Musculoskeletal Flashcards
spondylolisthesis is what type of back pain and what is it
nonspecific; vertebra on top that slide forward
cauda equina syndrome s/s
recent onset of bladder disfunction, sensory loss, saddle anesthesia, bila sciatica
back pain d/t tumor red flag s/s
pain worse at night in the supine position
mechanical low back pain and when is it precipitated
non-radiating pain and stiffness in the lower back, precipitated by heavy lifting
when does mechanical low back pain improve?
supine, resting
most common site of weakness with disc disease
foot plantar or dorsiflexion
what does proximal weakness suggest with disc disease?
femoral neuropathy or compression of lumbar plexus
do herniated disk problem envolve loss of bowel or bladder problems?
no
common s/s of herniated disk?
PAIN (#1) and paresthesia
risk factors for herniated disk
trauma, aging, degenerative disorders
most common herniation
posterior and oblique toward the intervertebral foramen and contained spinal nerve root and dorsal root ganglion
what can happen if you get a disk herniation in lumbar area?
cauda equina syndrome
1 cause of sciatica
herniated disk
causes of cauda equina syndrome
tumor or massive midline disk herniations
what do you do if you think someone has cauda equina syndrome?
EMERGENCY, decompression needed
when testing for lumbar nerve root compression, if patient has a S1 problem what cant they do?
toe walk
when testing for lumbar nerve root compression, if patient has a L5 problem what cant they do?
heel walk
classic presentation for back pain d/t metastatic cancer?
constant dull back pain that is not relieved by rest
osteoporosis
thinning of bone-density or mass of bone reduced
spongy bone loss exceeds compact bone loss in which disease?
osteoporosis
Type 1 primary osteoporosis
post-menopausal d/t lack of estrogen
Type 2 primary osteoprosis
senile osteoprosis d/t aging bones and ca deficiency
secondary osteoporosis occurs because of?
as a result of other conditions
Bone mass is gained up to what age
30
bone mass is gained through what?
physcial activity, intake of vitamins, overweight, exposure to sex hormones at puberty
soda and junk food interferes with what? and puts you at risk for what?
calcium and phosphorus balances causing osteoporosis
causes of male osteoporosis
hypogonadism and corticosteriod use
classic regional osteoporosis
associated with dissue or immobilization of a limb because of fractures, motor paralysis or bone/joint inflammation
claudication and what is it caused by
cramping in leg when exercising, caused by obstruction of arteries
vascular vs neurogenic claudication with walking
vascular=fixed distance before symptoms occur
neurogenic =variable distance before symptoms occur
vascular vs neurogenic claudication with going up hill
vascular=painful to walk up hill
neurogenic=no pain to walk up hill
vascular vs neurogenic claudication with standing
vascular=pain improves with standing still
neurogenic=pain improves by sitting or bending forward
vascular vs neurogenic claudication with pulses
vascular=absent pulses
neurogenic=present pulses
vascular vs neurogenic claudication with appearance of skin
vascular=shiny skin, loss of hair
neurogenic= normal skin
monoarticular arthritis
arthritis affecting a single joint
polyarticular arthritis
arthritis affecting many joints
gout
urate crystals deposit in joints, too much uric acid in body
secondary gout causes
excessive uric acid in the blood that is caused by another disease
risk factors for gout
obese, diabetes, renal disease, sickle cell disease, alcohol
primary gout causes
purine metabolism disorder
gout is which kind of arthritis?
monoarticular
podagra
pain with gout, red, swollen
what do you need to do to every acute gout inflammatory joint effusion?
tap it! except for septic joints
arthrocentesis and what is this needed to rule out?
joint fluid sent for cell count, gram stain, culture to r/t septic arthritis
which disease is associated with Calcium Pyrophosphate Dihydrate Deposition Disease (CPPDD)
hyperparathyroidism
similarities of CPPDD and gout
flare induced by trauma or illness, monoarticular attacks, incidence increases with age
differences of CPPDD and gout
CPPDD affects knee, gout affects great toe
serologies are important to do with suspicion of what?
lyme disease
septic arthritis
joint pain in knee, fever
what kind of arthritis is septic arthritis?
monoarticular
Calcium Pyrophosphate Dihydrate Deposition Disease (CPPDD)
older patient with acute flare of degenerative artritis
staphylococcus aureus is the most common organism that causes
septic arthritis
what should you assume about septic arthritis?
assume it is infected
disseminated gonorrhea s/s
rheumatologic manifestations seen in young people
disseminated gonorrhea presents in two different ways which are?
classic septic arthritis OR arthritis of hands, dermatitis and tenosynovitis (inflammation of tendons)
Borrelia burgdorferi
transmits lyme disease
early symptoms of lyme disease
av node block, h/a, cranial nerve 7 palsies
late symptoms of lyme disease
joint pain
if a patient has joint pain but there is an absence of lyme disease antibodies what can you rule out?
lyme disease
RA
systemic disease that affects connective tissue
is RA auto immune?
yes
Rheumatoid Factors (IgM, IgA, IgG) are elevated or decreased with RA?
elevated
Immunologically mediated inflammation and amount of erosive damage occurs in RA or OA?
RA
early RA form?
joint effusions
late RA forms?
granulomas
stills disease
RA found in children that develops after 16yrs
psoriatic arthritis you need what kind of diagnoses for this?
psoriasis
RF is negative in which disease?
psoriatic arthritis
psoriatic arthritis s/s
DIP joints, spine involvement, can loose finger
Systemic Lupus Erythematosus (SLE)
chronic, progressive inflammatory disease that can cause major organs to fail
classic s/s of Systemic Lupus Erythematosus (SLE)
undiagnosed anemia, arthritis in hands, fatigue
osteoarthritis s/s
joint stiffness occurs with inactivity, pain resolves with movement
articular cartilage
at ends of bones
tidemark or calcified front
calcified cartilage and non-calcified cartliage at the end of bone that interact
