ECR Back pain Flashcards
What part of spine is concave curve?
cervical and lumbar spine
what part of spine is convex curve?
thoracic and sacrococcygeal spine
What does tenderness as you palpate teh spinous process suggest?
fracture os dislocation if preceded by trauma, underlying infection, or arthritis
Which vertebrae would be tender in arthritis?
C5 and C6 feacet joints
What does Step-offs indicate?
Sondylolisthesis or forward slippage of one vertebra, which amy compress the spinal cord.
What is vertebral tenderness suspcicous for?
fracture or infection
What doees tenderness over teh sacroiliac joing suggst?
sacroiliitis
Ankylosing spondylitis
may produce scroiliac tenderness
Ankylosing spondylitis is a long-term disease that involves inflammation of the joints between the spinal bones, and the joints between the spine and pelvis.
These joints become swollen and inflamed. Over time, the affected spinal bones join together.
What is presentation of scoliosis?
lateral and rotatory curvature of the spine to bring teh head back to midline
Scoliosis often becomes evident during adolescence, before symptoms appear
What does undequal shoulder heigth suggest?
scoliosis
Sprengel’s deformity fo the scapulat (From attachement of extra bone or band between scapula and C7)
winging of the scapula from loss of innervation of serratus anterior m. by long thoracic nerve
contralateral wekaness of trapezius
What does unequal heights of the iliac crests or PELVIC TILT
suggests unequal lengths of the legs and disappear when a block is placed under the short leg and food
Scoliosis and hip abduction or adduction may also cause a pelvic tilt
Listing of the trunk to one side is seen with a herniated lumbarr disk
“Listing” of the trunk to one side
seen witha herniated lumbar disc
Birthmarks, port-wine stains, hariry patches, lipomas
often overlie bondy defects such as SPINA BIFIDA
Cafe aua lait spots (discolored patches ffo skin) , skin tags, and fibrous tumours in
NEUROFIBROMATOSIS`
Pain or percussion may arise from….
osteoporosis, infection, or malignancy
What roots do the sciatic nerve arise from
L4, L5, S1, S2, S3 (L4-S3
Nerve lies midway between greater trochanter and ishial tuberosity )
When do spasms occur
in degenerative and inflammatory processes of muscles, prolonged contraction from abnromal posture, or anxiety
What does scieatic nerve tenderness suggest?
herniated disc or mass lesion impinging on the contributing nerve roots
What specific discs, when herniated, may produce tenderness of the spinous processes, intervertebral joints, paracertebral muscles, sacrosciatic notch, and the sciatic nerve?
L5-S1, L4-L5
What is Torticollis?
muscle spasm that may cause limiations in range of motion
What is the most mobile protion of the spine?
teh neck
it supprots 10-15 poinds
How do you measure FLEXION of the spine?
mark the spine at the lumbosacral junction, then 10 cm aboce and 5 cm below this point
a 4cm increase between teh two upper marks
distance bewteen teh lower two marks should be unchanged
Cuase of Sciatica (Radiuclar Low Back Pain)
usualy from herniated intervertebral disc with compression or tractino of ner roots
Involves L5-S1 roots in 95% disc hernation
Physical Signs of Sciatica
disc herniation most likely if calf asting, weak ankel dorsiflexion, absent ankle jerk , positive straight leg raise
What is lumbar spinal Stenosis
Pseudclaudication pain in the back or legs with walking that IMPROVES WITH REST, lumbar flexion (which decomrpresses spinal ord) or both
Pain vague but bilateral with parasthesis in one or both legs
Causes of lumbar spinal stenosis
Arises from hypertorphic degeneative disease of one or more vertebral, facets, and thickening of ligamentaum flavum
anrrowign of spinal canal centrally or in lateral recesses
More common after age 60
Physical signs of Lumbar Spinal Stenosis
Lumbar may be flexed forward, with lower extemity weakness and hypoflexia
Straight leg test usually negative
Patterns of Mechanical Neck Pain
Aching pain in the cervical paraspinal msucles and ligaments with associated muscle spasm; stiffness and tightness in upper back and shoulder, lasitng up to 6 weeks;
no radiation, paresthesisas or weakness
Headache may be present
Possible causes of mechanical neck pain
possible sustained muscle contraction
Ass with poor posture, stress, poor sleep, poor head position during activties such as computer use, watching tv, driving
