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unit 10 > biomed > Flashcards

biomed Flashcards

1
Q

how many waddell signs must be present for concern?

A

3/5

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2
Q

what are the 5 waddell signs?

A

superficial or nonanatomic tenderness
pain on axial loading or simulated rotation
nonreproducability when patient is distracted
regional weakness or sensory change
overreaction

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3
Q

what is the waddell sign of superficial or nonanatomic tenderness?

A

pain with light or superficial palpation

light touch anywhere provokes patient reaction

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4
Q

what is meant by the waddell sign pain on axial loading or simulated rotation?

A

eliciting pain when pressing down on the top of the patient’s head or rotating the shoulders and pelvis together should not be painful

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5
Q

what is nonreproducibility or pain when patient is distracted as defined by waddell signs?

A

patient’s pain disappears when they’re thinking about something else

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6
Q

what is meant for the waddell sign of regional weakness or sensory change?

A

cogwheeling: fall, catch, fall, catch=CNS issue

real weakness is a smooth loss of strength

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7
Q

what is meant by the waddell sign of overreaction?

A

exaggerated painful response to a stimulus that is not reproduced when some stimulus is given later or response to a stimulus that should not cause back pain

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8
Q

what does a radiculopathy indicate?

A

nerve root problem
motor loss
reflex change
sensory change

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9
Q

what are the 3 categories the sTarT Back uses for back pain?

A

high risk: psychological obstacles to recovery, need enhanced package of care
medium risk: physical obstacles to recovery, need face to face “conservative treatment” (PT!!)
low risk: low risk of chronicity, advice, reassurance, medication

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10
Q

what is another name for the mckenzie scheme?

A

“mechanical diagnosis and treatment”

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11
Q

what are the key predisposing factors for lbp in the mckenzie framework?

A

poor sitting posture

frequency of flexion in adl

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12
Q

what is postural syndrome according to the mckenzie framework?

A

Refers to pain which occurs due to a mechanical deformation of normal soft tissue from prolonged end range loading of periarticular structures.
The pain arises during static positioning of the spine: for example sustained slouched sitting.
The pain disappears when the patient is moved out of the static position.

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13
Q

what is dysfunction syndrome according to the mckenzie framework?

A

Refers to pain which is a result of mechanical deformation of structurally impaired tissues like scar tissue or adhered or adaptively shortened tissue.
The pain arises at the end range of a restricted movement.

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14
Q

what is derangement syndrome according to the mckenzie framework?

A

Is the most prevalent treatment classification.

Refers to pain which is caused by a disturbance in the normal resting position of the affected joint surfaces.

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15
Q

as an obstacle to recovery, what are yellow flags? ex?

A

about the person

ex: fear, depression

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16
Q

as an obstacle to recovery, what are blue flags? ex?

A

about the workplace

ex: “my boss is a jerk, i hate my job”

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17
Q

as an obstacle to recovery, what are black flags? ex?

A

about the context, social

ex: more attention given at home if sick

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18
Q

according to fritz, what is the cut-off score for the FABQ-W?

A

34

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19
Q

according to the neuromatrix, where are the three areas of input from?

A

cognitive
sensory signaling
emotion-related brain areas

20
Q

according to the neuromatrix, what are the cognitive-related brain areas?

A

memories of past experiences
attention
meaning
anxiety

21
Q

according to the neuromatrix, what are the sensory-signaling systems?

A

cutaneous
visceral
musculoskeletal inputs

22
Q

according to the neuromatrix, what are the emotion-related brain areas?

A

limbic system and associated homeostatic/stress mechanisms

23
Q

according to the neuromatrix, what are the three outputs to brain areas?

A

pain perception
action programs
stress-regulation programs

24
Q

according to the neuromatrix, what is pain perception?

A

sensory
affective
cognitive dimensions

25
Q

according to the neuromatrix, what are action programs?

A

involuntary and voluntary action patterns

26
Q

according to the neuromatrix, what are stress-regulation programs?

A

cortisol
nonadrenalin
endorphin levels
immune system activity

27
Q

what is the acronym for motivational interviewing?

A

a: acceptance
c: collaboration
e: evocation/understanding
p: partnership

28
Q

what are the four steps in an informational interview?

A

open-ended questions
affirmations
reflections
summary

29
Q

combining ideas of the STarT Back approach and psychologically informed care, which group of patients would benefit the most from psychologically informed physiotherapy?

A

high risk

30
Q

what are the four categories in the sullivan’s pgap model?

A

catastrophizing, injustice, beliefs/experiences, fear

31
Q

what makes someone a candidate for lumbar discectomy?

A 
herniated disc
severe progressive neuromotor deficits
positive tension signs
more leg pain than back
failed pt or meds
positive mri
cauda equina
chronic sciatica
incontinence
back pain longer than 6 weeks
32
Q

what makes someone a candidate for lumbar fusion?

A 
low back mechanical in nature, 6+months
failed conservative treatment
large deformities?
degenerative pathologies
trauma
infection
neoplasia
fracture
cancer
33
Q

what is hyperalgesia?

A

lower thresh hold for pain

34
Q

What is allodynia? What is an example?

A

nervous system is sensitized for pain. ex sunburn, everything hurts when you touch it

35
Q

what are four substances related to inflammation that impact spread of pain?

A

cgrp
substance p
histamine
nerve growth factor

36
Q

what is nociplastic pain?

A

disturbance in central pain response
increased excitability
decreased inhibition

37
Q

what is nociceptive pain?

A

due to activation of nociceptors?
inflammation
mechanical irritant
injury

38
Q

what is neuropathic pain?

A

due to lesion or disease of somatosensory system

39
Q

if pain is the result of inhibition, what should i do?

A

focus increased attention on muscle activation

40
Q

if pain is the result of motor adaptations interfering, what should i do? ex?

A

reduce non-protective interfering adaptations

ex: muscle guarding is okay for first 6 days, but not for 6 months

41
Q

if pain is the result of volitional motor behaviors, what should i do?

A

consider fear avoidance or intentional motor response

42
Q

if pain is the result of suboptimal tissue loading, what should i do?

A

greater focus on mechanics

43
Q

if pain is not the result of motor adaptations interfering, what should i do?

A

maintain protective functional adaptations

44
Q

if pain is not the result of volitional motor behaviors, what should i do?

A

operant conditioning or reflexive pain response

45
Q

if pain is not the result of suboptimal tissue loading, what should i do?

A

less focus on mechanics, more focus on load

unit 10 (7 decks)

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