Exam 1: The history Flashcards
Sharp pain on motion is associated with what structure?
joint
Constant symptoms is associated with what structure?
Joint or nerve
Burning and/or hot feeling is associated with what structure?
nerve
Sharp pain not on motion is associated with what structure?
nerve
Stabbing or lightening like pain is associated with what structure?
nerve
Tingling and/or numbness is associated with what structure?
nerve
cramping/knot or spasm is associated with what structure?
muscle (bag of worms)
dull ache is associated with what structure?
muscle (bag of worms)
Radiating dull or deep ache is associated with what structure?
referred pain: sclerotogenous pain
deep burning or dull pain is associated with what structure?
bone/ligament
pinpoint pain over paraspinal tissue is associated with what structure?
myofascial trigger point
crawling sensation (formication) is associated with what structure?
vascular
well localized pain is associated with what structure?
peripheral
diffuse pain is associated with what structure?
central
What does intermittent mean?
less than 25% of the time when awake
What does occasional mean?
between 25 and 50% of time when awake
What does frequent mean?
between 50 and 75% of the time when awake
What does constant mean?
between 75 and 100% of the time when awake
What type of pain is radiating, sharp, stabbing and well demarcated and attributed to a particular nerve root level?
Dermatome pain
What type of pain is pain referral within muscular or fascial tissue?
myotogenous pain
What type of pain is dull, achy,difficult to pinpoint, and referred from somatic structure such as cartilage, ligament, joint capsule or bone?
Scleratogenous pai
What are the parts of the mini mental status exam?
-Orientation
-registration (name 3 objects)
-Attentiona and calculations
_recall (name the object)
-language
What does a person without demential usual score?
24-30
20 or below signifies disease
Does passive or active ROM test for end feel?
passive
What is the method where the doctor utilizes enough weight to overpower the patient’s muscle, allowing the doctor to compare on side of the body to another and noting weakness from side to side?
Break method
What grade of muscle strength is no muscle contraction?
0
What grade of muscle strength is a trace of contraction, 0-10% of normal movement, and cannot overcome gravity?
1
What grade of muscle strength is movement without gravity , 11-25% of normal movement, and cannot overcome gravity?
2
What grade of muscle strength is movement against gravity, 26-50% of normal movement, and is able to overcome gravity?
3
What grade of muscle strength is movement against gravity plus variable resistance, 52-75% of normal movement?
4
what grade of muscle strength is against gravity plus maximum resistance, 76-100% of normal movement?
5
What degree of ligament sprain is minimal extent of failure, no laxity on stress, <1/3 fibers torn, and possible slight reduced strength?
First degree
What degree of ligament sprain is a partial failure, mild to moderate laxity, >1/3 but less than 2/3 fibers torn, and decrease in strength?
second degree
What degrees of ligament sprain is complete failure, > than 2/3 fibers torn, and little to no residual strength?
third degree
NMS tests are positive when the tests causes symptoms to not increase or decrease as expected. T/F
False: increase or decrease as expected
If orthopedic testing causes different pain or sypmtology other than what was expected it may still be significant, but the result is not positive. T/F
True
Plain X-rays are recommended for routine evaluation of patients with acute low back pain problems within the first month of symptoms. T/F
False–only done unless a red flag is noted on clinical examination
What is a method of x-ray that examines a single layer of tissue and blurs the tissue above and below the tissue being examined by moving the x-ray tube in one direction while the film is moved in the other direction?
Tomography
what is Discography?
injection of a water soluble imaging material directly into the nucleus pulpous of the disc.
Discography is invasive, is not recommended for assessing patients with LBP. T/F
True
CT discography is recommended for patients with suspected nerve root compression due to lumbar disc herniation. T/F
False
No recommended over other imaging studies
What are the 2 diagnostic objectives for discography?
- evaluate radiographic leak to the extent of disc damage
2. to characterize pain response on disc injection to see if it compares to typical pain of patient
What are the components of a case history??
Chief Complaint
Comprehensive history
Review of systems
What is a CT?
uses x-rays similar to conventional X-rays but with a special machine that has scanner systems and uses a computer
What is x-ray helpful for?
-fx and integrity of joint space
What is MRI helpful for?
disc herniation and meniscus views
What is CT helpful for?
canal stenosis and metastatic bone disease
What is EMG/NCV helpful for?
peripheral nerve compressions and conductivity of nerve from stimulus to muscle
What is a bone scan helpful for?
infection and metastatic bone disease
What s an EEG good for?
brain waves and organic disease of brain
What is an EKG good for?
electrical activity of the hear and rate/rhythm of electrical impulses of the heart
What is angiography good for?
intracranial aneurysm and vascular disorders and tumors
What is an MRA good for?
integrity of blood vessels to end organ and aneurysm
How much of bone must be destroyed before you can see it on an x0ray?
25-30%
What does unilateral radiating pain that follows a dermatome indicate?
nerve root irritation/compression
What does unilateral radiating pain that follows a multi-dermatomal pattern indicate?
peripheral N issues
What does bilateral radiating pain that involves the upper extremities only indicate?
Cervical myelopathy C6-T2
What does bilateral radiating pain that involves the upper and lower extremities indicate?
spinal cord lesion of C5 and up
What does bilateral radiating pain that involves lower extremities indicate?
lumbar spinal cord lesion or canal stenosis
What is an x-ray taken of after the introduction of radio opaque substance into the spinal subarachnoid space?
myelography
What is a radiographic record after introduction of opaque contrast material into joint?
arthrogram
What is a type of radionuclide imaging that involves IV injection of readioactive compounds known to adhere to metabolically active bone?
Bone scan
What is a diagnostic technique which involves the use of an ultrasound generator which involves the use of an ultrasound generator and receiver that displays echoes on an oscilloscope?
ultrasound
What is the stud of electrical activity arising from muscles and associated with muscle activity.
EMG
What is a myelopathy?
dysfunction of the spinal cord
What is a ridiculopathy?
Dysfunction of the spinal nerve root
What is a neuropathy?
dysfunction of a peripheral nerve root
what is a myopathy?
muscle abnormalities
What may be useful in assessing suspected spinal stenosis and spinal cord myelopathy?
Sensory provoked potential
Primary evoked potential is specific in location and is noted where pathways from a particular sense organ start. T/F
False.
-Where they end
What is the study of the electrical activity in the brain?
Electroencephlagraphy (EEG)
