EXAM #2 Pathologies Related to Thorax Flashcards
Incidence:
Multiple myeloma is primary _______ in ______
Typically in ______
malignant tumor in bone marrow
older adults
Spinal malignancy; spinal metastases
-_________ common tumors of the spine
-________ common serious spinal pathology
-MOST often from ________,______,______,______,________,_________(6)
-MOST
-2nd MOST
-breast, lung, prostate, kidney, GI, and thyroid tumors
- What is the 3rd MOST common area of metastasis behind the lung and liver?
2a. What specific area?
2b. _______ rarely involved
- bone
2a. the vertebral body is the most common, in the anterior portion
2b. disk
What is the most common region for spinal malignancy and the least common region?
Thoracic 70% > Lumbar; least common in cervical region
Risk factors for spinal malignancy? (1)
hx of cancer
Pathogenesis of spinal malignancy:
healthy bone replaced by a tumor
PT implication for spinal malignancy:
unless?
urgent referral to MD unless cord S&S—-> emergency referral w/immobilization
slow, gradual and often progressive compression on cord is ________________
thoracic spinal cord myelopathy
Where is the most common region for myelopathy? Why?
thoracic due to smaller ratio of a canal to cord than other regions
thoracic spinal cord myelopathy is most commonly due to _____________
degenerative spinal changes
What are degenerative changes that can cause thoracic spinal cord myelopathy? (5)
lax and bulking ligamentum flavum
stenosis
age-related disc disease w/hernation
vertebral; body collapse/ fx
pathological instability i.e. spondylothesis
thoracic spinal cord myelopathy S&S:
-multi-segmental numbness and weakness/paralysis of extremities and trunk below level of injury resulting in paraplegia
-DTR= hyper UMN+
-spastic or retentive bowel and bladder
Central disc herniation for thoracic spinal cord myelopathy is rare? T or F
true
What are S&S of spinal malignancy:
spinal P! MOST common initial symptom
unfamiliar and severe P! that may become progressive and constant
bony landmark alteration (fxs), unable to lie flat due to P!, mechanical P!, TTP
MOST common serious spinal pathology?
non-traumatic spinal fxs
70% of non-traumatic spinal fxs occur in the _________ spine
thoracic
predominantly seen in _________w/osteoporosis
older females
Non traumatic spinal fxs are MOST commonly between ________ and _____ levels
common causes for non-traumatic spinal fxs_______ and _______
T8-L4
malignancy and osteoporosis
Risk Factors of Non-Traumatic Spinal fxs: high evidence
prior osteoporotic or low spinal fx
≥ 3 months of corticosteroid use
Risk Factors: Females
-late onset menarche
-early onset menopause
WHY?__________
over lifespan, peak bone density occurs in 20s
Risk factors for Non-Traumatic Spinal Fxs
Older age:
_______> 65 yrs.
_______> 75 yrs
-women
-men
What are some low evidence S&S of Thoracic Spinal Fxs: (5)
unfamiliar/serves P!
TTP
sudden posture changes
mechanical P!
Rare Nuro S&S
Is MRI imagining useful for non-traumatic spinal fxs? If so what will be shown?
yes, 1st choice
lateral views MOST useful
What are spinal infections primarily from?
mycobacterium TB
Infectious diseases of spinal structures = spinal infection? T or F
True
What are RFs of spinal infection?
Are these RFs low or high evidence?
-Sx, particularly of the spine and repeated procedure, IV drug use, Hx of TB
-Low evidence
Spinal infection develop ____-____ years after initial __________ into lungs.
2-3 years; air droplet
Spinal Infection: begins in the ________, progresses to __________ and eventually to the _______ and adjacent ________
lungs, vertebral body, disc, vertebra
Arthritic-like back P!/stiffness is the MOST common presenting symptom of?
Spinal infections
Spinal infections: if left untreated it can lead to
-neuro S&S, LE coordination, bowel, and bladder dysfunction
-increased thoracic kyphosis
X-ray imagining will present what findings for spinal infections?
body destruction, loss of height, diminished disc space, TB abscess
Angina aka _____
chest P!
What are the 2 types of Angina?
stable and unstable
Occurring with stress, physical and or emotional is what type of angina?
If < 20 min the _______ referral
If ≥ 20 min then _______ referral
stable
-urgenet
-emergency
Occurring at rest is what type of angina?
referral type?
unstable
emergency
Which type of Angina is worst type I or II?
Type II
Myocardial infarction aka ___________
heart attack
Angina is most often seen in:
males > 65yrs
Any condition that limits blood supply or increases the demand of the heart is a risk factor for angina and myocardial infarction? T or F
True
These are S&S of ___________
-sudden onset of chest P!, pressure, and or heaviness
-P! into jaw or left arm
-referred P1 C4-T4 dermatomal pattern
Angina and myocardial infraction
Atypical S&S of angina and myocardial infarction
gender?
females
interscapular and right arm P!
50% don’t have angina
Less P! w/diabetes due to neuropathy/blood suuply
