OSTEO HELP Flashcards
What are the 5 D’s used to aid diagnosis?
Dizziness, Diplopia, Dysarthria, Dysphagia, Drop attacks
What are the 3 N’s used in diagnosis?
Nystagmus, Numbness, Nausea
What is the single A in diagnosis?
Ataxia
List the 6 P’s in diagnosis.
- Pain
- Pallor
- Paralysis
- Paraesthesia
- Pulselessness
- Cold
Cooks cluster
For stenosis
(4) Over 60
(4) +ve extension test
(3) Pain reduced with flexion
(3) Pain eliminated with sitting
(3) Bilateral leg pain
(2) -ve SLR under 60 degrees
10/19 suggests stenosis with 90% sensitivity
What does SNNOOP10 stand for?
- Systemic symptoms
- New onset
- Neoplasm/neurological deficit
- Onset sudden
- Over 50
- Pregnancy or birth in the last 6 months
- Pathology of the immune system
- Positive Valsalva
- Post traumatic headache
- Positional headache
- Progressive headache
- Pattern change
- Papilledema
- Painkiller overuse/new meds
- Painful eye
What are the signs of spinal cord compromise?
- Non-dermatomal symptoms
- Ataxia/clumsiness
- Increased reflexes
- Positive Babinski’s sign
- Clonus
- Non-myotomal muscle weakness
What is the purpose of Well’s Criteria?
To assess the likelihood of DVT
List the criteria for Well’s Criteria that add +1.
- Active cancer or treatment in the last 6 months
- Paralysis, paresis, recent plaster immobilisation of the LEXX
- Recently bed ridden for 3 or more days or surgery with anaesthetic within the last 12 weeks
- Localised tenderness along the deep venous system
- Entire leg swollen
- Calf swelling <3cm compared to the asymptomatic side
- Collateral superficial veins
- Unilateral pitting oedema
- Previous DVT
What is the -2 criteria in Well’s Criteria?
Alternative diagnosis that is at least as likely as a DVT
What does VINDICATE stand for?
- Vascular
- Inflammatory or infectious
- Neoplastic
- Degenerative or drugs
- Idiopathic or intoxication
- Congenital
- Autoimmune or allergy
- Traumatic
- Endocrine or environment
What are the earliest cancer warning signs represented by CAUTION?
- Changes in bowel or bladder
- A sore that does not heal
- Unusual bleeding or discharge
- Thickening or a lump
- Indigestion or difficulty swallowing
- Obvious changes in warts or moles
- Nagging cough or hoarseness
What questions should be considered when making a DDx list?
- Muscles involved?
- Tendons involved?
- Ligaments involved?
- Could it be a disc?
- Is there any nerve compression?
What is the AROM and PROM for muscle strain?
AROM: Decreased AROM (painful), PROM: Within normal limits
What are the comments associated with muscle strain?
- Pain with palp of damaged muscles
- Stretching or contraction of muscle causes pain (possible weakness)
What is the AROM and PROM for tendinopathy?
AROM: Within normal limits (pain at end range), PROM: Within normal limits (pain at end range)
What are the comments associated with tendinopathy?
- Pain with palpation of damaged tendon
- Pain at end ROM both active and passive as tendon is stressed or stretched
What is the AROM and PROM for ligament sprain?
AROM: Decreased AROM (painful), PROM: Decreases PROM (painful)
What are the comments associated with ligament sprain?
- Pain with palpation of ligament
- Stretching of the ligament, especially with over pressure, causes pain
What is the AROM and PROM for arthropathy?
AROM: Decreased AROM (painful), PROM: Decreased PROM (painful)
What are the comments associated with arthropathy?
- Early may have no loss of ROM or pain
- Scour tests may show crepitus
- AROM may show repeatable ‘snapping’ or ‘popping’
What is the AROM and PROM for capsulitis?
AROM: Decreased AROM (painful), PROM: Decreased PROM (painful)
What are the comments associated with capsulitis?
- Pain with direct capsule palpation
- Multidirectional pain with motion – pain in a single direction indicated a muscle or tendon damage
What is the AROM and PROM for fascial strain?
AROM: Decreased AROM (painful), PROM: Decreased PROM (painful)
What are the comments associated with fascial strain?
- Can have palpatory subcutaneous adhesions
- Limited ROM or non-dermatomal pain and posture changes
What is the AROM and PROM for instability?
AROM: Increased AROM or within normal range, PROM: Increased PROM
What are the comments associated with instability?
- End play may show an empty end feel
- AROM and PROM may cause repeatable ‘click’, ‘clunk’, or snapping sensation
What is the AROM and PROM for joint dysfunction (subluxation)?
