Medical Screening of Lumbopelvic Part 1 and 2 Flashcards
When would a patient not be appropriate for physical therapy and would be referred out to an appropriate health care provider?
When the patient’s signs and symptoms are outside of the PT scope of practice.
What would you do if a patient as ‘red flags’ present?
Referral/Consulation to a medical specialist
What would you do if a patient has ‘yellow flag’ present?
Referral/Consultation with mental health provider
What is the most common site for metasteses?
Cancer Incidence
Skeleton
What is the common metastatic cancer that causes lumbar spinal pain?
Prostate Cancer
What are the following features of?
- clinican judgement consistent with maligancy
- neurologic symptoms
- unexplained weight loss
- not improved after 1 month
- age greater than or equal to 50
- no relieve with bed rest
- insidious onset
Cancer/Back Related Tumor
What are these back pain symptoms caused from?
- LBP, flank or pelvic pain
- local tenderness over spinal process with percussin
- concurrent infection or drug use
- fever
Spinal Infection
What syndrome is a neurologic emergency and if surgey is done within 72 hours it will be successful?
Cauda Equina Syndrome
What are the following features of?
- Urine retention
- Fecal incontinence
- Saddle anesthesia
- Sensory or motor deficits in the feet (L4, L5, S1 areas)
Cauda Equina Syndrome
What are the following features of?
- Major trauma (recent history)
- Pain and tenderness (with palpation to spine)
- Age greater than 50
- Female
- Prolonged use of corticosteriods
- Increased pain with weight bearing
Spinal Compression Syndrome
What is this a defintion of?
Numbness, tingling in groin and peroneal area
Saddle anesthesia
What are the following features of?
- Midline lower thoracic/lumbar pain*
- Palpable pulsating abdominal mass
- Pain descriptors: throbbing, pulsating
- Pt unable to find comfortable position*
- History of cigarette smoking
- Positive family history*
- Past history of it
Abdominal Aoritc Aneurysm (AAA)
What is the following a defintion of?
Inflammatory artropathy, systematic rheumatic disorder
- males > females
- history of inflammatory conditions (irritable bowel, Crohn’s)
Ankylosing Spondylitis
What are the following features of?
- Morning stifness > 30 min duration
- improvement in LBP with exercise but not with rest
- night pain during second half of night only
- alternating buttock pain
Ankyloking Spondylitis
Where can GI refer pain patterns?
into the back and can be mistaken for musculo-skeletal pain
Where do renal/urinary pain be referred to?
Back or Flank
When would you ask the following questions?
- Frequency
- Urgency
- Dysuria
- Noctura
- Fever, chills, malaise
- Cloudy, bloody, foul smelling urine
- Suprapubic, abdominal, flank pain
Renal/Urinary Disorders
There is a signficant relationship between low back pain and what?
Anxiety and depression
What are the following risk factors of?
- Chronic mental illness
- chronic minor daily stress
- Chronic pain syndrome
- Family history
- Low income/job less
- Low self-esteem
- Low social support
- Prior onset
- Single/divorced/widowed
- Traumatic brain injury
- Younger age
Depression
What are the following symptoms of?
- Depressed mood
- Loss of interest or pleasure
- Low energy or fatigue
- Sleep disturbance
- Appetite disturbance
- Psychomotor disturbrance
- Decreased concentration or difficulty making decsions
- Inappropriate guilt or worthlessness
- Thoughts of death or suicidal ideation or behavior
Major Depressive Disorder
What are the following features of?
- age and sex are at high risk for pelvic disorder
- body mass index in low normal range
- severe pelvic pain (hallmark symtpom)
- urinary urgency-frequency
- sudden and insidious onset of symptoms of unknowno origin
- constant pain, worse with walking and bending, sleep disturbance
- lower abdominal quadrant tenderness
- negative medical diagnostic tests for mechanical and nonmechanical disorders
- severe disability in a young and otherwise healthy adult
- family history of rheumatologic and endocrine disorders
Back pain of Visceral Orgin
