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Part B thématiques > DDx > Flashcards

DDx Flashcards

1
Q

Etiology of an intracranial Aneurysm?

A
  • ballooning/dilation of blood vessel wall
  • traumatic or congenital rupture of the middle or anterior cerebral arteries or communicating branches of the circle of willis
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2
Q

SS of intracranial aneurysm?

A
  • asym till rupture
  • new or change in HA
  • can compress other structures causing
    + ocular palsies
    + diplopia
    + squint
    + facial pain
  • bitemporal deficet indicate pressure on the optic chiasm
  • homo hemiopia b/c pressure on optic chaiasm
  • neuro deficits
  • once intracranial pressure increases vommiting, dizziness and alterations in pulse and respiratory rates
  • seizures
  • kernigs sign
  • B/L babinski
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3
Q

Tests for intracranial aneurysm?

A
  • CT scan
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4
Q

Treatment for intracranial aneurysm?

A
  • surgery

- lumbar puncture

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5
Q

Etiology of BPPB?

A
  • b/c degen otoconia floating in the post semicircular canal
  • debris gets stuck to the cupula making it heavier = cupulolithiasis
    debris can float int he long arm of the canal as well causing inappropriate endolymph movement = canalolithiasis
  • most commong cause of vertigo
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6
Q

SS of BPPV?

A
  • vertgio with certain head positions
  • severe vertigo for seconds to mins
  • horizontal nystagmus
  • diminishes over month or 2
    NO hearing loss
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7
Q

Tests for BPPV?

A
  • Dix Hallpike maneuver
  • take sitting patient w/ 45 deg head rotation into supine while maintian head turn
  • once supint the vertigo and nystagmus will begin
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8
Q

Treatment for BPPV?

A
  • Eply’s
  • Semonts
  • meds and surgery
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9
Q

Etiology for cervicogenic HA?

A
  • referal from soft tissue

- trigeminalcervical nucleus allows referal of the pain from the neck to the head

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10
Q

SS of cervicogenic HA?`

A
  • daily HA w/ neuro signs
  • decreased ROM w/ pain
  • restriction in the C spine especially occiput
  • xray show arthrosis
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11
Q

Treatment of cervicogenic HA?

A
  • SMT and soft tissue
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12
Q

Etiology of Classic Migraine (migraine w/ aura)?

A
  • neurogenic, thought to be vascular
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13
Q

SS of classical migrane?

A
  • female
  • unilateral throbbing (pulsating) HA
  • photophobia
  • phonophobia
  • prodrome: bild spot w/ lights, numbness, sensory loss, weakness
  • nausea
  • vommiting
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14
Q

Treatment of classic Migraine?

A
  • SMT for chronic

- meds

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15
Q

Etiology of clsuter HA?

A
  • unknown
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16
Q

SS of Cluster HA?

A 
- middle aged male
occurs over days or weeks and appear again weeks or months later
- last 30 mins 
- triggered by alcohol or certain foods
- Horner's syndrome 
  \+ Pitosis
  \+ miosis
  \+ anhydrosis
- severe
- unilateral
- periorbital
- lacrimation
stuff nose
- facial swelling
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17
Q

Treatment of Cluster HA?

A
  • meds
  • chronic cluster low grade mob
  • episodic cluster just exercise
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18
Q

Etiology of common migrane?

A
  • neuro cause

- hypothetical causes

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19
Q

SS of common migraine?

A
  • female
  • unilateral
  • pulsitile
  • severe HA
  • no neuro
  • nausea and vomitting
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20
Q

Treatment of common Migraine?

A
  • SMT

- meds

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21
Q

SS of concussion?

A
  • post trauma
  • loss of awareness or memory
  • papilary sign and brainstem function intact
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22
Q

Treatment of concussion?

A
  • ABC first aid and send to hospital
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23
Q

Eitology of Crainial nerve 1 (olfactory) lesion?

A
  • ethmoid #
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24
Q

SS of CN 1 lesion?

A
  • ansomia
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25
Q

SS of CN2 (optic nerve) lesion?

A
  • transection = ispsilateral blidness, loss of direct light reflex
  • w/ constriction = optic atrophy
  • compresion at the optic chaism = hemiopia
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26
Q

Etiology of Occulomotor nerve (CN 3) lesion?

A
  • transtentorial herniation, b/c supdural or epidural hematoma
  • aneurysm of carotid and posterior commnuicating artery
  • diabetese melitus
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27
Q

SS of transtentorial herniation on CN 3?

A
  • diplopia
  • ptosis
  • eye down and out
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28
Q

SS of aneurysm of carotid and posterior communicating artery?

A
  • dilated and fixed pupil
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29
Q

SS of Diabetes Mellitus on CN3?

A
  • pupil contrictor fibres fine

- central fibres damaged

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30
Q

SS of CN 4 (Trochlear) lesion?

A
  • cannot look down and out
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31
Q

SS of Trigeminal Nerve lesion?

A
  • general facial sensation
  • loss of corneal reflex
  • flaccid muscles of mastication
  • jaw deviates to side of lesion
  • tensor tympani paralysis (low pitch deafness)
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32
Q

SS of CN 6 (Abducens) lesion?

A
  • lateral rectus muscle weak

- cannot look out

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33
Q

SS of Facial nerve (CN 6) lesion?

A
  • muscles of facial expression don’t work
  • loss of corneal reflex
  • loss of ant 2/3 taste
  • hyperacusis b/c stapedius paralysis
  • bell’s palsy (half of face loss function)
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34
Q

What is central facial palsy?

A
  • corticobulbar fibres in the interal capsule transect causing contralateral weakness sparring the forehead (UMN lesion of the facial nerve)
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35
Q

What is crocodile tear syndrome?

A
  • lesion prox to the geniculate ganglison

- lacrimation during eating

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36
Q

What is Mobeius syndrome?

A
  • congenital facial diplegia and convergent strabismus
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37
Q

SS of CN 8 (vesibularcochlear) lesion?

A
  • vertigo

- nystagmus

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38
Q

SS of CN 9 (Glossopharengheal) lesion?

A
  • loss of gag (pharyngeal) reflex)
  • loss of carotid sinus reflex
  • loss of post 1/3 tongue taste
  • glossophanyngeal neuralgia
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39
Q

SS of CN 10 (vagus) lesion?

A 
- ipsilateral soft palate, lpharynx and larynx paralysis
  \+ dysphonia
  \+ dyspnea
  \+ dysarthia
  \+ dysphagia
- uvula goes to the contralateral side
- loss of gag (palatal) reflex
- anesthesia of pharynx and larynx
  \+ unilateral loss of cough reflex
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40
Q

Etiology of vagus nerve compression?

A
  • aortic aneurysm

- tumours of neck

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41
Q

SS of CN 11 (accessory nerve) lesion?

A
  • SCM paralysis
    + cannot rotate to opposite side
  • traepzius paralysis
    + shoulder drop
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42
Q

SS of CN 12 (Hypoglossal) lesion?

A
  • tongue hemiparalysis

- ipsilateral deviation

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43
Q

Etiology of facet syndrome?

A
  • minor trauma (sudden head turning)
  • facet or capsule is the source of the pain
  • emniscoids can become trapped or pinched
    degen can cause facet pain
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44
Q

SS of facet syndrome?

A
  • neck and upper back pain/stiffness
  • sharp pain w/ motion
  • local pain w/
    + kemps
    + Spurling’s
    + Jackson’s
  • scleratomal refferal
  • tender and motion restriction on palpation
    limited C spine A and PROM
  • NO nerve root tension signs
  • Muscle HT
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45
Q

Tests for Facet syndrome?

A
  • clinical

- facet arthrosis on xray

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46
Q

Treatment for facet syndrome?

A
  • SMT
  • ice
  • ultrasound, tens
  • meds, facet denervation/injections
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47
Q

Etiology of Glaucoma?

A
  • progressive damage to the eye b/c increased intraoccular pressure
  • most common cause of blindness
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48
Q

SS of Glaucoma?

A
  • no early symptoms
  • visual field loss
  • blindness
    + first there is peripheral vision loss
    + then central
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49
Q

Tests for Glaucoma?

A
  • asymmetric Intraocular pressure
  • elevated intraocular pressure in eye w/ most damage to optic nerve
  • intraocular pressure can be high or normal
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50
Q

Treatment of Glaucoma?

A
  • meds
  • laser therapy
  • refer to optometrist
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51
Q

Types of Hematoma?

A
  • subarachnoid
  • subdural
  • epidural
  • intracerebral
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52
Q

Etiology of subarachnoid hematoma?

A
  • berry aneurysm
  • AV malformation
  • trauma
  • hemorrhagic diathesis
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53
Q

Etiology of subdural hematoma?

A
  • venous bleeding between the dura and the arachnoid
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54
Q

SS of subdural hematoma?

A
  • gradual signs of cerebral compression

- takes hrs, days or weeks post injury to surface

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55
Q

Etiology of epidural hematoma?

A
  • arterial hemorrhage associated with skull # and laceration of the middle meningeal artery
  • # of temporal bone usually
  • # of occipital bone can also cause
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56
Q

SS of epidural hematoma?

A
  • short lucid period of consciousness followed by rapid cerebral compression signs
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57
Q

Etiology of a intracerebral hematoma?

A
  • hypertension
  • ass w/ Charcot-Bouchard aneurysms
  • often in the basal ganglia, thalamus, pons, cerebellum and frontal lobe
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58
Q

Etiology of Herpes Zoster of the facial nerve?

A
  • invasion of the 8th cranial nerve ganglia and geniculate ganglia of the facial enrve by the herpes zoster virus
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59
Q

SS of Herpes Zoster of the facial nerve?

A
  • pain before vessicle eruptionin 2 -3 days
  • severe ear pain
  • hearing loss
  • vertigo
  • paralysis of facial nerve
  • vessicles on pinna and inner ear canal
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60
Q

Tests for herpes zoster of the facial nerve?

A
  • elevated lymphocytes and protein in CSF
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61
Q

Treatment for herpes zoster of the facial nerve?

A
  • antivirals

coricosteroids

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62
Q

Etiology of hyper tension HA?

A
  • intracranial hypertension w/out evidence of SOL, obstruction, or infection
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63
Q

SS of hypertension HA?

A
  • papilledema (swelling of the optic nerve)

- partial or complete monocular vision loss

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64
Q

Tests for hypertension HA?

A
  • CT, MRI, EEG normal

- CSF presure increased but normal fluid

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65
Q

Etiology of intracranial mass?

A
  • expanding intracranial lesion
  • granuloma
  • paracytic cyst
  • hemorrhage
  • anurysm
  • abcess
  • neoplasm
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66
Q

SS of Intracranial mass?

A
  • b/c increased intracranial pressure
  • HA
  • vomitting
  • mental status changes
  • drowsiness
  • lethargy
  • obtuseness
  • personality changes
  • disordered conduct
  • impaired mental status
  • papilledema
    changes in
    + temp
    +BP
    + pulse
    + respiratoy rate suually before death
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67
Q

Treatment of intracranial mass?

A
  • depends on the type of mass
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68
Q

Etiology of medication reaction?

A
  • daily use of over the counter meds at reccomended dose or higher
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69
Q

SS of Medication reaction HA?

A
  • chronic overuse of analgesics

- HA

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70
Q

Treatment of medication reaction HA?

A
  • get patient to stop taking meds
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71
Q

Etiology of pneumoccocal meningitis?

A 
- acute bacterial infection of either:
  \+ Neisseris meningitides
  \+ strep pneumonia
- meningicoccal meningitis usually occurs within the first year of life
- pneumococcal meningitis common in adults w/ history of:
  \+ chronic otitis
  \+ sinusitis
  \+ mastoiditis
  \+ closed head injury w/ CSF leaks
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72
Q

SS of pneumococcal meningitis?

A
  • respiratory illness
  • fever
  • HA
  • stiff neckl
  • vommiting
  • adults ill w/in 24 hrs
  • change in conciousness
  • seizures and cranial neuopahties
  • waterhouse friderichsen syndrom w/ vascular collapse
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73
Q

Tests for Pneumococcal meningitis?

A
    • brudzinski’s
    • kernigns
  • Uni or bi lateral babinski’s
  • lumbar puncture should bne done after a CT to exclude a mass lesion
  • culture CSF to find: + for bacteria
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74
Q

Treatment for Pneumococcal meningitis?

A
  • multiple antibiotics
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75
Q

Etiology of aseptic meningitis?

A
  • meningitis inflammation w/out bacteria on exam

- can be due to a viral infection

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76
Q

Etiology of Myofascial trigger points of suboccipital muscles?

A
  • trigger pint = hypersensitive area of muscle that refers pain to another part of the body
  • usually b/c of repetitive trauma
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77
Q

SS of Myofascial trigger points of suboccipital muscles?

A
  • tenderness and hyper tonicity of suboccipital muscles

- trigger points in the suboccipitals

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78
Q

Tests for suboccipital myofascial trigger points?

A
  • palpation of the suboccipitals
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79
Q

Treatment of suboccipital myofascial trigger points?

A
  • soft tissue
  • stretches
  • MRT
  • postural education
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80
Q

Etiology of otitis media?

A
  • bacterial/viral infection of the middle ear
  • microrganisms from the nasopharynx migrate to the middle ear via the eustachian tube
  • newborns:
    + enteric bacteria
    + e coli
    + staph aureus
  • post neonatal
    + ecoli rarley cause
  • older kids
    + strep pneumonia
    + haemophilus infulenzae
    + s aureus
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81
Q

SS of otitis media?

A
  • persistent, sever earache initially
  • hearing loss
  • fever
  • nausea
  • vommiting
  • dirrhea
  • red bulging tympanic membrane
  • bloody purulent otorrhea
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82
Q

Tests for otitis media?

A
  • clinically found

- myringotomy can be performed to culture the exudate

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83
Q

Treatment of otitis media?

A
  • antibiotics

- refer

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84
Q

Etiology of nerve root irritation or segmental radiculopathy?

A
  • herniated disc

- bony changes in RA or OA can compress single roots

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85
Q

SS of nerve root impingement?

A
  • radicular pain w/ sensory deficits
  • ventral root involvment = motor weakness in dermatomal distribution
  • corresponding DTRs dimminished as well
  • pain agg by
    + moving spine
    + coughing
    + sneezing
    + valsava
  • ortho tests reproduce neck and arm pain
  • brokody’s releives the pain
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86
Q

Tests for nerve root impingment?

A
  • MRI is the best for disc herniation

- oblique xray can be used to observe the IVF of cervicals

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87
Q

Treatment for nerve root impingment?

A
  • muscle relaxants
  • surgical decompression
  • chiro mob or adjustment
  • traction
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88
Q

Etiology of Sinusitis?

A
  • inflammation of the paranasal sinuses due to viral bacterial or fungal infection
  • acute sinusitis usually caused by acute viral respiratory infection
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89
Q

SS of sinusitis?

A
  • area over affected sinus tender
  • different sinuses blocked cause pain in that area:
    + maxillary: toothache, maxillary area HA
    + frontal: frontal area, HA
    + ethmoid: behind eyes and frontal (splitting HA)
    + spenoid: not localised
  • malaise
  • fever
  • chills
  • red translucent mucous membrane
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90
Q

Treatment of sinusitis?

A
  • steam inhalation
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91
Q

Etiology of Temporal arteritis?

A
  • chronic inflam of the large blood vessels

- usually occurs alongside polymyalgia rheumatica

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92
Q

SS of temporal arteritis?

A
  • severe HA –> tempral and occipital
  • scalp tenderness, visual disturbance
  • pain on chewing
  • blindness
  • arthritis, carpal tunnel
  • fatigue
  • swollen and tender nodules in tempral arteries
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93
Q

Tests for Temporal arteritis?

A
  • increased ESR when active
  • normochronmic, normocytic anemia
  • increased alp
  • biopsy required
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94
Q

Treatment for Temporal arteritis?

A
  • Prednisone
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95
Q

Etiology of TMJ dysfunction?

