Conditions Flashcards
Conditon: Aggravating Factors
- Extension
- Prolonged standing or walking
- Walking downhill
- Lying flat
** Anything that loads the posterior column **
Spinal Stenosis
Condition:
- Swelling of costal cartilages
- Anterior chest pain, loacilzed and superficial
- Agg: breathing and trunk movement
- Usually resolves in 12 wks
Tietze’s Syndrome
Condition: Lumbar axial pain that may refer to the LE, pain increased with extension and lateral rotation
Lumbar Facet Arthropathy
Condition: Represents a pathologic state in which the function of the spinal nerve roots is affected
Lumbar Radiculopathy
Condition:
- Constant or Intermittent pain
- Low grade ache
- Leg sx rare
- Morning stiffness/pain
- Localized in low back, rare for pain to radiate
Degenerative Disc Disease
Condition: Aggravating Factors
- s/p vigorous activity
- Static posture
Functional Instability
Condition: acceleration-deceleration injury to the neck, injury to soft tissues
Whiplash injury
Condition: also known as a limbus fx, caused by excessive compression or distraction and present like a disc herniation
Apophyseal ring fx
Can think of it as a salter harris fx to the growth plate in the vertebral body
Condition: Presensts with excessive IR
Anteversion
Condition: Degenerative changes of the spine
Spondylosis
Condition: Objective
- Limited ROM +/- mm guarding
- Limited B SB
- PPIVM: segmentally limited
- PAIVM: limited, painful
- NO neuro sx
- Palpable tenderness and mm spasm
Cerivcal Facet Syndrome
Condition: MOI of sudden unguarded movement (i.e. flexion or rotation)
Acute Facet Joint
Condition: Symptoms
- Flexion does not ease symtpoms
- Rarely have back sx
Vascular Claudication
Condition:
AROM to end range limited by stiffness/spasm
Subacute stage of MVA/whiplash
Condition: Subjective Exam
- Ache/stiffness
- Cloward signs
- Pin in upper neck, head, face, top of shoulder, scapula, posterior upper arm
- May or may not have distal sx
Cervical Disc Herniation
Condition:
- 50 + yo
- Kyphotic position
- Extension activities reduc stress on vertebral body
Thoracic Vertebral Fracture
Condition:
- MOI: Sudden neck movement
- Synovial capsule impingement w/in facet
- Localized pain +/- mm spasm
- Acute torticollis
Acute Cervical Facet Syndrome
Condition: Objective Exam
- Skin color or temperature changes
- Hair loss
- Peripheral pulses absent
- LE cramping/tightness
Vascular Claudication
Condition: Widening of the pars interarticularis fx with increased pain and radiculopathy
Spondylolisthesis
Condition:
History includes sudden onset of localized back pain that may resolve with continued activity
Protrusion
Condition: Results in increased intervertebral segment motion
Spondylolysis/Spondylolisthesis
Condition:
- Upper T-spin (T3-7)
- Flat or Reduced thoracic kyphosis
Flexion movement impairment
Condition:
- Stiffness > 30 min
- Back pain improved w/exercise NOT rest
- Awakening during 2nd half of night due to back pain
- Alternating butt pain
- Less than 2.5 cm of chest expansion
Ankylosing Spondylitis
Condition: Objective Exam
- Flat lumbar posture
- Painful/limited extension
- Pain with SB on involved side
Spinal Stenosis
Flat back posture unload the posterior column
Condition: ASIS more lateral and PSIS more medial
Outflare
Condition: Easing Factors
- Flexion
- Sitting or squatting
- Walking uphill
- Bike riding
Spinal Stenosis
Condition: pounding headache associated with dizziness and visual distrubances
Vascular headache
Condition:
- Slight flexed posture
- Lateral Shift +/-
- Limited ROM/Gaurded movement
- Centralization of pain
Posterolateral Disc Herniation
Condition
- Tightness anywhere on the cranium or suboccipital region
- Bilat and trigeminal distribution
- W > M
Tension HA
Condition: Body chart can include unilateral pain, buttock pain, LBP, or posterior leg pain to knee
SI Joint Dysfunction
Condition:
- Lateral curve w/o rotational component
- Can lead to mm spasm, inflammation, injury
- Can be corrects with position changes
- Tx underlying cause and it will resolve
Functional Scoliosis
Condition: Subjective
- Bilat parathesia in glove distribution
- Intermittent posterior thoracic pain or scapula pain
- Sx worst in evening and with thoracic slump/flexion
- Position of comfort is laying completely flat
T4 Syndrome
Condition: head and face pain arising from the UCS
Cervicogenic headache
Cervical Disc Herniation: Pain at back of neck, head and face
Upper C-spin
Condition:
- M > F
- 40-50
