Pathologie 2

Question 1

The student is able to name the characteristics of nonspecific complaints of the lower back.

Answer 1

• These back complaints have no clear cause (non-specific), this is in about 90% of all PTs with low back pain
• The course is abnormal if there is no clear increase in activities and participation after 3 weeks
• Pain in the lumbosacral region
• The pt can radiate to the buttock and thigh
• The pain may be made worse by certain postures, movements and lifting or moving loads

Question 2

The student is able to name the characteristics of a cervical radicular syndrome.

Answer 2

• Neck pain
• Radicular pain: shooting pain
• Paresthesia: tingling, burning sensation
• Loss of strength: of arm and hand muscles
• Pain in arm or hand
• Sometimes there are also atypical symptoms such as: weakness of the deltoid muscle,
weakness of scapula musculature (*with scapula alata), chest pain and headache

Question 3

The student can name the cause of cervical radicular syndrome.

Answer 3

Cervical radiculopathy is caused by compression of one or more cervical nerve roots (spinal nerves). Compression can be caused by various factors: soft neck hernia, hard neck hernia or a combination of both

Question 4

The student can explain scapula alata

Answer 4

Scapula alata: abnormal position of the scapula

• winging: protrusion of the medial margo
• scutching: protrusion of the superior margin
• tipping: protrusion of the inferior angulus.

This occurs when the muscles of the shoulder girdle no longer function properly. In most cases in a reduced control by the nerve the cause of the abnormal position The nerve can be damaged by trauma or a bacterial infection A reduced muscle function can also be caused locally by a bursa inflammation or SAPS

Question 5

The student is able to name the red flags of the CS.

Answer 5

• Under 20 years old or over 50 years old
• Trauma
• Long-term use of corticosteroids
• Neurological failure
• Neurological complaints in legs / cotton wool feeling under feet
• Problems with bowel movements/incontinence
• Hoarseness/swallowing problems
• Structural deviations

Question 6

The student is able to name the red flags for the head.

Answer 6

• First headache > 40 years
• New headache > 50 years
• Temporal headache > 50 years (temporal arteritis)
• Sudden severe headache
• Headache after (recent) trauma.
• Headache in combination with neurological symptoms
• “Sentinel headache” (occipital unilateral headache as a “warning” for an aneurysm a. vertebralis, a. carotid int.)
• Increasing headache despite treatments
• Focal neurological signs and symptoms: glare, colored or dark
spots, sometimes even facial loss. Also, tingling in one hand or around the mouth may occur.
• Changes in mental status such as: memory disorders, confusion,
loss of consciousness, drowsiness, increased irritability

Question 7

The student is able to name the different types of neck complaints/headache.

Answer 7

→ Neck complaints
• Specific complaints
• Non specific complaints
• Cervical radiculopathy
Following headaches are also neck related:
- Migraine
- Tension type headache
- Cervicogenic headache

→ Headaches
• Primary headaches
- Migraine
- Tension-type headaches 
- Clusterheadache
- Other primary headaches: caused by movement, coughing, sexual activity.

• Secundary headaches

• Trauma related
• Medication related
• Cervicogenic headache
• Temperomandibular headache

Question 8

The student is able to name the signs and symptoms corresponding to cervicogenic headache

Answer 8

• Unilateral “side locked”
• Starts occipital
• Not pulsating
• Can be provoked
• (often) Cerv. mov. limitation
• Possible arm/shoulder pain (ipsilateral)
• Hours up to weeks

Question 9

The student is able to name the signs and symptoms corresponding to a migraine.

Answer 9

• Unilateral “side shift”
• Starts front-temporal
• Pulsating
• Cannot be provoked
• (often) no cerv. mov. limitation
• No arm shoulder/pain
• Max 72 hours

Question 10

The student is able to name the signs and symptoms corresponding to Tension Type Headache

Answer 10

• Pressing pain around skull
• Minutes to days
• Hypersensitive for sound OR light
• Not provokable

Question 11

The student is able to name the signs and symptoms corresponding to cluster headache

Answer 11

• Attacks of pulsating stabbing pain
• One side around eye or temporal
• 15 to 180 minutes
• Clusters of weeks to months
• 1 to 8 attacks a day
• Additional symptoms:
- ipsilateral red eye
- tearing eye
- a cold

Question 12

The student is able to name the signs and symptoms corresponding to temperomandibular headache

Answer 12

• Dysfunction of the jaw joint