A
  • stress
  • bruxism
  • head trauma
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96
Q

SS of TMJ dysfunction?

A
  • pain in the jaw and face around TMJ
  • clicking and popping sound with opening and chewing
  • pain when chewing hard foods
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97
Q

Treatment for TMJ dysfunction?

A
  • mild analgesics

- mouth guard

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98
Q

Etiology of Tension HA?

A
  • inhanced painproprioception

- co-mobuid migraine, mood disorder, sleep dysfunction, anxiety

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99
Q

SS of tension HA?

A
  • HA lasts form 30 min - 7 days
  • wraps around head (tight band around head)
  • bilateral
  • no nausea vomitting, photophobia
  • increased hypertonicity
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100
Q

Treatment of Tension HA?

A
  • analgesics

- tricyclic antidepressants

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101
Q

Etiology of Trigeminal Neuralgia?

A
  • disorder of the trigeminal nerve

- compression of the trigeminal root

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102
Q

SS of Trigeminal Neuralgia?

A
  • trigger point pain
  • eating = pain
  • brushing teeth = pain
  • last from seconds to mins most often maxillary
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103
Q

Treatment for Trigeminal neuralgia?

A
  • carbamazepine meds

- peripheral nerve blocks provide temporary releif

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104
Q

Etiology of Vertebrobasilar artery dissection?

A
  • can occur most commonly at C6 or C2 b/c of spinal manipulation or common daily actyivites like driving
  • intimal tearing occurs which causes decreased blood supply in itself of creates an embolis which further blocks the artery
  • Wallemberg’s syndrome or Locked in (cerebromedullospinal disconnection) syndrome can occur
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105
Q

Etiology of Wallenberg’s syndrome?

A
  • Vertebral artery dissection

- occlusion of the PICA

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106
Q

SS of wallenberg’s syndrome?

A
  • vertigo
  • diplopia
  • dysarthria
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107
Q

Etiology of Locked in Syndrome?

A
  • vertebral artery disection
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108
Q

SS of locked in syndrome?

A
  • more serious than wallenberg’s

- = leaves the patient paralyzed

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109
Q

SS of vertebrobasilar artery dissection?

A
  • neurologic dysfunction w/ sudden onset
  • less than 24 hrs
  • 5 D’s and 3 Ns
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110
Q

Etiology of Abdominal Aortic Aneurysm?

A
  • athersclerotic aneurysms
  • usually below the renal arteries
  • > M
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111
Q

SS of AAA?

A
  • asym until rupture
  • severe middle abdominal or LBP
  • leg pain w/ exertion (claudication)
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112
Q

Tests for AAA?

A
  • pusatile mid or upper abdominal mass
  • palation sensitive for masses greater than 3 cm
  • radio graph show calcification around L2 and L4, if greater than 3.8cm aneurysm
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113
Q

Treatment for AAA?

A
  • refer
  • if 4 - 6 cm surgery
  • contraindication to Lumbar SMT
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114
Q

Etiology for Cauda Equina Syndrome?

A
  • rare central compression of the spinal cord below L1
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115
Q

SS for Cauda Equina Syndrome?

A
  • urinary retention (bowelk and bladder issues)
  • saddle paresthesia
  • numbness aroudnt eh groin or genital area
  • sexual incontience
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116
Q

Tests for Cauda equina syndrome?

A
  • valsava
  • pain radiating B/L legs
  • sensory or motor loss in both legs
  • babinski response
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117
Q

Etiology of congenital hip dysplasia (dislocation()?

A
  • acetabular deformities
  • inversion of the limbs and capsular tightness causes dislocation
  • breach delievers
  • adduction and extension of the neonats legs
  • hormonal laxity
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118
Q

Tests for congential hip dysplasia?

A
  • ortolani’s sign:
    + abduction/ external rotation causes a clunk sound
  • Barlows Test
    + flexion and abduction w/ long axis traction or posterior rpessure of the femoral head creates clunk
  • Galeazzi’s test
    + comparing knee height with infant supine and hips and knees flexed
  • ultrasound
  • radiographic findings show a distruption of shelton’s line: concave curve under femoral neck going into the obturaor foramen, increased skinner angle
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119
Q

Treatment of congenital hip dysplasia?

A
  • depends on the age
  • usually harness if found early
  • if found later on surgery
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120
Q

SS of Osteoarthritis (degenerative arthrosis)?

A
  • non- inflammatory
  • gradual pain worse by exercise
  • pain worse in the morning* get better with activity
  • decreased ROM
  • tenderness
  • crepitus
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121
Q

Tests for OA?

A
  • clinical

- xray ( incidental finding)

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122
Q

Treatment for OA?

A
  • rehab
  • patient education
  • stretches, strenghtening exercises
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123
Q

Etiology of Degenerative disc disease (DDD)?

A
  • initial traumatic event

- involves forced forward flexion and/or rotational mocemtn

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124
Q

SS of DDD?

A
  • LBP
  • sometimes pain refers
  • exacerbated by activity
    + sitting
    + getting up from seated position
    + waking up in the morning
    + lumbar flexion
    lifting
    + vibration
    + coughing
    + sneezing
    + valsava
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125
Q

Tests for DDD?

A
  • patient prefer to stand or sit in extension position
  • palpation of lumbar paraspinals and spine stabilizers = tender
  • L spine ROM limited and painful, mostly flexion, extension can also be painful though
  • MRI for disc herniation
  • xray helpful for DDD but usually in older patients >35
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126
Q

Treatment for DDD?

A
  • adjustment (open space)
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127
Q

Etiology of Dysmenorrhea?

A
  • combination of vasoconstriction and myometrioal contraction
  • increased discomfort caused by fluid retention and estrogen increases salt retention
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128
Q

SS of dysmenorrhea?

A
  • increased pain w/ menses

- pain in lower abdomin and pelvis radiating to the back or inner thighs

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129
Q

Tests for Dysmenorrhea?

A

pelvis exam/ GIT exam

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130
Q

Management for dysmenorrhea?

A
  • NSAIDs, decrease prostoglandins

- SMT sometimes helps, omega 3, vitamin B12

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131
Q

Etiology of facet syndrome?

A
  • facet and capsule are the source of the pain

- predis[posed by degeneration of the facet usually in > middle aged people

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132
Q

SS of Facet Syndrome?

A
  • well localised LBP
  • sometimes have some buttock or leg pain above the knee
  • sudden onset after misjudged movement or getting up from a flexed position
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133
Q

Tests for Facet syndrome?

A
  • no neuro signs
  • no nerve roots tests positive
  • pain is local with kemps
  • if repro w/ slr doesn’t go past the knee
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134
Q

Treatment for Facet SYndrome?

A
  • SMT
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135
Q

Etiology of Intervertebral disc derangment?

A
  • protrusion of the nucleus through the annulus fibrosis, usually posteriolaterally
  • the herniated disc material releases substances that cause an autoimmune inflammatory reaction
  • this protrusion can sometimes sompress on nerve roots causing radicular symptoms
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136
Q

SS of Intervertebral disc derangement?

A
  • LBP and leg pain below the knee
  • agg by sudden bending or twisting
  • past history of LBP that has been resolved
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137
Q

Tests for L5/S1 Intervertebral disc derangement causing L5 radiculopathy?

A
  • usually L5 or S1 disc bulge
    L5
  • weakness of dorsiflexion of the big toe
  • numbness on lateral aspect of lower leg
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138
Q

Tests for L5/S1 Intervertebral disc derangement causing S1 radiculopathy?

A
  • absent achilles reflex
  • weakness of plantar flexion
  • numbness on the back of the calf, lateral or sole of the foot
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139
Q

Tests for general intervertebral disc derangement?

A
  • SLR
  • well leg raise
  • braggards
  • MRI
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140
Q

Treatment for intervertebral disc derrangement?

A
  • avoid rotation
  • open up joint space ( lateral flexion)
    flexion distraction
  • pelvic blocking
  • activator
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141
Q

Etiology for compression #?

A
  • combination of flexion and axial compression
  • usually at T/L junction
  • risk factors:
    + early menopause
    + osteopenia
    + corticosteroids
    + hyperthyroidism
    + malignancy
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142
Q

SS of compression #?

A
  • acute pain doesnot radiate
  • agg by weight bearing
  • local tenderness
  • subsides in few days or weeks
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143
Q

Tests for compression $?

A 
- xray
  \+ step defect
  \+ wedge deformity
  \+ linear zone of condensation
  \+ endplate distruption
  \+ paraspinal swelling
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144
Q

Etiology of lateral canal stenosis?

A
  • disc nucleus protrudes posterolaterally into the extradural space
  • compresses on the nerve root
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145
Q

SS of lateral canal stenosis?

A
  • pain in dermatomal distribution of the cord being compressed
  • worse on movement
  • agg by:
    + valsava
  • numbness or parasthesia in dermatomal distribution
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146
Q

Tests for lateral canal stenosis?

A
  • hypo reflexia when test DTR
  • weak flaccid muscles
  • SLR
  • CT
  • MRI
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147
Q

Treatment for lateral canal stenosis?

A

SMT, with little to no rotation

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148
Q

Etiology of Lumbosacral spine sprain/strain?

A
  • muscle contraction during a forcedull muscular stretch

- uisually occurs with lateral bending and flexion or lateral bending and rotation

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149
Q

SS of lumbosacral sprain/strain?

A
  • pain in the L/S area that is local
  • ROM mostly flexion is painful and reduced (AROM and RROM painful, PROM pain free)
  • pain worse w/ movement
  • muscle spasm w/ palpation
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150
Q

Management of lumbosacral sprain/strain?

A
  • reduced inflam
  • PRICE
  • Painfree ROM
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151
Q

Etiology of metastaic tumours to the brain or spine?

A
  • cancer cells migrate through lymph, blood or CSF
  • grow outside of the dural matter
  • mets from breast, prostate lungs and kidney are common
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152
Q

SS of metastatic tumours to the brain and spine?

A
  • persistent pain
  • worse at night
  • no mechanical aggrevation or relief
  • unplanned weight loss
  • excessive fatigue
  • worse w/ standing, lifting heavy objects
  • bed rest sometimes alleviates pain but gradually worsens
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153
Q

Tests for mets?

A
  • xray
  • CT
  • MRI
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154
Q

Etiology of myofascial trigger point of the Piriformis?

A
  • sciatic nerve can be compressed by the piriformis muscle ( piriformis syndrome)
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155
Q

SS of myofascial trigger point of the piriformis?

A
  • pain w/ resisted external rotation of hip

- palpation over the piriformis causes referal down back of the leg

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156
Q

Etiology of myofascial trigger point of the psoas?

A
  • shortening of the psoas which is a hip flexor, causing an increase in the lumbosacral angle and increasing the lumbar lordosis
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157
Q

SS of Myofascial trigger point of the psoas?

A
  • pain at the T/L
  • sometimes reffered to the knee
  • pain releived by sitting
  • patient present as being flexed forward
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158
Q

Tests for myofascial trigger point of the psoas?

A
  • Thomas Test
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159
Q

Etiology of Myofascial pain of the QL?

A
  • QL originates on the TVP of the lumbar vertebrae and inserts onto the ilac crest
  • serves to raise hip
  • QL trigger points refer into the low back, hips, butt and groin, common cause of LBP
  • weak abdonminal muscles causing overcomrensation by the QL
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160
Q

Etiology of primary low back tumours?

A
  • originate in the lumbar spine
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161
Q

SS of primary low back tumours?

A
  • radiating pain
  • loss of muscle function
  • unexplained weight loss
  • pain unrelated to activity
  • fatigue
  • chronic productive cough
  • night pain
  • smoker
  • unremitting pain
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162
Q

Types of Prostatitis?

A
  • Acute bacterial
  • chronic bacterial
  • chronic nonbacterial
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163
Q

SS of acute bacterial protatitis?

A
  • chills
  • fever
  • increased urinary frequency and urgency
  • peroneal and low back pain
  • dysuria
  • nocturia
  • hematuria
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164
Q

SS of chronic bacterial prostatiTIS?

A
  • relapsing UTI*
  • low back and peroneal pain
  • increased urinary urgency and frequency
  • painful urination
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165
Q

SS of chronic nonbacterial prostatitis?

A
  • more common than bacterial

- same as chronic but no history of UTI and no culture found on test

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166
Q

SS of Reiters (reactive arthritis)?

A
  • young male
  • LBP after
    + urethritis (burning on urination)
    + conjuntivitis
  • can’t see cant pee cant dance
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167
Q

Etiology of reiters syndrome (reactive arthritis)?

A
  • seronegative arthopathy following an infection
  • chlamydia
  • salmonella
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168
Q

Tests for Reiters syndrome?

A
  • conjuntivitis
  • mucocutaneous lesion on the tongue, palate, penis or foot
  • urethritis that is unresponsive to antibiotics
  • arthritis affecting SI, knee and ankles asymetrically
  • increase in ESR
  • increase in HLA- B27
  • on xray
    + unilateral narrowing and erosion of SI joint
    + sausage finger or toes because of the swelling
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169
Q

Treatment for Reiters?

A
  • refer

- SMT contra

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170
Q

Etiology of Sacroiliac joint dysfunction?

A
  • in younger patients
  • pregnancy
  • DDD
  • prolonged or sudden lifting or bending
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171
Q

SS of sacroiliac joint dysfunction?

A
  • pain over lower back
  • pain over unilateral SI joint after straightening from a stooped position
  • pain radiates down the back of the leg
  • pain relieved by sitting or lying
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172
Q

Tests for sacroliiac joint dysfunction?

A
  • compression of the SI
  • Ganslen’s
  • Gillets
  • conisder reiters if can’t see pee dance
  • consider AS if significant decrease in forward flexion
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173
Q

Treatment of Sacroiliac joint dysfunction?

A
  • SMT

- exercise

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174
Q

What are the seronegative spondyloarthopathies?

A
  • reiters
  • psoriatic
  • enteric
  • AS
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175
Q

SS of psoriatic arthritis?

A
  • psoriatic lesion on the extensor surfaces
  • pitting of nails
  • dry red silvery scaly rash
  • distal interphalangheal joint affected*
  • asymettrical involvement of joint
  • xray
    + sausage digits
    + mouse ears –> reabsorption of the terminal phalanges
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176
Q

SS of seronegative spondyloarthropathies?

A
  • young male
  • 20 - 40
  • intermittent inflmmation
  • back pain
  • worse at night
  • radiation of pain into the buttocks, anterior or posterior thigh
  • early mornming stiffness
  • stooped posture
  • anemia
  • loss of apetite
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177
Q

Tests for seronegative spondyloarthopathy?

A
  • chronic back pain
  • stiffness
  • global decrease in ROM
  • schober test
  • xray
    + SI changes (pseudowidening, erosions, sclerosis)
    + trolley track appearcne w/ AS
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178
Q

Treatment for seronegative spondyloarthropathy?

A
  • SMT- only in remssion periods
  • stretching
  • exercise
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179
Q

Etiology of lateral spinal stenosis?

A
  • bony or tissue encroachment
  • congenital or aquired
  • conmgenital predisposition is short pedicles
  • calcified ligamentum lavum
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180
Q

SS of spinal stenosis?

A
  • over 50
  • leg and back pain
  • unilateral opr bilater based off lateral or cental stenosis
  • onset of leg pain w/ walking that reduces after rest or maintaing a stooped posture
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181
Q

Tests for Spinal stenosis?

A
  • bicycle or walk test: to diff b/w vascular or neurogenic claudication
  • when stooped the pain remitis b/c IVF opens up in this posture
  • MRI
  • CT
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182
Q

Treatment for spinal stenosis?

A
  • improve or remain stable w/out treatment
  • if severe neuro deficit do surgery
  • flexion distraction is good
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183
Q

Etiology of Spondylolisthesis?

A
  • Isthmic b/c stress fracture of pars usually at L5

- in gymnists that do repetivitive hyper extensioin

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184
Q

SS of spondylolisthesis?

