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NPTE Study Practice > MSK Patho Spine > Flashcards

MSK Patho Spine Flashcards

1
Q

Spinal manipulation for pain inhibition is generally indicated for this condition True/False

A
  • True
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2
Q

Pathology of spinal/intervertebral stenosis

A
  • Congenital narrow spinal canal or intervertebral foramen, coupled with hypertrophy of the spinal lamina & ligamentum flavum or facets, as the result of age related degenerative processes or disease
  • Results in vascular and/or neural compromise
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3
Q

Signs and symptoms of spinal/intervertebral stenosis

A
  • Bilateral pain & paresthesia in back, buttocks, thighs, calves, & feet
  • Pain decreases in spinal flexion, increases in extension
  • Pain increases with walking
  • Pain relieved with prolonged rest or activity modification, such as leaning on a shopping cart
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4
Q

What position is the cervical spine placed in for optimal intervertebral foraminal opening during traction

A
  • 15º fo flexion
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5
Q

Contraindications to traction

A
  • Joint hypermobility
  • Pregnancy
  • RA
  • Down syndrome
  • Any other systemic disease that affects ligamentous integrity
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6
Q

Symptoms of internal disc disruption

A
  • Most common in lumber spine
  • Constant deep, achy pain
  • Increase pain with movement
  • No objective neurological findings although pt may have referred pain in lower extremity
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7
Q

What patient education should be given for internal disc disruption injuries

A
  • Proper body mechanics
  • Positions to avoid
  • Limiting repetitive bending & twisting movements
  • Limiting upper extremity overhead & sitting activities
  • Carrying heavy loads
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8
Q

Posterolateral bulge/herniation is the most commonly observed disc disorder of the lumbar spine due to 3 structural deficiencies

A
  • Posterior disc is narrower in height than anterior disc
  • Posterior longitudinal ligament is not as strong & only centrally located in lumbar spine
  • Posterior lamellae of annulus are thinner
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9
Q

Pathology of posterolateral bulge/herniation

A
  • Overstretching and/or tearing of annular rings, vertebral endplate and/or ligamentous structures, from high compressive forces or repetitive micro trauma
  • Results in loss of strength, radicular pain, paresthesia, and inability to perform ADLs
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10
Q

How to perform positional gapping fro a posterolateral disc bulge/herniation on the left

A
  • Pt side lying on right side with pillow under right trunk
  • Flex both hips/knees
  • Rotate trunk to left (or pelvis to right)
  • Pt can be taught to perform this at home
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11
Q

Pathology of a central posterior bulge/herniation

A
  • Commonly observed in cervical spine
  • Same as posterolateral disc bulge/herniation for etiology and symptoms
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12
Q

Pathology of DJD

A
  • Part of normal aging process due to weight-bearing properties of facets & intervertebral joints
  • Results in bone hypertrophy, capsular fibrosis. hypermobility or hypomobility of joint, & proliferation of synovium
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13
Q

Symptoms of DJD

A
  • Reduction in mobility of the spine
  • Pain
  • Possible impingement of associated nerve roots, resulting in loss of strength & paresthesia
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14
Q

Pathology of facet entrapment (acute locked back)

A
  • Caused by abnormal movement of fibroadipose meniscoid in facet during extension
  • Meniscoid does NOT properly reenter joint cavity & bunches up, becoming a space occupying lesion, which distends capsule & causes pain
  • Flexion is most comfortable and extension increases pain
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15
Q

Appropriate treatments for facet entrapment

A
  • Positional facet joint gapping
  • Manipulation
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16
Q

Signs and symptoms of whiplash associated disorder (WAD)

A
  • Early: HA, neck pain, limited flexibility, reversal of lower cervical lordosis & decrease in upper cervical kyphosis, vertigo, change in vision/hearing, irritability to noise/light, dysesthesias of face & bilateral UE, nausea, difficulty swallowing, & emotional lability (constant change)
  • Late: Chronic head/neck pain, limitation in flexibility, TMJ dysfunction, limited tolerance to ADLs, disequilibrium, anxiety, & depression
17
Q

What are the Canadian C-spine rules for referring for an x-ray

A
  • Any high risk factor AND age ≥65 OR dangerous MOI OR paresthesias in extremities = radiograph if YES
  • Any low risk factor that allows safe assessment of ROM AND simple rear-end MVA OR sitting position in ER OR ambulatory at any time OR delayed onset of neck pain OR absence of midline c-spine tenderness = radiograph if NO
  • Able to actively rotate neck 45º to the left/right = radiograph if NO/UNABLE
18
Q

In SIJ 2 of the following 4 tests should be positive to indicate SIJ or 3 out of 5 when Gaenslen’s test is included

A
  • SI gapping
  • SI compression test
  • Gaenlen’s test
  • Sacral thrust
  • Thigh thrust
19
Q

Metastatic (spread) bone cancer has primary sites in

A
  • Lung
  • Prostate
  • Breast
  • Kidney
  • Thyroid
20
Q

Primary tumors include

A
  • Multiple myeloma (most common primary bone tumor)
  • Ewing’s sarcoma
  • Malignant lymphoma
  • Chondrosarcoma
  • Osteosarcoma
  • Chondromas
21
Q

Signs and symptoms of bone tumors

A
  • Pain that is unvarying and progressive
  • Pain not relieved with rest and/or analgesics
  • Pain is more pronounced at night
22
Q

Esophageal cancer symptomatology

A
  • Pain radiating to the back
  • Pain with swallowing
  • Dysphagia (difficulty/discomfort swallowing)
  • Weight loss
23
Q

Pancreatic cancer symptomatology

A
  • Deep, gnawing pain that may radiate from the chest to the back
24
Q

Acute pancreatitis may manifest itself as

A
  • Mid-epigastric pain radiating through to the back
25
Q

Cholecystitis may present wiith

A
  • Abrupt, severe abdominal pain & right upper quadrant tenderness, nausea, vomiting, & fever
26
Q

Common signs and symptoms of TMJ conditions

A
  • Joint noise
  • Joint locking
  • Limited flexibility of jaw
  • Lateral deviation of mandible during depression/elevation
  • Decreased strength/endurance of muscles of mastication
  • Tinnitus
  • HAs
  • Forward head posture
  • Pain with movement of mandible
27
Q

What is Rocabado’s jaw opening

A
  • Flexibility and muscle strengthening exercises of the mandible
  • Jaw opening while maintaining the tongue in contact with the palate & isometric mandibular exercises

NPTE Study Practice (17 decks)

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