Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ORTHO- Clin Med Fall 2013 > Spinal Conditions > Flashcards

Spinal Conditions Flashcards

1
Q

Most common cause of back pain

A

sprain/strain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

degeneration of the spine

A

spondylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

anterior or posterior displacement of a vertebrae in relation to the vertebrae below

A

spondylolisthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

infection of intervertebral disc (discitis)

A

vertebral osteomyelitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

types of spinal tumors

A

extradural (vertebral- most common), intradural, and intramedullary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is osteoporotic thoracolumbar vertebral compression fracture?

A

vertebral fx without major trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

wry neck aka

A

torticollis- unilateral spasm of SCM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

where is pancoast tumor located

A

apex of lung- can compress nearby structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

dowagers hump aka

A

hyperkyphosis (overcurvature of thoracic spine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Scheurmann kyphosis diagnosis

A

self limited skeletal disorder in children defined as anterior wedging of 5 or more degrees in at least 3 adjacent vertebral bodies on lateral xray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

patient presents with back pain. started a couple hours ago. pain increases with stretching and bending. happened after soccer practice. pain improves with rest. dx and tx?

A

sprain/strain. x ray to r/o fracture. conservative tx, avoid prolonged bed rest. resolves in 2-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most common complication from sprain/strain

A

decreased activity leading to weight gain, loss of bone density and mm strength

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

most common location of spinal radiculopathy

A

lumbosacral region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Patient presents with tingling, achy or burning back pain that is sometimes sharp. Positive Spurlings and Lhermittes. MRI ordered to see if herniated disc present as a potential cause. dx and tx

A

Cervical radiuculopathy- treat underlying cause, conservative management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

most common etiology of radiucopathy is

A

disc herniation (use MRI) and spondylotic changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Patient presents with tingling, achy or burning back pain that is sometimes sharp. Positive SLR, positive slump test. MRI ordered to see if herniated disc present as a potential cause. dx and tx

A

lumbosacral radiculopathy- treat underlying cause, conservative tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

tear in annulus fibrosis (outer ring) of disc, allows soft tissue to bulge out

A

herniated nucleus pulposis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

herniated nucleus pulposis aka

A

herniated disc, prolapsed disc, ruptured disc, slipped disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

most common slipped discs

A

C6/C7 and L4/L5, L5/S1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

common age of slipped disc

A

middle aged pts d/t disc drying out as you age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what tests to order if patient presents with radiculopathy with positive spurlings and lhermittes. Pain is increased with standing, sitting, coughing, laughing and at night. You suspect it to be d/t slipped disc.

A

order Xray initially to r/o other causes. Get MRI after 12 weeks. can start conservative measures in meantime- often have spontaneous improvement, this is why MRI is not done initially

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

possible complications of slipped disc

A

cauda eqina, chronic pain, perm neurological sequelae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Most common causes of spinal stenosis

A

spondylosis (degeneration of spine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

65 year old patient presents with gradual pain in spine. Has previous history of spondylosis. Pain more in lumbar region. Positive rhombergs. Neuro exam normal, polyradiculopathy, wide based gait. dx and tx?

A

spinal stenosis in lumbar region. MRI is test of choice. conservative tx usually works. if not, injection/surgery considered.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

75% of the time, spinal stenosis occurs in lumbar region. But it may also occur in cervical region. How would this present?

A

cervical stenosis more serious because complication can be cauda equina, and perm. neurological eval.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

term used to describe back pain with degeneration but no specific caues

A

spondylosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how to treat spondylosis, complications

A

conservative tx usually helps resolve sx. complications- spondylolisthesis, spinal stenosis, cauda equina, neuro impairments, vertebrobasilar insufficiency

28
Q

Patient presents with history of spondylosis. Has stiffening of back and tightening of hamstrings. Snapping sensation when returning to standing positiion. decreased ROM, altered gait and posture. What do you suspect and what is in differential?

A

spondylolisthesis- presents similar to spinal stenosis

29
Q

types of slips that can occur

A

anterolisthesis (forward slip) and retrolisthesis (backwards slip)

30
Q

types of spondylolisthesis

A

degenerative (most common), dysplastic, isthmic, pathologic, traumatic

31
Q

spinal stenosis, spondylosis, and spondylolisthesis all have similar tx:

A

conservative tx

32
Q

patient presents with back pain that starts insiduously and progressively gets worse over last couple hours. Also has fever. Tenderness and warmth, decreased ROM in lumbar region. co-existing conditions include DM. dx and tx?

