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ECOS I Exam 1 > 21: Approach To Thoracolumbar Complaint > Flashcards

21: Approach To Thoracolumbar Complaint Flashcards

1
Q

Risk factors for spina bifida

A

FHx neural tube defects, folate deficiency, DM, increased body temp, obesity, meds

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2
Q

Three types of spina bifida and what they mean

A
  1. Spina bifida occulta: mildest, no sx besides possible patch of hair
  2. Meningocele: sac of fluid comes through baby’s back, nervous tissue intact and normal
  3. Myelomeningocele: most severe, spinal canal open with membranes and spinal nerves pushed through sac, can cause paralysis/bladder and bowel dysfunction
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3
Q

What does meningo mean?

A

Lining of vertebral canal

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4
Q

What does myelo mean?

A

Spinal cord proper

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5
Q

What does cele mean?

A

Something bulging out

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6
Q

Most common form of scoliosis

A

Adolescent idiopathic scoliosis (AIS)

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7
Q

Females with scoliosis

A

5-10x more likely to progress to severe disease

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8
Q

If both parents have AIS…

A

Offspring 50x more likely to require treatment for scoliosis

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9
Q

Why can scoliosis screenings be harmful?

A

May have referrals and radiographs that lead to significant expense and harm to patient when treatment isn’t even necessary

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10
Q

Risser Sign-progression prediction

A

Shows amount of calcification present in iliac apophysis (grade 1 = low ossification, grade 4 = 1–% ossification, grade 5 = fusion has occurred)

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11
Q

How to interpret Risser sign-progression prediction

A

The lower grade Risser sign means the child has a lot more growth to do, meaning scoliosis is likely to progress more

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12
Q

Five red flags for scoliosis

A
  1. Onset before age 8
  2. Severe pain
  3. Rapid curvature progression (>1 degree per month)
  4. Unusual left thoracic curve)
  5. Neurological deficits/findings
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13
Q

When does the first episode of LBP occur?

A

Between 20-40 years of age

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14
Q

Acute low back pain: definition

A

6-12 weeks of pain between the costal angles and gluteal folds that may radiate to 1 or both legs

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15
Q

Acute low back pain specificity

A

Acute LBP is often non-specific without a definite cause

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16
Q

Most susceptible population for compression fractures

A

Elderly white females

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17
Q

Some historical findings that may lead to believe pt has a compression fracture

A
  1. Significant age-related trauma (strongest)
  2. Prolonged steroid use
  3. Age 70+, osteoporosis
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18
Q

Most common “cause” of compression fractures

A

Osteoporosis

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19
Q

Some causes of herniated nucleus pulposus

A

Obesity, occupation, genetics, smoking

20
Q

Where do the following injuries refer pain to: spine, sacroiliac joint, lumbar roots

A

Spine -> refers to thigh
Sacroiliac joint -> refers to thigh, sometimes knee
Lumbar root -> refers to leg

21
Q

L1-L3 nerve root injury vs L4-S1 nerve root injury: where the pain radiations

A

L1-3: radiates to hip/thigh

L4-S1: radiates below knee

22
Q

Where are 98% of disc herniations?

A

Between L4/L5, L5/S1

23
Q

Where to test sensation for L4, L5, and S1?

A

L4: patella
L5: great toe
S1: Achilles, lateral foot

24
Q

Some red flags that may point to cancer in the back

A

Metastatic cancer, unexplained weight loss, pain increased with rest, vertebral tenderness

25
Q

Red Flags for back pain (with mnemonic)

A 
TUNAFISH
T: trauma
U: unexplained weight loss
N: neurologic sx
A: age >50
F: fever
I: IVDU
S: steroid use
H: Hx cancer
26
Q

Is psoas syndrome common?

A

No, other conditions such as herniation, arthritis, and sacroiliac pain are much more common

27
Q

What can cause psoas syndrome?

A

Shortening/injury of iliopsoas, most common in athletes, after sitting for a prolonged time and standing up

28
Q

Anatomical short leg syndrome vs functional short leg

A

Anatomical: one leg longer, can be corrected with a heel lift
Functional: apparent short leg, but structurally both are the same length when measured

29
Q

Two major causes of piriformis syndrome

A

Anatomical variation, Hx direct trauma to butt

30
Q

How is piriformis Syndrome different from disc herniation?

A

Piriformis syndrome exacerbated by active external hip rotation

31
Q

Neurogenic claudication

A

A combo of LBP, leg pain, numbness, and motor weakness that starts/intensifies after walking, eased by lying down

32
Q

Population where spondylosis is most common

A

Children and adolescents, most common in children/teeens in sports with lots of low back stress

33
Q

What is the most common cause of back pain in teens?

A

Spondylolisthesis

34
Q

Two examples of CT diseases

A

RA, SLE

35
Q

General presentation of CT disease

A

Multiple joint arthralgia, fever, weight loss, fatigue, other joint tenderness

36
Q

Spondyloarthropathies

A

Forms of arthritis that affects bones and nearby joints

37
Q

General presentation of spondyloarthropathies

A

Intermittent pain at night, morning pain, inability to reverse from lumbar lordosis to lumbar flexion

38
Q

Three examples of spondyloarthropathies

A
  1. Ankylosing spondylitis
  2. Psoriatic arthritis
  3. Reactive arthritis
39
Q

Most common form of spondyloarthropathy

A

Ankylosing spondylitis

40
Q

Most susceptible population to Ankylosing spondylitis

A

White males between 15-40 years of age

41
Q

What happens in Ankylosing spondylitis

A

Ossification of annulus fibrosus in lumbar spine from formation of syndesmophytes

42
Q

Scottie Dog is related to what condition?

A

Spondylolysis

43
Q

Step-off is related to what condition?

A

Spondylolisthesis

44
Q

Bamboo spine is associated with what condition

A

Ankylosing spondylitis

45
Q

Most susceptible population for reactive arthritis

A

Males in late teens/early adulthood

46
Q

Reiter’s syndrome

A

Spondyloarthropathy with eye, urethra, and joint inflammation

ECOS I Exam 1 (22 decks)

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