AROM: Within normal range or limited in specific ROM, PROM: Limited in specific ROM
What are the comments associated with joint dysfunction?
- Pain or point tenderness
- Asymmetry or misalignment
- ROM abnormality – joint feels ‘stuck’
- Tissue/muscle tone changes
What is the AROM and PROM for intra-articular loose body?
AROM: Decreased AROM (painful), PROM: Decreased PROM (painful)
What are the comments associated with intra-articular loose body?
- ROM assessment will result in sudden onset of pain, usually in one direction (typically extension)
- Other movements are within normal range
What is the AROM and PROM for nerve injury?
AROM: Decreased AROM or within normal range, PROM: Within normal range
What are the comments associated with nerve injury?
- Possible numbness, tingling or muscle weakness and shooting electrical pain
What characterizes visceral injury?
- Pain is secondary to internal organ capsule distention or vascular compromise
- Deep, achy, cramping pain that may be sharp at times, often poorly localised and may be immobilising in more severe cases
- Pain is often NOT changed by body position
What does MET stand for?
Muscle Energy Technique
What is the first mechanism of action in MET?
Post-Isometric Relaxation (PIR)
What is the second mechanism of action in MET?
Reciprocal Inhibition (RI)
What is the third mechanism of action in MET?
Golgi Tendon Organ (GTO) Activation
What is the fourth mechanism of action in MET?
Proprioceptive Neuromuscular Facilitation (PNF)
What is the fifth mechanism of action in MET?
Improved Joint Mobilization and Alignment
What is the sixth mechanism of action in MET?
Autonomic Nervous System Modulation
What does NMT stand for?
Neuromuscular techniques
What is the first mechanism of action in NMT?
Modulation of Neuromuscular Reflexes
What is the second mechanism of action in NMT?
Pain Gate Theory (Melzack & Wall, 1965)
What is the third mechanism of action in NMT?
Myofascial Release and Fluid Dynamics
What is the fourth mechanism of action in NMT?
Improved Proprioception and Motor Control
What is the fifth mechanism of action in NMT?
Autonomic Nervous System Regulation
What is the sixth mechanism of action in NMT?
Trigger Point Deactivation
What does STT stand for?
Soft tissue techniques
What is the first mechanism of action in STT?
Mechanical Effects
What is the second mechanism of action in STT?
Neuromuscular Effects
What is the third mechanism of action in STT?
Pain Modulation
What is the fourth mechanism of action in STT?
Circulatory and Lymphatic Effects
What is the fifth mechanism of action in STT?
Autonomic Nervous System Modulation
What does HVT stand for?
High-Velocity Thrust
What is the first mechanism of action in HVT?
Cavitation and Joint Gapping
What is the second mechanism of action in HVT?
Reflex Neuromuscular Inhibition
What is the third mechanism of action in HVT?
Pain Modulation (Gate Control Theory & Descending Inhibition)
What is the fourth mechanism of action in HVT?
Restoration of Joint Arthrokinematics
What is the fifth mechanism of action in HVT?
Improved Blood Flow and Lymphatic Drainage
What is the sixth mechanism of action in HVT?
Autonomic Nervous System Modulation
What are the mechanical effects of joint mobilizations?
- Restoration of Joint Arthrokinematics
- Reduction of Joint Stiffness
- Synovial Fluid Movement
What are the neuromuscular effects of joint mobilizations?
- Reflexive Muscle Relaxation
- Proprioceptive Enhancement
What are the pain modulation effects of joint mobilizations?
- Gate Control Theory
- Descending Pain Inhibition
What are the circulatory and lymphatic effects of joint mobilizations?
- Improved Blood Flow
- Lymphatic Drainage
What is the first mechanism of action in foraminal gapping?
Mechanical Decompression of Neural Structures
What is the second mechanism of action in foraminal gapping?
Reduction of Intervertebral Disc Pressure
What is the third mechanism of action in foraminal gapping?
Reflex Neuromuscular Inhibition
What is foraminal gapping?
A technique that increases the space between vertebrae, reducing mechanical compression on spinal nerves and nerve roots.
How does foraminal gapping relieve irritation?
By reducing mechanical compression caused by herniated discs, osteophytes, or inflammation.
What is the effect of foraminal gapping on intervertebral disc pressure?
It decreases disc bulging and allows for better hydration and nutrient exchange in the disc.
What is reflex neuromuscular inhibition?
A technique that stimulates mechanoreceptors in muscles surrounding the spine, leading to reflex relaxation of hypertonic muscles.
How does foraminal gapping affect pain modulation?