A
  • young = isthmic
  • older = degenerative
  • LBP worse w/ extension
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185
Q

Tests for spondylolisthesis?

A
  • xray lateral
  • increased back or leg pain with one leg test
  • increased pain w/ hyperextension
  • palaption find step defect, or more prominent sp at the level of the spondy
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186
Q

Treatment of spondylolisthesis?

A
  • grade 1 can SMT

- grade 2 or 3 refer

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187
Q

Etiology of UTI?

A
  • dependent on age and gender

- most commonly caused by gram-negative aerobic bacteria

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188
Q

SS of UTI?

A
  • increased urinary frequency and urgency

- painful urination =dysuria

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189
Q

Tests for UTI?

A
  • urinanalysis
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190
Q

Treatment for UTI?

A
  • cranberry juice

- antibiotic treatment

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191
Q

Etiology of avlusion fracture of the anterior superior iliac spine?

A
  • adolescent athletes
  • occurs at apophysis
  • caused by the sartoris muscle
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192
Q

SS of avulsion fracture of the anterior superior iliac spine?

A
  • sudden acute pain near the ASIS during athletic activity
  • local swelling
  • increased pain w/ hip and trunk movement
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193
Q

Tests for avulsion fracture of the ASIS?

A
  • pain w/ ROM, especially abduction and flexion
    • Thomas Test
    • gaenslens buit pain at hip not SI
  • xray
    + see callous formation during healing phase
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194
Q

Treatment of avulsion fracture of ASIS?

A
  • Acute: PRICE, NSAIDs

- After 48 hrs: ice, massage, tens, ifc, us

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195
Q

Etiology of bursitis?

A
  • bursae protects the points of friction b/w muscle and tendons and tendon and bone
  • can be injured by trauma
  • deep bursa injury b/c repetitive motions
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196
Q

What are the different shoulder bursa?

A
  • subacromial

- subdeltoid

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197
Q

What are the different hip bursa?

A
  • subtroachanteric
  • iliopectineal
  • ischial
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198
Q

What are the different knee bursa?

A
  • pre patella
  • infrapatella
  • sub patellar
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199
Q

What are the elbow bursa?

A
  • olecronon
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200
Q

SS of Bursitis?

A
  • pain in all AROM
  • swollen and hot
  • RROM painfull
  • patient is acute
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201
Q

Test for bursitis?

A
  • All ROM in different motion
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202
Q

Etiology of Degenerative joint disease?

A
  • progressive degeneration
  • loss of articular cartilage
  • joint margin changes
  • weight bearing joint, pips, dips, and shoulder or elbow joint are commonly affected
  • women get OA of hand
  • men get OA of Hip
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203
Q

SS of Degenerative joint disease?

A
  • HX of trauma or repetitive minor trauma
  • stiffness and joint pain
  • decreased ROM
  • gradual onset
  • short period of morning stiffness
  • heberden’s nodes at the DIPs
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204
Q

Tests for DJD?

A
  • crepitus and pain during passive ROM
  • xray
    + non uniform joint space loss
    + osteophytes
    + subchondral sclerosis
    + joint mice
    + facet arthrosis
    + loss of disc neight
    + subchondral sclerosis
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205
Q

Treatment for DJD?

A
  • SMT if tolerated
  • pain management:
    + rest
    + hot packs
    + meds
    + traction
  • weight loss, exercise
  • surgery if severe
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206
Q

Etiology for hip dislocation?

A
  • in MVA or contact sport

- Anterior or posterior

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207
Q

Etiology for anterior hip dislocation

A
  • hip flexed, leg abducted and externally rotated
  • common in sport where running and high speed and have to land with flexed knee
  • femoral head comes out of the head anteriorly causing fracture and tearing potential illiofemoral and pubofemoral ligaments
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208
Q

Etiology for psoterior hip dislocation?

A
  • 80% of hip dislocations are posterior
  • forces strikes flexed knee while hip is flexed adducted and interally rotated
  • running player tackled and falls onto a flexed knee
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209
Q

SS of posterior hip dislocation?

A
  • severe hip pain inn hip region and upper leg
  • inability to walk or do hip ROM
  • sometimes numbness and tiungling in the legs
  • affected limb of posterior hip dislocation appears shortened, internally rotated and adducted
  • superior dislocation: hip extended and externally rotated
  • inferior: hip flexed, abducted and externally rotated
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210
Q

Tests for hip dislocation?

A
  • xray

- CT

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211
Q

Treatment for hip dislocation?

A
  • refer
  • PRICE
  • post 7 days rehab
  • if neuro complications, surgery
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212
Q

Etiology of femoral neck fracture?

A
  • severe fall or MVA

- osteoporosis = most common cause

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213
Q

SS of femoral neck fracture?

A
  • pain in hip, buttock or pubic area
  • affected leg shortens
  • hip brusing
  • toe in on affected leg
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214
Q

Etiology of Fibromyalgia?

A
  • > Femals

- b/w 20 - 25

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215
Q

SS of Fibromyalgia?

A
  • chronmic diffuse pain
  • poor sleep
  • multiple somatic complaints
  • minimum 3 months duration
  • fatigue and poor sleep
  • morning stiffness
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216
Q

Tests for fibnromyalgia?

A
  • everything normal

- multiple tender points: atleast 11/18

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217
Q

Treatment for fibromyalgia?

A
  • SMT
  • Heat
  • massage
  • meds
  • excercise*
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218
Q

Etiology of iliotibialband contracture (ITB syndrome)?

A
  • gradual lateral knee pain that starts over ina few day to weeks
  • associated w/ running, downhill aggrevating b/c heel strike
  • ITB rubs against lateral femoral condyle
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219
Q

SS of ITB syndrome?

A
  • tender lateral femoral condyle
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220
Q

Tests for ITB syndrome?

A
  • Nobel’s Compression test
    + pressure on the distal ITB while extending the knee from flexed position
  • ober’s test
    + let the side lying patient leg fall behing them, if above table then ITB syndrome
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221
Q

Treatment for ITB syndrome?

A
  • stretching

- myofascial relase

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222
Q

Etiology for inguinal hernia?

A
  • bulging of organ through abnormal opending

- can be forced through the inguinal cannal

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223
Q

What is a direct inguinal hernial?

A
  • weakness in the floor of the inguinal canal lets herniation occur
  • in men >40
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224
Q

What is an indirect inguinal hernia?

A
  • most common

- herniation through the internal inguinal ring

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225
Q

SS of inguinal hernia?

A
  • lump in the groin near the thigh
  • pain in the groin
  • partial or complete blockage of the intestine
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226
Q

Tests for inguinal hernia?

A
  • auscultate scrotum for bowel sounds
  • swelling in the inguinal region when the patient cough
  • palation
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227
Q

Treatment for inguinal herina?

A
  • can usaully reduce on its own but refer to sdoc

- surgery to repair opening in the muscle or if the hernia is stragulated causing bowel obstruction

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228
Q

Etiology of Juvenile rheumatoid arthritis?

A
  • ages 16 or under

- = autoimmune

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229
Q

SS of Juvenile RA?

A
  • persistent joint swelling
  • pain
  • stiffness, worse in morning
  • systematic onset in 20% of patietns
    + affects one joint and organs
    + high fever
    + rash
    + splenomegaly
    + adenopathy
    + RF and ANA absent
  • Pauciarticular onset 40%
    + 4 or less joints
    + young girls
    + ANA
    + boys develop other spondyloathopathy
  • polyartcular
    + 5 or more joint
    + complete remssion
    + no RF
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230
Q

Tests for juvenile RA?

A
  • RF
  • increased esr
  • ANA
  • xray
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231
Q

Treatment of Juvenile RA?

A
  • if + RF then prognosis is poor

- refer to md for testing

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232
Q

Etiology for Leg-Calve-Perthes disease?

A
  • AVN of adolescent femoral head
  • most common osteochondroses
  • occurs b/w 5 and 10, usually unilateral
  • secondary to other condition
  • self limiting
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233
Q

SS of Leg-Calve-Perthes disease?

A
  • pain in the hip
  • gait disturbance
  • gradual onset and slow progression
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234
Q

Test for Leg-Calve-Perthes disease?

A
  • decreased hip abduction and internal rotation**
    • trendelemberg
  • xray
    + flat femoral head (mushroom cap deformity)
    + fragmentation of the femoral head (snow cap deformity)
    + head contains areas of lucency and sclerosis
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235
Q

Treatment of Leg-Calve Perthes?

A
  • comange with ortho
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236
Q

Etiology of Lumbar disc herniation?

A
  • commonly at L4/L5 and L5/S1

- spontaneously resolve within 6 months

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237
Q

SS of Lumbar disc herniation?

A
  • sudden onset of LBP and potential leg pain past the knee
  • dermatomal pattern
  • agg by, increase in intradiscal pressure
  • weakness in muscle
  • decreased sensation in dermatomal pattern
  • hyporeflexia when testing DTRs
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238
Q

Tests for lumbar disc herniation?

A
  • decreased ROM
    • SLR
    • kemps for referal
  • MRI
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239
Q

Treatment for lumbar disc herniation?

A
  • SMT, refer if not reponsive in 6 weeks
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240
Q

Etiology of MEralgia Paresthetica?

A
  • L2-3 ventral rami (lateral femoral cutaneous nerve)
  • uncommon excpet w/ pregnancy and obesity
  • trauma to groin area where nerve passes ASIS near the inguinal ligament
  • prolonged rest or standing can cause compression
  • prlonged hip extension or flexion can also cause compression
  • sometimes iatrogenic from surgery
  • sometimes an inguinal hernia can cause the compression
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241
Q

SS of meralgia paresthetica?

A
  • paresthesia over lateral thigh
  • no motor loss
  • decreased light touch
  • increased pin prink
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242
Q

Tests for meralgia paresthetica?

A
  • Tinel’s tap near the ASIS
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243
Q

Treatment of meralgia paresthetica?

A
  • chiro care

- reduced casuing factors = obesity, posture or ergonomics

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244
Q

Etiology of myofascial trigger point of the gluteus medius muscle?

A
  • hypersensitive area or band of muscle that refers pain

- usually because of constant state of contracture (HT)

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245
Q

SS of myofascial trigger point of the gluteus medias muscle?

A
  • tenderness and hypersensitivity of the gluteus medias muscle
  • referal-> into low back and the thigh
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246
Q

Treatment for myofascial trigger point of the gluteus medius muscle?

A
  • Stretch

- release trigger point

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247
Q

Etiology of Myofascial trigger point of the psoas muscle?

A
  • HT of muscle
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248
Q

SS of myofascial trigger point of the psoas?

A
  • tenderness of the psoas muscle

- refer to low back, upper gluteal, upper anterior thigh

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249
Q

Treatment for myofascial trigger point of the psoas?

A
  • massage
  • stretch
  • release trigger point
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250
Q

Etiology of Osteomyelitis?

A
  • infection of the bone and bone marrow
  • caused by many microorganisms
    + s aureus
    + streptococci
  • recent compromise in the skin
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251
Q

SS of osteomyelitis?

A
  • bone pain
  • high fever
  • formation of an abscess at the site of infection
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252
Q

Tests for osteomyelitis?

A
  • culture
  • biopsy
  • xray
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253
Q

Treatment for osteomyelitis?

A
  • refer for antibiotic treatment
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254
Q

Etiology for Paget’s disease?

A
  • osteitis deformans
  • localised areas of bone become hyperactive and relax the normal matrix with softened enlarged bone
  • > 40
  • > m
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255
Q

SS of Paget’s?

A
  • asymptomatic
  • insidious
  • pain
  • stiffness
  • fatigability
  • bone deformity
  • HA
  • decreased hearing
  • increasing skull size
  • bone ache very deep, worse at night
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256
Q

Tests for Pagets?

A
  • xray
  • elevated alkaline phosphatase*
  • increased urinary excretion of pyrinoline cross-links
  • serum calcium and phosphorus levels are usually normal
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257
Q

Treatment for Pagets?

A
  • chiro for non serious pain

- MD for emds to control the proliferation of bone

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258
Q

Etiology of piriformis syndroime?

A
  • irritation of the sciatic nerve due to piriformis contracture or spasm
  • mechanical or chemical irriation of the nociceptiors
  • causing paresthesia
  • can be b/c
    + trauma
    + vascular ischemia
    + tight external rotators
    + overuse
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259
Q

SS of piriformis syndrome?

A
  • leg length inequality
  • decreased internal rotation of the hip
    decreased adduction of the hip
  • foot external rotation
  • SI joint fixation
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260
Q

Tests for pirifomis syndroim?

A 
- palation
 \+ reproduce referal
- +SLR, bonnets
- + Hibbs and piriformis test
- (-) nafzinger and valsalva test 
- normal DTR
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261
Q

Treatment for piriformis syndrome?

A
  • stretch

- trigger point release

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262
Q

Etiology of poliomyelitis?

A
  • polio infection
  • fecal oral route
  • to CNS where it causes lesion of the gray matter
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263
Q

SS of minor polimyelitis?

A
  • recovery within 24 -72 hrs
  • fever
  • HA
  • stiff neck
  • sore throat
  • vomiting
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264
Q

SS of major poliomyelitis?

A
  • fever
  • HA
  • stiff neck and back
  • deep muscle pan
  • decreased DTR and muscle weakness
  • hyperesthesia
  • paresthesia
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265
Q

Tests for poliomyelitis?

A
  • asymetric flaccis limn paralysis without sensory loss

- spinal tap to check CSF

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266
Q

Treatment of polio?

A

refer and comange w/ physical therapy to keep the joint moving

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267
Q

Etiology of psoas tendonitis?

A
  • tendonitis = inflamation of a tendon
  • tenosynovitis = inflamation of a tendon sheath
  • occurs in middle aged or older people
  • repeated trauma, strain or excess exercise
  • ass w/ RA, systemic sclerosis, gout, diabetes, reiters
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268
Q

SS of Psoas tendonitis?

A
  • painful on hip/trunk flexion

- swollen

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269
Q

Test for psoas tendonitis?

A
  • calcium deposit on xray

- painful AROM

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270
Q

Treatment for psoas tendonitis?

A
  • rest or immobilisation for acute relief (2 - 3 days) + PRICE
  • NSAIDs for 7 - 10 days
  • corticosteroid injection`
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271
Q

Etiology of Septic (Pyogenic) Arthritis?

A
  • inflamation of joint caused by pyogenic microorganisms = painful and hot
  • Acute infection
    + 95 % neisseria gonorrhoeae = most common
    +nongonncoccal arthrits usualy staph sureus
  • Chronic infectious arthritis
    + myobacterium
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272
Q

SS of septic arthritis?

A
  • fever
  • painful swollen joints
  • decreased ROM
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273
Q

Tests for septic arthritis?

A
  • increased WBC, ESR and C-reactive protein
  • refer for joint aspiration for culture
  • xray
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274
Q

Treatment of septic arthritis?

A
  • refer antibiotics
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275
Q

Etiology of Rheumatic fever w/ monoarthritis of the hip?

A
  • affects children b/w 4 and 18
    after a streptococcal infection
    + tonsilitis
    + pharyngitis
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276
Q

SS of Rheumatic fever with mono arthritis of the hip?

A
  • recent ilness or infection
  • systemic illness
  • tenderness and inflammation around joints*
  • fever
  • jerky movements
  • nodules under the skin
  • skin rash
  • sometime heart or valve inflamation can result in scarring of valves = stenosis
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277
Q

Tests for Rheumatic fever?

A
  • increased ESR and C-reactive protein

- abnormal ECG

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278
Q

Treatment for Rheumatic fever?

A
  • penicilin
  • salicyates
  • steroids
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279
Q

Etiology of RA?

A
  • chronic acute inflammatory disease
  • > F
  • 20 - 50
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280
Q

SS of RA?

