticable/serious?

It is very visible and serious

Spina bifida cystica- location

meninges and neural tissue

Excess lumbar lordosis- what is it?

sway back

Excess lumbar lordosis- caused by

often seen in late stages of pregnancy

Excess lumbar lordosis- why is it seen in pregnant women?

to help support the belly

Fractures of the vertebral arch of the axis- location

between the articulating processes

Traumatic spondylolysis of C2- what is it known as

Hangman's fracture

Traumatic spondylolysis of C2- what does it result from

hyperextension of neck like from whiplash or hanging

Atlantoaxial subluxation- what is it

rupture of the transverse ligament of the axis which sets the dens (pivotal axis for skull and atlas) free

Atlantoaxial subluxation- may lead to

spinal cord or brainstem compression

Fracture of the dens- severity

less severe because the transverse ligament holds the fractured dens in place

Atlantoaxial rotation- what could it cause?

it may compress the C2 spinal nerve and ganglion

Atlantoaxial rotation- symptoms

severe pain and headaches

Atlantoaxial rotation- location

C2 spinal nerve and ganglion

Vertebral arteries atherosclerosis- what is it?

blood flow is reduced through the winding course of the vertebral arteries through the neck

Vertebral arteries atherosclerosis- caused by

atherosclerosis

Vertebral arteries atherosclerosis- symptoms

dizziness and lightheadedness during prolonged turning of the neck

Lumbar spinal stenosis- what is it?

narrowing of the vertebral foramen in one or more lumbar vertebrae

Lumbar spinal stenosis- caused by

narrowing may be related to disk bulging and may compress spinal nerve roots

Overall bone density and strength decrease- what happens

articular surfaces of vertebral bodies bow inward, causing the IV disk to become more convex

Overall bone density and strength decrease- caused by

osteoclasts (destroy bones) become more active after late 30s

Overall bone density and strength decrease- leads to

altered mechanics, loss of height, and bony or cartilaginous outgrowths

Hemisacralization and sacralization- what is it?

Part or all of the L5 vertebra is incorporated into the sacrum

Lumbarization of S1 vertebra- what is it?

S1 is partly or completely separate from the sacrum; happens in early life

Subperiosteal bruising - caused by

fall onto the lower back

Caudal epidural anesthesia- what is it?

injection of a local anesthetic into the fat of the sacral canal that surrounds the sacral nerve

Caudal epidural anesthesia- where can it be done?

sacral hiatus and the posterior foramina (transsacral epidural anesthesia)

fracture of the coccyx - caused by

fall onto the lower back

dislocation of the sacrococcygeal joint- caused by

fall on the lower back

Cervical rub anomaly- what is it

developmental costal element of C7 may be abnormally enlarged, often bilaterally

Cervical rib anomaly- what could happen?

it may press on the structures emerging from the superior thoracic aperture, causing thoracic outlet syndrome or compression of brachial plexus

Nuclei pulposi losing tugor- cause

age

Nuclei pulposi losing tugor- what happens

become more stiffer and resistant to deformation

What happens to the Annuli fibrosi with age

they become thicker

Annuli fibrosi- what do they develop with age

fissures and cavities

Herniation of the nucleus pulposus- what is it

herniation into or through the annulus fibrosis

Herniation of the nucleus pulposus- caused by

hyperflexion of the vertebral column often called slipped or ruptured disk; Improper lifting of heavy objects

Herniation of the nucleus pulposus- symptoms

lower back and limb pain

Spinal nerve injuries- caused by

when the zygapophyseal joints are injured or develop osteophytes, the related spinal nerves are often affected

Spinal nerve injuries- symptoms

pain along the dermatomes and spasm in the muscles of the associated myotomes

Spinal nerve injuries- treatment

Denervation of the articular branches of the nerves innervating the joint is standard for back pain caused by disease off the zygapophysial joints

Articulated vertebrae Fractures, dislocations, fracture-dislocation- caused by

excessive or sudden violent movement of the vertebral column

Articulated vertebrae Fractures, dislocations, fracture-dislocation- location

typically occur in the more mobile cervical and thoracic regions of the column

Lumbar spinal puncture- also known as

spinal tap

Lumbar spinal puncture- why is it performed?

