Pathologies 2 Flashcards
1
Q
IDD
A
- Less than 50 y/o
- AM/PM = worse in the morning
- Midline pain (hand print)
- (+) chin tuck + extension
- early 2D motion
2
Q
Facet Chrondropathy/Synovitis
A
- Lateral pain (non-midline)
- Worse in PM
- Greater than 50 y/o
- Forward head posture
- Late pain in 3D motion
- (+) side bend + rotation + extension = spurling (modify)
- hypomobile
3
Q
Disc Herniation
A
- dynatomal
- worse AM/PM
- less than 50 y/o
- guarded posture (Bakody’s sign)
- Pain = coughing/sneezing (valsalva)
- (+) chin tuck + ext test
- (+) Wainner’s CPR
- 2D motion … mainly flexion
4
Q
Foraminal Stenosis
A
- dynatomal but narrow
- pain worse in PM
- greater than 50 y/o
- forward head posture
- 3D ROM + comression
- (+) Wainner’s CPR
- Spurlings
5
Q
Cervicogenic Headache
A
- unilateral headache
- starts posterior
- Wose w/neck motions
- Females > males
- Restrictive ROM
- (+) C1- C2 flexion rotation test
- Repetitive posturing
6
Q
Whiplash Associated Disorder
A
- fear avoidance
- trauma: MVA
- guarded posture
- decrease of ROM
- Poor control
- (-) instability test
- (-) c-spine rules
- Excessive retraction moment; strains suboccibital extensor muscles
7
Q
Cervical Artery Dysfunction
A
- unilateral head and neck pain
- throbbing / unfamiliar pain
- 5 D’s / 3 N’s / A
- CAD = younger than 55 y/o (Horner’s syndrome)
- VBI = older than 55 y/o (prolonged rotation test, greater than 10 sec.)
- balance and gait disturbances
8
Q
Upper Cervical Spine Instability
A
- no pain at neck or head
- head feels heavy
- 5 D’s / 3 N’s / A
- trauma
- ligament laxity
- unwillingness to move head, will move whole body
- external support of head
- (+) Alar ligament test
- (+) Modified sharp purser test
9
Q
TOS
A
- We see disputed TOS (the fake kind)
- non-dynatomal arm pain
- pain in PM worse
- 20-50 y/o
- bulging of thoracic outlet (top of shoulders)
- (+) rotation / lateral flexion
- (+) Roos test
- weakness or decrease of sensation
- (-) Wainer’s CPR
10
Q
Myelopathy
A
- may have no pain or only diffuse stiffnes
- Lhermitte’s sign (water/electricity down back)
- Bilateral UE and LE complaints
- Altered gait, difficulty with curbs and stairs
- CPR
- age > 45
- gait abnormaility
- (+) Hoffman reflex
- (+) Inverted supinator reflex
- (+) Babinski reflex
11
Q
Costochondritis and Slipping Ribs
A
- anterior chest pain (unilateral / intermittent)
- Tender to palpation
- women > men
- 20-50 y/o
- repetitive positioning
- hypermobility (8-10 ribs = significant)
- hypomobility on uninvolved ribs
12
Q
Thoracic Compression Fracture
A
- Intense / short-duration (sharp)
- Pain laying flat / sleeping (extension hurts)
- > 60 y/o
- women > men
- osteoporosis
- (+) closed fist percussion
- (+) wall to occiput (2-3 in)
- (+) supine sign
MOI
- trauma - slip / fall
- excessive loading - typically into flexion
Fracture of VB:
- anterior only = stable (overlooked)
- anterior and middle = unstabble (typically require treatment)
13
Q
Postural Syndrome
A
- myofascial pain (upper back and upper cervical pain)
- 10-30 y/o
- excessive thoracic kyphosis
- reduced thoracic extension
- poor postural control
14
Q
Scoliosis
A
- increase pain pain 3-20x
- hereditary
- Rib hump, spinal frontal plane deviation
- (+) Ada,s forward bend test
- Non-structural: 2D curve (spasm, abnormal posture, leg length)
- Structural : 3D curve (progressive)
15
Q
TMD
A
- jaw, face, neck or headaches
- females > men
- older age
- Psychological distress
- early or “S” deviation = muscular issue
- late or “C” deviation = capsule / disc issue
- Locking (PO-AC) = disc displacement
- (+) clicking / crepitus
- (+) posteriorlateral palpation (tender)
- decrease ROM of joint play = hypomobile
16
Q
Chronic pain
A
- hyperalgesia / allodynia
- catastrophizing, fear-avoidance, low self efficacy
- hx: trauma / abuse / stress guarded posture
- pain limited testing
- they are crazy