A
  • symmetrical joint pain and swelling
  • fever
  • fatigue
  • polyarthritis
  • deformities of hand and wrist
    + swan neck and boutonneire deformity
  • bouchard nodes at PIP, never affects the DIPs
  • ulnar deviation of the wrist
  • can affect the cervical region
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281
Q

Test for RA?

A
  • RH factor
  • increased ESR
  • antinuclear antibodies (ANA)
  • xray
    + bilateral symmetry
    + marginal erosion
    + uniform joint space loss
  • C1 2 subluxation
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282
Q

Treatment for RA?

A
  • contraindication for cervical SMT

- adjust, soft tissue, remmber no cure

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283
Q

Etiology of sacroiliac joint dysfunction?

A
  • pregnancy
  • leg length inequality
  • trauma
  • ligament laxity
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284
Q

SS of sacroiliac dysfunction?

A
  • Low back or SI joint pain
  • worse when sitting or weight bearing
  • fell stiffness
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285
Q

Tests for sacroiliac dysfunction?

A
  • Si compression
  • yeomans
  • gaenslens
  • gillettes
  • faber
  • xray negative
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286
Q

Treatment for sacroiliac dysfunction?

A
  • chiro

- massage

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287
Q

Etiology for segmental radiculopathy?

A
  • herniated disc

- muscular entrapment

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288
Q

SS of segmental radiculopathy?

A
  • radicular pain
    ventral root = motor weakness and muscle atrophy
  • dorsal root = sensory changes in dermatomal distribution
  • DTR dimminished
  • pain aggrevated by moving spine, coughing, sneezing, valsalva
  • muscle stretches can agg the pain
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289
Q

Test for segmental radiculopathy?

A
  • xray
  • CT
  • SLR
  • increased thecal pressure
  • musc wasting
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290
Q

Treatment for segmental radiculopathy?

A
  • muscle relaxant
  • surgical decompression
  • chiro treatment, mobilisation, cervical traction
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291
Q

Etiology of Slipped capital femoral epiphysis?

A

growth plate of the femoral head slipps back and inward

  • results b/c deformity of the ball and socket = limitation of moevment
  • most common cause for limp in kids
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292
Q

SS of SCFE?

A
  • limited ROM
  • limp
  • decreased internal rotation*
  • > boys
  • slippage 12-15
  • sometimes bilateral
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293
Q

Tests for SCFE?

A
  • xray frog leg
    + see that the femoral head is below klein’s line: line at the superior part of the fenmoral neck intersects the femoral head, if it doesn’t this indicated SCFE
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294
Q

Treatment for SCFE?

A
  • surgery
295
Q

Etiology of thrombophlebitis (DVT)?

A
  • inflammation of a vein ass. w/ blood clot formation
  • usually in the legs or pelvis
  • occurs in patients reovering from child birth, surgery or prolonged bed rest
  • oral contraceptives predisposes females to this
  • clot in the leg can dislodge and cause blockage in the lung = pulmonary embolism
296
Q

SS of thrombophlebitis?

A
  • pain and swelling in the posterior calf

- prolonged period of bedrest or position where stasis of blood may occur

297
Q

Test for Thrombophlebitis?

A
  • homans test

- diagnostic ultrasound

298
Q

Treatment for Thrombophlebitis?

A
  • anticoagulant therapy (warfarin, herparin)
299
Q

SS of ALS?

A
  • progressive muscle weakness and atrophy
  • signs of anterior horn dysfunction seen inhand first
  • site of onset is random, progression is asymettrical
  • fasiculation and UML signs
300
Q

SS of Aneurysmal Bone cyst?

A
  • benign usualy before 30
  • metaphsysi of long bone
  • xray
    + well circumsribed, eccentric, periosteal bulging
301
Q

Treatment of ABC?

A
  • surgical removal of lesion

- get xray and refer

302
Q

SS of angina?

A
  • precipitated by exertion and relieved by rest or sublingual nitroglycerine
  • lasts usually less than 30 mins
303
Q

SS of Bicipital tendonitis?

A
  • tenderness over the proximal bicipital groove of the humerus,
  • resisted supination and flexion is painful
  • yergasons, resisted supination and flexion
  • speeds, 90 deg shoulder flexion + elbow extension, resist extension force applied to forearm
304
Q

SS of lateral epicondylitis?

A
  • lateral elbow pain (tennis elbow)
  • repetitive tearing of extensor carpi radialis brevis tendon and extensor carpi radialis longs
  • repetitive wrist extension, radial deviation and supination
  • cozen’s: arm pronated wrist radially deviated and extended, resist flexion
  • mills: pronation, extension of arm and flexion of the wrist, while palp epicondyle,
305
Q

Etiology of ITB sprain/strain?

A
  • ITB rubs against the lateral epicondyle of the femur
  • worse with running (downhill bad b/c heel strike)
  • hyper pronation is bad for it as well
306
Q

SS of ITB sprain/Strain?

A
  • insidious onset of lateral knee pain
  • agg w/ downhill running
  • pain with leg extension
307
Q

Tests for ITB sprain/strain?

A
  • lateral epicondyle palpation*

- nobels test, applying pressure ar various degress of flexion and extension

308
Q

SS of popliteal tendonitis?

A
  • insidious onset lateral knee pain
  • agg by
    + downhill running
    + walking
  • popliteal muscle allow internal rotation of the leg and pull the posterior lateral meniscus back during knee flexion
309
Q

Tests for popliteal tendonitis?

A
  • Tenderness at insertion point of distal femur, just anterior to the LCL*
  • tenderness can also be found behind the LCL
  • pain w/ resisted internall rotation mostly when combined with 30 deg of knee flexion
  • foot may be hyperpronated
310
Q

Treatment for popliteal tendonitis?

A
  • adjust areas around to improve function
  • PRICE
  • pain free ROM
311
Q

Etiology of fibular head fixation?

A
  • sudden onset of lateral knee pain
  • usually after sudden dorsiflexion or plantarflexion injury at the ankle
  • hamstring curls the biceps femoris draws the fibular head posteriorly leading to fixation
312
Q

SS of fibular head fixation?

A
  • tender over proximal fibular head
  • peroneal nerve impingment potential
  • ankle involvement*
  • agg by
    + leg curls (hamstring)
  • forced dorsiflexion = pain
  • hurts with running, tennis, squash
313
Q

Etiology of lateral collateral ligament tear?

A
  • severe varus stress*

- accompanied by a lateral meniscus injury

314
Q

Etiology of patellar #?

A
  • anterior knee pain after trauma
  • knee hitting dashboard in a car accident
  • usually comminuted
315
Q

Test for Patellar #?

A
  • xray

- pain localized over the patella

316
Q

Etiology for patellofemoral syndrome (runner’s knee(?

A
  • anterior knee pain
  • b/c running
  • b/c going up and down steps and sitting for long periods of time
  • tracking disorder of the patella b/c weak VMO
317
Q

SS of patellofemoral pain syndrome?

A
  • insidious onset
  • crepitus when squat
  • pain going up stairs or running
  • iritation tot he infrapatellar fat pad
318
Q

Test for patellofemoral pain syndrome?

A
  • palpation and auscultation of the patella as it undergoes ROM
  • if pain only at the bottom of ROM most probably meniscus not PFPS
  • chronic overpronation
319
Q

Etiology of Chondromalacia Patella?

A
  • not a tracking disorder (VMO is normal)
  • decrease in patellar cartillage
  • history of patellar injury
320
Q

SS of chondromalacia patella?

A
  • insidious
  • crepitus when squat
  • pain with running prolonged sitting, going up stairs
321
Q

Tests for chondromalacia patella?

A
  • xray if management for PFPS is not working
322
Q

Etiology of Patellar tendonitis (jumper’s knee)?

A
  • anterior knee pain w/ jumping or sprinting

- occurs b/c of repetitive stress

323
Q

SS of patellar tendionitis?

A
  • anterior knee pain with jumping or running
324
Q

Tests for patellar tendonitis?

A
  • pain at patellar tendon or tibial tuberosity

- resisted extension beyong 90 deg is painful*

325
Q

SS of Osgood-Schlatter’s disease?

A
  • young athlete
  • pain and swelling at tibial tuberosity
  • resisted extension painful
326
Q

Etiology of Osteochondritis Disicans?

A
  • anterior knee pain and crepitus
  • usually occurs at the lateral femoral condyle
  • caused by squating, running and rising from a seated position
  • condyle fragement in the joint space
327
Q

SS of osteochondritis dissecans?

A
  • locking of the knee with a feeling of instability
  • agg by
    + squating
    + running
    + rising from a seated position
  • anterior knee pain
328
Q

Treatment of osteochondritis dissecans?

A
  • refer for surgery
329
Q

Etiology of pes anserine bursitis?

A
  • near the proximal medial tibia
  • conjoined tendons of sartorius, gracilis and semitendinosus, lies superficial to the MCL
  • diabetic, older, overweight
330
Q

SS of pes anserine bursitis?

A
  • insidious onset of pain anterior medially in the knee
  • pain on knee flexion*
  • painful resisted external rotation and internal rotation
  • exaccerbated by walking up and down stairs
331
Q

Etiology of Plica syndrome?

A
  • chronic overuse of the knee from embryonic dividers in the knee
  • mediopatellar plica most commonly involved
    similar to pes anserine pain
332
Q

SS of plica syndrome?

A
  • clicking
  • snapping
  • occasionaly giving way
  • anterior medial pain
  • ## aggrevated by prolonged standing, squatinng, sitting or stair climbing
333
Q

Tests for plica syndrome?

A
  • taut band on the medial peripatellar region reproducing pain *
334
Q

osgood schlatter vs patellar tendonosis?

A

• Is there tenderness directly anterior and posterior to the patella. Is there pain on extension? If this is an adolescent athlete, select O-S, otherwise, patellar tendinosis.

335
Q

Etiology of baker’s cyst?

A
  • popliteal cyst
  • fluid distension of gastrocnemio-semimebranosus bursa
  • joint effsion displaced into this cyst as a prtective mechanism
336
Q

SS of backer’s cyst?

A
  • popliteal swelling
  • bowstrings test
  • posterior knee pain
337
Q

Treatment of backer’s cyst?

A
  • refer for drainage
338
Q

Etiology of MCL tear?

A
  • valgus stress injury
339
Q

Test for MCL injury?

A
  • valgus stress tests at different degrees of flexion
340
Q

Etiology of an ACL tear?

A
  • pop during an injury
  • anterior force causing anterior slippage of the tibia on the femur
  • twisting motions w/ deceleration
    + skiers
    + football
    + basketball
    + soccer
  • flexed knee gets a valgus load with internal rotation of the tibia
341
Q

Tests for ACL tear?

A
  • lachman test: knee 30 deg of flexion and pulled forward to see if anterior displacement
  • anterior draer test: knee at 90 and anterior draw
  • slocum test
  • MRI
342
Q

Etiology of compartment syndrome?

A
  • exertional compartment syndome seen mostly in athletes b/c increased exercise
  • blunt trauma to the leg can also cause an increase in the pressure
343
Q

SS of compartment syndrome?

A
  • ache in the leg 10 - 30 mins post exercise

- redness

344
Q

Treatment for compartment syndrome?

A
  • PRICE

- if trauma, care doesn’t work, or professionaol athlete refer

345
Q

Etiology of dislocated patella?

A
  • a young athlete with weak VMO, undergos trauma where the patella will displace laterally
  • high school football
346
Q

Etiology of meniscal tear?

A
  • due to rotational injury, usually accompanies ACL and MCL injury
347
Q

SS of meniscal tear?

A
  • swelling
  • knee locking untill patient reaches full extension
  • knee giving way
348
Q

Tests for meniscal tear?

A
  • medial joint line tenderness
  • McMurray’s
  • apleys
  • basically compression + rotation to mimic the injury
  • use MRI
349
Q

Treatment for meniscal tear?

A
  • PRICE, painfree ROM, strenghten, ADL, proprioception, Return to sport
350
Q

Etiology of PCL tear?

A
  • resists posterior translation of the tibia on the femur

- blow to the anterior tibia when the knee is flexed

351
Q

SS of PCL tear?

A
  • lack of pain
  • posterior drawer test
  • revere lachman test
  • hughston’s test
  • sag sign
  • bounce home test
352
Q

Etiology of osteosarcome?

A
  • 3rd most common primary bone tumour
  • b/w 10 -25
  • > M
353
Q

SS of osteosarcoma?

A
  • pain with activity
  • limp
  • site of tumour has swelling, redness and heat
354
Q

Etiology of suppurative osteomyelitis?

A
  • due to staph aureus
  • invades bone via hematogenous spread, post operative or puncture wounds
  • age 2 - 12, >M
355
Q

SS of suppurative osteomyelitis?

A
  • fever
  • chills
  • pain
  • swelling
  • prior infection
356
Q

Etiology of osteomyelitis?

A
  • infection of the joint
357
Q

SS of osteomyelitis?

A
  • tenderness and pain in the joint
358
Q

Etiology of Leukemia?

A
  • malignant disease of the bone marrow and blood b/c proliferating WBCs
  • most common = acute form in kids
  • b/w 2 - 5 yrs
359
Q

SS of Leukemia?

A
  • generalized joint pain
  • weakness
  • lethargy
  • xray
    + osteopenia of long bone
    + raindrop skull
360
Q

SS of growing pains?

A
  • diagnosis of exclusion
  • ages 2 - 5 and 10 - 12
  • intermittent pain
  • more muscular pain
361
Q

Etiology of Juvenile RA?

A
  • from 2 - 12
  • seronegative
  • autoimmune
362
Q

SS of Juvenile RA?

A
  • high fever
  • rash
  • uveitis
  • pericarditis
  • flare up = stills disease
  • must rule out lyme disease
  • symmettrical distribution, potential atlantoaxial instability
363
Q

Etiology of OA?

A
  • older patient

- trauma or surgery to knee

364
Q

SS of OA?

A
  • stiffness
  • knee pain, worse w/ prolonged sitting or walking
  • mild swelling
  • progressive bowlegged
365
Q

Etiology of acromioclavicular joint sprain?

A
  • direct trauma from a fall on the superior aspect of shoulder with arm adducted
  • indirect force from FOOSH injury, usually affects the AC ligaments and spares the coracoclavicular ligaments
  • car accident
  • sports injury
  • heavy lifting or pulling
366
Q

Tests for AC joint sprain?

A
  • O’Brien test
  • pain w/ >90 deg abduction
  • pain with passive horizontal adduction
367
Q

Type 1 AC joint sprain?

A
  • AC ligaments sprained,
  • minimal tenderness
  • swelling
  • no displacment
368
Q

Type 2 AC joint sprain?

A
  • AC sprain and slight coracoclavicular sprain

- slight elevation of the lateral clavicle (step off)

369
Q

Tpe 3 AC joint sprain?

A
  • complete AC and coracoclavicular ligament sprain
  • elevated clavicle
  • AC tenderness
370
Q

Management of AC sprain?

A
  • Acute: PRICE

- if grade 3 refer to ortho

371
Q

Etiology of Adhesive capsulitis?

A
  • unknown cause
  • ages 40 - 65
  • > W
  • diabetes
  • prolonged imobilization of arm
  • tendonitis
  • non dominant arm
372
Q

SS of adhesive capsulitis?

A
  • decreased ROM, abduction and external rotation = capsular pattern
  • pain with abduction and external rotation
373
Q

Stage 1 adhesive capsulitis?

A
  • peradhesive
  • gradual onset of painful abduction and external rotation
  • no limited ROM
374
Q

Stage 2 adhesive capsulitis?

A
  • acute adhesive synovitis
  • painful arc
  • decreased ROM
  • constant pain
  • pain decreased with motion
  • muscle atrophy
375
Q

Stage 2 adhesive capsulitis?

A
  • extreme decrease in ROM

- gradual improvement of ROM

376
Q

Etiology of Bicipital Tendonitis?

A
  • inflammation of the tendon sheath surrounding the long head of the biceps
  • b/c repeated overhead throwing activity of lifting
377
Q

SS of Bicipital Tendonitis?

