Clin Med- Low Back II Flashcards
________ _______ is a type of spondyarthropathy or spondyloarthride
Ankylosing Spondylitis
Ankylosing Spondylitis etiology:
Genetics- ___% are + for ____ -______ antigen blood test
Environmental
90
HLA-B27
Ankylosing Spondylitis is almost as common as ____
Onset < ____ and typically between ____-______ yrs.
RA
40
18; 30
With Ankylosing Spondylitis, it is usually 2-3x more common in ______
MALES
With Ankylosing Spondylitis, it is MOST common in the _________ region
lumbosacral
With _______ ________ pathogenesis, there is chronic inflammation at cartilage, tendon, ligament, and synovium attacments to bone (entheses)
Ankylosing Spondylitis
With _______ ________ , it has erosive bony overgrowth and osteopenia
Ankylosing Spondylitis
Osteopenia is ______ bone
weakened
Ankylosing Spondylitis leads to ______ of involved joints
fusion
With Spondyloarthropathies or Spondyloarthritides and multiple joint inflammation and pain:
> ____ min. of P!/stiffness after prolonged positions
Improved P! with ____ and _____ movement
Chronic inflammation and p! of _____ skeleton MOST often
_________ or unilateral extremity involvement to a lesser degree (typically smaller extremity joints)
- Localized to ______ or insertions of ligaments, tendons, and fascia
30
early; regular
axial
asymmetry
entheses
With Spondyloarthropathies or Spondyloarthritides common S&S:
_______ predisposition
__________ involvement of eyes, skin, GI tract, and renal and cardiac systems
Famial
Extraarticular
With Spondyloarthropathies or Spondyloarthritides common S&S: some describe it as…. “hurts to”
see, pee, and bend my knee
With Ankylosing Spondylitis, progressive LBP primarily from greatest influence on __________ joints > neck and lumbar regions
sacroiliac
With Ankylosing Spondylitis, it is ________ lasting for > ____ months
insidious; 3
With Ankylosing Spondylitis, there could be:
no _______ with rest
______ pain from static positioning
_______ and hip p!
change
night
buttock
What would you observe possibly with someone who has ankylosing spondylitis?
hyper kyphosis
loss of lumbar lordosis
With Ankylosing Spondylitis, in the Scan and biomechanical exam:
Multiple directions of ________ ROM/accesory motion of involved joints (possibly fused)
Combined motion- _________ block
Limited ______ excursion with manubrial and rib springs, possibly compromising cardiopulmonary function
_______ Berlin and Inflammatory Back Pain CPRs
limited
consistent
thorax
positive
With ankylosing spondylitis it is an ______ referral to what specialist?
urgent; rheumatologist
_________ _________ is a “Do Not Want To Miss” condition in any young adult with low back pain
ankylosing spondylitis
What condition is indicated?
Berlin Criteria- ≥2 =… 3, 4-6
88% probability
70% sensitive
AM stiffness
P! with rest AND relief with exercise
Awakening with LBP during 2nd half of night
Alternating buttock P!
Ankylosing Spondylitis
What condition is indicated?
IBP Criteria (≥ 4 = 80% sensitive /72% specific)
< 40 yrs. of age
Gradual onset
Relief with exercise
No change with rest
Night P! with improvement getting up
Ankylosing Spondylitis
What are some PT Rx with Ankylosing Spondylitis?
Be sensistive to _____ in patients with AS diagnosis
______ prevention
Gentle ______, ______ therapy, and ______ considering fragility
Postural ________
trauma
fall
ROM; manual, MET
education
Name some complicated conditions that may occur with Ankylosing spondylitis?
Osteoporosis
Fractures
Stenosis
Fusion in an upright or MORE often forward bent position
Cardiopulmonary disorders
__________ is a reproductive gland below the bladder that aids sperm function
prostate
An american man is at risk for what condition with these factors?
Age and ethnicity
Genetics
Chemical exposure
High fat, red meat diet
Obesity
Alcohol consumption
prostate cancer
________ cancer is ONLY in biological males and typically > _____ years of age
Prostate; 65
What cancer is the 2nd MOST common cancer and death in American men?
Prostate
Prostate cancer is typically more _______ americans
African
Pathogenesis of prostate cancer:
_______ gland cells infiltrate the prostate
disorganized
With prostate cancer, they typically have ________ P!
lumbopelvic
With prostate cancer, men can have what two dysfunctions?
bladder; sexual
Prostate cancer is more a _______ tumor
metastatic
Men after the age of ______ should get Prostate Specific Antigen (PSA) screening yearly
55
______ _______ muscle training has an overall benefit for bladder dysfunction
Pelvic floor (PFMT)
Prostate cancer is an _______ MD referral
urgent
__________ is toxicity to pancreas cells
pancreatitis
With pancreatitis, the _________ bille refluxes into pancreas and causes ________ and possible ________
gallbladder
inflammation
fibrosis
With pancreatitis there is a sharp ______ upper quadrant P! that radiates to the _______ region
right; thoracolumbar
With pancreatitis, it can worsen by _____ meals or drinking ______ due to difficult digestion
fatty; alcohol
With pancreatitis what position relieves the symptoms?
knees closer to the chest
With pancreatitis, the patient could become ______ or yellowed and experience ______ and vomitting
jaundiced; nausea
With pancreatitis, Grey-Turner sign indicates….?
swollen flanks
With pancreatitis, Cullen sign indicates…?
swollen umbilicus
With pancreatitis, it could progress to ______ S&S and vital/mental status changes
infection
With pancreatitis, it may lead to scarring in the _______ region and be unmodifiable to JM’s
thoracolumbar
With pancreatitis, it is an _______ and possible _______ MD referaal depending on severity
urgent; emergent
________ are weakening’s in a vessel wall
aneurysms
What is the MOST common site for an aneurysm?
aorta
Abdominal aortic aneurysm is more common in biological ______
males
With Abdominal aortic aneurysms it is increasing frequency due to ______ populations
aging
These are risk factors for what condition?
Smoking
> 50 yrs. of age
Biological male
Vascular diseases i.e., atherosclerosis and collagen disorder- weakens vessel walls
Genetics- family hx of AAA
AAA
What are the 3 etiologies for AAA?
trauma
vascular disease
infection
Pathogenesis of AAA?
Weakening of ______ in vessel walls
elastin
Clinical manifestation S&S with AAA:
Often ________
MOST often _____ and possibly _______ and flank P!, especially with activity
Searing, ripping, or tearing back or abdominal P! that stops all _______ (may indicate rupture)
asymptomatic
LBP; abdomen
activity
What would you observe MOST likely with AAA?
abdominal heartbeat
Palpation with AAA: ___-______ palpable mass (≥ 3cm) that pulses; typically just _____ of midline from umbilicus
non-tender
left
With AAA you would hear a ______ auscultation sound over AA
bruit
With AAA there will be absent or _______ pulses elsewhere
diminished
With AAA it is a “Do Not Want To Miss”condition and is an ________ referral
*MOST die before getting to a hospital
EMERGENCY
