Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK 2 > L/S Presentations pt 1 > Flashcards

L/S Presentations pt 1 Flashcards

1
Q

List the impairment/functional-based classifications for lumbar spine disorders

A
  1. A/SA LBP w/ Mobility Deficits
  2. A/SA LBP w/Related Cognitive or Affective Tendencies
  3. A/SA/C LBP w/Radiating Pain
  4. A/SA/C LBP w/Movement Coordination Impairments
  5. A LBP w/Related (Referred) Radiating LE Pain
  6. Chronic LBP w/related generalized pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

list some prognostic indicators for development of LBP

A
  1. Hx previous episodes
  2. excessive spine mobility
  3. excessive mobility in other joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

list some prognostic indicators for the developent of chronic LBP

A
  1. presence of symptoms below the knee
  2. pyschosocial distress or depression
  3. fear of pain, movement, and re-injury or low expectations of recovery
  4. pain of high intensity
  5. a passive coping style
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

LBP can be broken down to include what 2 areas?

A
  1. Lumbar spine pain
    • area bordered by transverse line from T12-S1
  2. Sacral spine pain
    • area bordered by vertical lines through PSISs and horizontal lines through S1 and sacrococcygeal joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List some common clinical presentations at the L/S

A
  1. Neoplasms
  2. Infection
  3. Spondyloarthropathies
  4. Vertebral Body frx
  5. Spondylolysis and Spondylolysthesis
  6. Discogenic Pain
    • Discitis
    • internal disc disruption (IDD)
  7. Radicular pain/radiculopathy
  8. Lumbar Stenosis
  9. Zygapophysial Joint Pain
  10. Muscle Pain
  11. L-S surgeries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are common sites for metastasis for lumbar neoplasms?

A
  • 16.5% from breast
  • 15.6% from lung
  • 9.2% from prostate
  • 6.5% from kidney
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

when suspecting a neoplasms what are you looking for in the patient interview?

A
  1. PMH includes cancer
  2. progressive in nature
  3. fatigue
  4. weight loss
  5. smoking
  6. Pain complaints:
    • persistent
    • not alleviated w/bed rest
    • worse at night
    • neurologic symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

for a neoplasm, the physical exam may include what?

A
  1. non-mechanical presentation
  2. age > 50 yrs
  3. anemia
  4. neurologic signs
  5. lab tests for confirmation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

list 2 types of infections that may occur at the L/S

A
  1. Vertebral Osteomyelitis
  2. Epidural abscess
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is an epidural abscess?

A

haematogenous spread of bacteria into epidural space

occurs in 10% of spine infections

associated with DM, chronic renal failure, IV drug misuse, alcoholism, cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are likely findings during a patient interview in someone with vertebral osteomyelitis?

A
  1. oftent traced to other source of infection (dental abscess, pneumonia, etc.)
    • bladder infection most common
  2. Increased risk
    • immunocompromised pts
    • DM
  3. Weight loss
  4. Fatigue
  5. Fever
  6. Neurologic symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what would pain compliants look like in someone with vertebral osteomyelitis?

A
  1. local, focal back pain
  2. worse w/mechanical loading
  3. improves w/recumbent position
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

physical exam findings in vertebral osteomyelitis

A
  1. Fever
  2. Local tenderness
  3. Aggravated w/local percussion
  4. Neurologic signs (cord/root)
  5. Lab tests important for dx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what may increase the risk of an epidural abscess?

A
  1. misdiagnosed vertebral osteomyelitis
    • they are common concomitants
  2. 12-30% have a Hx of preceding trauma (fall, etc)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the typical progression of symptoms with epidural abscesses?

A
  1. local, focal back pain
  2. radicular signs/symptoms
  3. paralysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

abdominal referrals may cause LBP, but viseral disease accounts for ____ of cases

A

2%

potential organs involved:

  1. pelvic organs
  2. kidneys
  3. Aortic aneurysm
  4. Gastrointestinal
17
Q

T/F: vertebral frxs are associated with increased mortality?

