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Gonstead > Midterm > Flashcards

Midterm Flashcards

1
Q

Disc lesion: Patient leans away from the side of pain

A

Lateral disc lesion

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2
Q

Disc lesion: patient will lean toward the site of pain.

A

Medial disc lesion

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3
Q

Disc lesion: Patient will lean forward or not at all.

A

Subrhizal disc lesion

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4
Q

Disc lesion: Patient will have bilateral pain or switching pain and antalgias

A

Central disc lesion.

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5
Q

How long does it take to resolve a lateral disc lesion?

A

2 weeks

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6
Q

How long does it take to resolve a medial disc lesion?

A

4 weeks

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7
Q

How long does it take to resolve a subrhizal disc lesion?

A

4-6 weeks

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8
Q

How long does it take to resolve a central disc lesion?

A

6 weeks

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9
Q

Ortho and Neuro:

A
  1. Valsalva/determines
  2. SLR + at 45 degrees
  3. Neurological package (mildly + in 50% of disc pts)
  4. Pain pattern correlation
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10
Q

Chiropractic exam: ??

A
  1. Scope - sympathetic run to pain may be inconclusive.
  2. Static palpation - A lot of fluid and muscle guarded/spasms.
  3. Motion palpation - Difficult to perform but is still done.
  4. Percussion/vibration - (+) on spinous of involved segment.
  5. X-ray - APOM Full spine 14X36 and Lat. Full SPine (2 exposure) *May perform a standing lumbar regional series ONLY if the patient is leaned over too much with an antalgique position to get a proper full spine view.
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11
Q

OPQRST associated with Disc lesion:

A

Rapid onset radiating pain, made worse by sitting, standing, and walking and relieved by rest with the knees flexed.

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12
Q

Chiropractic management of Disc lesion:

A

1- Ice over affected disc.

2- Pump the disc. (Repeat until pt. can tolerate it well.)

3- Side Posture Pull Adjustment, contacting spinous BELOW the affected side.

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13
Q

Patient home care instruction: ??

How many time a day can a patient be seen for disc lesions? (How many hours apart?)

A

Can be seen 2 times a day, 6 hours apart.

*EVERYDAY until symptoms are noticeably improved and antalgique is reduced or gone.

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14
Q

Patient home care instruction:

4 indications

A

Ice every 20 minutes/hour

Walk at least for 5 minutes each hour.

Mild stretching of LB

NO SITTING

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15
Q

What is the appropriate follow up care for disc lesion?

A

With improvement:
- Adjust once/day afternoon or evening

When symptoms subside:
- Re-x-ray (14x36 FS) and continue subluxation correction

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16
Q

The layers of the annulus fibrosis are oriented : ?

How many layers surrounding the nucleus?

A

At 30 degrees to the horizon in a “criss-cross” pattern.

20-30 layers.

17
Q

Which part of the annulus fibrosis of the lumbar spine is thin and tightly packed?

A

Posterior

18
Q

What is an incomplete lamella?

Where is it most common?

A

One that ceases to pass around the circumference of the disc.

Posterolateral quadrant 50% of total, 40% is seen in any other quadrant.

19
Q

Which “GAG” glycoaminoglycans are found in the IVDs?

A
  • Chondroitin-6-sulphate
  • Chondroitin-4-sulphate
  • Keratan sulphate and hyaluronic acid.
20
Q

What are the 2 types of proteoglycans?

A

Proteoglycans Units:
Several GAGs linked to a peptide chain.

Proteoglycans Aggregate:
Several proteoglycan unit linked to hyaluronic acid.

21
Q

The annulus is about __-__% water by weight.

Where is the proteoglycan gel found?

A

60-70%

B/w each layer of collagen in the annulus, binds the lamellar together to prevent buckling or fraying.

22
Q

The consistency of a healthy disc is like?

A

Toothpaste, it’s 70-90% water bound in a matrix.

23
Q

Making the Matrix:

What are the % of dry ingredients that make up the matrix.

A

65% proteoglycans
25% proteoglycans aggregates

Pinch of Type II collagen which holds the proteoglycans together.

24
Q

Annulus and nucleus have the same components just different ratio. Annulus had more _____ and Nucleus has more ________.

A

A: more collagen Type I and II

N: more proteoglycans

25
Q

Each vertebral endplate is a layer of cartilage that is about: _____ - _____mm thick.

A

0.6-1mm

26
Q

Cartilaginous endplates:

The tissue nearer bone endplates contains more ____ and the tissue nearer they nucleus contains more ___________ & ________.

A

Near endplate: collagen

Near nucleus: proteoglycan and water.

27
Q

DIffusion is not a chemical rxn, but rather a _________________.

A

Passive transport.

28
Q

What shows diffusion and accompanies degeneration?

A

Lower pH

Gonstead (1 decks)

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