Spinal Health and Imaging Techniques Quiz

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Questions and Answers

What is the purpose of a CT scan?

To visualize internal structures using X-ray technology (correct)

To measure electrical activity of muscles

To assess blood flow in peripheral nerves

To track the movement of radioactive tracers

Which surgical intervention involves the removal of a part of the vertebral disc?

Spinal fusion

Laminectomy

Foraminotomy

Discectomy (correct)

What does Nerve Conduction Studies (NCS) primarily measure?

The speed of electrical impulses along a nerve (correct)

The chemical composition of nerve tissues

The amount of pain experienced in limbs

The structure of the spinal vertebrae

Which conservative intervention is recommended for improving mobility and flexibility?

Strengthening exercises Signup and view all the answers

In the Slump Test, what is the initial position of the patient?

Sitting with flexed spine Signup and view all the answers

Which reflex is tested at the knee level?

L3/L4 Signup and view all the answers

What type of intervention focuses on ergonomics and preventing injuries?

Environmental modifications Signup and view all the answers

Which imaging technique involves using strong magnetic gradients and radio waves?

MRI Signup and view all the answers

What is the primary function of the vertebral body?

Absorb compressive forces Signup and view all the answers

Which vertebrae are known for lacking a body?

C1 Signup and view all the answers

Which of the following correctly describes the cervical spine compared to other spinal regions?

More mobile with shallower atlanto-axial facet joints Signup and view all the answers

The transverse foramen is a feature found in which vertebrae?

C1-C7 Signup and view all the answers

Which processes project laterally from a vertebra?

Transverse process Signup and view all the answers

What is the primary function of the nucleus pulposus in the intervertebral discs?

Distribute axial compressive forces Signup and view all the answers

Which ligament in the spine limits extension?

Anterior Longitudinal Ligament (ALL) Signup and view all the answers

What characterizes the C7 vertebra compared to C3-C6?

It has an absent transverse foramen Signup and view all the answers

Which spinal nerve roots are named based on the vertebra below them?

C1 to C7 Signup and view all the answers

What role does the annulus fibrosus play in the intervertebral discs?

Withstand tension in the disc Signup and view all the answers

Which of the following muscles are responsible for maintaining posture in the spine?

Deep (Intrinsic) muscles Signup and view all the answers

What movement is often caused by a hyperextension injury of the neck, commonly referred to as whiplash?

Sudden and forceful hyperextension Signup and view all the answers

Which component is absent between the occiput and C1 as well as between C1 and C2?

Intervertebral disc Signup and view all the answers

What type of condition is congenital torticollis primarily associated with?

Shortened sternocleidomastoid muscle Signup and view all the answers

Which condition is commonly known for causing involuntary muscle spasms and movements?

Cervical Dystonia Signup and view all the answers

What is a common cause of degenerative disc disease?

Aging and wear on discs Signup and view all the answers

What is typically the first step in the treatment of congenital torticollis?

Stretching and range of motion exercises Signup and view all the answers

What is spinal stenosis characterized by?

Narrowing of the spinal canal Signup and view all the answers

What is a hallmark symptom of Cauda Equina Syndrome?

Urinary incontinence Signup and view all the answers

Which vertebrae are most commonly affected by herniated discs in the cervical region?

C5-C6 and C6-C7 Signup and view all the answers

Spondylolisthesis results from which prior condition?

Spondylolysis Signup and view all the answers

What is the most common cause of back pain in individuals under the age of 45?

Back pain due to muscle strain Signup and view all the answers

What is commonly seen in patients with kyphosis?

