Neck and Back Pain

Question 1

acute low back pain is..

Answer 1

less than3 months

Question 2

chronic degenerative disk disease has a duration of

Answer 2

more than 3 months

Question 3

what is the number one reason for back pain

Answer 3

degenerative disk disease

Question 4

what are the pathological findings in degenerative disk disease

Answer 4

disc protrusion
spondylolysis
spondylolisthesis

Question 5

wear and tear of the spinal discs AND is age related

Answer 5

spondylolysis (lumbar is most often affected)

Question 6

how can there be damage to the spinal cord

Answer 6

direct compression of the spinal cord by boney or fibrocalcific tissues
ischemia caused by compromise of the vascular supply to the cord
repeated trauma in the course of normal flexion and extension of the neck or back

Question 7

mechanical pressure may cause a forward displacement of the deficient vertebra, which is known as

Answer 7

spondylolisthesis (commonly occurs in L5 S1)

Question 8

a person with a grade of 3-4 vertebral slip would need

Answer 8

operative decompression, stabilization or both

Question 9

a person with a grade 1-2 vertebral slip would

Answer 9

usually be managed symptomatically and nonsurgically

Question 10

abnormally narrow spinal canal

Answer 10

spinal stenosis

Question 11

usually begins with stiff neck pain and symptoms worsen with movement of the head and neck and stretching of the affected arm

Answer 11

cervical disc disease

Question 12

entrapment of a single nerve root

Answer 12

spinal stenosis

Question 13

may include both the root and spinal canal (most herniations occur at c5-6, c6-7)

Answer 13

cervical disc disease

Question 14

affects the area between the lower rib cage and gluteal muscles and often radiates into the thighs

Answer 14

low back pain

Question 15

most cases of low back pain are

Answer 15

idiopathic

Question 16

what are risk factors for low back pain

Answer 16

occupations that require repetitious lifting in the forward bent and twisting position, obesity, cigarette smoking, osteoporosis, and genetic predisposition

Question 17

protrusion of part of the nucleus pulpous through a tear in the posterior rim of the annulus fibrosus, the gelatinous material or nucleus pulpous extrudes and compresses the nerve root

Answer 17

lumbar disk herniation

Question 18

large amounts of extruded nucleus pulposus or complete disc herniation may _____ the ____ ___ causing ______

Answer 18

compress; spinal cord; spinal stenosis

Question 19

a herniated disc in the lumbosacral area is associated with pain that

Answer 19

radiates along the sciatica nerve course over button and into the calf or ankle

Question 20

symptoms of lumbar herniation are

Answer 20

limited ROM of the lumbar spine, decreased or absent ankle jerk, and mild weakness of the foot

Question 21

what is the dx tool of choice for localizing even small disc protrusions (particular of the lumbar spine disease)

Answer 21

MRI scan

Question 22

dx tool that is used to localize the specific spinal nerve roots involved

Answer 22

EMG

Question 23

what are the conservative approach of therapy

Answer 23

traction, bed rest, heat and ice, and an effective anti-inflammatory regimen

Question 24

when would a surgical approach come into play

Answer 24

evidence of severe compression like weakness, or decreased reflects, bladder or bowel involvement, or if the conservative approach did not work

Question 25

what is the goal of surgical tx

Answer 25

to reduce the pressure on the nerve root

Question 26

what causes less spinal trauma, less invasive and shortens recovery time

Answer 26

microsurgical technique (remove only the amount of tissue that is necessary)

Question 27

what are the 6 components of nursing management

Answer 27

vital signs
wound inspection
motor strength
urinary retention 
positioning (logroll)
home care

Question 28

how often are VS checked after lumbar disc excision

Answer 28

every 15min for 1 hour, every 30min for 2 hours, and then hourly for 4 hours

Question 29

for wound inspection what should you do

Answer 29

draw circle around drainage and if sx included fusion then there will be a second surgical incision to check

Question 30

where should you do a neuromuscular check

Answer 30

below the level of sx (cap refill, paresthesia, numbness, tingling)

Question 31

what si checked to assess for nerve root injury

Answer 31

sensation and motor strength of lower extremities

Question 32

why is it important to assess for urinary retension

Answer 32

it is another sign of neurological deterioration, but not unusual in men due to position in sx

Question 33

how do you position a pt

Answer 33

pillow is placed under the head and the knee bend is elevated to relax back muscles

Question 34

how can the patient releive pressure

Answer 34

move from side to side

Question 35

the pt is taught to turn as a ____, known as _____ to prevent ____ of the back

Answer 35

unit; logrolling; twisting