A
  • speeds
  • yergasons: pain and click
  • pain w/ pressure on the bicipital groove and in the biceps muscle belly
  • pop with flexion, abduction and external rotation
  • pain is more anterior
378
Q

Etiology of Breast Cancer?

A
  • carcinoma within the breast duct
  • lobular cancer
  • fam history
  • BRACA gene
  • early menarche late menopause
  • oral contraceptives
379
Q

SS of Breast Cancer?

A
  • non movable lump
  • exaggeration of unusual skin
  • peau d’oragne
380
Q

Etiology of cholecystitis?

A
  • acute inflammation of the gallbladder wall

- response to cystic duct obstuction by cholelithiasis (gallstones)

381
Q

SS of cholecystitis?

A
  • colicky pain
  • sever right upper quadrant
  • radiates to the lower scapular/ shoulder
  • nausea
  • involuntary guarding of the right side
  • gallbladder becomes palpable
  • pain with deep inspiration and right upper quadrant palpation (murphy’s sign)
  • takes 2 - 3 days to resolve
382
Q

Etiology of glenohumeral dislocation?

A
  • direct or indirect injury

- anterior most common, b/c external rotation and extension of humerus

383
Q

SS of glenohumeral dislocation?

A
  • pain

- can’t use arm

384
Q

Etiology of gout?

A
  • peripheral joint arthritis b/c crystal deposition

- usually in the olecranon and in the big toe of foot

385
Q

SS of acute gout?

A
  • no warning
  • minor trauma, purine rich food, alcohol, fatigue, stress
  • monoarticular
  • pain gets woese and more severe
  • swelling, warmth, redness and tenderness
  • big toe is most common
386
Q

SS of chronic gout?

A
  • permanent erosive joint deformity
  • decreased ROM of hand and feet
  • urate deposits in bursae and tendons
  • enlarging tophi
387
Q

Etiology of Myocardial Infarction?

A
  • abrupt redcution of blood flow to part of the myocardium
  • thrombus
  • plaque rupture
388
Q

SS of myocardial infarction?

A

shortness of breathe or fatigue

  • deep substernal pain
  • pressure on the chest ( elephant sitting on chest)
  • radiation to the back, jaw, or left arm
  • similar pain to angina pectoris, but long, not reliefed with rest
  • severe pain
  • restless
  • aprehensive with pale, cool, diaphoretic skin
  • peripheral/central cyanosis
389
Q

Etiology of myofascial trigger point of the subscapularis muscle?

A
  • b/c heavy push motion
  • swimmers often get this injury, leads to instability of the rotator cuff and impingement syndrome
  • bench press
  • push motions
  • popping shoulder
  • throwing
390
Q

SS of myofascial trigger point of the subsacpularis muscle?

A

limited abduction and external rotation

  • local pain
  • pain with pushing
391
Q

Etiology of Pneumonia?

A
  • acute infection of the lung parenchyma, involving alveolar spaces and interstitial tissue
  • caused by bacteria such as S. Pneumoniae = most common
    and H. Influenzae
392
Q

SS of pneumonia?

A
  • previous upper respiratory tract infection
  • sudden shaking chill, if persistent chills = other diagnosis
  • fever
  • pain with breathing on the affect side
  • cough -> purulent and blood streaked
  • dyspnea
  • increased temp 38 - 40 deg
  • increased pulse and respirations to
393
Q

Etiology of Polymyalgia Rheumatica?

A
  • pain and stiffness in the proximal muscle groups w/out weakness of atrophy
  • elevated ESR
  • underlying temporal arthesis (swelli gof blood vessels)
394
Q

SS of polymyalgia rheumatica?

A
  • severe pain the proimal muscle groups
  • pain and stiffness of the neck, pectoral and pelvic girdles
  • morning stiffness
  • systemic complaints: fever, depression, weight loss
395
Q

DDx polymyalgia rheumatic and RA?

A
  • Polymyalgia does not have hjoint synovitis, RH factor or rheumatoid nodules
396
Q

DDX polymyalgia rheumatica and multiple myeloma?

A
  • no monoclonal (plasma) overproduction
397
Q

DDx polymyalgia rheumatica and fibromyalgia?

A
  • systemic features and elevated ESR
398
Q

Etiology of Pulmonary (bronchiogenic) Carcinoma?

A
  • 90% of the primary lung tumours

- most common in 45 - 70 yrs olds that smoke cigarettes

399
Q

SS of pulmonary (bronchiogenic) carcinoma?

A
  • cough with hemoptysis
  • blood streaked sputum
  • horners syndrome: exothalamos, miosis, pitosis, ipsilateral facial anhidrosis
  • pancoast syndrome: pain, numbness, weakness in the affected arm
400
Q

Etiology of rotator cuff strain and tear?

A
  • trauma or activity that injured the supraspinatus (abduction), infaspinatus (abduction and internal rotation), teres minor (external rotation) subscapularis (internal rotation)
  • prolonged or repetitive use of muscle tendon: over head throwing, lifting activites, baseball, football, swimming
  • trauma to shoulder, usually b/c abduction and external rotation
401
Q

Grade 1 rotator cuff strain?

A
  • takes 7 days to 4 weeks to hea;
  • min fibre tearing
  • slight decrease in the strenght
  • min pain
402
Q

Grade 2 rotator cuff strain?

A
  • takes 2 weeks to 3 months to heal
  • partial tearing of the fibres
  • mod pain
  • strength loss
403
Q

Grade 3 rotator cuff strain?

A
  • takes 2 months to 1 yr to heal

- full muscle tear

404
Q

SS of Rotator cuff strain?

A
  • immediate pain
  • popping or tearing sensation at th etime of injury
  • increased shoulder pain with movement, specifically active and resisted ROM
  • decreased strength
405
Q

Etiology of SC joint sprain (dislocation)?

A
  • blow to the acromion of the scapula
  • force transmitted through the pectoral girdle with a FOOSH
  • clavicle can also break
406
Q

Etiology of subacromial bursitis?

A
  • subacromial bursa bound superiorly by coracoacromial ligament and acromion, inferiorly bound by rotator cuff and capsule
  • previous tendonitis, tenosynovitis or inflammatory process in the bone or joint
407
Q

SS of acute subacromial bursitis?

A
  • excrutiating pain w/out relief on repositioning
  • AROM painful
  • pain and limitation on passive abduction and external rotation
  • empty end feel b/c cannot go into full ROM without pain
  • heat
  • swelling
408
Q

SS of chronic subacromial bursitis?

A
  • vague
  • pain after excessive overhead use
  • night pain
409
Q

Etiology of Supraclavicular nerve entrapemnt?

A
  • inn. C3, c4 arising, supplying the supraspinatus and infraspinatus compression in the posterior triangle
410
Q

SS of supraclavicular nerve entrapment?

A
  • numbness and tingling along top and anterior shoulder

- decreased shoulder abduction strength

411
Q

Etiology of SUpraspinatus tendonitis?

A
  • eccentric overload of the supraspinatus
412
Q

SS of Supraspinatus tendonitis?

A
  • pain and weakness on full passive abduction

- painful arc

413
Q

Tests for subacromial impingement?

A
  • neers
  • empty can
  • hawkins kennedy
414
Q

Etiology of syringomyelia?

A
  • fluid filled neuro cavity (thecal sac) in the spinal cord (syringomyelia) or brain (syringobulbia)
  • related to congenital annomilies
  • usually in the cervical area
415
Q

SS of syringomyelia?

A
  • spinothalamic fibres interupted thus decreased pain and temp sensation
  • deficits begin in the fingers then spread
  • cape like sensory deficit over shoulders and bacl
  • corticospinal tract compression = motor involvement, spasticity of the legs
416
Q

SS pf syringobulbia?

A
  • vertigo
  • nystagmus
  • unilateral or bilateral facial sensation im,apirment
  • dysarthia
  • dysphagia
  • horseness
417
Q

Etiology of TOS?

A
  • women b/w 35 - 55
  • compression of the subclavian vessies, lower or medial trunks of thebrachial plexus against a cervical rib, Pec minor HT or HT scalene muscles
418
Q

SS of TOS?

A
  • pain and paresthesia medially in the arms
  • mild or moderate sensonary imapirment in the c8 - T1 dermatomal distribution
  • aching in the supper arm, shoulder and neck
  • waking up in the middle of the night, shake hand to normalize
  • discoloration of the hands
419
Q

Test for TOS?

A
  • adson’s
  • wrights
  • edens
  • east (ROO’s)
420
Q

Etiology of abdominal aortic Aneurysm?

A
  • in L2 - L4 region
  • AAA
  • caused by arthrosclerosis
  • hypertension
  • smoking
  • trauma
  • arteritis
421
Q

SS of AAA?

A
  • deep boring pain when ruture
  • visceral pain in the lumbosacral region
  • abdominal pulsation
  • asymptomatic until rupture
422
Q

Tests for AAA?

A
  • palpation
  • auscultation
  • lateral or ap lumbar films
423
Q

Etiology for Angina Pectoris?

A
  • myocardial ischemia b/c coronary atherosclerosis
424
Q

SS of Angina Pectoris?

A
  • vague ache that becomes sever with exertion
  • felt beneath sternum
  • radiates to the left shoulder and inside of arm
  • agg by exertion, emotional stress
  • relieved by rest, vasodilation of coronary arteries by sublingual nitoglycerin
425
Q

Tests for Angina Pectoris?

A
  • ECG testing
  • stress ECG
  • coronary angiography
426
Q

SS of Asthma?

A
  • recurrent:
  • dyspnea
  • wheezing on inspiration and expiration b/c constriction of the bronchi
  • coughing
  • viscous exercise
  • emotional stress
  • hypertinic accessory musckles of breathing
  • tripod stance
427
Q

Tests for Asthma?

A
  • pulmonary function test

- lung volumes and capacity

428
Q

Treatment for asthma?

A
  • elimination of causitive agent
  • bronchodilators
  • beta-adrenergic drugs
429
Q

Etiology of Bronchitis?

A
  • inflammation of the mucous membranes of the tracheobronchial tree
430
Q

SS of acute bronchitis?

A
  • rpoductive cough
  • fever
  • H/T of mucous secreting structures
  • back pain
  • b/c spread of the URTI
431
Q

SS of Chronic bronchitis?

A
  • excessive mucous production w/ productive cough at least 3 months in at least 2 years
  • frequent chest infections
  • cyanosis
  • hypoxemia
  • hypercapnia
  • cor pulmonale (RSHF)
  • respiratory failure
432
Q

Test for bronchitis?

A
  • clinically
  • pulmonary function test
  • chest xray
433
Q

SS of cervical facet joint syndrome?

A
  • neck and upper back stiffness
  • sharp pain with neck movements
  • absence of arm numbness and weakness
  • sudden onset
  • refered pain
  • decreased ROM
    + kemps for local pain
434
Q

SS of costovertebral dysfunction?

A
  • localised over non- articular rib tubercle posteriorly
  • sharp sudden pain
  • pain on deep inspiration or coughing
  • pain with direct prssure of the T spine
435
Q

Etiology of Cholelithiasis?

A
  • formation of presence of calculi in the gallbladder

- female, fat >40

436
Q

SS of cholelithiasis?

A
  • asymptomatic for long periods of time
  • pain occurs in the right upper quadrant, radiating to the right lower scapula
  • colic is constant
  • nausea
437
Q

Tests for Cholelithiasis?

A
  • ultrasound
438
Q

Etiology of GERD?

A
  • incompetence of the lower esophageal sphincter
439
Q

SS of GERD?

A
  • heart burn w or w/out regurgitation
  • epigastric pain after large meal or when lay down
  • esophagitis, esophageal strictyure
  • esophageal ulcer
  • barret’s metaplasia
440
Q

Treatment for GERD?

A
  • elevated head of bed
  • avoid acid: coffee. alcohol, fat, chocolate
  • avoid antricholeinergic drugs and smoking
441
Q

Etiology of Gastric/Peptic/duodenal ulcer?

A
  • NSAIDs
  • H pylori
  • these disrupt the normal mucosal lining and make it more susceptible to acid
442
Q

SS of gastric/ peptic ulcer?

A
  • eating exacerbates the pain

- burning pain

443
Q

SS duopdenal ulcer?

A
  • epigastric burning pain

- relieved by food, reoccurs 2 -3 hrs after meal

444
Q

Tests for GERD?

A
  • contrast medium endoscopy to rule out stomach cancer
445
Q

Etiology of Hiatal Hernia?

A
  • protrusion of the stomach above the diaphragm
446
Q

SS of Hiatal Hernia?

A
  • chest pain

- GERD

447
Q

SS of intercostal Neuritis?

A
  • unilateral pain, extending in a band like pattern around the chest
448
Q

Etiology of intercostal neuritis?

A
  • idiopathic
  • diabetes
  • herpes zoster
  • osteophytic encroachment
  • rib sublux
449
Q

SS of Kidney Stones?

A
  • sudden severe pain felt over the posterior lower ribs
  • radiates anteriorly into the groin
  • nausea
450
Q

Test for Kidney Stones?

A
  • location of pain
  • urinanalysis w/ hematuria
  • xray showing opacity
451
Q

Etiology of Pancreatitis?

A
  • biliary tract disease

- predisposed by alcoholism and excess fat

452
Q

SS of Pancreatitis?

A
  • fever
  • elevated WBC
  • severe abdominal pain radiates to the back
  • abdominal pain that radiates to the back
  • sitting up and leaning forward reduce the pain
  • coughing, movement and deep breathing accentuate pain
  • nausea
453
Q

Tests for pancreatitis?

A
  • serum amylase and lipase
454
Q

Etiology of Pnemothorax?

A
  • spontaneous in tall people
  • trauma
  • free area in the visceral and the parietal pleura
455
Q

SS of Pneumothorax?

A
  • sudden sharp chest pain
  • dysponea
  • occasionally a dry hackin cough
  • pain refered to the same side shoulder, across the chest of the abdomin
456
Q

Tests for Pneumothorax?

A
  • decreased chest wall motion on the affected side

- increased resonnacnce on percussion, absent tactile femitis

457
Q

Etiology of Pulmonary Embolism?

A
  • blood clot or nitrogen buble blocvking a pulmonary artery, restricting blood flow to lung parenchyma
458
Q

SS of Pulmonary Embolism?

A
  • dysponea
  • sudden chest pain
  • shock
  • cyanosis
459
Q

SS of pulmonary infarction?

A
  • 6 to 24 hrs after formation of embolus
  • pleural effesion
  • hemoptysis
  • leukocytosis
  • fever
  • tachycardia
  • arrhythmia
  • striking distension of the neck veins
460
Q

Etiology of Scheuermann’s disease?

A
  • males
  • 13 -17
  • thoracic spine
461
Q

SS of scheurmann’s disease?

A
  • pain
  • fatigue
  • increased kyphosis
462
Q

Etiology of shingles?

A
  • herpes zoster

- invaded the posterior root ganglion of the thoracic and trigeminal nerves

463
Q

SS of shingles?

A
  • intermittent or constant pain that is superficial or deep
  • fever
  • HA
  • vessicles form leaving that area of skin hypersensitive
  • unilateral
464
Q

SS of Thoracic compression #?

A
  • sudden Thoracic pain
  • hyperflexion, axial compression
  • pathological # if patient is above 50
  • long term corticosteroid use and over 70 suggests compression #
  • pain with percussion and deep pressure
465
Q

Etiology of URTI?

A
  • common cold
  • picornaviruses
  • rhinovirus
  • echovirus
  • coxdakievirus
466
Q

SS of URTI?

A
  • burning in the nose or throat
  • sneezing
  • rhinorrhea
  • no fever
  • pharyngitis
  • mild cough
467
Q

Etiology of anterior interossesous nerve syndrome?

A
  • entrapment of the motor branch of the median nerve
  • innervates the FPL, FDP and pronator quadratus
  • compressed at the flexor digitorum superficialis or the deep head of the prionator teres
468
Q

SS of anterior interossesou nerve syndrome?

