Clin Med- Pathologies Related to Low Back III Flashcards
Nephrolithiasis is also known as what?
aka kidney stones or renal calculi
Nephrolithiasis involves the urinary system structures, which are?
kidneys, ureters, bladder, and urethra
Nephrolithiasis involves the urinary system functions:
______ waste
Retain essential substances for _______ and _______
Stimulates _______ production
______ _________ regulation
Coverts Vitamin ______ (absorbs Ca2+) to its active form
removes
electrolytes; pH
RBC
Blood pressure
D
With nephrolithiasis, the etiology and risk factors include:
Disorders that lead to _________ of Ca2+ and uric acid (ex. hyperthyroidism)
Not primarily drinking _____
Obesity
High animal _____ intake
hyperexcretion
water
protein
_________ is the 3rd MOST common UT disorder behind infections and prostate conditions
Nephrolithiasis
The pathogenesis of nephrolithiasis- hard mass of salts composed of _____ > ____ _____ and other minerals deposited in urinary system as follows
Ca2+; uric acid
With Nephrolithiasis, there will be referred P! into the ___-____ dermatomes
T10; L1
The progression of nephrolithiasis…
May begin with ________ unilateral LBP
Could progress to acute/_____ back and (between ribs and iliac crests) and possibly ______ P!
intermittent
severe
abdominal
The clinical S&S of nephrolithiasis:
- Radiating P! to the _____ and _______ regions
- ________ dysfunction
- Unrelenting P!
- __& ____ due to P! severity
_ ________ (urinary or kidney) could occur
groin; perianal
bladder
N & V
infections
With nephrolithiasis and the Murphy percussion test:
You would place a ____ and _______ fisted percussion over the 12th costovertebral angle
WNL = __________
P! may also be present with bladder _______/________
firm; closed
painless
palpation; percussion
With nephrolithiasis, this is a ______ but possible _____ referral depending on pain severity
urgent; emergent
Pertaining to osteoporosis, bone mass peaks between ____-_____ years old
25;35
With osteoporsois, the skeleton is _______ active and undergoes continous ______ throughout life with an annual turnover of bone
metabolically; remodeling
With osteoporosis, remodeling with the bone is neccesary because it maintains the _________ integrity of the skeleton
structural
With osteoporosis, remodeling with the bone is neccesary because it serves as the metabolic demands as a storehouse of _____ and ________
Ca2+ and phosphorus
_______ is a persistent, progressive metabolic disease
Osteoporosis
Osteoporosis is characterized by:
Low bone ______
Impaired bone _____
Decreased bone _______
Enhanced risk of ________
mass
quality
strength
fractures
What is the MOST common types/etiology with osteoporosis?
aging
What is the seondary type/etiology with osteoporosis?
consequence of disease or medication
With osteoprosis is NOT often a ______ diagnosis; ____% goes undiagnosed
presenting; 70
With osteoporosis, it has an ______ number in younger individuals
increasing
What is the MOST common METABOLIC BONE disease?
Osteoporosis
________ or low bone mass is a precursor to osteoporosis
Osteopenia
Osteoporosis is expeced to increase with ______ population
aging
___________ is highest in post-menopausal biological women with estrogen deficit and Scandanavian ancestry
Osteoporosis
_____ % of biological women and ____% of biological men over 50 yrs. will suffer an osteoporotic fx
33; 20
What are some risk factors for osteoporosis?
Lower ______ and ______ levels
hormone; estrogen
With lower estrogen levels, it limits the release of ______ into the blood and absorption
calcium
Lower estrogen (osteoporosis) is associated with ______ and abnormal menses
menopause
With osteoporosis, lower ______ in men also limits the release of calcium into the blood
testosterone
With osteoporosis risk factors and genetics, this plays a role with _______ hormone for calcium balance and bone stature
parathyroid
Social ______ play a role in osteoporosis risk factors, such as > 2 beers per day, > 300 mg caffeine a day
habits
Risk factors for osteoporosis:
_______ inactivity
_______ alters hormone levels
≥ 3 months of __________ use
Tobacco
Low Vitamin _____
physical
depression
corticosteroid
D
People with risk factors for osteoporosis should have a _____ scan if they meet the criteria
DEXA
Pathogenesis of osteoporosis- PRIMARILY a _______ disorder as osteoclastic> osteoblastic activity
metabolic
Pathogenesis of osteoporosis- SECONARILY an _______ disorder due to other conditions that limit calcium regulation and sex hormones for bone health
endocrine
Osteoporosis is the loss of inner _______ bone
cancellous
With osteoporosis: wedging, compression, and fx of vertebral body MOST often in lower ______ and upper _______ regions
thoracic; lumbar
With osteoporosis, femurs, ribs, and radius are also common areas for ______
fractures
With osteoporosis, ___-______ fractures occur MORE often
non-traumatic
With osteoporosis, what might you observe with your patient?
