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Pathophysiology 2 > MSK PATHOLOGIES - Spinal Conditions and Red Flags > Flashcards

MSK PATHOLOGIES - Spinal Conditions and Red Flags Flashcards

1
Q

Name 6 Spinal Conditions.

A
  • ANKYLOSING SPONDYLITIS (AS)
  • SPINAL STENOSIS
  • SPONDYLOSIS
  • SPONDYLOLISTHESIS
  • SCOLIOSIS
  • WHIPLASH ASSOCIATED DISORDER (WAD)
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2
Q

Name 9 Red Flag Pathologies ?

A
  • MYELOPATHY (spinal cord compression)
  • CERVICAL ARTERY DYSFUNCTION
  • MALIGNANCY
  • DVT
  • INFLAMMATORY CONDITIONS ( Rheumatoid Arthritis )
  • INFECTIONS
  • FRACTURES
  • RELATIVE ENERGY DEFICIENCY (RED-S)
  • CAUDA EQUINA SYNDROME ( ces )
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3
Q

What is ANKYLOSING SPONDYLITIS ?

A

Systemic Inflammatory Arthritis ( its all over the body )

Its characterised as dysregulation of the immune system which can result into Tissue Damage.

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4
Q

ANKYLOSING SPONDYLITIS Risk Factor.

A
  • GENETICS (HLA-B gene)
  • MEN > WOMEN
  • AGE ( late adolescent )
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5
Q

What are the typical presentation of ANKYLOSING SPONDYLITIS.

A
  • Gradual onset of back pain & stiffness over weeks/months.
  • Persistent for more than 3 months
  • Feeling better after exercise and worst after rest.
  • Weight loss
  • Fatigue / Tiredness
  • Feverish / Night sweats
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6
Q

Common Spinal Condition Managements

A
  • Exercise
  • MEDICATION ( to reduce underlying inflammation and pain )
  • Biologic medication (therapy)
  • Address individuals beliefs and goals
  • REASSURANCE ( normal age related )
  • Encouragement normal movement and functions/ normal activities
  • (surgery)
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7
Q

What is Spinal Stenosis ?

A

Its the narrowing of the spinal canal.

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8
Q

What are the 2 different Spinal Stenosis ?

And how do they differ from each other.

A

1.) CENTRAL SPINAL STENOSIS
Its the narrowing in the Central Spinal Cord.
- It can cause MYELOPATHY / CES

2.) FORAMINAL SPINAL STENOSIS
Its the narrowing of where the nerve root exits.
- symptom is improved with FLEXION because the canal opens up

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9
Q

What are some possible cause of Spinal Stenosis ?

A
  • Osteophytes
  • Disc Herniation
  • Thickening of the LGT
  • Age
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10
Q

What are some common Spinal Physiotherapy Management ?

A
  • ADVICE & EDUCATION
  • PAIN MANAGEMENT STRATEGIES
  • EXERCISE
  • LIFESTYLE CHANGES
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11
Q

What is SPONDYLOSIS ?

A

Its a generic umbrella term for OSTEOARTHRITIC changes within the spine.

  • It can affect vertebra / Intervertebral discs / Facet Joints / Joints of LUSHKA
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12
Q

How to reduce symptom of SPONDYLOSIS ?

A

You have to keep moving so that it remains strong rather than protecting and not doing anything.

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13
Q

What is SPONDYLOLISTHESIS ?

A

SLIPPED VERTEBRA
( anterior translation of the superior vertebra relative to the Inferior Vertebra )
There’s 5 grades depending on severity

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14
Q

What are some SPONDYLOLISTHESIS risk factors ?

A
  • GENETICS
  • TRAUMA
  • DEGENERATION
  • SPONDYLOLISIS PARS FRACTURE
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15
Q

What is SCOLIOSIS ?

A

Its an S-shaped curve in the spine that may/not cause pain

IDOPATHIC

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16
Q

What is WHIPLASH ASSOCIATED DISORDER (WAD) ?

A

Its a generic term for neck pain following sudden force acceleration / deceleration.

  • Once all serious pathology have been ruled out (SCI/Fractures) it can be diagnosed as WAD.
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17
Q

What are some possible symptoms of WAD ?

