Step I IV disk herniation

[Jalby]

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This has been killing me for a while. I think I've gotten so many different answers for this. Or maybe 2 different answers.

If the C4-C5 disk herniates, it impinges the C5 nerve, right?? And a L4-L5 herniation gets the L5 nerve?? Opinions?? Facts??

 

[bigfrank]

That's right. I always try and remember that there are 7 cervical vertebrae and 8 cervical nerves. The 1st and 2nd nerves go above and below the 1st vertebrae. Then you can just draw things out.

I missed this exact question on the Step I, so I know it's on there. 😡

 

[Jalby]

Yeah. I think I got a source with a different answer, and I could not for the life figure out why they had that answer. Gracius.
I'm going through my final review and asking all the things I never figured out.

 

[MissMedicine]

right but if you draw it out, the nerve between L4-L5 is actually L4, the reason it effects the L5 nerve is specific to lumbar vertebra (related to how the spinal nerves "hang" in the lumbar region... if you look at plate 149 on the lower right hand image, there is an excerpt that explains it...

good luck tomorrow

 

[MissMedicine]

plate 149 of netters that is

 

[Jalby]

Nice citation. I think the cerival spinal roots exit more horizontal, so that is why C4-C5 gets the C5 Nerve, since that is the one between C4-C5.

 

[Mixmaster]

Lets see if I got this right
IF: Cervical: Ex. C3-C4 disc herniates then C4 is impinged upon because that is the nerve coming closest to that disc
Thoracic: ???
Lumbar: Ex. If L4-L5 disc herniates then L4 in impinged upon but not for the same reason that the cervical ones are but due to the way the nerve exits in the lumbar region.

Ok, but what about thoracics. I tried searching the web real quick but I didnt find a quick answer Anyone know a site that will explain this good??

 

[Mixmaster]

oops the lumbar should also be L5 right??

 

[Jalby]

There is no thoracic disk herniation. Doesn't really happen.

 

[DrSmiles]

I have been told that thoracic herniations can happen too, but they are extremely rare and would most likely not be asked on a board exam (these would typically be seen in someone with some other path going on).
If you herniate the disc between L4- L5, the L5 nerve is affected. I was also told to watch out for any instance where they just say L4 disc, so you would have to know that they mean L4-L5, and that the L5 nerve is the one that is affected.