Performed for extraction of cerebrospinal fluid from the lumbar cistern for examination of the cellular competition, pressure, and chemical constituents

Lumbar spinal puncture- location

Lumber cistern

Spinal block- what is it?

entails introduction of an anesthetic into the CSF through a lumbar puncture

Spinal block- location

subarachnoid space

Narrow vertebral canal in cervical region- what is it?

encroachment of the vertebral canal by protruding IV disks, swollen ligamenta, flava, or osteoarthritis may exert pressure on nerve roots.

Narrow vertebral canal in cervical region- why is it dangerous?

it is dangerous because a minor fracture or dislocation may damage the cord and could lead to paralysis/quadriplegia

Transection of the cord- what is it?

cutting cervical spine across

Transection of the cord- results in

loss of sensation and movement inferior to the damage

Spinal cord fractures, dislocations, and fracture-dislocations- may interfere

blood supply to the spinal cord from the spinal and medullary arteries

Spinal cord ischemia- what is it

deficiency of blood supply

Spinal cord ischemia- can lead to

muscle weakness and paralysis

What is a laminectomy?

surgical removal of one or more spinous processes and the adjacent lamine

The lumbar spinal nerves ____ in size from superior to inferior, while the intervertebral foramina _____ in diameter

increase; decrease

Herpes Zoster: cause

Viral disease of the spinal ganglia caused by reactivation of chickenpox

Herpes Zoster: symptoms

• skin lesions (shingles)

• sensory neuropathy which may cause muscle weakness

Herpes Zoster: location

• lateral cutaneous nerves

• innervates strip of skin (dermatome)

Clavicular fracture: what could it cause

brachial plexus and subclavian vessel injury

Most common bone fraction

clavicular fracture

Clavicular fracture: weakest point

is at the junction of the middle and lateral thirds. Medial to acromial end

Lower Rib fracture: can cause injury to

internal organs like spleen and liver or tear diaphragm

Middle Ribs fracture: cause

result of a blow or crushing injury

Middle ribs fracture: weakest part

anterior to its angle

Partial ossification of xiphoid process looks like

lump in the pit of the stomach, often mistaken for a tumor

Sternal foramen: what is it?

Result of incomplete fusion of fetal sternal plates

sternal foramen: mistaken for

bullet wound

Thoracic outlet syndrome: what is affected

Structures that emerge through superior thoracic aperture being affected by obstructions in the root of the neck

Thoracic outlet syndrome: located

superior thoracic aperture and upper limb

Vascular Thoracic Outlet Syndrome: what does it cause?

compression of arteries

Vascular Thoracic Outlet Syndrome: symptoms

lack of blood flow, cold, cyanotic

Nervous Thoracic Outlet Syndrome: what does it cause?

compression of brachial plexus

Nervous Thoracic Outlet Syndrome: symptoms

numbness

Long thoracic nerve paralysis: symptoms

difficulty breathing and moving arm

Intercostal nerve block: what is it?

Introduction of an anesthetic agent around intercostal nerve and nerve collateral

Intercostal nerve block: symptoms

produces anesthesia of an intercostal space

Intercostal nerve block: location

Intercostal nerve and nerve collaterals

Carcinoma of the breast: symptoms

• Deviation of the nipple

• Thick, leathery skin between dimpled pores

• Large dimples

• Inversion of nipple

Hemiparalysis of diaphragm: cause

injury to phrenic nerve

Hemiparalysis of diaphragm: symptoms

paradoxical movement

Pneumothorax: what is it

air surrounding lung

Atelactisis: what is it?

collapsed lung

Bronchial and pulmonary disorders: causes

tumor and abscesses

Bronchial and pulmonary disorders: location

Bronchopulmonary segment

Bronchial and pulmonary disorders: treatments

Surgical resection - segmentectomy, lobectomy, pneumonectomy