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MSK 1 > Flags of MSK system > Flashcards

Flags of MSK system Flashcards

1
Q

systems review flow

A

cardiovascular
nervous
GI
pulmonary
urogenital
endocrine
psychological

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2
Q

what are red flags

A

cue to a more serious medical pathology
indicates if referral is necessary

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3
Q

how are red flags in isolation interpreted

A

most people will check at least one or two red flag boxes but they are only informative when multiple are indicated

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4
Q

how are red flags used

A

management strategy not a screen

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5
Q

what do red flags give us more information about, diagnosis or prognosis?

A

prognosis

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6
Q

what do unilateral red flags indicate

A

heighten us to be aware of changes over time

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7
Q

what is medical screening

A

process in which disease/condition is assessed in an asymptomatic population who may or may not have disease precursors

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8
Q

what does screening allow for? when is it typically done?

A

guide whether or not diagnostic testing should be done

preclinical phase

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9
Q

when is diagnostic testing done

A

when symptoms are present

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10
Q

relationship between red flags and prognosis

A

little to no red flags = good prognosis

many red flags = not as good

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11
Q

identification in patients when using 10 or 23 items of the OSPRO

A

10 - 95%
23 - 100%

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12
Q

what does OSPRO stand for

A

optimal screening for prediction of referral and outcome

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13
Q

if there is a yes reported on the OSPRO, what needs to be done by a therapist

A

asking more questions
- why? when? how does it change?

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14
Q

what does the OSPRO provide

A

prediction of 12 month quality of life and comorbidity change

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15
Q

those with more “yes” answers on the OSPRO need to

A

monitored - watchful wait approach

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16
Q

what is watchful waiting effective in

A

avoidance of unnecessary imaging/surgery

improving patient rapport

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17
Q

mortality vs morbidity

A

mortality - death
morbidity - illness or disease

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18
Q

how to manage red flags as a clinician

A

utilize screening test/tools versus imaging to identify a need first

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19
Q

what are red flag conditions determined by

A

demographics
previous family history
previous medical/surgery history
medications
macro vs micro trauma
symptom descriptions
location of the body

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20
Q

structures that produce pain

A

somatic
visceral
neural

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21
Q

superficial structures that can cause somatic pain

A

skin
fascia
tendon sheaths

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22
Q

deep structures that can cause somatic pain

A

periosteum of bone
muscles
tendons
joints
deep fascia
capsules
dura

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23
Q

description of somatic pain

A

dull
aching
gnawing
diffuse
multiple dermatomes

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24
Q

characteristics of somatic pain

A

improve with rest/non-weight bearing

increases with activity

no constitutional symptoms

more predictable pattern of response to position, rest or activity

25
Q

constitutional symptoms can be thought as

A

systemic symptoms

26
Q

visceral pain characteristics

A

not well localized
unpredictable pattern of response
does not change with rest or nonweight bearing

27
Q

what are the proposed visceral referred pain mechanisms

A

embryologic development
multi-segmental innervation
direct pressure and shared pathway

28
Q

what is embryologic development mechanism of referred visceral pain

A

neural networks formed between organs due to the position of the organs in development

will maintain through development when they separate

29
Q

what is the multisegmental innervation mechanism of visceral referred pain

A

overlapping innervations that will refer pain to corresponding somatic area due to sensory fibers entering spinal cord at the same level

30
Q

what is visceral organ cross-sensitization

A

multiple organs that have overlapping segmental projections have presentations of dysfunction

31
Q

what is the direct pressure and shared pathway mechanism of visceral pain referral

A

pain is referred through shared ganglions from each organ’s neural system where they gather and share information through the cord to the plexus

32
Q

descriptors of neuropathic pain

A

sharp, shooting, burning, lancinating

33
Q

how does brain tissue feel pain

A

it does not, it is insensitive to pain

34
Q

which types of pain need nociceptive information

A

somatic and visceral

35
Q

muscle pain description

A

cramping
dull
aching
poorly localized

36
Q

ligament or joint capsule pain description

A

dull
aching

37
Q

nerve root pain description

A

sharp
lancinating
shooting

38
Q

nerve pain description

A

sharp lancinating
lightening like

39
Q

bone pain description

A

deep
nagging
boring
dull
localized

40
Q

fracture pain description

A

sharp
severe
intolerable

41
Q

vascular pain description

A

throbbing
aching
diffuse
poorly localized

42
Q

nocioplastic pain description

A

disproportionate to activity or mechanism of injury
diffuse, non-anatomic areas

43
Q

method of action when a low level of concern is present

A

begin a trial of therapy
revision if clinical features change

44
Q

method of action when there are a few concerning features

A

begin a trial of therapy with a watchful waiting mentality

monitor progress or any changes in clinical presentations

45
Q

method of action when there are some concerning features

A

urgent referral
no therapy
further investigation (referral)

46
Q

method of action when there is a high level of concerning features

A

emergency referral
do not begin therapy

47
Q

types of yellow flags

A

pathological
precautions
psychological

48
Q

psychosocial yellow flags

A

fear avoidance
incorrect beliefs regarding exercise
pain catastrophizing
hypervigilance
depression
social withdrawal

49
Q

clinical presentation of fear-avoidance behaviors

A

reluctance to participate in activities that may increase symptoms

50
Q

clinical presentation of incorrect beliefs regarding exercise

A

belief that any exercise or movement that hurts a patient will cause more physical harm

51
Q

clinical presentation of pain catastrophizing

A

constant ruminating on one’s pain
magnification of the threat that the pain poses

52
Q

clinical presentation of hypervigilance

A

constantly on guard for threats to one’s safety

53
Q

yellow flag considerations

A

A - attitudes
B - beliefs
C - compensation
D - diagnosis
E - emotions
F - family
W - work

54
Q

something to consider when thinking about diagnosis yellow flags

A

inappropriate communication can lead to patient misunderstanding of their medical condition

55
Q

what measure and what score indicates a patient is at risk for chronic pain

A

orebro MSK pain questionnaire > 50
StarT Back = 4 or more

56
Q

examination for pain catastrophizing? what score is significant?

A

PCS
>30

57
Q

what is the examination for kinesiophobia? what score is significant?

A

TSK-11
11-44, higher is more avoidant

58
Q

what is the examination for avoidance behavior? what score is significant?

A

FABQ
>34 for work
>15 for physical activity

59
Q
A

MSK 1 (11 decks)

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