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MSK 2 > Exam 2: UQS > Flashcards

Exam 2: UQS Flashcards

1
Q

The “Fundamental Four”

A

Present Illness (Chief complaint)
Past Health History
Family Health History**
Personal/Social History**

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2
Q

The “Sacred Seven”

A

Setting or Onset
Location/Radiation
Severity
Quality
Chronology/Timing
Associated Symptoms/Modifying Factors
Current Medical Management

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3
Q

location of pain

A

Local; Referred; Radicular; Regional

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4
Q

Canadian Cervical Spine Rules - high risk factors

A

age > 65
dangerous MOI
parathesia in the extremities

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5
Q

Red FlagsSpinal Neoplasm

A

Medical history is (+) for cancer, even if cleared or thought to be in remission

Night pain and other atypical pain manifestations

Worsening Pain

Unexplained weight loss

Fatigue, malaise, unwellness

No response to conservative management

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6
Q

Red Flags(Fractures/Dislocation)

A

Trauma, sufficient energy exchange
MVA, Falls, Direct blow or impact

Severe limitations of motion all planes

Muscular spasm; unwillingness to move

Deformity may be present

Must be ruled-out by diagnositc imaging

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7
Q

Canadian Cervical Spine Rules - low risk factors

A

safe to assess ROM

simple rear end motor vechile accident

normal sitting posture in ER

amb at anytime during injury

delayed onset of neck pain and absence of midline tenderness

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8
Q

Red FlagsInflammatory/Systemic Disease

A

Body Temperature > 100 F

Blood pressure > 160/95 mmHg

Resting pulse > 100 bpm

Resting respiration > 25

Redness, warmth, swelling

Discoloration (eg. Jaundice)

Fatigue, malaise, unwellness

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9
Q

Red FlagsReferred Pain: Visceral Cardiac Considerations

A

Chest, neck and arm pain

Jaw, posterior thorax, epigastrium

Classically, left sided, C8

angina

Associated symptoms:
Dyspnea, lower extremity edema, SOB, fatigued, syncope

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10
Q

Dysarthria

A

where you have difficulty speaking because the muscles you use for speech are weak

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11
Q

Dysphagia

A

hard time swallowing

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12
Q

Referred Pain: Visceral gall bladder

A

Recurrent, right thoracic/lower rib region, right scapular region

Increased intensity following meals

Fatty, greasy foods tend to worsen symptoms

At risk:
Obese, women, in their 40’s

Associated symptoms:
Nausea/heartburn, vomiting/diarrhea, difficulty swallowing, jaundiced, rectal bleeding/stool changes

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13
Q

Referred Pain: Visceral lungs and associated structures

A

Thoracic and chest regions

Possibly cervical region or shoulders

Pancost Tumors

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14
Q

Pulmonary Disease

A

Rarely manifests purely as pain

Infections, pleurisy, cancer

Difficulty with respiration, cough

Hoarseness, sore throat, wheezing

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15
Q

is Multi-segmental weakness
a red flag

A

yes

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16
Q

is double vision normal

A

no this is abnomral

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17
Q

what is Myelopathic Involvement

A

the result of compression of the spinal cord and nerve roots caused by inflammation, arthritis, bone spurs and spinal degeneration due to aging

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18
Q

Myelopathic Involvement presentation

A

More common in the cervical region than the thoracic region

Gait and balance disturbances, generalized weakness

May not be associated with any radiating pain

Bilateral P/N Arms and/or legs

May have local radicular involvement

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19
Q

Myelopathic Involvement positive test

A

(+) Signs of UMN involvement
Hoffman’s, Hyper-reflexic DTR’s, Clonus

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20
Q

Shoulder Component

A

Symptoms are primarily affected by movements of the shoulder joint

Stiff shoulder; Weakened shoulder; Unstable shoulder

Symptoms are essentially unaffected by head movements/positions

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21
Q

Thoracic Component

A

Symptoms may be diffuse and hard to localize without direct palpation

Thoracic Dermatome: Circumferential

Rib Involvement: Unilateral radiation

Symptoms may be affected by breathing

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22
Q

Vertebrobasilar insufficiency (VBI)

A

is defined by inadequate blood flow through the posterior circulation of the brain, supplied by the 2 vertebral arteries that merge to form the basilar artery.

