Sectional 2 (part 2) Flashcards
_ is aggravated by lumbar hyperextension, prolonged standing in lordosis, sleeping prone, and axial loading in lumbar lordosis. Eased by sitting and flexion.
SPONDYLOLISTHESIS
What are the 3 most common causes (in order) of back pain in adolescents
Spondylolysis (stress fx)
Lumbar disc disease
Lumbosacral sprain
Risk factors for vertebral fractures include: prolonged use of _, _ _ in a person over 50 years old, being over _ _ _, history of _ or a recent _ _ at any age.
Risk factors:
- prolonged use of CORTICOSTERIODS
- MILD TRAUMA in a person over 50
- being over 70 YEARS OLD
- history of OSTEOPORSIS
- recent SIGNIFICANT TRAUMA at any age (MVA/ fall from substantial height)
Stress fractures are initially _ _ on _ _ for up to 12-16 weeks. Can _ _ using _ _.
Are initially NOT VISIBLE on X-RAYS for up to 12-16 weeks
Can BE DETECTED using TUNING FORK
Red flags for Cancer in patients with LBP: history of _; _ _ loss; age _ _ or _ _; failure to _ with _; pain that persists for _ _ - _; _ pain or pain _ _.
Red flags:
- history of CANCER
- UNEXPLAINED WEIGHT loss
- age OVER 50 or UNDER 17
- failure to IMPROVE with PT
- pain that persists for MORE THAN 4-6 WEEKS
- NIGHT pain or pain AT REST
Bone cancer in adolescents/ young adults: usually occurs b/w _ and _ years of age; _ _ are most common site; early stage symptoms include _, _ ache; end stage symptoms include _ _ and _.
- usually occur b/w 10 AND 25 years of age
- LONG BONES are the most common site
- early stage symptoms include DULL DIFFUSE ache
- end stage symptoms include JOINT SWELLING AND TENDERNESS
What are the 2 common types of cancer of the long bones in adolescents? What bones/ location is usually affected? (2) Bone cancer is _ in middle age.
2 common types affecting adolescents: OSTEOSARCOMA AND EWINGS SARCOMA
Usually affects tibia and femur near or at the joint
Bone cancer is RARE in middle age
Beware the _ with _ _ (unless it is due to _ _ or _)
Beware the CHILD WITH BACK PAIN (unless it is due to SPECIFIC INCIDENT OR TRAUMA)
_ is an infection that affects long bones. Common causes include: _ fracture; infection _ that _ to bone; minor trauma with a _ _ near bone; _ in the blood stream and _ _ sites such as the _ _ and the _ _ _
OSTEOMYELITIS is an infection that affects long bones
Common causes include:
- OPEN fracture
- infection ELSEWHERE THAT SPREAD to bone
- minor trauma with a BLOOD CLOT near bone (seeding for bacteria)
- BACTERIA in the blood stream
- VULNERABLE VASCULAR sites such as the PROXIMAL TIBIA and the TIBIAL PLATEAU FRACTURE
At risk population for osteoporosis: _ _ women, those treated with _ _ of _ for prolonged periods of time (_ than _ _).
At risk:
- ELDERLY POSTMENOPAUSAL women
- those treated with HIGH DOSES of CORTICOSTERIODS for prolonged periods of time (GREATER than 6 MONTHS)
Osteoporosis is not visible on an X-ray until it reaches _ than _% bone loss. Before that it is called?
Not visible on an X-ray until it reaches GREATER than 40% bone loss
Before (less than 40%) it is called OSTEOPENIA
_ test and _ _ are a precaution with osteopenia and a contraindication with osteoporosis
SLUMP test and SPINAL MANIPULATION are a precaution . . .
In a direct access world what are a PT’s 3 choices?
- Treat
- Refer
- Refer and treat
If a woman’s low back pain symptoms increase around her menstrual cycle problem could be _ and _ _.
Problem could be VISCERAL and NOT MUSCULOSKELETAL
If a female patient has deep ache in her lower back with complaints of the calf pain that worsen around period it could be?
It could be an OVARIAN CYST
_ _ is known as the ‘silent killer’ in women due to it’s vague symptoms, which often include: _, _ or _ pain, difficulty _ or _ _, and frequent or urgent _.