Dorsal hump appearance Signup and view all the answers

Study Notes

OCCTH 583: Neck and Trunk

Course name: OCCTH 583
Course topic: Neck and Trunk
Instructor: Jennifer Krysa, MSc, OT Reg (AB), OTR

Outline

Structure and Function of the neck and back
- Bones
- Ligaments
- Nerves
- Muscles
Conditions related to the neck and back

The Trunk: Osteology

Skull
Ribs
Sternum
Vertebral Column
Pelvis (Ilium)

Vertebral Column

5 regions:
- Cervical (C1-7)
- Thoracic (T1-12)
- Lumbar (L1-5)
- Sacrum (5 fused segments)
- Coccyx (4 fused segments)

Vertebra

Vertebral body: structure & support; absorbs compressive forces
Vertebral arch formed by pedicles & laminae; protects spinal cord
Vertebral foramen: the bony canal for spinal cord; posterior to vertebral body
Vertebra is singular, vertebrae is plural

Vertebra - Processes

Spinous process: projects dorsal & inferior; the first palpable spinous process is C2
Transverse process: projects laterally
Superior facet
Inferior facet

Vertebra - Lateral View

Superior & inferior facets: joints between the vertebrae; thoracic vertebrae also have costal facets (ribs)

Cervical Spine

C1 (atlas): no body
C2 (axis): odontoid process (dens) evolved from body of C1; C-spine more mobile; Atlanto-axial facet joints quite shallow

C-spine Cont'd

Transverse foramen on C1-C7
Vert. a. travels thru C1-C6
C3-C7 called the subaxial vertebra
Bifid spinous process C2-C6
C7 is a transitional vertebra with smaller (or absent) transverse foramen and usually not bifid

C-spine: Intervertebral Discs

Approx 25% of the height in C-spine
Nucleus pulposus distributes axial compressive forces
Annulus fibrosus withstands tension in the disc
No disc between occiput & C1 nor C1-C2
Gives the lordotic shape to the C-spine

Function of the Vertebral Column

Protection
Support
Provides an axis for the body and pivot for the head
Posture and locomotion

Spine Ligaments

Anterior Longitudinal Ligament (ALL): from occipital bone (&C1) to sacrum; Limits extension
Posterior Longitudinal Ligament (PLL): within the vertebral canal from C2 to sacrum; mostly to IV discs

Intervertebral Jt Ligaments

Ligamentum flavum: lamina to lamina of adjacent vertebral arches
Supraspinous Ligament: thick; tips of spinous processes C7 to sacrum
Interspinous Ligament: thin; adjoining spinous processes from root to apex
Intertransverse ligaments: adjacent transverse processes

Spinal Nerves

31 pairs
Dorsal roots - afferent (sensory) fibers
Ventral roots - efferent (motor) fibers
SAME: Sensory-Afferent, Motor-Efferent

Spinal nerve roots

Named for the vertebra below it (C1 to C7)
Rest of spine named for vertebra above starting with T1
C8 spinal nerve root is between C7 and T1 vertebrae

Spine Musculature

Spinal muscles surround and support spinal column
Agonist and antagonist muscles act simultaneously
Co-contraction: Exerts force in different directions to stabilize; Acts as synergists for movement

Muscles of the Neck

Muscles listed with their specific functions for flexion, extension, lateral flexion, and rotation

Muscles of the Back

Superficial (Extrinsic)/Intermediate - Responsible for movements of the scapulae and shoulder and respiratory movements
Deep (Intrinsic) - Responsible for movements of the spine and maintaining posture
Muscles listed with their specific functions for flexion, extension, lateral flexion, and rotation

Conditions of the Neck and Back

Hyperextension Injury of Neck (Whiplash)
Cervical Dystonia (Spasmodic Torticollis)
Congenital Torticollis
Common Conditions: Kyphosis, Lordosis, Scoliosis

Disc Conditions

Degenerative Disc Disease
Bulging Disc
Herniated Disc
Cervical discs mostly commonly ruptured are between C5-C6 and C6-C7; Spinal nerve roots are compressed causing pain & dysfxn

Vertebral Fracture

MOI: Sudden, forceful flexion or extension of the vertebral column
Atraumatic compression fracture (osteoporosis)
T11 or T12 most commonly fractured non-cervical vertebrae due to trauma
Thoracic spine most common place for compression fracture

