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| How many vertebrae are there? | 33
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| How many cervical spine vertebrae are there? | 7
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| How many thoracic vertebrae are there? | 12
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| How many lumber? | 5
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| How many sacral? | 5
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| Vertebral anatomy | 1. Spinous Process 2. Transverse processes 3. Foramina 4. Body (Cancellous/spongy bone and cortical rim)
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| What do the three foramina do? | 2 on side are for nerves and the large on in the middle if for the spinal cord
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| What is the largest vertebrae? | C7
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| Where does the spinal cord exit the brain? | At the foramen magnum at the base of the skull
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| Where does the spinal cord end? | At the conus medullaris (L3 in child and L1-L2 in adult
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| What lay between the vertebrae? | The cartilaginous disks
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| External landmarks of the back | 1. Spinous processes 2. Scapulae 3. Iliac crests 4. Sacrum 5. Coccyx
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| Examination technique- Inspection | 1. General configuration 2. Symmetry 3. Depressions, hair at midline, sacrum 4. Changes in skin texture, pigmentation 5. Curvature of the spine
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| Curvature of the spine: Kyphosis | Convex, normal is 30 degrees to 50 degrees
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| Curvature of the spine: Lordosis | concave curvature
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| Curvature of the spine: Scoliosis | Lateral curvature
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| Postural kyphosis | Usually presents in adolescence
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| Schuermann kyphosis | Usually presents in adolescence - Often familial -abn. growth of vertebrae - "wedge-shaped" -One side grows faster than the otther
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| Congenital kyphosis | Malformation of vertebrae
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| Paralytic disorders associated with kyphosis | MD, CP, etc.
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| Lordosis is often caused by... | 1. Achondroplasia 2. Benign 3. Spondylolisthesis (misalignment of the lumbar vertebrae, congenital (rare)
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| Scoliosis | 1. uneven shoulders and hips 2. unilateral rib hump 3. infantile scoliosos is a deformation caused neurologic DOs
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| Examination techniques- Palpation | For dimples, depressions of the spinal processes and sacrum
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| Minor variants/anomalies of the back | 1. Sacral dimples 2. Pigmentation 3.
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| Sacral dimples | 1. 2-3% of all newborns 2. Blind 3. Usually midline 4. Must be differentitated from spinal dysraphism
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| Minor anomaly: pigmentation | (Nevi, Mongolian spots, hematomas) -"Stork bites" "angel kisses" etc. -Evaluated for tethered cord, spina bifida occulta
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| Dysplasias of the back | 1. Gibbus 2. Platyspongyly 3. Winged scapulas
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| Malformations of the back | 1. Scoliosis 2. Scapular abnormalities 3. Hypoplastic scapulas 4. Pilonidal dimple/sinus/cysts 5. Arnold-Chiari malformation 6. Midline masses 7. Spinal dysraphism
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| Minor variants/anomalies | -Relative trunk length: height- Normal lumbar lordosis of toddlerhood- bifid spinous process-Sacral dimples and others mentioned above
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| Disruptions | None
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| Deformations of the back | 1. Scoliosis
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| Deformation scoliosis is due to | severe intrauterine constraint
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| Other deformations that present with scoliosis are (Joint contractures)... | Arthogryopsis multiplex congenital
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| What is a gibbus? | -Dysplasia- Severe kyphosis; humpback; curvature is not smooth
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| What is polyspondyly? | -Dysplasia-Flattening of vertebral body> shortened trunk
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| When does a Gibbus occur? (syndrome) | -Hunter syndrome
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| When does platyspondyly occur? | OI, MPS, skeletal dysplasias
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| What syndromes are associated with winged scapulas? | Muscular dystrophy, cleidocranial dysplasia, EDS
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| Describe scapular abnormalities | 1. Malformations2. Sprengel sequence3. Failure of normal scapula descent; hypoplastic
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| Scapular abnormalities are typically seen in what syndrome? | Klippel-Feil
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| What syndrome is hypoplastic scapulas (chondrodystrophies) typically seen in? | Campomelic dysplasia
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| Describe Pilonidal dimple/sinus/cyst | - Malformation of the back- Found in natal cleft- Often have hair, may drain fluid- Evaluate for tethered cord(1)Caudal end of spinal cord attached to bone by connective tissue (2) As spine grows, cord is stretched downward
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| Arnold-Chiari malformations | -Can be caused by tethered cord-Herniation of the cerebellum through the foramen magnum- Symptoms range from none to obstructive hydrocephalus
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| 2 types of midline masses (malformations) | (1) lipomas (2) sacrococcygeal teratoma
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| Lipomas | (1) can be irregulary shaped (2) move with the skin, firm (3) benign, fat cells (4) may signifiy underlying spina bifida(5) may extend into the spinal cord
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| Sacrococcygeal teratoma | (1) most common newborn tumor (2) 1:35,000-40,000 LBs (3) composed of many types of cells
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| 4 Types of spinal dysraphism (malformation) | (1) SB occulta (2) meningocele (3)myelomeingocele (4)Spinal rachischisis
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| Spina Bifida occulta | -Mildest form of Spinal dysraphism-Usually no clinical signs-Sometimes marked by lipomas, hemangioma, hairy patch
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| Meningocele | -Spinal membrance protrude through spinal canal-Usually lower lumbar or sacral-Usually no neurological sequelae
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| Myelomenigocele | -Most serious form of spina bifida-Spinal cord and meninges protrude-Problems with movement and sensation below the level of the defect
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| Spinal rachischisis | -Failure of fusion of a large part of neural tube-Incompatible with life-Most common in thoracic region-Anencephaly/inencephaly
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Created by:
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