OVARIAN CANCER
Which often include: BLOATING, PELVIC or ABDOMINAL pain, difficulty EATING or FEELING FULL, and frequent or urgent URINATION
If a female patient has femoral neuralgia: possible musculoskeletal conditions include: - HNP, spinal _, or _ nerve or _ _ nerve entrapment/ injury.
Include:
L2-L4 HNP
Spinal STENOSIS
FEMORAL nerve or L3 SPINAL nerve entrapment/ injury
If a female patient has femoral neuralgia possible NON-MUSCULOSKELETAL conditions include: uterine _ _, _, or _ hernia
Include:
- uterine FIBROID TUMOR
- ENDOMETRIOSIS
- FEMORAL hernia
What are common sites for endometrial growth outside of the uterus? (3)
ROB
- rectum
- ovary
- bladder
What is the best position to treat a patient that is pregnant (lying down)?
LEFT SIDE-LYING
Red flags is exercising pregnant patient: _ swelling or pain; _ pain; leakage of _ _; decreased _ _, _/ _, and _ _. Heart rate parameters are set by the _ or _.
Red flags:
- CALF swelling or pain
- CHEST pain
- leakage of AMNIOTIC FLUID
- decreased FETAL MOVMENT
- DIZZINESS/ HEADACHE
- VAGINAL BLEEDING
Heart rate parameters are set by PHYSICIAN OR FACILITY
_ can cause hyper pigmentation, palmar erythema, and dermatoses.
PREGNANCY can cause . . .
Ectopic pregnancy can cause pain the _ _ or _ _
Can cause pain in the LEFT SHOULDER or LOW BACK
Risk factors for ectopic pregnancy are: age -; _ (#1 risk factor); history of pelvic _ _, _ surgery, or past _ _; _ induced _; certain _ _ methods.
Risk factors: age 35-44; ENDOMETRIOSIS (#1 risk factor); history of pelvic INFLAMMATORY DISEASE, PELVIC surgery, or past ECTOPIC PREGNANCY; PHARMACEUTICAL induced OVULATION; certain BIRTH CONTROL methods
Signs and symptoms of ectopic pregnancy: lower _ pain, _ or _ pain, pain referred to the _ _/ _, _ tenderness, _ or _ pain, and vaginal _.
S AND S:
- lower ABDOMINAL pain
- LUMBAR or PELVIC pain
- pain referred to the SHOULDER GIRDLE/ NECK
- REBOUND tenderness
- SHARP or STABBING pain
- vaginal BLEEDING
- is a sudden onset of increased blood pressure and swelling during pregnancy. May lead to?
PRE-ECLAMPSIA is a sudden . . .
May lead to ECLAMPSIA
1st or high risk pregnancy, teenage pregnancy, greater than 35, black, multiples, diabetes, HTN, and renal disease are all?
Are all risk factors for PRE-ECLAMPSIA
Onset of preeclampsia is _ _ of gestation up to _ _ post-partum
Is 20 WEEKS of gestation up to 6 WEEKS post-partum
What are the signs and symptoms that make up the pre-eclampsia triad?
PEE
- proteinurea
- elevated BP
- excessive edema (face, neck, excessive weight gain)
Red flags for pre-eclampsia: _ BP (_ mmHg _ in systolic; _ mmHg in diastolic or _) and _ _ of greater than _ _ in one week.
ELEVATED BP (30 mmHg HIGHER in systolic; 15 mmHG HIGHER in diastolic or greater) and a WEIGHT GAIN of greater than 5 POUNDS in one week
If you do not know the patients baseline BP, in the absence of HTN, use / as a baseline
Use 140/90 as a baseline
Eclampsia is the signs and symptoms of pre-eclampsia plus _. What should you do if something happens while pregnant patient is in the clinic.
Eclampsia is the signs and symptoms of pre-eclampsia plus SEIZURES
If it occurs while you are in the clinic: CALL 911, and stabilize (remove anything that might be injurious while she is seizing) for safety
_ _ is premature separation of the placenta form the uterine wall. Can be caused by a shortened _ _, _ _, or a _ _ _.
PLACENTA ABRUPTIO is premature separation . . .
Can be caused by a shortened UMBILICAL CORD, HIGH BP or a MOTOR VEHICLE ACCIDENT
Symptoms of Placenta abruptio are: vaginal _, _ and _ pain. Should?
Symptoms are:
- vaginal BLEEDING
- BACK and ABDOMINAL pain
Should REFER OUT