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23
Q

symptoms of VBI

A

headache nausea redness of the face

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24
Q

how do you test VBI

A

hautards test

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25
Q

Tromner sign position

A
  • Patient is sitting with head in a neutral position
  • Set the hand mid-way between pronation and supination
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26
Q

tromner sign procedure

A

flick the finger up

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27
Q

positiove tromner sign

A

Flexion of the IP in the thumb

  • Localized cervical and higher
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28
Q

what can hautards test tell you

A

upper body proprioception, positional provocative testing, VBI

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29
Q

angle of seating and injury

A

the greater the seat angle the greater the impact

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30
Q

rim lesion

A

an avulsion of the disc from the end plate
the ant longitudinal ligament is also torn

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31
Q

neck the healing process

A

3 weeks - rest
3 weeks - 3 months: therapy
after 3 months there is not much we can do

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32
Q

what is the def of a concussion

A

trauma induced change in mental status that may or may not involve a LOC

caused by a jolt to the head that disrupts the function o the brains

33
Q

how long do concussion symptoms last

A

varibles

34
Q

MOI of concussion

A

blow to the head or the body - direct contact is not necessary

acc/dec

disrupts the neuro-metabolism in the brain results in a energy crisis

no anatomical changes: MRI/CT are normal

freq. LOC

35
Q

concussion staff noticed sym

A

LOC
forgets prior events
forgets events after the hit
appears dazed or confused
is confused about assignment
forgets play
is unsure of game, score or opponent
moves clusmily
ans questions slowly
shows behavior or personlity chnages

36
Q

concussion pt noticed syms

A

feels foggy or groggy
chnage in sleep
feels fatigued
headache
nausea
balance problems or dizziness
double or fuzzy/blurry vision
sensitive to light or noise
feels sluggish or slowed down
conccentration or memory issues

37
Q

the sharps pursors test is looking at what ligament and boney structure

A

transverse
AA joint (dens)

38
Q

the kick test is testing what ligmant

A

alar ligament

39
Q

what is the shear test looking at

A

the movement of the atlas in the frontal plane

40
Q

what is the Tectorial membrane of the cervical spine

A

provides for a second line of defense, preventing the odontoid process from compressing the spinal cord

41
Q

hautard’s cervogenic issue

A

alteration in the cervical afferent input

42
Q

hautard’s vestibular issue

A

status stabilizes as the head position is stabilized

43
Q

hautrad’s vascular issue

A

VBI

development of neighborhood signs

status worsens with sustained head position

44
Q

Neighborhood signs

A

used to help distinguish a central from a peripheral origin of a patients vertigo.

45
Q

jaw jerk is looking at what segments

A

C5 and above

46
Q

what is the neck torsion test differentiating between

A

cervical and vestibular

47
Q

morphlogical difference between c spine and lumbar spine

A

vert art
spinal cord

48
Q

in the llumbar spine how much compression do the disc bear

A

85% of the axial compressive load
15% is borne by the facets

49
Q

c spine axial loading - % borne

A

disc and posterior facets bear the same amount

50
Q

facet orientation and movement in the lumbar spine

A

resistance to flexion and rot

stopping forward translation

51
Q

c spine facet orientation

A

promote movement in the sagittal plane

translation in the horizontal plane will occur

52
Q

nucleus in the c spine compared to lumbar

A

25% nucleus - c spine
50% nucleus - lumbar spine

nucleus of the discs in the c spine are only there briefly - only gel like for a little

53
Q

where do cervical disc hernation occur compared to the lumbar spine

A

posterior laterally

lumbar - lateral disc herniations

54
Q

soft discc herniations

A

small well contained herniations of nuclear material

55
Q

hard disc herniations

A

actual fragmentation of nuclear material

56
Q

what does cerviogenic means

A

sym that are associated with movements of the head and neck region

57
Q

C5 radiating pain mimics what

A

shoulder pain

58
Q

referred pain in cerviogenic presentation

A

medial border of the scapula

59
Q

what vert make up the articular column

A

C2-C7

60
Q

what runs through the transverse foreman

A

vertrbral art

61
Q

what is the orientation of sup facet of C1 - atlas

A

sup and medial

62
Q

what is the orientation of inf facet of C1 - atlas

A

inf and medial

63
Q

C2 SP

A

large and bifid

64
Q

inf facet orientation for c spine

A

down and forwards

65
Q

is there a disc between AA and AO

A

no

66
Q

movement seen at the AO joints

A

nodding and side bending

tranverse axis - nodding
A/P axis - slight lateral flexion

67
Q

what is the function of the transverse ligamaent

A

retains den in contact with the anterior arch of the atlas during movement

68
Q

movement and joints seen at the AA joint

A

rotation and slight flexion and extension

medial - dens and the atlas, rot
lateral - facet joint of A and A, supports the weight of the head and flexion and ext

69
Q

range of rot seen t the dens

A

45-degrees

70
Q

what is the tectorial membrane

A

extension of the posterior long lig
axis body to occiput

71
Q

alar ligamnet

A

2 lig that run from the side of the dens to the condyles of the occciput

72
Q

what is the alar ligament a primary restraint for

A

contralateral rotation and SB

73
Q

what is the scalene ant attached to

A

1st rib

74
Q

what is the scalene meduis attached to

A

1st rib

75
Q

what is the scalene post attached to

A

2nd

76
Q

what is in the suboccciptal triangle

A

vert art and C1 DPR

77
Q

the vert art travels through what seegments

A

C1 - C6 transverse canal

78
Q

what is the most mobile spinal segment

A

AO

MSK 2 (15 decks)

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