A
  • local proximal anterior forearm pain
  • due to repetitive activity or single vilent forearm muscle contraction
  • weakness of pinching thimb and index finger
469
Q

Tests for anterior interosseous nerve syndrome?

A
  • froment sign (instead of an ok with the dip of the thumb flexed it is extended so that the thumb and the index grip flat
  • resisted elbow pronation w/ full elbow flexion
  • numbness of the pronator quadratus
470
Q

Treatment for anterior interosseous nerve syndrome?

A
  • NSAIDS
  • splinting
  • rest
471
Q

Etiology of Avascular nercrosis of the scaphoid?

A
  • # of scaphoid b/c of FOOSH
472
Q

SS of scaphoid AVN?

A
  • pain at the anatomical snuff box after a foosh
  • extension, flexion and radial deviation are all decreased
  • hematoma
  • tenderness to pressure over the scaphoid
473
Q

Test for Scaphoid AVN?

A
  • xray in 2 weeks post injury to show the non- union
474
Q

Etiology of carpal tunnel syndrome?

A
  • compression in the tunnel from prolonged/repetitive extension
  • fluid retention with pregnancy, RA, diabetes, connective tissue disorders, vitamin B deficiency
475
Q

SS of carpal tunnel syndrome?

A
  • pain, numbness and tingling in the palmar surface of the thumb and radial two and one half fingers
  • worse at night, burning and aching
476
Q

Tests for carpal tunnel?

A
  • tinels tap
  • phalen’s
  • reverse phalen’s
477
Q

Treatment for carpal tunnel?

A
  • splinting
  • ergonomic change
  • vitamin B suplemments
478
Q

Etiology of Colle’s #?

A
  • silver fork #
  • # withing the epiphysis of the radius
  • FOOSH
479
Q

SS of Colle’s #?

A
  • hand is displaced dorsally and laterally

- used xray to confirm

480
Q

Etiology of cubital tunnel syndrome?

A
  • compression of the ulnar nerve at the elbow
  • compression between the 2 heads of the Flexor carpi ulnaris
  • seen in baseball pitchers
481
Q

SS of cubital tunnel syndrome?

A
  • elbow pain
  • medial forearm pain
  • paresthesia into the ring and the little finger
482
Q

Tests for cubital tunnel syndrome?

A
  • pain reproduced with passive or resisted elbow flexion, while elbow is maximally flexed
483
Q

Treatment for cubital tunnel syndrome?

A

-PRICE

484
Q

Etiology of de quervian’s syndrome?

A
  • stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis as a result of chronic microtrauma
  • activity with forceful gripping, ulnar deviation and repetitive use of the thumb
485
Q

SS of de quervain’s syndrome?

A
  • local pain over the anatomical snuffbox
  • pain radiates up distal forearm
  • swelling in the tendons
486
Q

Tests for de quervain’s syndrome?

A
  • Finklestein’s
487
Q

Treatment for de quervain’s syndrome?

A
  • activity modification

- NSAIDS

488
Q

SS of diabetes mellitus?

A
  • peripheral neuropathy
  • sensory deficits, beginning with a glove and stocking distribution
  • numbness, tingling and paresthesia B?L in all extremities
489
Q

Tests for Diabetes mellitus?

A
  • oral glucose test

- fasting glucose test

490
Q

Etiology of Guyon’s cannal compression?

A
  • compression of the ulnar nerve in the tunnel of guyon
  • constant compression from handlebars (cyclists)
  • vascular abnormalities
  • # of the hook of hamate
491
Q

SS of guyon canal compression?

A
  • numbness/tingling or pain in the fourth and fifth digits
492
Q

Tests for guyons canal compression?

A
  • tinels at the wrist for ulnar nerve

- froment’s sign`

493
Q

Treatment for guyon’s canal compression?

A
  • change activites
494
Q

Etiology of Median nerve palsy?

A
  • originated fomr the C5 - T1 spinal nerves (lateral and medial cords)
  • compression points:
    + axilla
    + bicipital aponeuosis
    + sublimis bridge
    + next to humerus
    + pronator teres
    + carpal tunnel
495
Q

SS of median nerve palsy?

A
  • decreased sensation over the thumb, 2, 3 and half of the 4th digit
496
Q

Etiology for a metacarpal #?

A
  • direct blow or axial force ex. punching a wall

- alsoe called bar room #

497
Q

SS of metacarpal #?

A
  • pain over the metacarpal joint
  • usually 4th metacarpal
  • rotational deformity at the metatcarpal with flexion
498
Q

Tests for metacarpal #?

A
  • xray

- percussion of the finger will increase pain

499
Q

Etiology of Myasthenia Gravis?

A
  • neuromuscular transmission is blocked by autoantibodies that bind acetylcholine rexeptors at the post-synaptic NMJ
  • idipathic or ass. with RA. SLE
500
Q

SS of Myasthenia Gravis?

A
  • young women
  • double vision
  • difficulty swallowing
  • weakness of more used arm
  • weakness of the jaw muscles when chewing
  • single sided miosis
501
Q

Tests for myasthenia gravis?

A
  • drug testing w/ anticholinesterase, causes temporary increase in strength
502
Q

SS of palmaris longus muscle strain?

A
  • pain at the medial epicondyle of the humerus or distal flexor retinaculum
  • potential compressio nof the median nerve due to inflammation
  • pain with active or resisted wrist flexion
503
Q

Etiology of Radial tunnel syndrome (Posterior Interosseous nerve syndrome)?

A
  • compression of the superficial branch of the radial nerve in the proximal forearm or back of the arm, radiating pain into the dorsum of forearma nd hand
  • lesions at the elbow include
    + trauma
    + ganglia
    + lipoma
    + bone tumour
    + radial bursitis
504
Q

SS of radial tunnel syndrome?

A
  • posterior wrist or forearm pain
  • weakness of wrist extension or thumb and index finger extension
  • no sensory loss*
  • pain is reproduced w/ forceful wrist extension
505
Q

Tests for Radial Tunel syndrome?

A
  • localized tinel’s sign
  • tenderness along the course of the radial nerve
  • ddx from lateral epicondylitis
  • palpation and muscle testing
506
Q

Etiology of Pronator Teres Syndrome?

A 
- compression at 
  \+ bicipital aponeuosis, 
  \+ between the 2 heads of the pronator teres
  \+ FDS
  \+ ligament of struthers
  \+ median artery
  \+ bicipital tuberosity bursa
507
Q

SS of pronator teres syndrome?

A
  • anterior forearm pain
  • rrepetitive pronation and wrist flexion
  • carpanter
  • weight lifter
  • no trauma
508
Q

Tests for Pronator teres syndrome?

A
  • pressure over the pronator teres
  • resisted elbow flexion and supination w/ max elbow flexion, implies bicipital aponeurosis or ligament of struthers
  • resisted pronation, keeping elbow extended and wrist flexed, suggests pronator teres compression
  • resisted middle finger flexion suggests compresion b/c FDS
509
Q

Etiology of radial nerve palsy?

A
  • branch of posterior cord C5 - T1
  • compression at
    + axilla
    + spinal groove
    + humerus #
    + saturday night palsy
    + arcade of frohse
    + wrist
510
Q

SS of radial nerve palsy?

A
  • decreased posterior arm forearm and back of hand sensation
511
Q

Test for radial nerve palsy above elbow?

A
  • triceps
  • brachioradialis
  • ECRL
  • ECRB
512
Q

Tests for radial nerve palsy below the elbow?

A
  • supinator
  • ECU
  • ED
  • extensor digiti minimi
  • Abductor pollicis longus
  • extensor indicis
  • extensor pollicis brevis
  • extensor policis longus*
513
Q

Test for median nerve palsy?

A
  • pronator teres
  • flexor carpi radialis
  • palmaris longus
  • flexor digitrum superficialis
  • flexor digitorum profundus
  • flexor policis longus
  • pronator quadratus
  • abductor pollicis brevis
  • flexor pollicis brevis
  • opponens pollicis
  • 1st and 2nd lumbrical
514
Q

Etiology of Raynaud’s phenomenon?

A
  • spasm of arterioles in the digits and sometimes the nose and tongue - cold and cyanosis
  • common in young women
  • seondary to other conditions
    + scleroderma
    + RA
    + SLE
    + obstructive arterial disease
    + neurogenic lesion
    + drug intoxications
515
Q

SS of Raynaud’s Penomenon?

A
  • intermittent blanching or cyanosis of the digits is precipitated by exposure to the cold or emotional upset
  • do not occur above the MCP and spares the thumb
  • pain is uncommon but paresthesias are frequency
  • lasts minutes to hrs
  • phenomenon is due to an underlying condition, the raynauds disease is idiopathic
516
Q

Etiology of a Smith’s # (reverse colle’s #)

A
  • hyperflexion
517
Q

SS of smith’s #?

A
  • anterior displacment of the distal radial bone fragment
518
Q

SS of RA?

A

any of 4

  • morning stiffness > 1 hr
  • arthritis of 3 or more joints
  • arthritis of the hadn
  • symmetrical arthritis
  • rheumatoid nodules
  • Rh factor
  • synovial thickening
519
Q

Etiology of a Ulnar nerve palsy?

A 
compression at:
- axilla
- upper arm (above elbow) =
  \+ weak FCU and FDP
- cubital tunnel = most common
- guyon's canal
520
Q

SS of ulnar nerve palsy?

A
  • decreased medial forearm and palmar 4th and 5th digit sensation
521
Q

Tests for ulnar nerve palsy?

A
  • flexor carpi ulnaris
  • flexor digitorum profundus
  • interossei
  • lumbricals 3 and 4
  • adductor pollicis
  • abductor digiti minimi
  • flexor digiti minimi brevis
  • opponens digiti minimi
522
Q

Treatment for cervical disc?

A
  • SMT adjacent to the level of herniation after trial of mobilisation, improvement should be seen in 6- 8weeks
523
Q

Treatment for cervical rib induced TOS?

A

adjust

- gradual improvement in 3 months

524
Q

Etiology of Chronic Fatigue Syndrome?

A
  • chronic and persistent fatigue and cognitive difficulties of 6 months duration
  • females > males
  • epstein-barr infection prior
525
Q

SS of chronic fatigue?

A

4 of following

  • fatigue
  • short term memory impairment
  • sore throat
  • tender lymph nodes
  • myalgia
  • chest pain
  • palpitation
  • HA
  • photophobia
  • depression
  • mood swings
526
Q

Treatment for chronic fatigue?

A
  • chiro care and comange w/ other modalities of care
527
Q

Etiology of DISH?

A
  • general spinal and extraspinal articul;ar disorder

- ligamentous calcification and ossifiation specifically the ALL

528
Q

SS of DISH?

A
  • Males > Females
  • diabetes
  • dysphagia
  • decreased rotation (<45 deg)
529
Q

Tests for DISH?

A

xray

  • ossification of atleast 4 flowing segments
  • disc height normal
  • sometimes also ossification of the PLL
530
Q

Etiology for TVP #?

A
  • avulsion of the paraspinal muscle with severe hyperextension and lateral flexion injury to the lumbar spine
531
Q

Etiology for Pars #?

A
  • hyperextension of the lumbar spine
  • # at L4 or L5
  • oblique xray can see the scotty dog collar brokern
532
Q

SS of pars and TVP #?

A
  • flank pain

- hematuria if renal damage

533
Q

SS of spinal stenosis?

A

pain in back or legs with

  • walking
  • urnning
  • climbing stairs
  • pain relieved with flexion, uphill walking therefore less painful then downhill walking)
534
Q

Etiology of Toticolis?

A
  • involuntary tonic contraction or intermittent spasm of the neck muscles, especially the SCM
535
Q

Etiology of congenital torticolis?

A
  • b/c birth trauma causing SCM to become fibrous
536
Q

Etiology of Adult torticolis?

A
  • CNS infection
  • tumour
  • basal ganglion disease
  • spontaneous recovery
537
Q

SS of congenital torticolis?

A
  • fixed asymetry of the head

- bruising of the SCM can be seen days after the delivery

538
Q

SS of adult onset torticolis?

A
  • painful SCM spasm
539
Q

Treatment for torticolis?

A
  • SMT

- SCM massage and lengething

540
Q

Names for acoustic neuromas?

A
  • acoustic schwannomas

- acoustic neurinomas

541
Q

Etiology of Acoustic neuroma?

A
  • from schwan cells arising from the vestibular division of the vestibulocochlear nerve
  • the 5th and 7th cranial nerves can also be affectd
542
Q

SS of acoustic neuroma?

A
  • hearing loss*
  • tinnitus*
  • gradual onset
  • dizziness and unsteadiness (not true BPPV b/c not position related)
543
Q

Treatment of acoustic neuroma?

A
  • refer for surgery
544
Q

Etiology of acute vestibular neuritis?

A
  • sudden onset of severe vertigo that is at first persistent then becomes paroxysmal
  • neuron inflamation of the vestibulocochlear nerve because viral infection
545
Q

SS of acute vestibular neuritis?

A
  • first attack of vertigo is sever and persists
  • accompanies by nausea and vomitting
  • lasts 7 to 10 days
  • nystagmus toward affected side
  • no hearing loss or tinnitus*
  • sometimes dysarthia, ataxia and disdiadochokinesis
546
Q

Tests for acute vestibular neuritis?

A
  • audiologic assessment
  • MRI of head
  • electronystagmography w/ caloric testing
547
Q

Treatment of acute vestibular neuritis?

A
  • refer to MD meds same as meniere’s disease

- vestibular training and balance exercises

548
Q

Etiology of Benign Paroxysmal Positional Vertigo (BPPV)?

A
  • vertigo less than 30 sec brought on by certain head positions
  • cupulolithiasis: deposits of debris in the cupular of the posterior semicircular canal
  • occurs when patient lies on one side or tips their head backward to look up
549
Q

SS of BPPV?

A
  • vertigo when head in certain position usually lying on ear or tipping head backward
  • Nystagmus
  • non hearing loss or tinnitus*
  • gets better in few weeks to months
550
Q

Tests for BPPV?

A
  • positional nystagmus
  • dix hall pike
  • CNS lesion is vertical nystagmus, continues for as long as the position is held
  • audiologic assessment
  • electronystagmography with caloric testing
  • head MRI
551
Q

Treatment for BPPV?

A
  • avoid the provocative position
  • otoconia repositing maneuvers
  • epleys
  • semont
  • habituation exercises
  • if last >1 consider surgery
552
Q

Etiology of a concussion?

A
  • transient post traumatic loss of awareness or memory
  • lasts from seconds to minutes
  • pupilary and other brain stem functions are still intact
553
Q

SS of postconcussion syndrome?

A
  • HA
  • dizziness
  • difficulty concentrating
  • variable amnesia
  • depression
  • apathy
  • anxiety
554
Q

Test for concussion?

A
  • state of conciousness
  • breathing pattern
  • pupil size
  • reaction to light
  • occulomotor activity
  • motor activity in the limbs
  • CT
  • MRI
  • glasgow coma scale
555
Q

Treatment for concussion?

A
  • observe for 24 hrs

- if no fracture or hematoma seen in xray or CT no need to be hospitalised

556
Q

What is diplopia?

A
  • double vision
557
Q

Myopia?

A
  • nearsighted
558
Q

Hyperopia?

A
  • farsighted
559
Q

Etiology of primary Encephalitis?

A
  • aacute inflammation of the brain b/c viral invasion or hypersensitivity
  • usually b/c viral infection
    + arbovirus
    + poliovirus
    + echovirus
    + coxsackievirus
560
Q

Etiology of secondary encephalitis?

A

complication of infection:

  • measles
  • chickenpox
  • rubella
  • smallpox
561
Q

SS of encephalitis?

A
  • fever
  • HA
  • nausea
  • stiff neck
  • altered conciousness
  • personality changes
  • seizures
  • paresis
562
Q

Tests for encephalitis?

A
  • normal glucose
  • no bacteria
  • virus isolated from the CSF
  • MRI detect the brain inflammation the earliest
563
Q

Treatment for encephalitis?

