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Spine Disorders & Dermatomes Demystified

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Manage episode 201643750 series 2108787
Content provided by PA Study Sesh. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by PA Study Sesh or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
This week on PA Study Sesh, we’ll be covering disorders of the spine and demystifying the dermatomes.
* Cauda Equina
* SURGICAL EMERGENCY
* Symptoms
* Urinary/bowel retention/incontinence
* Saddle anesthesia
* Decreased anal sphincter tone (no anal wink)
* Tx: steroids (decrease inflammation) and emergent surgery
* Spinal stenosis (pseudoclaudication)
* Narrowing of spinal canal
* > 60 y.o. (but can be congenital)
* low back + BIL leg pain
* increased with walking/standing (extension)
* Dcreased with sitting/walking uphill (flexion)
* Diagnose with Xray or MRI
* Tx:
* Injections
* PT
* Sy
* Sprain/Strain
* MOI: lifting/twisting (or whiplash)
* Muscle spasms
* Decreased ROM 2/2 pain
* NORMAL NEURO
* Tx:
* Brief rest (1-2 days)
* Nsaids scheduled
* +/- muscle relaxants
* pt for prolonged pain & to improve mechanics
* majority recover by 4 weeks
* Scoliosis
* Females >10 y.o.
* >10 degrees of lateral curvature
* Typically not painful
* 90% are to the right, left curve requires further evaluation
* Look for shoulder or pelvic obliquity & LLD
* Adams forward flexion exam
* Xrays indiciated if scoliometer >5 degrees
* Evaluate Cobb angle
* Tx:
* Observe if small
* Brace at 20 degrees
* Sy greater than 40 degrees
* Kyphosis
* Increased convex curvature of T spine
* 1/3 also have scoliosis
* brace >60
* Spondylolysis
* Repetitive hyperextension injury (gymnasts, football players)
* Defect of pars interarticularis
* #1 form of back pain in children/adolescents
* Most commonly L5-S1
* X ray:
* Scotty dog sign
* Oblique view x ray
* + dog has a collar
* May progress to spondylolisthesis
* Spondylolisthesis
* Vertebrae slips forward
* Possible step off
* >50% displacement = surgical
* Conservative (same for spondylolysis)
* Symptomatic
* PT
* Bracing
* Happens at C2=hangman’s fx
* Jefferson Fracture
* C1 fx (Atlas)
* Burst fx
* Associated with axial loading (shallow dive or certain MVAs)
* Compression fx
* Fall from a height or non-traumatic
* X-ray: vertebral height narrowing
* Risk factors: chronic steroid use, tobacco use, postmenopausal, osteoporosis, low body weight
* Point tenderness
* Ankylosing Spondylitis (ankly=stiff, spondyl=spine, itis=inflammation)
* White males 15-30
* Axial skeleton & SI joint with increasing stiffness
* Progresses from inferior to superior
* AM stiffness with decreased ROM
* Decreases with activity (most autoimmune arthropathies do)
* Labs
* Increased ESR
* + HLA B-27
* Negative ANA & RF (seronegative)
* X ray:
* Bamboo spine (squaring of vertebral bodies)
* Tx:
* NSAIDS
* PT
* TNF alpha blockers
* Herniated Disc
* Herniation of nucleus pulposus
* Most often posterolateral
* Pain in a dermatomal pattern
* Increases with coughing, sitting
* L5-S1#1
* Physical Exam Tests:
* + SLR
* + Crossover Test
  continue reading

22 episodes

Artwork
iconShare
 
Manage episode 201643750 series 2108787
Content provided by PA Study Sesh. All podcast content including episodes, graphics, and podcast descriptions are uploaded and provided directly by PA Study Sesh or their podcast platform partner. If you believe someone is using your copyrighted work without your permission, you can follow the process outlined here https://player.fm/legal.
This week on PA Study Sesh, we’ll be covering disorders of the spine and demystifying the dermatomes.
* Cauda Equina
* SURGICAL EMERGENCY
* Symptoms
* Urinary/bowel retention/incontinence
* Saddle anesthesia
* Decreased anal sphincter tone (no anal wink)
* Tx: steroids (decrease inflammation) and emergent surgery
* Spinal stenosis (pseudoclaudication)
* Narrowing of spinal canal
* > 60 y.o. (but can be congenital)
* low back + BIL leg pain
* increased with walking/standing (extension)
* Dcreased with sitting/walking uphill (flexion)
* Diagnose with Xray or MRI
* Tx:
* Injections
* PT
* Sy
* Sprain/Strain
* MOI: lifting/twisting (or whiplash)
* Muscle spasms
* Decreased ROM 2/2 pain
* NORMAL NEURO
* Tx:
* Brief rest (1-2 days)
* Nsaids scheduled
* +/- muscle relaxants
* pt for prolonged pain & to improve mechanics
* majority recover by 4 weeks
* Scoliosis
* Females >10 y.o.
* >10 degrees of lateral curvature
* Typically not painful
* 90% are to the right, left curve requires further evaluation
* Look for shoulder or pelvic obliquity & LLD
* Adams forward flexion exam
* Xrays indiciated if scoliometer >5 degrees
* Evaluate Cobb angle
* Tx:
* Observe if small
* Brace at 20 degrees
* Sy greater than 40 degrees
* Kyphosis
* Increased convex curvature of T spine
* 1/3 also have scoliosis
* brace >60
* Spondylolysis
* Repetitive hyperextension injury (gymnasts, football players)
* Defect of pars interarticularis
* #1 form of back pain in children/adolescents
* Most commonly L5-S1
* X ray:
* Scotty dog sign
* Oblique view x ray
* + dog has a collar
* May progress to spondylolisthesis
* Spondylolisthesis
* Vertebrae slips forward
* Possible step off
* >50% displacement = surgical
* Conservative (same for spondylolysis)
* Symptomatic
* PT
* Bracing
* Happens at C2=hangman’s fx
* Jefferson Fracture
* C1 fx (Atlas)
* Burst fx
* Associated with axial loading (shallow dive or certain MVAs)
* Compression fx
* Fall from a height or non-traumatic
* X-ray: vertebral height narrowing
* Risk factors: chronic steroid use, tobacco use, postmenopausal, osteoporosis, low body weight
* Point tenderness
* Ankylosing Spondylitis (ankly=stiff, spondyl=spine, itis=inflammation)
* White males 15-30
* Axial skeleton & SI joint with increasing stiffness
* Progresses from inferior to superior
* AM stiffness with decreased ROM
* Decreases with activity (most autoimmune arthropathies do)
* Labs
* Increased ESR
* + HLA B-27
* Negative ANA & RF (seronegative)
* X ray:
* Bamboo spine (squaring of vertebral bodies)
* Tx:
* NSAIDS
* PT
* TNF alpha blockers
* Herniated Disc
* Herniation of nucleus pulposus
* Most often posterolateral
* Pain in a dermatomal pattern
* Increases with coughing, sitting
* L5-S1#1
* Physical Exam Tests:
* + SLR
* + Crossover Test
  continue reading

22 episodes

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