1 Medial Screening Flashcards
What are the High Risk factors for a Cervical Fracture?
- Age >65 years
- Dangerous mechanism (fall from >3ft/5 stairs, axial load, MVC >60MPH, rollover, ejection , MVA, bike collision
- Upper Extremity Paresthesia
What are the low risk factors for a Cervical Fracture? (ROM)
- Simple rear end motor accident
- sitting position in external rotation
- Ambulatory at any time
- delayed onset neck pain
- Absence of midline cervical spine ternderness
How many degrees of rotation is a minimum for imaging?
Imaging for patients <45 degrees
What are the mechanical causes of cervical myelopathy?
- Truama (ligament instability, fx)
- Spinal cord compression
- Degenerative changes
- Buldging Disk, thicked ligamentum flavum
- RA with subsequent AA subluxation
UMN (pressing against spinal cord)
What are the systemic causes of cervical myelopathy?
- MS/ALS
- Gullian-Barre
- Multifocal motor myopathy
What are the 5 test for cervical myelopathy and how many are needed +ve?
- Gait Deviation
- Hoffmans
- Inverted Supinator Sign
- Babinski
- Age > 45 years
Need 3/5 Positive test
What are the signs and symptoms of Upper Cervical Ligamentous Laxity?
- Occiptal hadache/Numbness
- Server limtation during neck AROM in all directions
- Signs of cervical myelopathy
What are the causes of Upper Cervical Ligamentous Laxity?
- Trauma
- RA with AA subluxation, down syndrome, Kippel-Feil
- OS odontoideum
- OS dontoind Fx
What are the signs of a spinal infection?
- Spine that is unrelenting (worse/severe at night- doesnt change with position)
- history of diabetes, SCI w/ neurogenic bladder/immune supression
- potential fever, chills, fatigue
- Concurrent infection or IV drug use
- Possible redness, swelling, warmth
- local tenderness over spinous process
- Spinal percussion = Painful
REFER for imaging/clinical lab test
Treatment: Antibiotics, surgical decomrepssion
What are the signs and symptoms of a cardiovascular event?
- Chest pain (gripping pressure)
- Abdominal pain
- SOB
- Heart palpitations
- Irregular heart beat
- Dizziness, nausea
- Peripheral edema
- Syncope
CALL 911
What are the musculoskeletal complaints of a CV event?
- Jaw, neck, shoulder, arm, back pain
- Myalgis, muscular fatigue and muscle atrophy
- Weakness and fatigue
- Poor Exercise Tolerance
Women = more midchest and back/possible jaw pain
What are the 5Ds and 3N’s of Cervical Arterial Dysfunction?
- Dizziness
- Drop attacks
- Dysphagia
- Dysarthria
- Diplopia
- Ataxia
- Nausea
- Numbness
- Nystagmus
Wha are the pain descriptors of a pulmonary event?
- Sharp, localized
- Aggravated by breathing, coughing, sneezing, laughing, etc
- Better in upright/worse recumbant
- Better with Autosplinting (holding arms close to chest/ribcage)
- Pain in chest region or midback
What are the signs and symptoms of a pulmonary event
- Dyspnea/SOB (exertional or at rest)
- Persistant cough
- Fevers, chills, general malaise
- Weak, rapid pulse with fall in BP (pneumothorax)
- Cyanosis
What are the signs for Pneumothorax?
- SOB, dry cough
- Acute onset sharp pain in chest
- reffer ipsialteral shoulder/upper trap region, across chest to scap and abdomen
- Change in respiratory movements
- Drop in BP (increased distension in neck)
- More pain in recumbent positon (better in sitting)
What are the predictor variables for Pulmonary Embolism?
- Clinical signs of DVT
- No alternative diagnosis
- heart rate > 100BPM
- Immobilzation following surgery in past 4 weeks
- Previous DVT/PE
- Hemoptysis
- Malignancy (treated currently or last 6 months)
> 6 points high risk
What are common refferal patterns from organs?
- Pancrease - L shoulder
- Stomach, duodenum, liver, gallbladder, common bile duct - R shoudler
- Esophagus, liver, galbladder, common bile duct, pancease - Mid back
What are some stomach, duodenal, pancreatic conditions a patient can present with?
- Gnawing, craping, burning, heart burn
- Suddent onset weight los, nausea, vomiting fever, malaise
- Pain in waves or related to drinking/eating
- Black tarry stools or light colored (cancer)
- Causes: Gastic, pyloric, duodenal ulcers, stomach cancer
what are common Renal Syste Refferal patterns?
- Kidney-Renal - L shoudler, L hip
- Ureter - R thigh radiates or lower rib
What are common Metastatic cancers?
- Prostate
- Breast
- Kidney
- Thyroid
- Lung
- Lymphoma
“PB KETTLE”
Rare in C spine 60% thoracic 40% lumbar
What are cancers affecting the Cervico Thoracic spine?
- Thyroid/esophageal
- Hodkings Lymphoma
- Pancost tumor (tumor upper lung)
- Multiple meyloma
- Breast Cancer
- Other organs that refer to T spine
What is the #1 sign for neoplastic conditions
Prior history of cancer
What are top 2 signs of major depressive disorder?
- Depressed mod most of the day, every day
- markedly diminished interest or please in all or almost all activities
Top 2 common Suicide risk factors?
- Previous attempt or plan to commit suicide
- Makes have higher rate
History of psychiatric illness
