Neck and Back Pain Flashcards
acute low back pain is..
less than3 months
chronic degenerative disk disease has a duration of
more than 3 months
what is the number one reason for back pain
degenerative disk disease
what are the pathological findings in degenerative disk disease
disc protrusion
spondylolysis
spondylolisthesis
wear and tear of the spinal discs AND is age related
spondylolysis (lumbar is most often affected)
how can there be damage to the spinal cord
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
mechanical pressure may cause a forward displacement of the deficient vertebra, which is known as
spondylolisthesis (commonly occurs in L5 S1)
a person with a grade of 3-4 vertebral slip would need
operative decompression, stabilization or both
a person with a grade 1-2 vertebral slip would
usually be managed symptomatically and nonsurgically
abnormally narrow spinal canal
spinal stenosis
usually begins with stiff neck pain and symptoms worsen with movement of the head and neck and stretching of the affected arm
cervical disc disease
entrapment of a single nerve root
spinal stenosis
may include both the root and spinal canal (most herniations occur at c5-6, c6-7)
cervical disc disease
affects the area between the lower rib cage and gluteal muscles and often radiates into the thighs
low back pain
most cases of low back pain are
idiopathic
what are risk factors for low back pain
occupations that require repetitious lifting in the forward bent and twisting position, obesity, cigarette smoking, osteoporosis, and genetic predisposition
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
lumbar disk herniation
large amounts of extruded nucleus pulposus or complete disc herniation may _____ the ____ ___ causing ______
compress; spinal cord; spinal stenosis
a herniated disc in the lumbosacral area is associated with pain that
radiates along the sciatica nerve course over button and into the calf or ankle
symptoms of lumbar herniation are
limited ROM of the lumbar spine, decreased or absent ankle jerk, and mild weakness of the foot
what is the dx tool of choice for localizing even small disc protrusions (particular of the lumbar spine disease)
MRI scan
dx tool that is used to localize the specific spinal nerve roots involved
EMG
what are the conservative approach of therapy
traction, bed rest, heat and ice, and an effective anti-inflammatory regimen
when would a surgical approach come into play
evidence of severe compression like weakness, or decreased reflects, bladder or bowel involvement, or if the conservative approach did not work
what is the goal of surgical tx
to reduce the pressure on the nerve root
what causes less spinal trauma, less invasive and shortens recovery time
microsurgical technique (remove only the amount of tissue that is necessary)
what are the 6 components of nursing management
vital signs wound inspection motor strength urinary retention positioning (logroll) home care
how often are VS checked after lumbar disc excision
every 15min for 1 hour, every 30min for 2 hours, and then hourly for 4 hours
for wound inspection what should you do
draw circle around drainage and if sx included fusion then there will be a second surgical incision to check
where should you do a neuromuscular check
below the level of sx (cap refill, paresthesia, numbness, tingling)
what si checked to assess for nerve root injury
sensation and motor strength of lower extremities
why is it important to assess for urinary retension
it is another sign of neurological deterioration, but not unusual in men due to position in sx
how do you position a pt
pillow is placed under the head and the knee bend is elevated to relax back muscles
how can the patient releive pressure
move from side to side
the pt is taught to turn as a ____, known as _____ to prevent ____ of the back
unit; logrolling; twisting
