Innervation and dermatomes
Patient is complaining of neck pain that radiates to the second and third digit with extension of the neck. What spinal level would you be most concerned about imaging?
C7 level
Your patient Madalynn got caught smuggling camel crush cigarettes into MA (an illegal state), due to such she has been sentenced to death by hanging. What fracture is most likely to occur with this type of injury?
Note- looking for mechanism and/or anatomy involved NOT the name
Hangman's Fracture:
- Hyperextension and distraction injury
-Involves pars interarticularis of C2 bilaterally
What is the diagnostic study of choice for any radicular symptoms?
MRI
Your elderly female patient Mary recently suffered a compression fracture after falling trying to get out of her chair for supper time. What is the name of the brace that will be prescribed?
Thoraco-lumbo-sacral orthosis (TSLO)
What is the Flexor tenosynovitis mainstay of treatment?
1. Immediate surgical debridement
2. Vancomycin + ceftrixaone
What reflex is associated with extension of the big toe?
Babinski Reflex
What is the common relationship between C2 and C3 with a Hangman's fracture?
Anterolisthesis
Your patient Tiger presents to the emergency department with back and bilateral leg pain that began after playing with his new cat. He noticed that he cannot get up off the ground as easy as he used to. What surgical emergency should we be concerned about?
Cauda Equina Syndrome
What is the characteristic x-ray finding of ankylosing spondylitis?
What are the most common pathogens involved in flexor tenosynovitis?
1. Staph aurues
2. MRSA
3. Eikenella
4. Pasteurella
Ryan has extremely ticklish nipples. What dermatome are you exciting during tickling ryan?
T4
Your patient Ryan is a 24 Year old male who dove into a lake during the fourth of July party, unknowing that the lake was only 2 feet deep. He reports (through blinking) that he cannot move his arms or legs, what type of fracture did he most likely experience?
-Note not looking for name but mechanism/ anatomy involved
"dens fracture"- Fracture through odontoid process of C2
Which back pain is exacerbated by sitting?
Which back pain is exacerbated by standing?
1. HNP- usually acute pain, patients do not want to sit
2. Spinal stenosis- sitting or flexing the lower back may relieve symptoms
Bone marrow edema of the SI joints and spine
Brodie Abscess seen on x-ray may indicate what disease?
Subacute Osteomyelitis
PA Emily is doing her routine neuro checks on Simon (an MCV patient in the ICU), she notices an absent knee reflex, which motor innervation level should be now be concerned about?
S2
Your patient Dr. Jones has been complaining of neck pain for years and noticed that she has been shrinking over the last few years. While NSAIDs, PT and steroid injections worked initially, she noticed the pain has now become unbearable. What is the surgical treatment of choice?
-Discectomy of affected disc (fusion of the vertebrae affected)
Your patient Emily is a college gymnast who is now complaining of lower back pain. You decide to order an Xray and see a "scotty dog" formation on the oblique view, what is the most likely diagnosis?
Spondylolysis
What anatomical structures make up the thoracic outlet?
First rib, scalene muscles and the clavicle
Flexor Tenosynovitis is diagnosed with 4 Kanavel signs, what are these signs?
1. Flexed posturing of the involved digit
2. Tenderness to palpation over the tendon sheath
3. Marked pain with passive extension of the digit
4. Fusiform swelling of the digit
Mid posterior calf muscles have TWO sensory dermatomes splint down the middle, what two are they?
S1 S2
Spurling test
Severe spondylolysis can degenerate into what?
Spondylolisthesis- displacement of the vertebral body in relation to vertebra below
Flail chest
Bone Biopsy!