By stimulating large-diameter afferent fibers (A-beta), which inhibit pain signals from smaller nociceptive fibers (A-delta, C fibers).
What are the benefits of improved circulation and lymphatic drainage from foraminal gapping?
Better blood flow to neural and surrounding soft tissues, and enhanced lymphatic drainage helps clear inflammatory mediators.
What does foraminal gapping restore in joint arthrokinematics?
Normal joint function and reduces restrictions that may contribute to pain and stiffness.
How does foraminal gapping influence the autonomic nervous system?
By reducing nerve root irritation, it can balance sympathetic nervous system activity.
What is myofascial release (MFR)?
A manual therapy technique in osteopathy that focuses on reducing fascial restrictions, improving tissue mobility, and alleviating pain.
What are the mechanical effects of myofascial release?
Includes fascial elongation, breaking of adhesions, and improved tissue glide.
What neurological effects does myofascial release have?
Stimulates mechanoreceptors, leading to reduced fascial tension and reflexive muscle relaxation.
How does myofascial release modulate pain?
By inhibiting nociceptive input through the gate control theory and activating central inhibitory pathways.
What circulatory effects are associated with myofascial release?
Enhanced blood flow and lymphatic drainage, reducing inflammation and promoting tissue oxygenation.
What is the goal of lymphatic techniques in osteopathy?
To enhance the movement of lymphatic fluid, improve immune function, and reduce tissue congestion.
What does mechanical pumping in lymphatic techniques do?
Creates rhythmic pressure changes that enhance lymphatic circulation and reduce edema.
How do lymphatic techniques affect the autonomic nervous system?
They can decrease sympathetic overactivity, promoting parasympathetic dominance.
What is the significance of the respiratory-circulatory model in lymphatic techniques?
It enhances diaphragmatic motion and rib cage mobility, optimizing lymphatic flow.
What is the Gate Control Theory?
A theory that explains how pain signals are regulated in the spinal cord before reaching the brain.
How do large-diameter nerve fibers affect pain transmission according to the Gate Control Theory?
They inhibit pain signals from smaller fibers by ‘closing the gate’ in the spinal cord.
What clinical techniques can stimulate A-beta fibers to reduce pain perception?
Joint mobilization, soft tissue work, and myofascial release.
What symptoms are associated with Giant Cell Arteritis?
Headaches, jaw claudication, fever, and pain around the temples.
What criteria are used to assess Deep Vein Thrombosis (DVT)?
Wells criteria and medical history regarding travel, cardiac issues, and recent surgery.
What are common symptoms of Pulmonary Embolism?
Sudden shortness of breath, chest pain, and swelling in one leg.
What are the risk factors for Abdominal Aortic Aneurysm (AAA)?
Being male, over 60, having a family history, and experiencing pulsating mass in the abdomen.
What indicators suggest cervical instability?
Neck pain, hypermobility, and nausea or dizziness.
What symptoms may indicate cancer?
Unexplained weight loss, night sweats, and unusual lumps or swelling.
What symptoms are associated with meningitis?
High temperature, bad headache, stiff neck, and drowsiness.
What are common symptoms of fractures?
Recent trauma, swelling, bruising, and inability to weight bear.
What are the symptoms of Cauda Equina syndrome?
Increased urinary frequency and urgency, changes in bowel movements, and leg pain.
What are the symptoms of hyperthyroidism?
Weight loss, fast heartbeat, increased hunger, and tremors.
What symptoms suggest hypothyroidism?
Fatigue, weight gain, cold sensitivity, and dry skin.
What symptoms are indicative of Polycystic Ovary Syndrome (PCOS)?
Irregular periods, excessive hair growth, and weight gain.
Where is gallbladder pain typically located?
Right upper quadrant, possibly radiating to the back or right shoulder.
What symptoms may indicate liver dysfunction?
Fatigue, loss of appetite, jaundice, and easy bruising.
What symptoms suggest kidney issues?
Lower back pain, changes in urine color, and burning during urination.
What does dark, red, or foamy urine indicate?
Changes in urine color can suggest various health issues such as infections or kidney stones.
Urine color changes can be indicative of underlying conditions that require further investigation.
What does burning or pain when urinating suggest?
Dysuria suggests infection or kidney stones.
Dysuria is a common symptom in urinary tract infections and other urological conditions.
What is nocturia?
Nocturia is the condition of urinating more frequently than usual at night, commonly associated with kidney disease.
Nocturia can significantly disrupt sleep and may indicate underlying health issues.
What could urgency to urinate with only small amounts passed indicate?
Could suggest infection or bladder issues.
This symptom may be caused by conditions such as urinary tract infections or bladder dysfunction.
What does swelling in the legs, ankles, or around the eyes indicate?
Kidney disease can cause fluid retention.
Fluid retention is a common symptom of kidney dysfunction and may require medical evaluation.
What might unexplained weight gain due to swelling indicate?
It may indicate kidney disease due to fluid retention.
Monitoring weight changes can help in assessing kidney health.
What are common symptoms of kidney dysfunction?
- Unusual tiredness or weakness
- Persistent itching without a rash
- Changes in urine color
- Swelling in legs or ankles
- Frequent urination
- Burning during urination
- Unexplained weight gain
- Foul odour in urine
These symptoms can vary and may require further investigation to determine the underlying cause.
What does burning pain in the stomach suggest?
It suggests acid-related issues like ulcers or reflux.
Understanding the type of pain can help in diagnosing gastrointestinal conditions.
What does pain worsening after eating indicate?
Could indicate gallbladder issues or ulcers.
Pain related to food intake is a key factor in diagnosing digestive issues.
What does the presence of blood in vomit indicate?
Could suggest a bleeding ulcer.
Vomiting blood is a serious symptom that requires immediate medical attention.
What condition may cause greasy, pale, or foul-smelling stools?
Suggests pancreatic enzyme deficiency (steatorrhea).
This can be a sign of malabsorption and may indicate pancreatic issues.
What does a sudden worsening of pain, then temporary relief suggest in appendicitis?
Could indicate a ruptured appendix.
Recognizing this symptom is critical, as a ruptured appendix can lead to serious complications.
What does pain in the upper left abdomen radiating to the left shoulder indicate?
Classic sign of splenic issues.
Splenic pain often involves referred pain to the shoulder due to diaphragm irritation.
What are common symptoms of anaemia?
- Tiredness or fatigue
- Weakness
- Lightheadedness
- Pale skin
- Shortness of breath
- Cold hands and feet
These symptoms can indicate various types of anaemia and should be evaluated by a healthcare provider.
What does chest pain associated with shortness of breath indicate?
May indicate cardiovascular issues.
Chest pain and shortness of breath are critical symptoms that require immediate medical evaluation.
What does sudden numbness or weakness on one side of the body suggest?
May indicate a stroke or TIA (transient ischemic attack).
Timely recognition of these symptoms is crucial for effective treatment.
What is the recommended screening age for colon cancer?
50 years old, or earlier with family history.
Regular screening can help in early detection and treatment of colon cancer.
What is a common symptom of stroke or TIA?
Sudden numbness, weakness, or difficulty speaking
Stroke or TIA symptoms may include sudden blurred vision or loss of vision in one eye, difficulty walking, dizziness, or loss of coordination.
What might sudden blurred vision indicate?
Possible stroke or TIA
Sudden blurred vision can be associated with neurological issues.
What is a symptom of lung problems during physical activity?
Shortness of breath
This can occur during rest as well.
What does a persistent cough lasting more than 3 weeks suggest?
Possible lung issue
This symptom warrants further evaluation.
What does blood-streaked mucus indicate?
Possible lung infection or cancer
Coughing up blood should be assessed by a healthcare professional.
What are common symptoms of hyperglycemia?
Increased thirst, frequent urination, increased hunger
Other symptoms include fatigue, blurred vision, and unexplained weight changes.
What does polyuria refer to?
Increased urination
It is a common symptom of hyperglycemia.
What might unexplained weight loss despite normal eating indicate?
Potential hyperglycemia
Weight gain, especially around the abdomen, is also a concern.
What are symptoms of hypoglycemia?
Shakiness, nervousness, dizziness
Other symptoms include sweating, weakness, and difficulty concentrating.
What might a rapid heartbeat indicate in the context of blood sugar levels?
Possible hypoglycemia
It can also be a response to anxiety or stress.
Fill in the blank: Increased thirst is also known as _______.
polydipsia
It is a common symptom of hyperglycemia.
True or False: A persistent cough that produces mucus may indicate a lung infection.
True
The color of the mucus can provide additional diagnostic information.
What condition may excessive tiredness during the day despite good sleep indicate?
Obstructive sleep apnoea
This condition can worsen lung function.
What is a common symptom of both hyperglycemia and hypoglycemia?
Fatigue
Both conditions can lead to feelings of tiredness, though for different reasons.
What does polycystic ovary syndrome (PCOS) relate to?
Potential hyperglycemia
It is often associated with insulin resistance.
What is a symptom of hypoglycemia related to mood?
Irritability or mood swings
This can occur alongside other physical symptoms.