Forward _______ ______
Loss of _______
Increased thoracic and lumbar _______
_______ posture
head posture
height
kyphosis
Slouched
With osteoporosis, a fx can occur with a benign ______ activity such as bending or coughing
flexion
Clinical manifestation S&S
Osteoporosis
Fx S&S
Severe back pain potentially between mid ____ and _____ lumbar region with FLX, compression, and valsalva stresses
thoracic; upper
With osteoporosis, P! may refer to _____ and abdominal region
flanks
With osteoporosis, and ROM there will be pain and limitation primarily with ______ BUT possibly all directions
FLX
With osteoporosis and resisted tests, there will be pain and ________ with what direction mainly?
weakness, FLX
Osteoporosis stress test findings:
P! with ______ and relief with ______
P! with ______ pressures
compression; distx; PA
With osteoporosis, neuro is often _____ but possible in more severe cases
-
Biomechanical exam- special tests
Osteoporosis:
________ test
______ sign- inability to lie supine due to P!
percussion
supine
__________ clinical manifestations S&S
More hx with Roman’s CPR
> 52 yrs. of age
No, LE P!
BMI < 22
No regular exercise
Biological female
Criteria for compression fx
osteoporosis
If you suspsect a fx with osteoporosis most likely a ______ referral
______ referral if neuro symptoms or inability to walk
urgent
emergent
With PT Rx and osteoporosis: MOST osteoporotic fx are stable and able to tolerate ____ due to ________ structure so proceed based on symptoms
Rx; ligamentous
With PT Rx and osteoporosis, you should minimize ______ ______ compression
vertebral body
What is the MET focus for osteoporosis?
_______ integrity- maintenance or improving density
_______ and resistance training
Bone
Walking
What activity could help with osteoprosis the BEST?
A. plyometrics
B. JM
C. balance activities
C.
With osteoporosis and MT, be cautious with _____ particurlaly higher grades or > 3 months of _________ use
JM; corticosteroid use
With osteoporosis, you may utilize JM to normalize _____ and stresses throughout the spine
motion
With osteoporosis, majority will heal after _____ to _____ weeks of Rx with subsequent decline in pain
8; 12
With osteoporosis and MD Rx, a good treatment for some patients with acute/subacute back pain is ________ ________
percutaneous vertebroplasty
With osteoporosis and MD Rx, percutaneous vertebroplasty with the addition of _______ vs none provided better subjective outcomes starting at 6 months and lasting out to two years following sx
exercises
_________ is when the bone softens without the loss of bone mass or brittleness as with osteoporosis
osteomalacia
Osteomalacia is a _______ disease
metabolic
Etioligic factors with osteomalacia:
Insufficient intestinal ______ absorption due to lack of calcium absorption or low vitamin D
Increased _______ loss
Ca2+
phosphate
With Osteomalacia, increased phosphate loss could be due to…
______ conditions
long term _____ use
___________ disorder that alters calcium balance
kidney
antacid
hyperparathyroidism
Risk factors for Osteomalacia:
Lack of dietary or sunlight vitamin _____
Malabsorption conditions including age that affect _____ and ______ functions
________ that alter Vit. D, Ca2+ , or phosphate i.e., antacids and anticonvulsants
D
digestive; metabolic
medications
Pathogenesis of osteomalacia:
Lack of bone _______, Ca2+, and phosphates that lead to ____ bones with possible fx but more likely bending
NO affect on _______
minerals; soft
osteocytes
With osteomalacia, it primarily effects which bones?
vertebra and femur
Clinical manifestations S&S with osteomalacia:
____ _____ pain and _____ and LE pain, aggravated by WB
Myalgia/______
proximal muscle ______ and polyneuropathy
altered ______ and increased falls
LBP; pelvic
arthralgia
weakness
gait
Osteomalacia progressive deformities:
Increased thoracic _____
Genu _____- bow legged
kyphosis
varum
Osteomalacia is an _______ referral unless it worsens neurologically or causes the inability to walk
urgent