A
  • Neck Pain
  • Hearing Loss
  • Headaches
  • Tinnitus
  • Double Vision / Vision Loss / Eye Pain
  • Weakness of Extremities
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18
Q

What is MYELOPATHY ?

A

Its a term used to describe any neurological deficit related to SC.
- This is usually due to compression of the Spinal Cord.

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19
Q

What are some common Myelopathy Symptoms ?

A
  • Muscle weakness
  • Impaired co-ordination
  • Spinal Pain
  • Altered Muscle Tone
  • Sensory Loss / Spasticity
  • GAIT & URINARY DISTURBANCE
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20
Q

What is CERVICAL ARTERY DYSFUNCTION (cad) ?

A

Its an umbrella term used into cover a range of VASCULAR PATHOLOGIES (arterial/venous disease) and ANATOMICAL SRUCTURES that may be compromised by movement/manual therapy.

  • This can lead to CERVICO-CRANIAL ISCHAEMIA.
21
Q

What are some symptoms of CERVICAL ARTERY DYSFUNCTION ?

A
  • Pain
  • Stroke
  • Cranial Nerve Dysfunction
  • Blindness
  • Sympathetic Nerve Dysfunction
  • DEATH
22
Q

What are some Cervical Artery Dysfunction (cad) symptoms of compromised movement/manual Therapy ?

A
  • DYSPHAGIA ( swallowing problems )
  • DYSPHASIA ( cant generate speech )
  • DYSARTHRIA ( unable to control their tongue / slur words )
  • PARAESTHESIA ( numbness)
23
Q

What are some Cervical Artery Dysfunction Risk Factors ?

A
  • Previous trauma to CX Spine
  • Long term use of STEROIDS
  • Hypertension
  • High Cholesterol
  • Diabetes
  • History of smoking
  • Cardiac Vascular Disease
24
Q

What is Malignancy ?

A

This is when cell divides in an uncontrolled way forming a tumor.

25
Q

What are the 2 different tumours ?

A

1.) PRIMARY TUMOR
- Cancer starts to grow and spread, causing healthy body parts to be pushed away
causing damage.

2.) SECONDARY TUMOR (metastases)
- This forms when cancer cell spread to distant part of the body via
bloodstream/lymphatic system.

26
Q

What are some General Signs and Symptoms of Malignancy ?

A
  • Constant Pain
  • General Fatigue
  • Night Sweats
  • Unexplained weight loss
  • Unusual Lumps / Bumps / Swelling
  • Previous HX of Cancer
27
Q

What is DEEP VEIN THROMBOSIS ?

A

Its a type of venous thrombosis involving the formation of a blood clot in a deep vein.

28
Q

What are some DVT Symptoms ?

A
  • Pain
  • Swelling
  • Redness
  • Enlarged Veins in affected areas
29
Q

What Increases a person’s chance of getting DVT ?

A
  • Age
  • Past Surgery
  • Long Distance Flight
  • Pregnancy
  • Drugs ( Oral Contraceptives )
  • Medical co-morbidity ( its a condition where a person has more than one disease )
30
Q

What causes DVT ?

A

VIACHOUS TRIAD

  1. ) Vessel Injury
  2. ) Venous Stasis
  3. ) Hypercoagulability
31
Q

What are the different Phases of Thrombosis (DVT) ?

A

1.) EMBOLISM
- This is the most Life Threatening Phase whereby, THROMBISE becomes embolise
and it travels to the heart via circulatory system, Blocking the pulmonary artery.
( it can cause INFARCTION & complications )

  1. ) PROPAGATION
  2. ) ORGANIZATION
  3. ) RECANULIZATION
32
Q

What is INFLAMMATION ? and give one common inflammatory condition.

A

Inflammation is a biological response to a stimuli interpreted by the body to have a potentially Harmful Effect.

  • RHEUMATOID ARTHIRIRTIS (RA)
33
Q

What is Rheumatoid Arthritis ?

A

RA is a systemic autoimmune disease characterised by Inflammatory arthritis with extra articular involvement.

34
Q

What are some factors that Increases a person’s chance of getting RA ?