Vertebral Fracture/Dislocation

Cervical vertebrae more stacked, less interlocked so easier to dislocate
Can spare spinal cord
Hangman's fracture: fracture & dislocation of axis (C2)
MOI: hyperextension of head ON neck
Dens of axis fracture: MOI horizontal blow to head or osteopenia

Other Conditions

Spondylosis - OA of the spine; Usually cervical or lumbar
Spinal Stenosis - narrowing of the spinal canal

Other Spine Conditions Cont'd

Spondylolysis - stress fracture of vertebra (pars interarticularis); Usually L5, sometimes L4; Unilateral or bilateral
Spondylolisthesis - anterior displacement of vertebra due to above fracture

Common Conditions

Muscle Strain
Ligament Sprain

Signs, Symptoms, Sequelae

Foot drop
Sciatica
Cauda Equina Syndrome
Nerve root compression (herniated disc or injury)
Medical emergency requiring Sx
Pain, weakness, urinary retention or incontinence

Clinical Importance

Back pain - most common cause of disability for those under age 45
Majority of people can return to normal function after 4-6 weeks
7-10% of people will develop chronic back pain
Many factors affect back health

Dermatomes

Surface of the skin is divided into specific areas called dermatomes
Useful in clinical practice for possible injury involving the spine by localizing neurological levels
Weakness in extremities
Absent deep tendon reflexes
Reports of radiculopathy (symptoms related to irritation of a nerve root)

Diagnostic Tests

X-rays - electromagnetic radiation
Bone Scan - radioactive tracer injected; bony disruption uptakes the tracer
CT Scan - computed tomography using x-ray
MRI - magnetic resonance imaging using strong magnetic gradients and radio waves
Nerve Conduction Studies (NCS) - flow of electrical current through a peripheral nerve
Electromyography (EMG) - amount of electrical activity produced by a muscle contraction
EMG & NCS usually performed together, but as separate tests

Reflex Testing

Knee - L3/L4
Ankle - S1/S2

Neck Special Tests

Are beyond the scope of OT practice
Refer to physiotherapist colleagues

Slump Test

Impingement of dura and spinal cord or nerve roots
Progressively provocative until symptoms reproduced
Start: in sitting Patient flexes spine & sags shoulders forward (slumps)
1: examiner holds head chin too keep head erect
1. flex neck
1. extend knee
1. dorsiflex ankle

Surgical Interventions

Spinal fusion - joining vertebrae together
Laminectomy - removal of spinous process and lamina
Foraminotomy - widen space where nerve root exits
Discectomy - removal of all or part of vertebral disc

Conservative Interventions

Treatment: Restore function of the muscles, ligaments and joints.
Most back injuries are treated conservatively
Conservative treatments include: Modalities- heat, ice, ultrasound, TENS machine, Proper posture and lifting techniques, Stretching, Strengthening
Low Impact Aerobic Conditioning

Common OT Interventions

Education
Therapeutic exercise
Mobility
Strength
Endurance
Environmental modifications
Adaptive equipment
Prevention (ergonomics)

Resource

Occupational Therapy: Body Postures During Daily Activity

Case Study 1

Fredo (68 y.o.) experiencing back pain radiating down his left leg; diagnosed with spinal stenosis via MRI
What is spinal stenosis?
Why does it cause pain?
Recommendations for Fredo's weekly golf game?

Case Study 2

Bart recovering from laminectomy (10 weeks post-op)
Bart wants to soak in his tub, recommendations?
Tasks Bart can start to do?
What limits Bart from fully engaging in ADLs & I-ADLs?

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Description

Test your knowledge on spinal health, imaging techniques such as CT scans and MRIs, and the anatomy of the vertebral column. This quiz covers important concepts including nerve conduction studies, spinal interventions, and specific vertebrae characteristics. Enhance your understanding of these critical topics for better overall health and wellness.