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Clin Med 1 > Neck and LBP > Flashcards

Neck and LBP Flashcards

0
Q

myelopathy signs (2)

A 
hyperactive reflexes (clonus), spasticity
weakness, muscle atrophy
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1
Q

myelopathy affects?

A

upper motor neurons (CNS, brain, spinal cord)

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2
Q

radiculopathy affects what?

A

lower motor neurons (after the nerve leaves the spinal cord)

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3
Q

signs of radiculopathy (2)

A

hypoactive reflexes, flaccidity

weakness, muscle atrophy, fasiculations

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4
Q

rapid deceleration injury w/ hyperextension of the neck, followed by flexion can cause?

A

cervical strain/sprain

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5
Q

strain =

A

muscle-tendon injury

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6
Q

sprain =

A

ligamentous injury

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7
Q

gradual onset of neck stiffness & soreness, muscle tightness, headache starting at the back of the skull, shoulder pain

A

cervical strain/sprain

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8
Q

acute onset of pain in lower back w/ identifiable event (lifting, twisting)
pain increases w/ activity and is improved w/ rest

A

lumbar strain/sprain

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9
Q

in lower back: decreased ROM due to pain, tender to palpation, muscle spasm, normal neuro exam

A

lumbar strain/sprain

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10
Q

Treatment for both cervical and lumbar strain/sprains (3)

A

limit activities (bed rest no more than 48 h), local ice/heat, massage = 48h “therapeutic trial”
NSAIDs, muscle relaxants, analgesics for 48-72h around the clock
PT, education

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11
Q

majority of strains/sprains recover within?

A

4 weeks

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12
Q

degenerative disk disease and hypertrophy of ligamentum flavum & facets in the cervical vertebrae

A

Cervical spondylosis

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13
Q

A disorder with variable clinical presentations:
one level w/ variable radicular symptoms- neck tenderness &/or muscle spasm
multiple levels with bilateral symptoms
signs consistent with myelopathy

A

Cervical spondylosis

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14
Q

Cervical spondylosis most commonly affects? (3)

A

C4-5
C5-6
C6-7

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15
Q

where is herniated lumbar disk disease most common?

A

L4-5

L5-S1

16
Q

presents w/ symptoms consistent w/ L5 or S1 radiculopathy

A

Herniated lumbar disk disease

17
Q

Sciatica is a symptomatic hallmark of what?

A

Herniated lumbar disk disease

18
Q

Treatments of both Cervical Spondylosis and Herniated Lumbar Disk Disease (3)

A

NSAIDs, analgesics
muscle relaxants
PT, bed rest

19
Q

urinary retention, bilateral lower extremity weakness, “saddle anesthesia”, anal wink

A

Cauda Equina syndrome

20
Q

pathology of cauda equina syndrome

A

massive midline herniation due to trauma or metastatic disease

21
Q

treatment of cauda equina syndrome

A

based on etiology:
herniation = surgical decompression
metastatic disease = oncology consult, radiation therapy

22
Q

defect in the pars interarticularis, seen mostly on kids and teens

A

Spondylolysis

23
Q

“a collar on the scottie dog” on x-ray indicates?

A

Spondylolysis

24
Q

Spondylolysis results from?

A

repetitive hyperextension stress: gymnasts, divers, athletes

25
Q

Spondylolysis treatments?

A

rest & NSAIDs for LBP only

26
Q

anterior displacement of one vertebrae on another. Associated w/ degenerative disk disease

A

Spondylolisthesis

27
Q

where is spondylolithesis most common? (2)

A

L4-L5

L5-S1

28
Q

back pain, worsened by bending, lifting, twisting

“step off” of spinous processes on exam

A

Spondylolithesis

29
Q

Spondylolisthesis treatment

A

NSAIDs, rest, conservative exercise

30
Q

condition that narrows the neural foramen, compressing spinal cord & or nerve roots

A

Lumbar spinal stenosis

31
Q

combination of degenerative disk disease & hypertrophy of ligamentum flavum & facets in lower back

A

Lumbar spinal stenosis

32
Q

progressive low back and bilateral leg pain that is worsened by standing &/or walking, improved by leaning forward or laying down

A

Lumbar spinal stenosis

33
Q

treatment of lumbar spinal stenosis? (4)

A

NSAIDs
PT to retain ROM
Refer to pain management for epidural steroid injections
Surgery for intractable pain or neuro deficits

34
Q

night pain that is dull, progressive, persistent, worse w/ recumbency
pt w/ hx of malignancy

A

Spinal tumor

35
Q

new LBP in a patient w/ hx of malignancy is what until proven otherwise?

A

metastasis

36
Q

what bone condition is associated with invasive procedures, drug abusers, diabetics, and the immunosuppressed?

A

Osteomyelitis/bone infection

37
Q

back pain, malaise, fever, sepsis, wound drainage, elevated ESR indicate?

A

spinal infection

38
Q

treatment of spinal infection? (2)

A

antibiotics

surgical drainage

Clin Med 1 (18 decks)

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