A
  • Genetics
  • Air pollution
  • Low Vitamin D
  • Smoking
  • Obesity
35
Q

What are some Clinical Presentation of RA ?

A
  • Insidious onset over a period of months.
  • Joint stiffness in the morning.
  • Deformity and restricted mobility in affected joints
36
Q

How does INFECTIONS occur ?

A

Infections occur when a foreign organism enters the body or multiplies in a harmful way. (BACTERIA / VIRUS / FUNGI / PARASITE > INFECTION)

37
Q

What increases the chance of having an Infection ?

A
  • Drugs ( steroids/ Anti-rejection drugs for a transplanted organ )
  • HIV + AIDS
  • Cancer ( other disorders that affect your immune system )
  • Open Surgery
  • Poor Nutrition / Stress / Lack of sleep
38
Q

What are some signs and symptoms of an Infection ?

A

IT CAN AFFECT THE WHOLE BODY.

  • Fatigue
  • Weight loss
  • Night Sweats
  • Swelling
  • Loss of Appetite
  • Fever / Chills
  • coughing / runny nose
  • Aches and Pain
39
Q

What are some different types of Fractures ?

A
  • Transverse
  • Linear
  • Oblique non / displaced
  • Spiral
  • Greenstick
  • Comminuted
40
Q

What Increases a persons chance of having a Fracture ?

A
  • TRAUMA
  • Age + Gender
  • Alcohol
  • Smoking
  • RA
  • Diabetes
  • other SYSTEMIC DISEASE
41
Q

What kind of Management would be done if someone had a Fracture ?

A
  • None ( rib fracture )
  • Sling
  • Cast
  • Internal / External Fixation

Physiotherapy, help restore ROM / Strength and Function. ( depending on patients goal )

42
Q

What is Relative Energy Deficiency (RED-S) ?

A

RED-S is a syndrome in which disorder eating ( low energy availability ) and decreased bone mineral density (osteoporosis) are present.

43
Q

Name a RED-S Risk factor.

A

Eating too little food

to support the amount of energy being expended.

44
Q

What are some Signs and Symptoms of RED-S ?

A
  • Dull pain along the bone ( can increase w/ activity ).
  • Potential Mild swelling around the affected area.
  • Tenderness around the Affected area
45
Q

How do you manage RED-S ?

A
  • PHYSIOTHERAPY GUIDANCE
    Advice and educate, teach them Techniques
  • MDT IS REQUIRED
    GP, Dietician + PT, potentially Psychologist
46
Q

What is CAUDA EQUINA SYNDROME (CES) ?

A

This is when the spinal cord terminates between the L1 - L2 vertebra forming the conus medullas.

47
Q

Name some possible cause of CAUDA EQUINA SYNDROME.

A
  • HERINATED LUMBAR INTERVERTEBRAL DISC
  • Epidural Abscess ( infection in between the skull and brain lining )
  • SPINAL EPIDURAL HAEMATOMA
    ( accumulation of blood in the epidural space that compresses the SC )
  • DISKITIS ( infection in between the vertebra )
  • Tumor
  • Trauma
  • SPINAL STENOSIS ( narrowing of spaces within the spine )
48
Q

What are some common RED FLAG SIGN & SYMPTOMS.

A
  1. ) SADDLE ANAESTHESIA
    • loss of feeling around the anus / genital area.
  2. ) BACK PAIN
    • severe low back pain with uni / bilateral weakness.
  3. ) BLADDER DYSFUNCTION
    • inability / difficulty in urinating / Urinary Retention / Loss of sensation.
  4. ) BOWEL DYSFUNCTION
    • faecal Incontinence / Loss of anal tone or sensation.
  5. ) NUMBNESS AND LEG WEAKNESS
  6. ) ALTERED REFLEXES IN KNEES & ANKLES
49
Q

What are some common Management for a RED FLAG PATHOLOGY.

A
  • EARLY NEUROLOGICAL REVIEW
  • SURGICAL DECOMPRESSION (acute ces patients)
  • MALIGNACY / RADIOTHERAPY / CHEMOTHERAPY
    ( patients not suitable for surgery )

Pathophysiology 2 (10 decks)

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