Midterm: Musculoskeletal Complaint Flashcards
Radicular pain with weakness and sensory loss over an area innervated by a nerve root (dermatomal distribution) most likely is…
Radiculopathy
What type of pattern do radiculopathies follow?
Dermatomal
What condition involves spinal cord damage or dysfunction, including disorders involving the meninges and perimeningeal spaces of spinal cord?
Myelopathy
Basically anything involving the spinal cord
Do myelopathies result in loss of function?
Yes, significant
What are some important palpatory landmarks involving the neck?
Spinous Process
Facet Joints
Paracervical muscles
What does a spurling test/maneuver try to elicit?
Radiculopathy
-nerve root compression
What condition is synonymous for osteoartritis of the vertebrae with defects in the pars interarticularis and subsequent spinal nerve root compression?
Spondylosis
In advanced spondylosis, what four conditions arise?
Radicular pain
Neuropathy
Compression fractures
Spondylolisthesis (step off)
What specific population is scoliosis most common in?
Adolescent girls
What is the most common way to test for scoliosis?
Forward bending test
-clinical evident for curvatures 30 degrees or more
What positions make lumbar stenosis worse?
Back extension
What back position alleviates lumbar stenosis pain?
Back flexion
This is pain in the lower extremities that is caused by lumbar stenosis. It is relieved almost immediately and is NOT due to vascular compromise?
Pseudoclaudication
How do you differentiate pseudoclaudication (lumbar stenosis) from true claudication?
Pseudoclaudication is relieved immediately and is not associated with vascular compromise
This condition presents with pain with flexion or prolonged sitting. It has radicular pain and lower extremity weakness. Straight leg raise test will elicit pain at less than 70 degrees!
Disk herniation
In a disk herniation, will a straight leg raise test of the contralateral leg reproduce symptoms in the affected leg?
Yes
What is sciatica?
Basically disk herniation that follows the radicular pattern of the sciatic nerve going from butt pain that travels down into knee
If a patient has disk herniation with urinary retention, saddle anesthesia, progressing weakness, and neuro deficits how would you treat?
Surgical emergency
-immediate MRI
Is imaging recommended for back pain within the first six weeks?
Nope, not unless there are red flags
-90% will resolve within 6 weeks
Aggravating symptoms with flexion and prolonged sitting suggest that the lesion is where?
Anterior spine disk problems
Aggravating symptoms with extension suggest that the lesion is where?
Facet joints, stenosis, or SI joint
What are some red flag symptoms for malignancy?
Unexplained weight loss, failure to improve w treatment, pain >6 weeks, pain at night/rest
-pt older than 50 w other risk factors as well
What are some red flag symptoms for infection?
Fever, rest pain, recent infection, history of immunocompromised or IVDU
Is nerve root impingement back pain dominant or leg dominant?
Leg
Back is probably more functional impairment