A
  • refer for meds to control virus
564
Q

Etiology of Facet Syndrome?

A
  • well localised LBP w/ some hip or butt pain above the knee
  • sudden onset after misjudged movement
  • facet and the capsule are the source of the pain, mediated by the medial branch of the posterior primary rami
  • meniscoids become entraped or pinched and cause pain
  • substance )
  • degeneration in older individuals
565
Q

Tests of Facet syndrome?

A
  • local pain
  • absence of neuro symptoms
  • absence of nerve root tension signs/tests
  • local pain w/ kemps, if repro w/ SLR does not extend past the knee
  • xray, general degeneration and hyperlordosis
566
Q

Etiology of Herpes Zoster Oticus (Pamsy hunt, viral neuonitis, ganglionitis)?

A
  • invasion of the vestibulocochlear and the geniculate ganglion of the facial nerve by the herpes zoster virus
567
Q

SS of Herpes Zoster Oticus?

A
  • severe ear pain
  • hearing loss
  • vertigo
  • paralysis of the facial nerve
  • vesicles in the ear canal
  • vertigo lasts from days to weeks
  • facial sensory loss can resolve or become permenant
568
Q

Treatment for Herpes Zoster Oticus?

A
  • refer to MD, corticosteroids, antiivirals, decompression
569
Q

Etiology of primary hypertension?

A
  • elevated systolic or diastolic BP

- unknown cause

570
Q

Etiology of secondary hypertension?

A 
- renal parenchymal disease
  \+ glomerulonephritis
  \+ pyelonephritis
  \+ polycystic renal disease
  \+ collagen disease of the kindey
- pheochromocytoma (adrenals)
- cushings
- Addisons
- hyperthyroidism
- myexedema
- excessive alcohol
- oral contraceptives
571
Q

SS of hypertension?

A
  • dizziness
  • flushed face
  • ha
  • fatigue
  • epitaxis
  • Left ventricular HT
  • renal changes
    + hemorrhage
    + excudate
572
Q

Tests for hypertension?

A
  • higher systolic and diastolic BP
573
Q

Treatment of hypertension?

A
  • lifestyle change:
    + weight reduction
    + salt decrease
574
Q

Etiology of Orthostatic hypotension?

A
  • fall in BP > 20/10 mm Hg when stand up

- b/c hypovolemia

575
Q

SS of orthostatic hypotension?

A
  • faint
  • light headed
  • dizzy
  • confused
  • visual blurring
  • all b/c decreased blood flow to the brain
576
Q

Etiology of Labyrinthine Tumor?

A

similar to acoustic neuroma

577
Q

Etiology of Labyrthitis?

A
  • inner ear bacterial infection
  • seondary to otitis media or purulent meningitis
  • usually get meningitis after
578
Q

SS of Labyrinthitis?

A
  • severe vertigo and nystagmus
  • complete hearing loss
  • sometimes facial paralysis
579
Q

Treatment of Labyrinthitis?

A
  • IV antibiotics
580
Q

Etiology of Meniere’s disease?

A

idiopathic

581
Q

SS of meniere’s disease?

A
  • recurrent prostrating vertigo
  • sensory hearing loss
  • tinnitus
  • feeling of fullness in the ear
  • sudden onset
  • nausea and vommiting
  • feeling of fullness*
582
Q

Treatment of Meniere’s disease?

A
  • vestibular neurectomy relieves th vertigo and preserves the hearing
  • meds
  • SMT
583
Q

Etiology of Motion sickness?

A
  • repetitive angular and linear acceleration and decelleration causing nausea and vommiting
  • basically the excessive stimulation of the vestibular apparatus
584
Q

SS of motion sickness?

A
  • cyclic nausea and vomiting
585
Q

Etiology of Multiple sclerosis?

A
  • progressive CNS disorder, characterized by patches of demylination in the brain and the spinal cord
  • idiopathic
  • > W
  • 20 - 40
  • mostley affect the lateral and the posterior columns
586
Q

SS of MS?

A
  • paresthesias in extremities, trunk or side of the face
  • weakness or clumsiness of a leg or a hand
  • visual disturbances: partial blindness
587
Q

Tests for MS?

A
  • diagnosis of exclusion
  • brain MRI
  • lumbar puncture
588
Q

Treatment for MS?

A
  • corticosteroids
  • symptomatic treatments
  • regular exercise
589
Q

Etiology of Myringitis?

A
  • Inflammation of the tympanic membrane secondary to viral or bacterial infection
590
Q

SS of Myringitis?

A
  • inflammation of the tympanic membrane
  • vesicles develop on the tympanic membrane
  • pain is sudden onset and lasts from 24 - 48 hrs
  • if hearing loss and fever = ostits media
591
Q

Treatment for myringitis?

A
  • differential cause if bacterial or mycoplasmal

- rupture the vesicles and give antibiotics

592
Q

Etiology of Otitis media?

A
  • bacterial or viral infection in the middle ear, usually after an URTI
  • common in young children
  • escherichia coli
  • staph aureus
  • stepth pneumonia
  • h influenzae
593
Q

SS of otitis media?

A
  • persistent severe earache
  • hearing loss
  • fever
  • nausea
  • dirreha
594
Q

SS of chronic otitis media?

A
  • conductive hearing loss b/c perforation in the tympanic membrane
595
Q

Etiology of Temporal Bone fracture?

A
  • bleeding from ear after a skull injury
  • facial paralysis
  • permanent hearing loss
  • assessed w/ Weber’s and Rinne’s tests
596
Q

Treatment of temporal bone fracture?

A
  • penicillin to prevent meningitis

- tympanic repair if patientexperiences hearing loss

597
Q

Etiology of temporal lob seizures?

A
  • comples partial seizure

- originate in the temporal lobe

598
Q

SS of temporal lobe seizures?

A
  • losses contact w/ surroundings for 1 - 2 mins
  • stare
  • purposeless movements
  • unintelligible sounds
  • mental confusion
599
Q

Etiology of TIA?

A
  • sudden focal neural abnormalities of breif duration

- due to cerebral emboli in the internal carotis, middle cerebral or the vertebrobasilar system

600
Q

SS of TIA?

A
  • last from 2 - 30 min
  • resolve without any persisting neurological function compromise
  • 5 ds and 3 NS
601
Q

Etiology of Atelectasis?

A
  • airless states of the lung
  • caused by intraluminar bronchial obstruction which result from:
    + bronchial excudate
    + endobronchial tumours
    + granuloma
602
Q

SS of Atelectasis?

A
  • pain oni the affected side
  • sudden onset of dyspnea and cyanosis
  • drop in BP
  • tachycardia
  • elevated temperature
  • shock
  • dullness on percussion
  • no breath sounds with auscultation
  • mediastinum deviates towards the side of lung collapse
603
Q

Etiology of Bronchiectasis?

A
  • irreversible focal bronchial dilation
  • chronic infection
  • diverse conditions
  • congenital or hereditary
  • inhalation of noxious chemicals
  • preceding atelectasis
604
Q

SS of bronchiectasis?

A
  • chronic cough with sputum prodcution
605
Q

Etiology of costochondritis?

A
  • inflammation of the costochondral or costosternal joints that causes local pain and tenderness
  • b/c repetitive micro trauma
606
Q

SS of costochondritis?

A
  • insidious onset
  • chest wall pain usually w/ repetiive motion or unaccustomed activity ex. painting
  • worse when move trunk, deep inspiration or exertion
  • pain decreased with decreased breathing or changing position
  • sharp pain
  • wax and waning
  • mostly bilateral
  • if unilateal and edema = tietze
607
Q

Treatment of costcoshondirits?

A
  • NSAIDS
  • stretching and local heat
  • avoid repetive use of the musculature in the area
  • modify ergonomics
608
Q

Treatment of myofascial trigger point of the pectoralis muscle?

A
  • pec is stretched w/ horizontal abduction

- prees down on coracoid process

609
Q

Etiology of scalene trigger point?

A
  • ipsilateral lateral flexion and contralateral rotation overuse
610
Q

Treatment of the myofascial trigger point of the serratus anterior muscle?

A
  • stretched with arm abducted and lateral flex to the opposite side
611
Q

Etiology of COPD?

A
  • airflow obstruction due to chronic bronchitis or emphysema
  • progressively worsens
  • chronic productive cough for 3 months for atleast 2 years
612
Q

SS of COPD?

A
  • productive cough
  • worse in morning and produces a small amount of colorless sputum
  • dyspnoea
  • cyanosis
  • cor pulmonae
  • elevated and distension of julglar veins
  • peripheral edema
  • crackles w/ inspiration
613
Q

Etiology of Pancoast Tumor?

A
  • in the apex of the pleura
  • direct spread from a sulcus bronchiogenic carcinoma
  • pain in the shoulder and ulnar distribution of the arm
  • also cause horner syndrome
614
Q

SS of Pancoast tumor?

A
  • pain in the shoulder an ulnar distribution of the arm
  • horner syndrome
  • unremmiting pain
  • xray:
    + apical cap on the lung
615
Q

Etiology of Pleurisy?

A
  • direct entry of infectious or irritating substance into the plueral space
  • trauma, asbestos
616
Q

SS of pleuristy?

A

inflam of the pleura

  • stabbing chest pain
  • worse by cough, respiration, trunk bending
  • pain occurs with deep breathe or cough
  • local spot of pain
  • motion and breathe sounds of the affected side is diminished
617
Q

Tests for plueisy?

A
  • recent infection
  • no nausea vomiting or disturbed bowel function
  • pain agg by breathing or coughing
  • intercostal neurtitis if no pain on respiration
618
Q

Etiology of Subacute endocardidits?

A
  • previous infection
  • congestive heart failure
  • IV drug users
619
Q

SS og Subacute endocarditis?

A
  • fever and chills
  • anorexia
  • weight loss
  • malaise
  • HA
  • night sweats
  • shortness of breath
  • cough
  • dyspnea
  • petichiae
  • splinter hemorrhages
  • osler nodes: tender nodes on distal digits
  • janeway lesion: non tender macuale on palms and soles
  • roth spots: retinal hemorrhages w/ small clear centers
620
Q

Etiology of achilles tendonitis?

A
  • formed from the gastrocs and the soleus, inserting into the superior aspect of the calcaneus
  • overuse in running or jumping
  • direct trauma from forced dorsiflexion
621
Q

SS of achilles tendonitis?

A
  • pain with palpation
  • pain with passive dorsiflexion
  • palpable scarring in the tendon
622
Q

Treatment of achilles tendonitis?

A
  • rest ice and NSAIDs

- do not exercise through the pain or will form a rigid scar

623
Q

Etiology if Anterior talo-fibular ligament sprain?

A
  • excessive inversion
624
Q

Tests for anterior talo-fibular ligament sprain?

A
  • talar tilt test

- anterior drawer test

625
Q

Treatment of grade 1 anterior talo fibular ligament sprain

A

PRICE

626
Q

Treatment of grade 2 anterior talo fibular ligament sprain

A
  • PRICE
  • crutches
  • rehab w/ ROM and ankle strenghtening
627
Q

Treatment of grade 3 anterior talo fibular ligament sprain

A
  • refer
628
Q

Etiology of calcaneal spur?

A

ossification b/c of plantar fascia traction on the periosteum of the calcaneus

  • stress at the plantar aspect of the calcaneus at the acttachment of the plantar aponeurosis
  • excessive running, standing or walking
  • can occurs by itself or with diseases like reiters, AS, DISH
629
Q

SS of calcaneal spur?

A
  • constant pain on the undersurface of the heel, radiates from the anterior portion into the rest of the plantar aspect of the foot
  • pain with walking or standing
  • pain relieved by rest
  • local tenderness is found over the medial portion of the spur
  • swlling
  • passive dorsiflexion of the toes may accentuate the pain
630
Q

Test for calcaneal spur?

A
  • see on an xray
631
Q

Treatment for calcaneal spur?

A
  • PRICE
  • heel lifts
  • donut shaped show inserts which take pressure off of the heel spurs
  • surgery
  • shock wave therapy
632
Q

Etiology for Charcot’s joints?

A
  • rapid destructive arthropathy of various causes from impaired pain perception and position sense
  • no sensation of pain or proprioception compromised the protective reflexes of the joint = trauma to occurs, mostly in the knee
633
Q

SS for charcots joints?

A
  • confused with OA
  • mild pain, but usually not present
  • hemorrhagic effusion
  • subluxation and instability
  • acute joint dislocation
  • neurogenic arthropathy progresses more rapidly than OA
  • neurological disorder that results in painless but destructive arthropathy
634
Q

Tests for charcots joint?

A
  • 6 D’s: increased density, debris, destruction, distension, dislocation and disorganization
  • parrots beak deformity
635
Q

Distribution of charcots joint based off of the underlying neurological condition. What is the distibution of tabes doralis charcots joint?

A
  • knee and hip
636
Q

What is the distibution of diabetes melitis charcots joint?

A
  • foot
637
Q

What is the distibution of Syringomyelia charcots joint?

A
  • upper limb, especialy the elbow and shoulder
638
Q

Treatment of charcots joint?

A
  • treatment of underlying neurlogical condition

- surgery and prevention

639
Q

Etiology of Diabetes Melitus Type 1?

A
  • impairment in insluin secretion (type 1)
  • hyperglycemia
  • diabetic ketoacidosis
  • any age mostly develops in childhood or teen years
640
Q

SS of Diabetes mellitus?

A
  • polyuria
  • polydipsia
  • weight loss
  • hyperglycemia =
    + blurred vision
    + fatigue
    + nausea
641
Q

Tests for diabetes mellitus?

A
  • fasting glucose: > 140 mg/dL or > 7.77 mmol/L

- almost 0 blood insulin

642
Q

Etiology of type 2 Diabetes Melitus?

A
  • non insulin dependent
  • hyperglycemia and insulin resistence
  • diabetic ketoacidosis is rare
  • ass. w/ obesity
  • vaginal candidiasis (yeast infection)
643
Q

SS of type 2 diabetes mellitus?

A
  • atherosclerosis leads to symptomatic coronary artery disease
  • claudication
  • skin breakdown
  • infection
  • retinopathy, macular edema -> blindness
  • diabetic neuropathy, glove stocking sensory deficits
  • foot ulcers and joint problems
644
Q

Tests for diabetes mellitus?

A
  • overnight fasting blood glucose:

+ > 140 mg/dL or >7.77 mmol/L

645
Q

Treatment for diabetes mellitus?

A
  • diet to reduce weight
  • patient education
  • oral drug to control hyperglycemia
646
Q

Etiology of gout?

A
  • monosodium urate crysta deposition in avascular tissues
  • Tophi are deposited in the jonit and are large enough to be seen on xray
  • b/c decreased renal clearance of urate
647
Q

SS of gout?

A
  • starts w/out warning
  • precipitated by minor trauma
  • overindulgence in purine rich food, alcohol
  • fatigue
  • emotional stress
  • medical stress
  • acute monarticular pain
  • nocturnal
  • progressively more severe
  • acute infection
  • warm shiny or purplish skin
  • big toe, ankle, knee and elbow = common sites
648
Q

Tests for gout?

A
  • elevated blood urate
    + > 7mg/dL
  • needle shaped urate crystals are free in the fluid or engulfed by phagocytes
  • xray
    + punched out lesions in the subchondral bone
649
Q

Treatment of gout?

A
  • nsaids
  • colchicine, allopurinol
  • diet prevention
650
Q

Etiology of hallux limitus?

A
  • limited ROM in the big toe
  • biomech abnormalities
  • pressure from shoe can cause the pain or neuritis
651
Q

SS of hallux limitus?

A
  • pain w/ swelling
  • bony proliferation around the dorsal aspect and lateral aspect of the metatarsal head
  • alignment of the joint is altered in hallux valgus
  • limited dorsiflexion of the big toe
  • xray:
    + djd of 1st metatarsal head
    + lateral osteophytes
    + naroowing of JS
  • Lab no rheumatoid factor or HLA - B27 = this
652
Q

Treatment of hallux limitus?

