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Ortho
| Question | Answer |
|---|---|
| Cervical Nerve Root Sensation | C5 - anterolateral shoulder, C6-thumb, C7 middle finger, C8 - little finger |
| Cervical Nerve root motor | C5 - deltoid and bicep, C6 - radial wrist extensors, C7 - triceps, wrist flexors, finger extensors, C8 - interossei, finger flexers |
| Cervical nerve reflexes | C5 - biceps, C6 - brachioradialis, C7 - triceps |
| Lumbar Nerve root Sensation | L2 - lateral thigh, L3 - medial knee, L4 - medial ankle great toe, L5 - Dorsum of foot |
| Lumbar Nerve root motor | L4 - anterior tibialis, L5 - great toe extension/ankle dorsiflexion, S1 - plantar flexion of foot/great toe |
| Lumbar Nerve Root reflex | L4 - patellar tendon, S1 - achiles tendon |
| Spurling Test | extend neck turning one way with downward pressure += affected side will have pain; indicative of cervical disk herniation or spondylosis |
| Straight-leg Raise | Pt. supine, elevate leg until knee bends or pt. has pain, puts tension on L5 and S1 nerve roots and sciatic nerve(L4-S1) |
| Reverse Straight-Leg raise | Pt. prone, hip in extension and knee straight, puts tension on L1-L4 |
| Apprehension test/Flip Test | Pt. seated at edge of table/bed, lift foot extend knee, measure degree(<45 degrees) of knee flexion at point when back pain occurs. +=flip back with little knee extension, maybe indicative of sciatic problem, LDDD |
| Lumbar degenerative disk disease(disk herniation)- causes, symptoms, physical exam, Diagnostic Test | chronic back pain >3mo; Causes: age, trauma, infect, smoking; sympt: pain in low back radiate buttocks,w/ bend; lift, twisting, relieved with rest; PE: lumbar/sacroiliac tender, + straight leg/flip test; Dx:AP/Lat(loss of height) x-ray, MRI; |
| Lumbar degenerative disk disease(disk herniation - Treatment | Nsaids, Muscle relaxants, injections, Physical activity/exercise, weight redux, smoking cessation |
| Scoliosis | Lateral Curvature of spine; Cause:congen, DDD, osteomyelitis, fracture; Sympt: pain midthoracic to lower lumbar, c/o curve progression, no cardiopulm probs; PE:obs. and palp standing and flexed at waist |
| Degnerative Sponylolisthesis - Causes, Symptoms, PE, and Diagnostic Test | forward slip of lumbar vertebral body(L4/L5), Cause:idio, iatro, post-trauma, degen in facet joints and intervet disk, Females>40, AA; Sympt: back pain w/lift, bend, twist, radiculo; PE: step off; Dx: AP/lat x-ray: lat shows slip degen of disk space; |
| Degnerative Sponylolisthesis - Treatment | excercise, Nsaids, Lifestyle mod(limit bend and heavy lift), Sx decomp or stabilazation |
| Isthmic Spodylolithesis - Causes | One Vertebral body slips in relation to the one below(L5/S1)defect at pars interarticularis (pedicle/lamina junction); Causes: fatigue fracture in childhood(extension, football gymnastics), hereditary predis |
| Isthmic Spodylolithesis - Symptoms, PE, Diagnostic Tests, Treatment | Sympt: back pain radiate to post thighs/knees, worse when standing, difficulty bending forward; PE: diminished lumbar lordosis, step-off, limited flexion at waste; Dx:X-ray(lat, oblique: absent scotty dog); Tx: excercise, F/U xrays, limit activities, Sx |
| Spinal Stenosis - Symptoms, PE, Diagnostic Test, Treatment | narrowing of spinal canal=compression of nerve roots; Sympt: radiculo w/or w/o back pain, progress proxi->distal, walk/stand exacerbates, releif w/ leaning forward; PE:Ms weak, impaired proprio,sensory, DTRs; Dx: AP/lat xray, Tx: PT(flexion), nsaids |
| Cauda Equina Syndrome | compression of L2-S4; Cause: central disk Hern, epidural abcess/hematoma, trauma; Sympt: radiculo pain, weak, and numb bilat LEs, urine reten or incont of bowel and bladder; PE: anal sphincter tone/perianal numness, Dx: xray, MRI, Tx: Sx emergency-Decomp |
| Malignant Tumors of the Spine | Most commonly mets from Breast, lung, prostate and colon CA |
| Cervical Spine X-ray | AP: equal height of spines, midline; Lat: Ant, post, spinolaminar line, <6mm at C2, <22mm at C6; Odontoid: dens, C1 and C2 LM aligned, LM of C1 symmetric to dens; |
| Hangman's fracture | fracture of both pedicles of C2 |
| Clay Shoveler's Fracture | fracture of lower cervical spinous process(C7) secondary to lifting, stable |
| Reiter's Syndrome | Triad of Conjunctivitis, urethritis, arthritis, secondary to infectious diarrhea in young children, nongono(chlam) urethritis in adloescents |
| Neer Impingement Sign | pt seated elevate arm while depressing scapula, compresses greater tuberiosity against ant. acromion |
| Hawkins impingement sign | Shoulder and elbow flexed to 90, forearm neutral rotation,internally rotate humerous; pain with rotator cuff tear or impingement |
Created by:
bmg4