low back pain Flashcards
MSK Ddx for low back pain
muscle strain SD compression Fx spondylosis spondylolysis spondylolisthesis annulus fibrosis tear herniated nucleus pulposus arthritis, ankylosing pondylitis, osteomyelitis, vertebral cancer, vertebral ischemia, discitis, degenerative disk, paget's
What are the cardio Ddx for low back pain
MI thrombus embolus aortic abdominal aneurism arterial-venous malformation
What are the GI Ddx for low back pain
constipation flatus necrotizing enterocolitis volvulus intussuseption perforation colitis diverticulitis IBS, IBD
what are the renal Ddx for low back pain
nephrolithiasis
hydronephrosis
infection
polycystic kidney disease
what are the neuro Ddx for low pack pain
cauda equina syndrome tumor impingement syndromes neuritis trauma
What are the respiratory Ddx for low back pain
lower lobe pneumonia
diaphragmatic abscess
what are the repro Ddx for low back pain
endometriosis
ectopic pregnancy
what are the other Ddx that should be on your list for low back pain
trauma
autoimmune
infection
low back pain that stays above knee is most likely what
non-specific muscular or ligamentous injury, SD, degenerative disease, fracture, spondylolysis
low back pain that radiates below knee is most likely what
radiculopathy
spinal stenosis
cauda equina syndrome
associated piriformis syndrome
spinal nerve root compression caused cauda equine syndrome usually causes dysfunction where
bowel or bladder
what is the Tx for cauda equina syndrome
surgical decompression
What can cause radiculopathy
herniated nucleus pulposus tumor exostoses spinal stenosis infection
foramen are usually how much larger than exiting nerves
2-3x
Vertebral discs are mainly what material
water so affected by hydrostatic pressures
and alot of GAGs
Describe a protruded herniated disc
annulus fibrosis still intact
describe an extruded herniated disc
through annulus but posterior longitudinal ligament maintains disc within vertebral space
describe a sequestered herniated disc
free to roam spinal canal
where do most herniated discs occur and why
lumbar because most stress
thoracic spin is protected by movement of thoracic cage
Which nerve is most commonly affected by disc herniation
S1 because disk L5
posterior longitudinal ligament gets thinner as descend spine
what type of discs cause radiculopahty
bulging or herniations
what are risk factors for herniated nucleus pulposus
advancing age, tobacco, ehtanol, history of back pain, bending or lifting, professions that require weight bearing activity
what mm and reflexes are affected if disc levels L3L4 herniate
so n L4
tibialis anterior
patellar
what mm and reflexes are affected if disc levels L45 herniate
so on L5
extensor digitorum longus