A
  • pad area
  • local anesthetic
  • antiinflamatory
  • show modification
  • analgesics
653
Q

Etiology of Hallux Valgus?

A
  • lateral deviation of the hallux

- excessive pronation of the ankles

654
Q

SS of hallux valgus?

A
  • bunion at 1st met head
  • pain at 1st met head
  • lateral deviation of 1st met head
655
Q

Tests for hallux valgus?

A
  • enlarged 1st MTP joint w/ lim motion
  • pain on palp of joint
  • increased dorsiflexion of the the 1st big toe
  • xray
    + JS narrowing
    + bony spurs extending from the metatarsal heads
656
Q

Treatment for hallux valgus?

A
  • passive exercises and toe traction
  • local anesthetic
  • orthotics
657
Q

Etiology of mortons neuroma (interdigital nerve pain?

A
  • neuroma usually b/w 3rd and 4th digit
  • loss of fat pad protecting the interdigital nerves of the foot
  • repetitive trauma
  • improper foot wear
  • gradual persistent benign thickening and enlargement of the perineurium of one or more of the interdigital nerves of the foot
658
Q

SS of Mortons neuroma?

A
  • pain along one or more nerves of the foot radiating to the ball or the toes
  • patients with neuroma complain of a mild ache or discomfort in the foot near the 4th metatarsla head
  • burning or tingling near 4th metatarsal head
  • feels like a marble or a pebble is inside your foot
659
Q

Tests for mortons neuroma?

A
  • plantar palpation of ther interdigital space

- thumb pressure applied b/w 3rd and 4th metatarsal heads = pain w/ morton neuroma

660
Q

Treatment for morton’s neuroma/

A
  • resloves quick with insoles
  • lidocaine helps w/ neuralgia
  • corticosteroids
  • surgical excession of the neuroma
661
Q

Etiology of Osteochondritis Dissecans?

A
  • loss of blood supply to an ares of bone underneath the joint surface = pain
  • AVN of bone
  • cartilage eventually seperates from the diseased bone
  • fragments break loose into the knee joint causing locking of the joint
662
Q

SS of osteochondritis dissecans?

A
  • weakness
  • sharp pain
  • joint locking
663
Q

Tests for osteochondritis dissecans?

A
  • xray
  • MRI
  • arthroscopy
  • positive wilsons test
664
Q

Treatment for osteochondritis dissecans?

A
  • if not fragmented the bone can be fixed in place with pins or screws
  • if fragements bone graft
665
Q

Etiology of Osteoid Osteoma?

A
  • benign bone tumor of the long bones
  • small lucent nidus surrounded by sclerotid region
  • 10 - 25 yrs olds
666
Q

SS of osteoid osteoma?

A
  • painful, worse at night

- releieved w/ aspirin

667
Q

Tests for osteoid osteoma?

A
  • xray
    + small lucent zone surrounded by a larger sclerotic zone
    + similar appearance to a brodie’s abcess
668
Q

Treatment for osteoid osteoma?

A
  • small radiolucent zone is located and surgically removed
669
Q

Etiology of Raynaud’s Disase?

A
  • spasm of arterioles in the digits and occasionally nose and tongue with intermittent pallor or cyanosis
  • disease = idiopathic
  • phenomenon= b/c underlying conditions
670
Q

Etiology of Raynaud’s Phenomenon?

A 
- secondary to other conditions:
 \+ scleroderma
 \+ SLE
 \+ RA
- neurolesions
- drug intoxication
- dysproteinemia
- myxedema
- primary pulmonary hypertension
- trauma
671
Q

SS of Raynaud’s phenomenon?

A
  • intermittent blanching or cyanosis of the digits precipitated by exposure to cold or by emotional stressor
  • color change
  • does not affect the thumb
  • no pain, often paresthesia
  • vasospasm of the digital arteries
  • warm hands restores the color and sensation
672
Q

Test for Raynauds?

A
  • in disease the tropic skin changes are not present whereas in phenomenon there will be changes in the skin according to the underlying disease
673
Q

Etiology for Reiter’s syndrome?

A
  • seronegative arthropathy
  • can’t see cant pee cant dance
  • infectious
    +chlamydia
    +shingella
    +salmonella
    +yersina
    +campylobacter
  • men 20 - 40
  • increased incidence in people with HLA-B27
674
Q

SS of Reiter’s syndrome (reactive arthritis?

A
  • urethritis
  • fever
  • conjunctivitis
  • arthritis
  • asymetrical
  • back pain
675
Q

Tests for Reactive arthrits?

A
  • peripheral arthritis w/ urethritis or cervicitis
  • ddx in several months
  • positive gonococcal culture, rapid response to penicillin
  • arthritis or skin lesion similar to psoriatc
676
Q

Treatment for reactive arthrits?

A
  • tetracycline for up to 3 months reccomended
677
Q

Etiology of RA?

A
  • idiopahtic
  • > W
  • b/w 25 - 50
678
Q

SS of RA?

A
  • insidious
  • progressive joint involvement
  • tenderness in inflamed joints
  • synovial thickening
  • siffness for > 30min
  • early afternoon fatigue and malaise also occur
679
Q

Tests for RA?

A
  • lab findings
  • increased ESR
  • RF
  • no crystals
  • xray
    + soft tissue sweeling
    + periarticular arthritis
    + JS narrowing
    + marginal erosion
680
Q

Treatment for RA?

A
  • improve w/ conservative treatment
  • contra for cervical manipulation b/c atlanto axial instability
  • NSAIDs
681
Q

Etiology of infectious (septic arthrits)?

A
  • mos commonly caused by neisseria gonorrheoae
  • spreads from infects surfaces, cervix, rectum or pharynx to small joints fo the hands, wrists elbows, knees and ankles
  • nongonococcal arthritis is caused by Staph Aureus
682
Q

SS of infectioous (septic) arthritis?

A
  • acute onset of joint pain and swelling
  • rapid onset
  • mod to severe joint pain
  • warmth
  • tenderness
  • restricted motion
683
Q

Tests for infectious arthrtis?

A
  • increased WBC
  • increased ESR
  • increased c reactive protein
  • viscosity and glucose conentrations usually decreased
684
Q

Treatment for infectious arthritis?

A
  • depends on the results of culture, wheterh antibacterial or antiviral
685
Q

Etiology of Epiphysitis of the calcaneus (sever’s disease)?

A
  • develops from 2 centers of ossification
  • one begins at birth and other doesn’t begin before the 8th yr
  • in ages 8 - 16
  • excessive strain w/ vigorous activities
686
Q

SS of Sever’s disease?

A
  • heel pain

- history of trauma

687
Q

Tests for sever’s disease?

A
  • location of pain along the margins of the heel
  • patients age
  • history of athletic involvement
  • warmth and swelling
  • xray no relpful
688
Q

Treatment for severs disease?

A
  • heel pads: reduce the pull of the achilles on the heel

- immobilization of the foot in a cast is usually effective

689
Q

Etiology of posteriolateral talar tubercle fracture?

A
  • sudden jump on the ball of the foot or toes or from steeping backward off a chair with force
  • tow walkers more prone to this injury
690
Q

SS of posteriolateral tala tubercle #?

A
  • pain and swellin behind the ankle
  • difficulty walking downhill or descending stairs
  • persistent swelling with no obvious history of injury
  • heat may be present but is mild
691
Q

Tests for posteriolateral talar tubercle #?

A
  • plantar flexion = pain

- lateral flexion xray = see #

692
Q

Treatment of posteriolateral talar tubercle #?

A
  • refer
  • immobilize for 4 - 6 weeks
  • if pain still there corticosteroids and an anestetic may be effective
693
Q

Etiology of tibial nerve neuralgia (tarsal tunnel syndrome)?

A
  • compression of the tibial nerve at the medial part of the ankle under the tarsal tunnel
  • synovitis of the flexor tnedons
  • inflam arthritis
  • venous stasis edema
694
Q

SS of Tarsal tunnel syndome?

A
  • pain in and around ankle that extends into the toes
  • pain worse w/ walking
  • releieved with rest
  • can occur while standing or while wearing various types of foot wear
695
Q

Tests for tarsal tunnel syndrome?

A
  • tapping the posterior nerve below the medial malleolus, when the site of compression is struck it will generate distal tingling
  • electrodiagnostic testing
  • when swelling in the area of the nerve try to determine why?
696
Q

Treatment for tarsal tunnel?

A
  • strap foot into neutral or more inverted position
  • orthotic
  • corticosteroids w/ local anesthetic
697
Q

Etiology of varicose veins?

A
  • valvular dysfuinction
  • weakness in the vein wall
  • hormonal changes ( preggo)
  • abdominal tumor
  • prolonged standing aggrevates but does not cause varicose veins
  • deep thrombphlebitis
698
Q

SS of varicose veins?

A
  • aching
  • fatigue
  • heat
  • relieved by elevating leg or wearing compression socks
  • symptoms do not relate to the size of degree of varicosities
  • worsen with menstration
  • tense and palpable
699
Q

Tests for varivose veins?

A
  • seen by patient
  • pain relief when the leg is elevated
  • sometimes trendelembergu = retrograde flow of blood = incompetent saphenous valve
700
Q

Treatment for varicose veins?

A
  • incurable
  • symptom relief is primary goal
  • compression socks
  • cosmetic surgery
701
Q

Etiology of Venous Thrombosis?

A
  • can occur in superfical or deep veins
  • Superficial thrombophlebitis
  • deep vein thrombosis
  • chronic venous insufficiency
  • anticoagulant drugs can prevent these from forming
702
Q

SS of venous thrombosis?

A
  • acute thrombophlebitis arise over hours to 1 or 2 days
  • superficial thrombophlebitis
  • pain
  • tenderness
  • erythema
  • warmth
  • palpation of a superficial cord in the leg reflects occlusion of a superficial vein
  • ## DVT can be asym
703
Q

Where can DVT occur?

A
  • popliteal, femopral and inliac segments = hard cord in the femoral triangle, medial thigh or popliteal space
  • with an iliofemoral DVT we can see dilated superficial veins over the leg, thigh , hip and lower abdome
704
Q

Treatment for Venous throbosis?

A
  • no therapy
  • warm compress
  • NSAIDs
  • acute DVT hospitslb/c risk of pulmonary embolism
705
Q

Etiology of acute bronchitis?

A
  • bacterial or viral infection of the bronchial tress
706
Q

SS of acute bronchitis?

A
  • prior URTI
  • distressing cough
  • initially non-productive cough but becomes prulent
  • if fever = pneumonia
  • dyspnea
  • crackling
  • wheezing
707
Q

Treatment for acute bronchitis?

A
  • rest

- antibiotics

708
Q

Etiology of Asthma?

A
  • airway obstruction and inflammation\

- due to brachospasm trigger by a hypersensitivity reaction

709
Q

SS of Asthma?

A
  • varies
  • wheezing, cough and shortness of breath
  • itching voer anterior neck
  • dry cough
  • dyspnea
  • tightness or pressure in the chest
  • tachycardia
  • high pitched wheeze
  • hyperinflated chest
  • cyanosis
710
Q

Treatment of Ashtma?

A
  • control allergne exposure
  • anticholinergics to relax smooth muscle
    long term: corticosteroids
711
Q

Etiology of Bronchiectasis?

A
  • infection
  • mechanical alteration b/c atelectasis or loss of parenchymal volume
  • unilateral or bilateral
  • chronic inflammation and loss of cila
712
Q

SS of Bronchiectasis?

A
  • begins in early childhood
  • chronic cough
  • worsen gradually
  • wheezing
  • dyspnea
  • crackles
  • airflow obstruction
713
Q

Treatment of bronchiectasis?

A
  • refer for anti biotics
714
Q

Etiology of Chronic obstructive pulmonary disease?

A
  • chronic bronchitis or emphysema and progressive obstruction
  • smokers, dilation of submucosal glands and dilated ducts
  • panacinar emphysema: affects whol acinus
  • centrilobular emphysema: begins in the respiratory bronchiole and spreads peripherally
715
Q

SS of COPD?

A
  • smokers develop productive cough
  • as gets worse intervals between syumptoms shorten
  • hyperinflation of the lungs
  • breath sounds decreased
716
Q

Treatment of COPD?

A
  • reduce environmental exposure i.e smoking
  • oxygen therapy
  • reduce symptoms using anti inflamatories
717
Q

Etiology of congestive heart failure?

A
  • plasma volume increases and increased fluid in the lungs, abdomin and peripheral tissue
  • b/c L ventricular failure: coronary heart disease and hypertension
    and b/c R ventricular failure: L ventricle failure and tricuspid regurg
718
Q

SS of CHF?

A
  • right sided, left sided or both
  • gradual or sudden onset
  • cyanosis
  • edema
  • LVF: pink frothy sputum
  • RVF: peripheral edema
719
Q

Etiology of scleroderma?

A
  • degenerative adn vascular abnormalities in the skin (Scleroderma), articular structures and internal organs (esopahgus, GI, lung, heart, kidney)
  • unknown cause
  • degen changes
  • > W
  • cicumscribed patches or linear sclerosis
720
Q

SS pf scleroderma?

A 
- CREST:
 \+ calcinosis
 \+ Raynauds
 \+ esophageal dysfucntion
 \+ sclerodactyly: taught shiny and pigmented skin, mask like face
 \+ telangiectasia
- musculoskeletal pain: friction rubs on the jonits
- renal insufficiency
- cardiac arythmia, lung fibrosis
- dysphagia
721
Q

Etiology of sinus infection?

A
  • inflammation of the paranasal sinuses
  • acute by:
    + streptococci
    + pneumococci
    + Haemophilus influenzae
    + staphylococci
  • chronic sinusitis by:
    + gram nergative
722
Q

SS of sinus infection?

A
  • area over the sinus tender adn swollen
  • maxillary, ethmoid and frontal sinusitis cause local pain and frontal HA
  • malaise
  • fevers
  • chills
  • nasal mucosa
723
Q

SS of myofascial trigger point of the intercostal muscles?

A
  • pain local to trigger point extends anteriorly when severe
  • restricted rotation of T spine
  • chest pain with deep respiration
724
Q

SS of myofascial trigger point of the pectorals?

A
  • refered pain, localizes substernally, anterior chest and breast, extends down the ulnar aspect of the arm to the 4th and 5th digits
  • can be mistaken for ischemic pain if on the left side
725
Q

SS of myofascial trigger point of the scalene muscle?

A
  • refered pain radiates anterior, lateral or posterior
  • anterior pain: pectoral
  • lateral pain: down front and back of the arm (skipping elbow)
  • posteriorly: upper vertebral border of the scapula and the area medial to it
726
Q

SS of myofascial trigger point of the serratus anterior muscle?

A
  • refered pain to the side and back of the chest and down ulnar side of the arm
727
Q

SS of hypocalcemia?

A
  • muscle cramps
  • tetany
  • convulsion
  • caused by decreased magnesium
728
Q

SS of hypercalcemia?

A
  • excessive bone reabs
  • constipation
  • anorexia
  • nausea
  • abdominal pain
729
Q

SS of chromium toxicity?

A
  • skin irritation
  • potential perforation of the nasal spteum
  • carcinoma of the lung
730
Q

SS of folic acid deficiency?

A
  • in prego women = spina bifida, neural tube defects
731
Q

Niacin (B3) deficiency?

A 
- pellegra 
 \+ dermatitis
 \+ dirreaha
 \+ dementia
 \+ death
732
Q

SS of cerebral beri-beri?

A
  • also called wenicke koraskoff syndrome
  • mental confusion
  • aphonia
  • confabulation -> nystagmus
733
Q

SS of peripheral beri beri?

A
  • paresthesia of toes
  • burning of feet
  • peripheral neuropathy
734
Q

SS of vitamin D deficiency?

A
  • rickets

- osteomalacia

Part B thématiques (9 decks)

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