NMS 2 Exam 2 Flashcards

1
Q

Thoracic Radiculopathy is associated w/:

A

-Compressed nerve root* in the thoracic area of the spine
-Least common location for radiculopathy
-Common causes: herniated discs, tissue changes, bone spurs, spinal infections, and tumors
-Dermatomal distribution/can cause pain and numbness in front of body
-Sharp pain in back, worse with coughing

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2
Q

Thoracic Myelopathy associated w/

A

-Cord pathology*; Compressed due to bulging or herniated discs, bone spurs or spinal trauma
-Degenerative conditions, central disc herniations, autoimmune disorders, cysts, hematomas, and spinal tumors
-Difficulty walking, loss of bowel control, issues w/balance and coordination, increased reflexes in extremities

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3
Q

Rib Fractures: Symptoms

A

-Breathing Issues (pain on inspiration and dyspnea)
-Coughing spells
-Most common in elderly d/t osteoporosis
-Athletes: upper and middle ribs

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4
Q

Postural Syndrome

A

-Chronic neck, back and arm pain secondary to postural fatigue of muscles in the shoulder girdle, anterior spine and prevertebral fascia
-Most commonly seen in students and office workers; Also common in the elderly
-Extremely common
-Slumping head forward d/t rounding of the shoulders; Increased kyphosis and compensatory cervical lordosis
-Caused by: Chronic stress and pain

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5
Q

Tietze Syndrome: Most common regions/associations

A

-Most common regions: 2nd, 3rd, 4th rib; Any of the above* (Less common at sternoclavicular joint)
-Associated w/ Ostochondritis*
-Injury or lesions of the costosternal articulations
-Most common in women and those over 40 years old
-Can be due to trauma, chronic cough, previous injury or pectus deformities
-Mode: Often insidious, overuse, or sneezing/coughing
-Swelling in chest wall, usually unilateral

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6
Q

Which structures are removed in TOS surgery

A

Removal of 1st rib* or cervical ribs, removal of adhesive bands or anterior scalenectomy*

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7
Q

Thoracocostal Facet Sprain: Causes/Symptoms

A

-Sprain complex that involves the thoracocostal facets
-Causes: Trauma, chronic cough, prolonged slouched postures, or degenerative joint disease
-Feel like rib is out of place
-Difficulty breathing, short breaths

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8
Q

Case study: Older person w/ rash

A

-Rash: Shingles* (Radicular pattern)
-No rash: Nerve root compression*

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9
Q

Intercostal Neuralgia

A

-A neuropathic pain involving the intercostal nerves
-Tends to affect the thoracics, chest wall and upper trunk
-Burning, sharp or shooting pain
-Pain to the shoulder blade or pelvis
-Myelopathy*

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10
Q

Scoliosis

A

-Convexity area of the spine, curve progression, high degree of curve*
-Lateral bending and/or rotary deformation of the spine named for the side of convexity
->7* axial trunk rotation on scoliometer
-Curves >60* may encroach IVD foramen/cardiovascular

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11
Q

How many hours should a brace be worn for scoliosis

A

-Milwaukee brace: Worn 23 hours/day in most cases
-Boston brace: Easier to wear

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12
Q

Fracture of rib causes

A

-Elderly: Osteoporosis
-Athletes: High force, recurrent movements of arms leading to stress fractures in the upper and middle ribs
-Coughing spells
-Pediatric: Non-accidental trauma

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13
Q

Scapular Bursitis/Crepitis is associated w/

A

*Clicking/popping
-A crepitus at the superior medial angle of the scapula
-Patient reports feeling a catch in the upper back (Restricted scapular motion)

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14
Q

Which muscles are involved with TOS

A

1st rib or cervical ribs, anterior and middle scalenes, space between the clavicle and ribs, and pectoralis minor

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15
Q

Vertebral artery syndrome

A
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16
Q

Migraines: Types/Causes/Who it affects

A

-2 Types: Migraines w/o Aura (80%) or w/ Aura (20%)
-Genetic: 4 out of 5 report a family history
-Women experience more than men 3:1; Hormones
-Usually in 20s-30s
-60% are unilateral

17
Q

Syncope: Types/Symptoms

A

-Temporary loss of consciousness usually related to insufficient blood flow to the brain
-Types: Nervous stress, orthostatic hypotension, cardiac function, endocrine function, neurologic

18
Q

Vertebral artery dissection

A

-Rare but increasingly recognized cause of stroke in patients younger than 45 years old
-Characterized by severe occipital headache with posterior nuchal pain following a head injury, followed by neurologic
-Signs: IL face dysesthesia, Dysarthia or hoarseness, CL loss of pain and temperature sensation in trunk/limb, IL loss of taste

19
Q

Temporal Arthritis: Associations/Definitions

A

-Associated w/ PMR* (Polymyalgia Rheumatica)
-Temporal arteries become inflamed or damaged
-Also called cranial arteritis or giant cell arteritis
-Delay on medical emergency means blindness/stroke

20
Q

Types of Auras

A

Visual, sensory, motor or any combination

21
Q

TOS Symptoms

A

-Diffuse arm pain/numbness/tingling (often 4th/5th digit), worse with over head activity
-Neck/shoulder pain
-Thenar atrophy
-Diminished grip strength
-Hand/arm swelling
-Cold distal extremity
-Pallor or discoloration of hand

22
Q

Postural Syndrome: What muscles are tight, what muscles are loose?

A

-Tight posterior upper back musculature
-Weak deep neck flexors/rhomboids/serratus anterior

23
Q

Scoliosis: Functional vs. Structural

A

-Functional: Compensatory, Postural, can usually be corrected with stretching, joint mobilization, strengthening and postural training
-Structural: Idiopathic, congenital, mesenchymal disorder, trauma, vertebral neoplasm, metabolic

24
Q

Cervicogenic Headaches

A

-IL head pain that is localized to the neck and occiput
-Pain may radiate to forehead, orbital region, temples, ears
-Cause: Neck movement or sustained position/head trauma
-More common in females

25
Which headache is associated with a viral infection?
Sinus Headaches; Sinus congestion
26
What types of headaches are associated with papilledema?
Pathologic Headaches
27
Scoliosis: Clinical Presentation
-Progressive: Adolescent, idiopathic -Acute: tumor, fracture, disc disease -Previous diagnosis or family history -Loss of balance and falls -Asymmetric stress on lower limbs -Low body image, self-esteem, depression
28
Scoliosis: Treatment (By degrees)
-<10 degrees: Follow up every 6 months, osseous manipulation and joint mobilization as needed -10-20 degrees: X-Ray every 3-6 months, conservative management, consider bracing if significant progression -20-25 degrees: Same as 10-20 degrees -25-40 degrees: Refer for brace therapy if >5 degree progression in one year -40-50 degrees: Often considered a grey zone, Milwaukee bracing may not be necessary ->50 degrees: Surgery is usually necessary
29
Costochondritis
-Inflammation of 1+ costal cartilages/localized pain on anterior chest wall -More common in females 2:1 -Direct trauma, aggressive exercise or upper respiratory infections with cough -Usually unilateral -Decreased with rest or ice
30
Cluster Headaches
-A primary neurovascular headache disorder characterized by severe, short duration, strictly unilateral pain -Accompanied by prominent cranial fascial PS features -Location of pain is periorbital (mostly) or retro-orbital
31
Types of cluster headaches
-Episodic: Occurs in periods lasting 7 days to 1 year, separated by pain free periods of 2+ weeks (80% persist) -Chronic: Occur for more than 1 year w/o remission or with remissions lasting less than 2 weeks (55% persist)
32
Who do cluster headaches affect
-20-50 year olds -More common in males
33
Clinical presentation of cluster headaches
Severe UL periorbital head pain, that is “excruciating” -Short duration, nocturnal attacks, sweating, tearing and rhinorrhea -Triggered by stress, relaxation, extreme temperature, allergic, rhinoritis, and exercise
34
Hypertension headaches
-Caused by fluctuations in blood pressure (>200/120mmHg) -Most commonly presented as a headache that occurs in the morning accompanied by dizziness
35
Post-Traumatic Headaches
-Caused by a subdural head bleed after trauma -Associated w/concussions, contact sports, whiplash
36
Withdrawal Headaches
-Caused by acute substance use or exposure, medications -Examples include opioids, caffeine, hormones
37
Ice Pick Headaches
-Sudden stabbing pain in the face or head -Sharp, intense pain for up to 30s -Can occur several times during the day