- Occupation involves lifitng, sitting, oversure
Degenerative Disc Disease
Cervical Disc Herniation: Pain at base of neck and top of shld
C4-5
Condition: Pain worse with incline walking but improved with decline walking
Vascular Claudication
Condition: Pt. may have back pain, leg pain, or a combination of the two
Spondylolisthesis
Condition:
- Lateral curve w/rotational component
- Can be congential/idiopathic
- Can’t be corrected by positioning
- Can cause wedge shaped vertebra
Structural Scoliosis
Condition:
- Hx of neck or shld pain
- Unilateral, associated pain in neck, shld, arm
- Variable pain, moderate intensity, dependent on movement
- NOT throbbing
Cervicogenic HA
Condition: Sudden chest pain, radiationg to back that is unrelenting (emergency situation)
Dissecting thoracic aneurism
Condition: Inflammatory response at pubic symphysis and ischial rami caused by susatined or repetitive trauma to the pubic symphysis
Osteitis Pubis
Condition:
- C/T junction or high T-spine segments
- Excessive kyphosis
- vertebral bodies may become wedge shaped
Extension movement impairment
Condition: Consists of radicular pain in a dermatomal distribution in combination with N/T and motor weakness
Lumbar Radiculopathy
Condition: Subjective
- Pain worse distally w/dermatomal pattern
- Possible cloward sign
- Pain can be constant
Cervical acute nerve root
Condition:
- poor posture: hangs on ligaments/posterior pelvic tilt
- weak or hypermobile hip/spine
- weak gluteals and abdominal wall
- prolapse
Weakness of pelvic girdle
Condition: Symptoms
- Localized vauge pain
- Back and leg pain (can be bilateral)
- Presence of N/T and weakness in LEs
- Cramping
Spinal Stenosis
Condition: Objective
- Increased cervical lordosis and C/T kyphosis
- Flattened/restricted upper T-spine
- Minimal thoracic movement w/single arm elevation
- Local tenderness and sx reproduced w/mobilization between T2-7
- Local hypomobility
- ULTT/Slump +
T4 Syndrome
Condition:
- UE/LE weakness
- B&B dysfunction
- Gait disturbance
- Due to cord compression
Cervical myelopathy
Condition: Starts as stress fx on the pars interarticularis, typically L5 followed by L4
Spondylolysis
Condition:
- 20s-50s
- Poorly localized dull ache in back
- May have buttock pain
- Increased pain in AM
- Unloads spine from sit to stand
Protrusion
Condition:
- > 55 yo
- neck and arm pain
- painful/restricted ROM
- sensory/motor defects
- intrinsic hand mm wasting/loss of hand dexterity
Cervical Stenosis
Condition:
Agg: neck movement, posture, position,
Ease: meds, modalities, change in posture, lying down, tx
Decreased ROM
Pattern: occipital/suboccipital
Cervicogenic HA
Condition:
- Localized pain
- Reduced motion w/respiration, coughing, and sneezing
- Local mm spasm
Rib subluxation
Anterior = concavity of rib posteriorly
Posterior = prominence of rib posteriorly
Condition:
- Pain with change in position
- Deep shift/clunk
- Difficulty with WB activities
- Positive stability tests
- Active SLR +
- Pain provocation +/-
Hypermobile Pelvic Girdle
Condition
- Hx of reciprocal clicks that have now stopped
- Often have limited opening range or “closed lock”
Anterior disc displacement WITHOUT reduction
Condition: vertical compression resulting in massive suboccipital HA
Fx of posterior arch of atlas (C1)
Condition: Symptoms
- More distal than proximal signs i.e. radiating
- Limited ROM and activity
- Muscloskeletal involement is central/local
ANR
Condition: no audible sound with full anterior displacement w/o reduction
Locked joint
Condition: ASIS more medial and PSIS more lateral
Inflare
Condition: Subjective
- Young > Old
- Commonly L5-S1
- Fluctuating symptoms, rarely radiating
- Localized pain
Functional Instability
Condition
- Severe back pain
- SLR +
Possible Cauda Equina
Condition: Objective
- Altered posture
- Neuro +/-
- ROM limited by closing movements
- Spurling +
- Neurodyanmic testing +
Cervical chronic nerve root
Condition: Subjective
- Agg: looking down or turning head
- Limited ADLs
- Altered speed of movement
- Driving, sitting, work
Cervical Disc Herniation
Condition: can be seen in adults due to repeated (occupational) stress
Spondylolysis/Spondylolisthesis
Condition:
History includes: sudden onset but usually due to repetitive bending, lifting or frequent lifting, recurrent episodes
Posterolateral Disc Herniation
Condition: Objective
- Uncomfortable posture
- Corrected posture/deformity increases pain
- ROM only available in 1-2 motions
- Neuro +
Cervical acute nerve root
Condition: Aggravating Factors
- WB activities: standing, single leg stance, hopping, running
- Ascending/descending staris
- Pain with change of position: sit to stand, moving in bed
SI Joint Dysfunction
Condition:
- Difficulty with activities requiring anterior rotation
- ASIS posterior and superior
- PSIS inferior
- Functionally short leg
- Decreased hip extension and anterior rotation
Posteriorly rotated ilium
Condition: separation of the pubic bones anteriorly leads to outflaring of the iliac bones; sacrum is less tightly held and can move anteriorly
Pubic symphysis dislocation
Cervical Disc Herniation: Pain at scapula, across the shld joint, posterior/lateral aspect of upper arm
C5-6 OR C6-7
Condition: Objective
- Localized pain but can refer to larger area
- Local tenderness with palpation, stiff, thick
- Initially hypomoble
Chronic Facet Joints
Condition:
- Loss of disc height
- Loss of normal lordosis
- Lateral clefts at U-joints
- Intersegmental hypermobility/instability
Cervical Disc Degeneration
Condition: Objective
- Abnormal posture
- Limited flex/ext
- Painful unilateral ROM (SB or Rot)
- Central PA pain > unilateral
- Spurling +
Cervical Disc Herniation
Condition:
Objective
- SLR (-)
- Thickened soft tissue
- PAIVM increased, decreased mobility, min pain
Degenerative Disc Disease
Condition: Compression of the sciatic nerve, typically presents with similar presentation to L5/S1, LBP/Buttock pain radiation now the posterior thigh/leg
Piriformis syndrome
Condition: Presents with reciprocal clicks
Anterior disc displacement WITH reduction
Condition: HA with redness under eyes
Cluster HA (vascular)
Condition: Objective
- Poor posture
- limited and painful ROM
- Painful central/unilateral PA
- Sensory AND Motor Loss
- Hyporeflexia
Spondylosis
Condition: side to side curvature of the spine (Cobb angle) of > 10 degrees
Idiopathic scoliosis (more common in females)
Condition: Symptoms
- Unilateral pain
- Less sharpt over the joint
- Rarely radiates down leg
Chronic Facet Joint
Condition:
- MOI: increased neural tension, stiff joints, natural posture
- Stiffness of C/T junction and T3-7
- Flexion restriction
Flattened Upper Thoracic Spine
Condition: Easing factors
- Rest
- Changing to a new position
Functional Instability
Condition: defect in pars interarticularis
Sponylolysis/Spondylolisthesis
Condition: Symptoms
- Stiffness and pain in AM
- Increased pain with stretch of joint
Chronic Facet Joint
Condition: Typically occurs in vertebrae from T12-L2
Chance fx
Condition:
- Increased tone of pevlic floor mm and mm of hip and trunk
- Mm imbalance/incoordination of hip and trunk
- Mobility impairment of scar/CT in perinuem, inner thight, abs
- Diaphragm tightess/poor use
- Dysfunction of pelvic joints
- poor posture
Hypertonus dysfunction
Condition: Presents with excessive ER
Retroversion
Condition: Symptoms
- More proximal than distal
- Minimal limitation of activity
CNR
Condition: History
- Past Acute Facet Joint
- Never entirely symptom free
- Trauma
- Degeneration
Chronic Facet Joint
Condition:
- Occuring in older pt. w/degenerative changes
- Occuring in younger pt. w/trauma
- Inflammation due to viral or chemical
Cervical acute nerve root
Condition:
Aggravating factors include
- Extending
- Bending
- Sitting
- Sit to stand
- sustained posutre
- sudden motion
- end ROM
Degenerative Disc Disease
Condition: Subjective
- Constantly moving positions
- Pain decreased when new positions reached
- Hx of catching/locking
Functional Instability
Condition:
- Pain isolated to upper back or radiate in dermatomal pattern
- Pain shooting around or through chest wall
- Possible sensory deficits and neurological weakness
- Agg: movement, deep breathing, cough/sneeze
Thoracic Disc Lesion
Condition: Compression fx to the vertebral body
Burst Fx
Condition:
- First rib
- Limited painful caudal glide
Superior subluxation
Condition: wedging of multiple vertebral bodies
Scheuermann’s Disease
Condition: Those with Posterolateral Disc Herniation are at high risk
Cauda Equina
Condition: Transverse fx of the vertebral body right under the epiphysis, flexion and distraction fx
Chance Fx
Condition:
Sx intermittent
Limited active movements
weak mm
postural changes
Chronic stage of MVA/whiplash
Condition:
- Difficulty with activities requiring posterior rotation
- ASIS anterior and inferior
- PSIS superior
- Functionally long leg
- Decreased hip flex and posterior rotation
Anteriorly Rotated Ilium
Condition: Subjective