A

TRUE

predictor for subsequent vertebral frx (4-5x) and hip frx (3x)

18
Q

the TLICS classification system for vertebral fractures is based off of what 3 things?

A
  1. Morphology
  2. Integrity of PLC
    • supraspinous, interspinous ligaments, ligamentum flava, z-joint capsules
  3. Neurologic status
19
Q

what are the 3 morphologic descriptors in the TLICS classification system?

A
  1. compression → vertebral body buckles under load to produce a compression/burst frx
  2. translation/rotation → vertebral column is subjected to shear/torsional forces causing the rostral part of spinal column to translate/rotate w/respect to caudal portion
  3. distraction → rostral spinal column becomes separated from caudal segement b/c of distraction forces
20
Q

what are the 2 subtypes of compression frxs?

A
  1. Traditional
  2. Burst
21
Q

describe traditional compression frxs

A
  1. stable injury
  2. invovles anterior column
  3. common mechanism → axial loading in flexed position
  4. Traumatic
    • high energy
    • osteoporotic
22
Q

describe burst compression frxs

A
  1. anterior and middle column invovlement
  2. 15-20% of all major vertebral body frxs
  3. most common at T/L junction
  4. potential neural involvment
  5. vertebral segment subjected to high force axial (and/or flexion load)
    • MVC
    • falls from heights
    • high-speed sport injury
23
Q

describe rotation/translation frxs

A
  1. associated w/fall from a height or heavy object falling on body w/bent trunk
  2. torsion/shear force
  3. horizontal displacement of one T/L vertebral body on another
  4. dislocation → facet joints intact but dislocated
24
Q

describe distraction frxs

A
  1. separation in the vertical axis
  2. anterior and posterior ligaments, anterior and posterior bony structures both
  3. potential frx to posterior elements
25
Q

list vertebral frx red flags

A
  1. older age
  2. sig trauma
  3. corticosteroid use
  4. contusion/abrasion
26
Q

List the Henschke cluster for vertebral frxs

A
  1. Age > 70
  2. sig trauma
  3. prolonged corticosteroid use
  4. sensory alterations from trunk down
27
Q

list the components of the Roman cluster for osteoporotic vertebral compression frxs

A
  1. Age > 52
  2. no presence of leg pain
  3. BMI = 22
  4. does not exercise regularly
  5. female gender

4/5 = +LR 9.6

28
Q

what is spondylolysis?

A

fatigue frx of pars interarticularis

proposed mechanism:

  1. acquired → repetitive microtrauma w/extension or extension w/side-bending activities
  2. congential
  3. developmental
29
Q

90% of spondyloysis occur _____

A

at L5 level (L5/S1 > L4/L5)

30
Q

what is spondylolythesis?

A

anterior slip of the vertebra following bilateral spondylolysis

graded 1-4 via the percentage of body slipped

31
Q

describe the grades for spondylothesis

A
  • I = 1-25%
  • II = 25-50%
  • III = 50-75%
  • IV = >75%

greatest slippage occurs between 10-15 y/o

32
Q

how would a spondylothesis show up on a radiograph?

A

“Scotty dog with collar”

(on PA, lateral oblique radiographs)

often, reduced ROM observed with flexion/extension radiographs (rather than instability)

33
Q

prevelance of spondylolysis and spondylothesis is higher in what population?

A

up to 43% in athletes

  1. repetitive extension: gymnastics, diving, weight lifting
  2. high grade slippage 2x greater in girls and 4x greater in women
  3. greater risk among adolescents
34
Q

describe the symptomology of spondylolysis and spondylothesis

A
  • localized LBP, worsened with extension activities
35
Q

what physical exam findings are expected with spondylolysis and spondylothesis?

A
  1. include neurologic testing
  2. visual inspection: excessive lumbar lordosis
  3. possible step-off deformity
  4. pain with lumbar extension, rotation
  5. “hamstring tightness” has been proposed
    • instability testing and spring testing at involved segment (if administered)

MSK 2 (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions