Musculoskeletal Day 2

Question 1

damage of spinal cord below L2 resembles what?

Answer 1

peripheral nerve lesion

-varies in presentation

Question 2

damage of spinal cord above L2 resembles what?

Answer 2

spinal cord injury

Question 3

what is a level of lesion?

Answer 3

last remaining 3+ muscle strength

Question 4

what spinal cord fracture would allow a pt to walk?

Answer 4

T8 or below

Question 5

what lesion would result in death most likely?

Answer 5

anything above C3

-goes to the diaphragm and you quit breathing

Question 6

what is characterized by tenderness, pain on movement of neck, and taught bands of musculature on palpation?

Answer 6

cervical strain

-usually lasts longer than stiff neck

Question 7

what is characterized by local tenderness, pain with certain movements and lasts usually 1-4 days?

Answer 7

“stiff neck”

Question 8

what kind of neck pain is characterized by neck pain with radiating to arm?

Answer 8

cervical radicular pain

Question 9

in cervical radiculopathy, pain would be worse with

Answer 9

coughing, sneezing, straining

Question 10

what causes cervical radiculopathy?

Answer 10

herniated disc or DDD with spurring

Question 11

cervical cord compression could be caused by

Answer 11

herniated disc
DDD with spurring (arthritis)
trauma (car crash)

Question 12

what does a positive babinski sign indicate?

Answer 12

spinal cord damage

Question 13

what is treatment for spinal cord injury?

Answer 13

decompress and stabilize with a cage

Question 14

what is the most common LBP?

Answer 14

mechanical

Question 15

when is mechanical LBP aggravated?

Answer 15

moving, lifting, twisting

Question 16

when is mechanical LBP alleviated?

Answer 16

rest

Question 17

will mechanical LBP go below the knee?

Answer 17

no, if it does, it is something else

Question 18

what risk factors are involved with older women with mech LBP?

Answer 18

long term steroid use
think: osteoporosis
compression fx

Question 19

what do muscle spasms do?

Answer 19

limits your movement to protect the area tht is involved

Question 20

what will mechanical LBP not have?

Answer 20

motor/sensory/reflex abnormalities

Question 21

what PE findings accompany osteoporosis?

Answer 21

percussion tenderness over spinous process
Fxs elsewhere
thoracic kyphosis

Question 22

what characterizes radicular LBP?

Answer 22

shooting pain radiating below the knee in a dermatomal distribution-numbness, tingling
*worse with sitting, bending, coughing, sneezing, straining

Question 23

what is a common cause of radicular LBP?

Answer 23

herniated IV disc with compression or traction of nerve

Question 24

why does sitting increase radicular LBP?

Answer 24

pressure on front of disc increases and pushes disc farther backward

Question 25

what would cause a positive straight leg test?

Answer 25

herniated disc

Question 26

what is lumbar stenosis?

Answer 26

pseudoclaudication | -pain in back of legs that worsens with walking and gets better with sitting

Question 27

what causes lumbar stenosis?

Answer 27

combination of DDD and OA that narrows the spinal canal

Question 28

which patients will most likely have lumbar stenosis?

Answer 28

>65 yo

Question 29

what are the PE findings of ankylosing spondylitis?

Answer 29

loss of normal lumbar lordosis muscle spasms anterior and lateral flexion

Question 30

what is DISH?

Answer 30

diffuse idiopathic skeletal hyperostosis

Question 31

what is a PE finding of DISH?

Answer 31

flexion and immobility of spine

Question 32

pt presents with back pain that is worse at night and unrelieved by rest, what would you be suspicious of?

Answer 32

malignancy

Question 33

referred pain with normal spinal movements and ROM would cause suspicion for...

Answer 33

abdominal or pelvic problems

Question 34

what is the most commonly separated shoulder joint?

Answer 34

acromoclavicular joint

Question 35

what is considered the "shoulder joint"

Answer 35

glenohumoral joint

Question 36

what are the rotator cuff muscles?

Answer 36

``` SITS supraspinatous infraspinatous teres minor subscapularis ```

Question 37

how is the rotator cuff most commonly injured?

Answer 37

by the arm having to slow down | -eccentric contraction

Question 38

what are the axioscapular muscles?

Answer 38

rotate the shoulder internally - trap - rhomboids - serratus anterior - levator scapulae

Question 39

what are the axiohumoral muscles?

Answer 39

internal rotation of the shoulder - pec major - pec minor - latissimus dorsi