- Dermatomal pattern, not necessarily distal
- “Patchy” distribution
- Usually intermittent
- Agg: sustained flexion or movement that narrow foramen
- Can be nagging
- able? to sleep at night
Cervical chronic nerve root
Condition:
- 20-55 yo
- LBP, back and leg pain
- Associated muscle spasms +/-
Posterolateral Disc Herniation
Condition: Objective
- Localized thickness in tissues
- Stiff segmentally
- May report pain with OP
CNR
Condition:
- Entire ilium higher
- ASIS/PSIS superior
- May have decreased anterior/posterior rotation
- Decreased hip ABD strength
Upslip
Condition:
Pain as dominant complaint
Apprehensive with AROM of neck
Shld/arm movement tolerated
Dizziness with active movement
Acute stage of MVA/whiplash
Condition: Localized irriation of costosternal joint/2nd rib
Costochondritis
Condition:
Aggravating factors include: flexion, sitting, sit to stand, walking, sneezing, coughing
Posterolateral Disc Herniation
Condition: fx of anterior and posterior arch of C1
Jefferson fx
Condition:
- Pain
- Limited chest excursion
- Limited spinal mobility
- Bone scan +
Anklyosing Spondylitis
Condition: boring pain to mid T-spine after eating
Peptic Ulcer
Condition
- Sensory distrubances in hand
- Intrinsic mm wasting of hand
- Unsteadiness during walking
- Hyperreflexia
Myelopathy that has progressed to the point where surgery would be indicated
Condition: Increased thoracic kyphosis with compensatory cervical and lumbar lordosis
Scheuermann’s Kyphosis
Condition: Symptoms
- Unilateral pain, sharp over facet
- Increased pain with stretch/compression of joint
- Limitation in SB and extension
Acute Facet Joint
Condition: Ojective
- Increased lumbar lordosis
- End ROM may provoke symptoms
- Hesitation in flexion at 30-40 degrees
- Hinging with extension
- Gowers +
Functional Instability
Condition: Small herniation of disc material into the endplate of vertebral bodies
Schmoral’s nodes
Condition: Objective
- Poor pelvic and abdominal control
- Central PA painful with altered end feel
- Leg load test +
Functional Instability
Condition: Pain with referred pain along the joint line and ipsilateral hip/trochanter, can also refer along posterior thigh to knee, and can resemble lumbar disc pathology
Sacroiliitis
Condition: Subjective
- Cloward sign
- Diffuse uni/bilateral sx
- Agg: sustained flex, quick motion, end ROM
- Long hx of neck pain or MVA
Spondylosis
Condition: Irritation/Inflammation, compression, or tension to the nerve root
Acute Nerve Root (ANR)
Condition:
- Occurs more commonly in the T-Spine
- 20s-30s
- Pt. unloads spine before getting up
Intra-Spongy Herniation
Condition: MOI can include trauma, pregnancy, chronic L/S or hip problems, pelvic floor dysfunction
SI Joint dysfunction
Condition:
History includes repeated micro trauma to annular fibers, trauma to disc, or bone spur formation
Degenerative Disc Disease
Condition:
Fx of C2 pedicles with disolcation of C2 on C3
Dens migrates into brainstem
Hangman’s Fx
Condition: rupture of transverse lig.; may result in cord compression
AA dislocation
Condition:
- Stiffness
- Headache
- Neck pain
- UE pain
- B “stocking glove” paresthesias
T4 Syndrome
Condition:
- Reduced costal mobility (rotation)
- Agg: twist or reach
- Pain: breathing, trunk rot, unilateral PA over C/T junction
- Pain and stiffness w/rib mobility
Costal Joint Derangement
Condition:
- Hx of cancer
- 50+ yo
- Failure of conservative tx
- Unexplained wt loss
Cancer
Condition: Chronic irritation of nerve root/adhesion
Chornic Nerve Root (CNR)
Condition:
Objective
- ROM limited in the acute phase
- Pain with flex/ext, OP, sustained posture
Degenerative Disc Disease
Condition:
- Middle age +
- Stiffness at multiple levels
- Loss of elastic end feel
- Limited arm elevation
- Stiff/painful accessory glides
- Mm imbalance
Generalized upper/mid thoracic stiffness
Condition:
- MOI: Chronic neck pain, poor posture, tight scalenes
- May cause thoracic outlet syndrome
- Limited end range cervical rotation and shld flex
Elevated 1st Rib
Condition
- Ache in neck, shld, arm, or hand
- N/T on inside of forearm and 4th and 5th fingers esp w/shld flex
- Weak/clumsy hands
- Sweeling/redness in arms/hands
- Difficulty w/OH activities
Thoracic outlet syndrome
Condition: Typically in teens due to trauma
Spondylolysis/Spondylolisthesis
Condition:
- Unable to close mouth or “open lock”
- Rare but can occur after prolonged dental procedures
- Lateral pterygoid becomes overstretched
Posterior disc displacement
