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Physical Assessment > Chapter 24, Module 6; Lower back pain (acute) > Flashcards

Chapter 24, Module 6; Lower back pain (acute) Flashcards

1
Q

Trauma to spine or back; pain is felt near site of injury

A

Spinal fracture

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2
Q

Palpable tenderness over site of fracture

A

Spinal fracture

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3
Q

DIAGNOSTIC STUDIES of Spinal fracture

A

Considered an emergency; immobilize patient and transport for radiographs

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4
Q

History of cancer; progressive pain is unremitting; occurs at night and at rest

A

Tumor

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5
Q

Weight loss, fever, tenderness near tumor

A

Tumor

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6
Q

DIAGNOSTIC STUDIES OF tumor

A

ESR; bone scan

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7
Q

Neck or back pain not relieved by aspirin; occurs in older adolescents and young adults

A

Osteoblastoma

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8
Q

Localized tenderness; may have scoliosis with muscle pain

A

Osteoblastoma

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9
Q

DIAGNOSTIC STUDIES OF Osteoblastoma?

A

Plain film shows an expansive osteolytic lesion surrounded by thin peripheral rim of bone; bone scan; CT scan

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10
Q

Occurs primarily in adolescents; rare in patients older than age 40; well- localized pain that may be more se¬ were at night and relieved by aspirin or other prostaglandin inhibitors

A

Osteoid osteoma

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11
Q

Painful, well-localized scoliosis may be present

A

Osteoid osteoma

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12
Q

DIAGNOSTIC STUDIES OF Osteoid osteoma?

A

Bone scan

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13
Q

History of infection, invasive procedure; continuous, dull back pain; chronic back pain

A

Infection (vertebral osteomyelitis)

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14
Q

Acute onset with fever, diaphoresis; tenderness over affected disk; positive SLR

A

Infection (vertebral osteomyelitis)

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15
Q

DIAGNOSTIC STUDIES OF Infection (vertebral osteomyelitis)?

A

ESR; blood culture; bone biopsy; CT scan; MRI

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16
Q

Pain aggravated by movement; more common in children

A

Diskitis

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17
Q

Tenderness over affected disk

A

Diskitis

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18
Q

DIAGNOSTIC STUDIES OF Diskitis?

A

ESR

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19
Q

LBP radiating down the buttock to below the knee, symptoms present less than 1 mo

A

Herniated disk

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20
Q

Positive SLR

A

Herniated disk

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21
Q

DIAGNOSTIC STUDIES OF Herniated disk ?

A

None

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22
Q

Constant pain in a saddle distribution; urinary retention, fecal incontinence, radiculopathy

A

Cauda equina syndrome

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23
Q

Positive SLR, abnormal DTRs, motor weakness

A

Cauda equina syndrome

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24
Q

DIAGNOSTIC STUDIES OF Cauda equina syndrome?

