Podcast
Questions and Answers
How does the alignment of spinal cord segments relate to the corresponding vertebrae?
How does the alignment of spinal cord segments relate to the corresponding vertebrae?
- The segments are not in line, and the difference increases as you descend. (correct)
- The spinal cord segments are always longer than the corresponding vertebrae.
- They are precisely aligned at all levels.
- The spinal cord segments are shorter in length compared to the vertebrae.
Where do spinal nerves emerge from the spinal column?
Where do spinal nerves emerge from the spinal column?
- Through the vertebral body.
- Via the spinous process.
- Through the intervertebral foramen. (correct)
- Directly through the spinal cord.
How do the first seven cervical nerves exit relative to their corresponding vertebrae?
How do the first seven cervical nerves exit relative to their corresponding vertebrae?
- Through the sacral hiatus.
- Above their corresponding vertebrae. (correct)
- At the same level as their corresponding vertebrae.
- Below their corresponding vertebrae.
In which direction does a herniated disc typically occur?
In which direction does a herniated disc typically occur?
Which part of the intervertebral disc protrudes or leaks in a disc herniation?
Which part of the intervertebral disc protrudes or leaks in a disc herniation?
What is the primary component of the intervertebral disc that weakens, leading to herniation?
What is the primary component of the intervertebral disc that weakens, leading to herniation?
Which lumbar levels are most commonly affected by disc herniation?
Which lumbar levels are most commonly affected by disc herniation?
What happens when there is leakage & pressure on spinal nerves due to herniation?
What happens when there is leakage & pressure on spinal nerves due to herniation?
What type of fibers are carried by the somatic sensory nerve?
What type of fibers are carried by the somatic sensory nerve?
What is the function of the somatic motor nerve?
What is the function of the somatic motor nerve?
What is a dermatome?
What is a dermatome?
What is a myotome?
What is a myotome?
Damage to the L5 nerve root would MOST likely result in weakness in which movement?
Damage to the L5 nerve root would MOST likely result in weakness in which movement?
Which sensory change is MOST likely associated with L4 nerve root compression?
Which sensory change is MOST likely associated with L4 nerve root compression?
Which reflex is typically affected by an L5/S1 disc herniation?
Which reflex is typically affected by an L5/S1 disc herniation?
What is one of the major symptoms of disc herniation?
What is one of the major symptoms of disc herniation?
What does the Straight Leg Raise (SLR) test primarily assess?
What does the Straight Leg Raise (SLR) test primarily assess?
What provides sensation from the dura matter?
What provides sensation from the dura matter?
What imaging modality is most commonly used to aid the diagnosis of a herniated disc?
What imaging modality is most commonly used to aid the diagnosis of a herniated disc?
The *Test L5 described is used to assess what function effectively?
The *Test L5 described is used to assess what function effectively?
Flashcards
Spinal Cord Segment Alignment
Spinal Cord Segment Alignment
The segments of the spinal cord are not aligned with their corresponding vertebrae, and this difference increases as you move downwards.
Intervertebral Foramen
Intervertebral Foramen
Spinal nerves emerge from the spinal column through these openings.
Cervical Nerve Placement
Cervical Nerve Placement
The first 7 cervical nerves pass above their corresponding vertebrae.
Disc Herniation
Disc Herniation
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Posterolateral Disc Herniation
Posterolateral Disc Herniation
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L4/L5 or L5/S1 Herniations
L4/L5 or L5/S1 Herniations
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Dermatome
Dermatome
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Myotome
Myotome
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Spinal Nerve injury symptoms
Spinal Nerve injury symptoms
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Low Back Pain (Disc Herniation)
Low Back Pain (Disc Herniation)
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Meningeal Branch
Meningeal Branch
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Straight Leg Raise Test (SLR)
Straight Leg Raise Test (SLR)
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Study Notes
- The segments of the spinal cord are not aligned with their corresponding vertebrae; the difference increases moving downward.
- Nerve roots increase in length as they descend.
- Every spinal nerve emerges from the spinal column via the intervertebral foramen, beneath its corresponding vertebra.
- The first 7 cervical nerves pass above their corresponding vertebrae.
Spinous Process and Spinal Cord Segment Correspondence
- C7 spinous process corresponds to the C8 spinal cord segment.
- T3 spinous process corresponds to the T5 spinal cord segment.
- T9 spinous process corresponds to the T12 spinal cord segment.
- T10 spinous process corresponds to the L1-L2 spinal cord segments.
- T11 spinous process corresponds to the L3-L4 spinal cord segments.
- T12 spinous process corresponds to the L5 spinal cord segment.
- L1 spinous process corresponds to the S1-end spinal cord segment.
Herniated Disc
- A herniated disc involves the protrusion/leakage of the gelatinous nucleus pulposus through the anulus fibrosus of the intervertebral disc.
- Protrusions usually occur in a posterolateral direction due to the thinner annulus fibrosus.
- 95% of herniations occur in L4/L5 or L5/S1.
- Leakage and pressure on spinal nerves lead to symptoms.
Spinal Nerves
- Somatic sensory nerves (GSA) and somatic motor nerves (GSE) are key components
- Each area of skin is supplied by spinal nerves
- Groups of muscles are supplied by specific spinal nerves
Common Lumbar Disc Problems
- L3-L4 disc herniation (L4 nerve root):
- 3-10% incidence.
- Causes weakness in knee extension (quadriceps femoris).
- Results in anteriomedial leg sensory changes (saphenous nerve).
- Diminished knee jerk reflex.
- L4-L5 disc herniation (L5 nerve root):
- 40-45% incidence.
- Causes weakness in big toe dorsiflexion (EHL) and TA muscles.
- Results in sensory changes in the big toe and anteriolateral leg (common peroneal nerve).
- Diminished hamstring jerk reflex
- L5-S1 disc herniation (S1 nerve root):
- 45-50% incidence
- Causes weakness in foot plantar flexion (gastrocnemius).
- Results in sensory changes in the lateral border of the foot (sural nerve).
- Diminished ankle jerk reflex.
Clinical Tests
- L5 myotome testing involves asking the patient to stand on their heels.
- S1 myotome testing involves asking the patient to stand on their tiptoes.
Major Symptoms of Disc Herniation
- Low back pain, radiating to the gluteal region, back of the thigh and leg.
- Spinal nerves give off a meningeal branch that supplies the canal.
- Dura matter is sensitive to stretch.
- Pain is diffused due to overlapping dermatomes.
- Straight Leg Raise Test (SLR) checks for sciatic nerve problems; pain indicates irritation or compression.
- Pain at a lower angle during SLR indicates a disc problem.
Diagnosis
- MRI is commonly used to aid in diagnosing a herniated disc.
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