Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2 MSK > Back ache > Flashcards

Back ache Flashcards

1
Q

what are some causes of back pain

A 
viscerogenic 
spondylogenix 
discogenic 
neurogenic 
phychogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is a serious visceral cause of back pain

A

leaking abdominal aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

abdominal causes of back pain

A 
peptic ulcer 
gall bladder 
pancreatic 
gall bladder 
urterogenic
colonic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

presenting symptoms in back pain

A

back pain
leg pain
neurological symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

possible causes for back pain

A

possible spinal pathology
nerve route problems
mechanical back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

questions to ask for back pain

A

SOCRATES

site 
onset 
character 
radiating 
associated symptoms 
timing 
exacerbating/relieving factors 
severity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

2 types of leg pain

A

referred

root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe referred leg pain

A

dull/knawing
buttock/thigh
rarely below the knee
ill defined sensory symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe root leg pain

A

sharp/shooting/electric
invariable below the knee to foot and ankle
anatomical sensory/motor symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

example of root leg pain

A

sciatica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Neurological red flags in back pain

A 
incontinence 
loss of control/awareness 
perineal numbness 
bilateral/unilateral symptoms 
no leg symptoms
parasthesia 
numbness 
weakness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what social factors should u ask about when taking a back pain history

A

age
occupation
presence/absence of litigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when should you beware of a patient presenting back pain which could suggest litigation

A

when they can tell the exact date and time it starts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

red flags for back pain

A

non-mechanical pain
systemic upset
major, new neurological deficit
saddle anaesthesia +/- bladder or bowel upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are some possible spinal pathologies

A

fracture (wedge fracture often OA)
tumours (metastatic)
Infection
Inflammatory arthritis (ankylosing spondylitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what tumours metastasise to the spine

A 
Bad -breast
boys -bronchus 
pee -prostate 
though -thyroid 
kidneys -renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what history suggests a spinal tumour

A 
weight loss 
anaemia 
fatigue 
insidious onset back pain 
constant 
night pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

history suggesting infection

A

recent foreign travel

fever

19
Q

what causes nerve root problems

A

disc prolapse

20
Q

what causes disc prolapse

A

impaired disc nutrition
disc prone to damage by load, torsion, shear
disc tissue - free fragments
leads to profusion, extrusion, sequestration

21
Q

what does a large vertebral canal lead to

A

back pain from stretched annulus

wouldn’t cause sciatica

22
Q

what does a small vertebral canal lead to

A 
root compression 
inflammatory mediators 
root pain and tension signs 
resolution/surgery 
may cause sciatica
23
Q

what does loss of disc height lead to

A

facet joint arthropathy leading to back pain

when it is out of alignment the bones rub like in OA

24
Q

what does degenerative disc disease cause

A

facet joint arthropathy
stenosis or narrowing or vertebral canal

cause by loss of water in ageing

25
Q

whats the most common type of back pain

A

mechanical

26
Q

how do you diagnose mechanical back pain

A

diagnosis of exclusion

no nerve root cause
no spinal pathology

27
Q

what is spndylolysis

A

linear crack - stress break along the collar of the scotty dog (pas interarticularis)

28
Q

what is spndylolisthesis

A

break on the neck of the scotty dog (pas interarticularis) allows the vertebrae to slide on the one above

29
Q

examination steps for back pain

A

observation - does it look straight, are curves normal
range of movement - schrobers test, lateral movements
neurological examination

30
Q

what causes loss of lumbar lordosis

A

spasm

ankylosing spondylitis

31
Q

what do you look at in neurological examination

A

Myotomes
dermatomes
reflexes
nerve irritation

32
Q

what are the myotomes

A

L1/2 - hip flection
L3/4 knee extension
L5 - foot dorsiflection & EHL
S1/S2- ankle plantarflextion

33
Q

how to check for nerve irritation

A

straight leg raise test

shooting pain down the leg along the dermatome shows nerve irritation

34
Q

what is pain drawing

A

where a patient marks on a picture where their pain is

can show whether dermasomal or not

35
Q

what are overt pain behaviours

A 
guarding 
bracing 
rubbing 
grimacing 
sighing
36
Q

what are behavioural responses (Waddell)

A 
superficial/non anatomical tenderness 
simulation 
distraction (straight leg raise) 
over reaction to examination 
regional sensory disturbance
37
Q

Investigations for back pain

A

X-rays not very useful
MRI- not the answer, 76% false positives
Myelogram
CT

38
Q

specialised investigations for back pain

A

myelogram
CT- contrast enhanced
provocation discography
selective nerve block

39
Q

what is sciatica

A

buttock and/or leg pain in a specific dermatomal distribution accompanied by neurological disturbance

40
Q

what is disc prolapse surgery for

A

leg pain
removed fragments of disc pressing on nerve root
effect on neurology unpredictable

41
Q

common presentation of disc prolapse

A

episodic back pain
onset of leg pain +/- neurology
leg pain becomes dominant
myotomes and dermatomes

42
Q

what happens if you leave the disc prolapse alone

A

70% settle in 3 months
90% settle in 18-24 months
surgery carries risk and is only done if its having a massive effect on the patients life style

43
Q

First line treatment for back ache

A 
Conservative 
short bed rest (debatable) 
anti-inflammatory +/- muscle relaxant 
mobilise thereafter 
physical therapies 
return to normal activity
44
Q

second line treatment for back pain

A 
education/inttruction/reassurance 
physiotherapy 
osteotherapy
TENS, psychology/pain clinic 
complementary therapies 
surgery

2 MSK (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions