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Cervical and Low back pain Flashcards

1
Q

Where does 50% of rotation occur

A

C1 and C2

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2
Q

What is the atlas

A

C1

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3
Q

What is the axis

A

C2

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4
Q

What is the most prominent of the cervical spine

A

C7

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5
Q

How many nerve roots are there in the cervical spinal cord

A

8

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6
Q

what is cervical Radiculopathy

A

injury/compression to the cervical nerve roots

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7
Q

What does cervical radiculopathy cause

A

herniated disc, cervical spinal stenosis, deg, disk disease, tumors, injury

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8
Q

What are symptoms of cervical radiculopathy

A

motor and sensory muscle weakness
tingling to the UE
(sensory symptoms more common)

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9
Q

What is cervical myelopathy

A

compression on the cervical spinal cord rather than the nerve root

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10
Q

What causes cervical myopathy

A

herniated disc, cervical spinal stenosis, deg. disk disease, tumors, injury

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11
Q

What are symptoms of cervical myelopathy

A 
weakness
problems manipulating small objects 
gait disturbance
bowel bladder dysfunction 
heavy feeling in legs or numbness/tingling
usually not as painful as radiculopathy
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12
Q

Which cervical problem is more serious

A

Cervical myelopathy

but myelopathy isn’t as painful

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13
Q

What is spinal stenosis

A

narrowing of the spinal canal in the neck

from age or trauma

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14
Q

what is deg. disk disease

A

bones are touching each other

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15
Q

How to treat cervical radiculopathy

A

NSAIDS
Therapy-modalities/stretching
surgery to relieve pressure off the spinal nerves or cord and possible fusion of the neck

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16
Q

What is the only effective treatment for myelopathy

A

surgery

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17
Q

What are precautions after surgery

A

Philadelphia collar
no flex/ext
no rotation of the neck

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18
Q

What must you keep in mind in regards to cervical pain

A
  1. understand where pain is coming from
  2. what is the action that produces it
  3. is there a disease process that causes it
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19
Q

What is the etiology of cervical pain

A 
Trauma
Arthritis
Cervical strain and sprains
cervical spondylosis 
cervical herniated disc
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20
Q

What’s arthritis

A

inflammatory process or reaction to injury or stress

osteoarthritis

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21
Q

What are cervical strains or sprains

A

Ligament stretching, accelerating-deaccelerating injuries

RA- chronic pain, jt changes, leads to instability in neck and decreased ROM

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22
Q

How to treat cervical strains and sprains

A

rest, icing, meds, gentle stretch as able

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23
Q

how to treat RA

A

meds, cervical collar, isometric exercises

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24
Q

How to test for RA

A

XRAY
MRI
CT

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25
What is cervical spondylosis
General term for age-related wear and tear on our discs
26
What are symptoms of cervical spondylosis
``` stiff painful neck shoulder pain parathesia numbness or weakness in UE and LE Lack of coordination difficulty walking abnormal reflexes loss of bowel and bladder control ```
27
What can cervical spondylosis cause
cervical radiculopathy
28
Treatment for cervical spondylosis
Conservative: cervical collar, meds, strengthening and stretching exercise, apply ice then heat Surgery Anterior approach-remove herniated disc or bone spurs Corpectomy-remove portion or vertebrae to release compression Posterior approach
29
What is a common cervical spine condition
cervical herniated disc
30
What do cervical herniated discs cause
arm pain
31
Where are heniated disc most common
c5-6 and C6-7
32
What are conservative tx's for herniated discs
``` PT OT cervical traction activity mod bracing med injections ```
33
What does the cervical spine do
Supports and stabilizes the head allows for ROM of the head protection and transport for spinal cord and vertebral artery
34
What does the lumbar spine do
Furnishes support to the upper body | transmits weight of the upper body to the pelvis and lower extremities
35
What movements are involved that cause low back pain
``` Rotation Sustained posture flexion extension a combination of all ```
36
What can to much extension cause
Increased lordosis of the spine
37
What are more prone to injury in low back pain
Lumbar discs
38
What is spondylosis
Generation of the inter-vertebral disc
39
What is spondylolysis
A defect in the vertebral arch
40
What is spondyliolisthesis
displacement or subluxation of one disc over another
41
How can discs be injured
Protrusion extrusion sequestrated desk
42
What is protrusion
Disc bulges posteriorly | no rupture
43
What is extrusion
Outer fibrous layer is a ruptured and disc moves into the epidural space
44
Is a sequestrated disc
Nuclear material of the desk spills out and completely separates from disk most severe
45
What do injury to discs cause
Nerve root impingement
46
Where do Many symptoms of low back pain occur
In the LE
47
What May you feel with injury to discs
Radicular pain | deep burning pain
48
Kind of injuries you can have in low back pain
Injury to discs mechanical low back pain or sprain fractures and dislocations
49
What kind of pain do you have in mechanical low back pain or sprains
Localized pain, not usually constant | may have muscle guarding
50
What can you have in fractures and dislocations
Compression burst fracture flexion and distraction
51
What is compression
When vertebrae are crushed which causes vertebrae to be wedge-shaped and thin in the front
52
What is a burst fracture
Bony fragments into spinal canal, vertebral body is severely compressed fall from a height or motor vehicle accident
53
What is flexion and distraction
Stretching and tearing, a high energy force | example: from seatbelt from motor vehicle accident
54
What is treatment for low back pain
``` Modalities(Ultrasound) positioning stretching meds surgery ```
55
How to prevent back injuries
Ergonomics and body mechanics | use of assistive devices to prevent worsening conditions
56
When does most back pain go away
Within six weeks
57
What Do general spinal precautions include
No Bending no lifting (greater than 10 pounds) No twisting
58
What is OT treatment following spinal surgery
Teach logroll technique instruct in bathroom transfers/arrange bathroom equipment brace instruct in spinal precautions Adjust position instruct in lower body ADLs with or without adaptive devices as tolerated toilet aids
59
What kind of fractures do you see in hip fractures
Femoral neck fractures intertrochanteric fractures subtrochanteric fractures
60
Who do you see it with femoral neck fractures
Adults over age 60 | women
61
Where do Femoral neck fractures occur
In bone weakened by osteoporosis
62
Where does the femoral neck fracture occur in the bone
Inside of hip capsule and damage to bloodflow
63
Who do intertrochanteric fractures affect
Mostly in women over 50 years of age
64
Where does an intertrochanteric fracture occur
Between greater and lesser trochanter
65
What part of the bone does intertrochanteric fracture affect
Outside of the capsule | blood supply is not affected
66
What is an intertrochanteric fracture caused by
Direct force or trauma over the trochanter (any force that exceed strength of the bone)
67
Where does a subtrochanteric fracture occur
1 to 2 inches below the lesser trochanter
68
What is a subtrochanteric fracture usually due to
Trauma
69
Who are subtrochanteric fractures usually seen in
Younger people (sports related injury)
70
What is weight-bearing as tolerated
Patient allowed to put as much weight as he or she can tolerate through the operated extremity with pain being the limiting factor WBAT
71
What is partial weight-bearing
Patient allowed to put up to 50% of his or her bodyweight on the operated extremity (PWB)
72
What is Touch toe or touch down weightbearing
Patient is not allowed to bear weight on the operated extremity but is allowed to touch his or her toes to the floor to maintain balance TDWB or TTWB
73
What is nonweightbearing
Patient is not allowed to bear any weight on the operated extremity NWB
74
What are hip replacements caused by
``` RA osteoarthritis trauma disease Ankylosing spondylitis ```
75
When are hip replacements done
When significant pain interferes with daily function
76
What will traditional hip replacement limitations be
Limitations in range of motion | possible weight-bearing status
77
What are hip precautions
No bending past 90° no hip external Rotation avoid turning foot in word or outward no twisting
78
OT interventions for hip surgeries
Instruct in hip precautions Know weight-bearing status instructed in lower body ADLs with adaptive equipment transfer training (tub/shower, toilet, chair, bed) adaptive equipment recommendations
79
When to do a total knee replacement
For those with arthritis degenerative disease drama
80
What will OT include for total knee replacements
Lower body ADL training transfer training adaptive equipment as needed
81
What is a continuous passive motion machine used for
Those with knee replacements

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