A

MRI, surgical emergency

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25
Acute  back  pain  with  radiculopathy; history  of  strain  or  trauma,  relief with  sitting
Sciatica
26
Paravertebral  tenderness  and spasm;  positive  SLR;  sitting knee  extension,  sensory findings
Sciatica
27
DIAGNOSTIC STUDIES OF Sciatica?
EMG  if  chronic
28
Pain  in  back,  buttocks;  history  of  new activity  or  exertion;  relief  of  pain with  sitting
Musculoskeletal strain
29
Paravertebral  tenderness,  scoliosis,  or  loss  of  lumbar  lordosis; no  neurological  signs
Musculoskeletal strain
30
DIAGNOSTIC STUDIES OF Musculoskeletal strain?
None
31
Young  person  in  a  sport  that  demands rapid  movement  between  hyperflexion  and  hyperextension  or  requires excess  loading  in  hyperextension
Spondylolisthesis
32
No  neurological  signs;  pain localized  to  low  back,  just below  level  of  iliac  crest; tight  hamstrings
Spondylolisthesis
33
DIAGNOSTIC STUDIES OF Spondylolisthesis?
Lumbar  spine radiographs
34
Younger  than  age  40:  insidious  onset; progressive  morning  back  pain  relieved with  exercise
 Ankylosing spondylitis
35
Painful  sacroiliac  joints, reduced  spine  mobility; may  have  uveitis
 Ankylosing spondylitis
36
DIAGNOSTIC STUDIES OF
ESR;  spinal radiographs
37
Pain  worse  throughout  day;  aggravated by  standing,  relieved  by  rest; pseudoclaudication
Spinal  stenosis
38
Signs  of  osteoarthritis  of  joints; may  have  neurological  signs
Spinal  stenosis
39
DIAGNOSTIC STUDIES OF Spinal  stenosis?
None
40
Affects  mostly  adolescent  males;  mild to  moderately  severe  pain,  worse  at end  of  day,  relieved  by  rest
Scheuermann disease
41
Normal  examination;  may show  an  exaggerated  thoracic  kyphosis  that  is  fixed in  attempted hyperextension
Scheuermann disease
42
DIAGNOSTIC STUDIES OF Scheuermann disease?
Thoracic  spine radiographs
43
Chronic,  poorly  localized  back  pain; postmenopausal;  slight  build;  history of  inactivity  or  endocrine  disorder
Osteoporosis
44
Palpable  tenderness  over  area  of compression  fracture;  kyphosis  or  lordosis;  loss  of  height
Osteoporosis
45
DIAGNOSTIC STUDIES OF Osteoporosis?
Bone  densitometry; spinal  radiograph to  assess  fracture
46
Severe,  acute-onset  pain  not  related  to activity  or  movement;  increased  risk older  than  age  30;  pallor,  diaphoresis,  anxiety,  confusion
Aortic  aneurysm
47
Intact  aneurysm  will  be  a  visible  pulsatile  midline  upper quadrant  abdominal  mass; in  a  dissected  aneurysm, upper  extremity  pulse  and pulse  pressures  are  asymmetric;  posterior  thoracic pain  may  be  felt
Aortic  aneurysm
48
DIAGNOSTIC STUDIES OF Aortic  aneurysm?
Emergency  surgical referral
49
Increased  incidence  with  age;  steady, intense  pain  in  RUQ  with  radiation to  right  scapula  or  shoulder;  belching,  bloating,  fatty  food  intolerance
Gallstones
50
Normal  physical  examination or  positive  Murphy  sign  on palpation  of  abdomen
Gallstones
51
DIAGNOSTIC STUDIES OF Gallstones?
Surgical  referral
52
Ill-appearing;  sweating,  nausea,  back or  flank  pain,  headache
Pyelonephritis
53
Fever;  cloudy,  malodorous urine;  CVA  tenderness  on percussion
Pyelonephritis
54
DIAGNOSTIC STUDIES OF Pyelonephritis?
Urinalysis;  urine culture
55
History  of  recent  URI;  pleuritic  pain
Pleuritis
56
Normal  examination  or  crackles  and  bronchial  breath sounds
Pleuritis
57
DIAGNOSTIC STUDIES OF Pleuritis?
PPD;  chest  radiograph
58
Sexually  active  female;  low  back  and abdominal  pain;  history  of  urinary or  vaginal  symptoms,  sexually transmitted  disease,  IUD,  multiple sex  partners
Pelvic  inflammatory disease
59
Cervical  and  uterine  motion tenderness,  adnexal  tenderness;  cervicitis,  fever
Pelvic  inflammatory disease
60
DIAGNOSTIC STUDIES OF Pelvic  inflammatory disease?
Gonorrhea,  Chlamydia cultures;  ESR
61
History  of  psychosocial  stressors, depression,  exaggerated  expressions of  pain
Psychological back  pain
62
Exaggerated  or  inconsistent reactions  to  testing;  normal examination
Psychological back  pain
63
DIAGNOSTIC STUDIES OF Psychological back  pain?
none

Physical Assessment (27 decks)

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