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CLASS 22010 MSK > CLINICAL CARE OF THE SPINE > Flashcards

CLINICAL CARE OF THE SPINE Flashcards

1
Q

True or False

Radiculopathy is a pathologic process affecting the nerve root

A

True

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2
Q

True or False

Cervical radiculopathy is a clinical condition that involves the neck, shoulder or arm pain

  • Muscle weakness
  • Sensory changes
  • Diminished deep tendon reflexes
A

True

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3
Q

What is usually a result of a compressive source caused by the following?

  1. Cervical spondylosis
  2. Non specific degenerative changes of the spine
    a. aging
  3. Bony growth/remodeling that occurs
    a. osteophyte formation
    b. may irritate the nerve root
A

Cervical and lumbar radiculopathy

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4
Q

What is a pulpous prolapse from the intervertebral disc?

A

Disc herniation

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5
Q

True or False

Non-compressive causes of radiculopathy are less common

A

True

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6
Q

The deficits in Cervical and lumbar radiculopathy may be more severe and effect a greater distribution of nerves than seen in compressive symptoms in conditions such as what?

A
  1. Diabetes
  2. Nerve root infarction
  3. Nerve root avulsion
  4. Infection
  5. Cancer
  6. Demyelination syndromes
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7
Q

A patient presents with the following symptoms, what may be the most likely diagnosis?

  1. Neck, shoulder, or arm pain
  2. muscle weakness
  3. sensory changes
  4. diminished DTR
  5. Headaches
  6. Symptoms vary with nerves involved
A

Cervical and lumbar radiculopathy

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8
Q

When concerned for Cervical and lumbar radiculopathy should you asses C5-T1 nerve roots for weakness and asses the upper extremity DTR’s

A

Yes

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9
Q

What is the treatment for Cervical and lumbar radiculopathy?

A
  1. May have spontaneous resolution of symptoms in weeks to months
  2. NSAIDS, Tylenol, muscle relaxers
  3. PT or chiropractor
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10
Q

When should patients with Cervical and lumbar radiculopathy be referred out?

A
  1. Failure of conservative management
  2. Atrophy
  3. Motor weakness
  4. Signs of demyelinating conditions, infections, or tumors
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11
Q

What is a ligamentous, facet joints, muscular or disc injury that is usually self-limiting and commonly from a whiplash mechanism?

A

Cervical strain/Neck strain

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12
Q

The following symptoms are associated with what?

  1. Non radicular, focal neck pain from the base of the skull to the cervicothoracic junction
  2. Worse with ROM
  3. Paraspinal spasm
  4. Occipital headaches
  5. Irritability, fatigue, sleep disturbances, difficulty concentrating
A

Cervical strain/neck sprain

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13
Q

What is the treatment for Cervical strain/neck sprain?

A
  1. Soft c-collar for 1-2 weeks and reassurance
  2. NSAIDS and muscle relaxants
  3. Massage, manipulation, and cervical traction
  4. Return to activities as soon as possible
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14
Q

What is a common primary care complaint that is one of the most common causes of disability in people under the age of 45?

A

Lower back pain

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15
Q

What is the 2nd most common primary care complaint?

A

Lower back pain

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16
Q

How long does acute lower back pain last?

A

Up to 4 weeks

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17
Q

How long does subacute lower back pain last?

A

4-12 weeks

18
Q

How long does chronic lower back pain typically last?

A

Over 12 weeks

19
Q

True or False

“nonspecific” back pain refers to back pain in the absence of condition that can be readily diagnosed

A

True

20
Q

What accounts for the majority of back pain encounters?

A

Nonspecific back pain

21
Q

Non specific back pain is usually do to what and improves in less than four weeks?

A

Musculoskeletal cause

22
Q

Weakening of the bones in the spine causes what fracture that includes risk fractures like old age and chronic steroid use?

A

Vertebral compression fracture

23
Q

What refers to symptoms or impairment related to a spinal nerve, degenerative changes, disc protrusion, and typically improves gradually with supportive care?

A

Radiculopathy

24
Q

These may be rare systemic causes of what?

  1. Cauda equina syndrome
  2. Metastatic cancer
  3. Infection
  4. Abscess
  5. Vertebral Osteomyelitis
A

Low back pain

25
Q

What are the most common cancers to metastasize to bone in relation to lower back pain?

A
  1. Breast
  2. Prostate
  3. Lung
  4. Kidney
  5. Thyroid
26
Q

What are some alarming symptoms with lower back pain that may lead to a suspicion of metastatic cancer?

A
  1. Unexplained weight loss
  2. Night pain
  3. Night sweats
  4. History of cancer
  5. Risk factors for malignancy
27
Q

Epidural abscesses and vertebral osteomyelitis may be causes of what?

A

Lower back pain

28
Q

What is the treatment for lower back pain?

A
  1. Control pain, reassurance
  2. Activity/lifestyle modification
  3. Early mobility (if acute)
  4. Core stabilization through rehab
29
Q

If patients with lower back pain fail home exercise program or conservative management consider referrals to where?

A
  1. Neurosurgery
  2. Ortho
  3. Pain clinic
  4. Sports medicine
  5. Mental health
30
Q

Over time, fissures develop on annulus fibrosis the nucleus pulposus contents herniate in what disease process of the spine?

A

Herniated disc

31
Q

The following symptoms are associated with what?

  1. Abrupt or gradual onset
  2. Unilateral radicular leg pain
  3. Aggravated by various factors
  4. Possible neuro involvement
    a. L4-L5, L5-S1 distribution
    b. L1-L4 refers pain to anterior thigh
A

Herniated Disc

32
Q

True or False

Herniated disc

The specific weakness and numbness depends on the affected myotome

A

True

33
Q

What special tests would you perform for a patient with a herniated disk?

A
  1. Seated and supine SLR

2. Cross SLR

34
Q

What is the treatment for a herniated disc?

A
  1. Control pain
  2. Activity/lifestyle modification
  3. Rehab
  4. Consider chiro/PT
35
Q

What is known as a lateral curvature of spine that is more than 10 degrees in an adult?

May be from spinal degeneration or from childhood

A

Scoliosis

36
Q

True or False

Scoliosis

Up to 70% of adults will have progression of the curvature

A

True

37
Q

Lumbar scoliosis greater than ____ degrees or thoracic scoliosis greater than ___ degrees is disqualifying

A
  1. 20 degrees

2. 30 degrees

38
Q

What is the initial treatment for scoliosis?

A

PT, managing pain conservatively

39
Q

What is the goal treatment for scoliosis?

A
  1. Improve function
  2. Quality of life
  3. Stamina improvement
40
Q

True or False

Scoliosis

Correction of the spinal deformity is a realistic goal for all cases

A

False

It is not a realistic goal

CLASS 22010 MSK (12 decks)

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