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ECOS > Approach to Thoracolumbar Complaint > Flashcards

Approach to Thoracolumbar Complaint Flashcards

1
Q

What are the emergent conditions of concern in regards to a thoracolumbar complaint?

A

cauda equina syndrome or malignancy

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2
Q

spina bifida is what type of defect?

A

neural tube defect

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3
Q

What is one main cause of spina bifida?

A

folate deficiency

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4
Q

mildest form of spina bifida?

A

spina bifida occulta

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5
Q

a sac of fluid comes through an opening in the baby’s back. No opening of sac on the back. Spinal cord and nerves usually normal

A

meningocele

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6
Q

most severe type of spina bifida. Spinal canal is open along several vertebrae

A

myelomeningocele

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7
Q

What is the most common form of scoliosis?

A

adolescent idiopathic scoliosis (AIS)

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8
Q

Are males or females more likely to have their scoliosis progress to severe disease?

A

females

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9
Q

What is the physical examination for scoliosis?

A

adam’s forward bent test

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10
Q

If a patient is diagnosed with AIS, when would they be evaluated?

A

if the angle of trunk rotation was greater than 7 degrees and if the Cobb angle was greater than or equal to 10 degrees

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11
Q

What are the red flags for patients presenting with scoliosis?

A

onset before age 8, severe pain, rapid curve progression (>1 degree per month), unusual left thoracic curve, neurological deficits

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12
Q

what could a compression fracture lead to?

A

could cause the vertebra to collapse or pieces of bone to press the spinal cord and nerves

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13
Q

what signs would lead you to think compression fracture?

A

point tenderness and pain that worsens with flexion

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14
Q

what is the most common cause of compression fractures?

A

osteoporosis

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15
Q

What is the clinical presentation of a herniated nucleus pulposus?

A

pain will originate from the lumbar spine and radiate down the leg into the foot “sciatica”, weakness in affected myotome (decreased reflexes) and decreased sensation to affected dermatome

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16
Q

What is the gold standard for diagnosing a herniated disc?

A

MRI

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17
Q

if the L1-L3 nerve roots are impinged, how will pain present?

A

pain will radiate to the hip and/or thigh

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18
Q

if the L4-S1 nerve roots are impinged, how will pain present?

A

pain will radiate below the knees

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19
Q

How do you test the L4 nerve root?

A

Patellar reflex

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20
Q

How do you test the L5 nerve root?

A

great toe sensation and heel walk

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21
Q

how do you test the S1 nerve root?

A

achilles reflex and toe walk

22
Q

What is the mnemonic for red flags of back pain?

A

TUNAFISH

23
Q

large central disc herniation compressing the tail of the lumbar spine, causing compression of sacral nerve roots

A

cauda equina syndrome

24
Q

What does impingement of S2-S4 cause?

A

bowel dysfunction, bladder dysfunction, sexual dysfunction, and saddle anesthesia

25
Q

Who most commonly gets psoas syndrome?

A

athletes, runners, and those engaged in plyometric jumping exercises

26
Q

What is psoas syndrome initiated by?

A

positions that shorten that psoas, sitting, bending, getting up quickly from squatting position, and desk jobs

27
Q

What is the exam for psoas syndrome?

A

tender point at iliacus (medial to ASIS), positive Thomas test, positive FABER

28
Q

What is the most common symptoms of psoas syndrome?

A

lower back pain

29
Q

What is the most common presentation of sacroilitis?

A

pain in the buttocks or low back, extending down one or both legs

30
Q

What is the sign of sacroiliitis?

A

positive faber test with buttock pain not groin pain

31
Q

What is the clinical presentation of spinal stenosis?

A

leg pain is greater than back pain, pain worsens with standing and walking and improves with rest or when spine is flexed

32
Q

Osteoarthritis is often times related to the formation of what?

A

osteoarthritic growths on the bone (osteophytes)

33
Q

what is osteoarthritis of the spine referred to as?

A

spondylosis

34
Q

most common cause of low back pain in people younger than 26

A

spondylolysis

35
Q

defect in par interarticularis without anterior displacement of the vertebral body

A

spondylolysis

36
Q

how is the diagnosis of spondylolysis made?

A

by an oblique view of the lumbar spine

37
Q

condition where the vertebral body slips in relation to the one below

A

spondylolisthesis

38
Q

how is spondylolisthesis diagnosed?

A

on palpation of lumbar spinous process, step off sign and as seen on the lateral view of the x-ray

39
Q

forms of arthritis that usually affect the bones in your spine and nearby joints

A

spondyloarthropathies

40
Q

what is the most common spondyloarthropathy?

A

ankylosing spondylitis

41
Q

ankylosing spondylitis is related to the prevalence of what?

A

HLA-B27

42
Q

Ankylosing spondylitis most often affects who?

A

white males between 15-40 years of age

43
Q

ossification of the annulus fibrosus in the lumbar spine

A

ankylosing spondylitis

44
Q

what is the pattern used to diagnose ankylosing spondylitis?

A

bamboo spine

45
Q

what often develops after an infection in the urinary tract or digestive system?

A

reactive arthritis

46
Q

what does reactive arthritis tend to attack?

A

asymmetrical LE joints

47
Q

eye, urethra, and joint inflammation

A

reiter’s syndrome

48
Q

What cancers commonly metastasize to bone?

A

breast, colon, testicular, lung, and prostate

49
Q

what is the presentation of malignancy?

A

pain worsens in prone position, recent weight loss, and fatigue

50
Q

inflammation that develops between the intervertebral discs of the spine

A

discitis

51
Q

who is at risk for discitis

A

IV drug users

ECOS (32 decks)

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