A

Increased WBC, CRP, ESR, blood cultrure. Bone biopsy is definitive diagnosis for vertebral osteomyelitis, but MRI is PREFERRED. Echo to r/o endocarditis. tx- bed rest x 10 days, intensive in-bed non-weight bearing PT, analgesics, and debridement then IV abx for 6 weeks

33
Q

Patient presents with c/o headache and neck pain. Has head tremors, stiffness, and swelling of neck mm. No fever or back pain. SCM mass is palpated on R side. what do you observe about head and chin in PE, how would you diagnose and treat

A

head tilts toward shortened SCM (R), head tilt to opposite side. US confirms. Can resolve spontaneously, conservative measures- active/passive stretching, ice/heat, analgesics.

34
Q

if child with torticolis, what additional tx besides conservative measures?

A

opthalmologist referral- may cause problem with vision alignment

35
Q

Most common cause in kids of torticolis

A

congenital

36
Q

patient presents with upper extremity weakness, paresthesias, aching pain. Gilliat sumner hand, positive compression test, positive wright test, and positive EAST test. suspect

A

neurogenic TOS

37
Q

patient presents with upper extremity weakness, paresthesias, aching pain. positive adson’s test and EAST test (stick em up). asymmetric pulses. suspect

A

arterial TOS

38
Q

types of TOS

A

neurogenic disputed neurogenic (90%), arterial, and venous

39
Q

imaging/tests in TOS

A

neurogenic TOS- EMG/NCS. vascular TOS- vascular imaging. disputed TOS- clinical diagnosis

40
Q

patient presents with upper extremity weakness, paresthesias, aching pain. activity related pain, tenderness of scalene mm. suspect

A

disputed neurogenic TOS

41
Q

patient presents with upper extremity weakness, paresthesias, aching pain.UP edema, DVT, swelling and cyanosis. collateral venous pattern seen in neck/shoulder. suspect

A

venous TOS

42
Q

tx for TOS

A

most respond to conservative tx. may use injections. vascular- anticoag, thrombolysis

43
Q

Shoulder and arm pain in lower distribution of patient. Also has Horner’s syndrome and weakness and atrophy of mm. of hand. May also have superior vena cava syndrome and TOS. dx and tx?

A

CT/MRI- order after 4 weeks, biopsy. Pancoast tumor- gold standard is chemo followed by surgical resection (if no mets)

44
Q

cause of pancoast tumor

A

from NSCLC and mets by local invasion

45
Q

Patient presents with mild pain in back/discomfort, breathing/digestive issues, fatigue, increased falls, increased fracture risk. abnormal occiput- to wall. what diagnostic tests to order

A

Xray- cobb angle and r/o osteoporosis fx, PFT to assess lung funciton prn. bone density if suspected osteoporosis

46
Q

Most common cause and tx of hyperkyphosis

A

postural. tx underlying disease (posture or osteoporosis). analgesia, postural taping, PT/exersie Tx

47
Q

Patient with history of cancer has pain with nocturnal awakening, neurological impairments. dx and tx?

A

MRI is test of choice to detect spinal tumor. Bone scan for metastases. Biopsy for diagnosis. tx- surgery is tx of choice. chemo, radiation may be added.

48
Q

major complication of spinal tumor

A

spinal cord compression

49
Q

Most spinal cord tumors are…

A

gliomas

50
Q

Patient with positive adams forward bend test (school finding). what else do you examine on PE?

A

evaluate for leg length discrepancies, cafe au lait spots (NF), dimpling of skin (intraspinal tumor), patch of hair over spine (spinal dysraphism), joint laxity (marfans, ehlers danlos)

51
Q

diagnostic measures in scoliosis

A

curves of 10 degrees= scoliosis. scoliometer reading equal or more than 7 degrees. Xray- standing PA and Lat view, cobb angle, riser sign.

52
Q

who is important to screen for scoliosis

A

all children before growth spurt!

53
Q

tx of scoliosis

A

observation and re-evaluation every 6-8 months, or sooner if younger. consider bracing and surgery

54
Q

worst progrosis in scoliosis

A

prepubertal onset

55
Q

when to refer in scoliosis

A
  1. trunk rotation greater than 7 degrees and cannot get cobb angle. 2 cobb angle 20-29 in premenarche female or 12-14 in boy. 3. cobb angle greater than 30 in ANYONE. 4. progression of cob more than 5 in anyone. 5. neuromuscular scoliosis signs
56
Q

risks for progression in scoliosis

A

3-10x more in females

57
Q

fracture occuring in spine a/w osteoporosis

A

osteoporotic thoracolumbar vertebral compression fracture

58
Q

Child with back pain that increases with activity and improves with rest at end of day. No neurological impairment. Upon PE, there is rigid kyphosis which sharp angulation as child bends over. Curvature does not flatted. Increased lumbar lordosis. dx and tx?

A

Xray- lateral spine views. self limited disease - correct kyphosis while spine is still growing via PA and bracing

59
Q

what kind of neuro deficits seen in cauda equina syndrome

A

detrusor weakness, sexual dysfunction, decreaed rectal tone, bilateral ankel reflexes absent, saddle anesthesia.

60
Q

Dx and tx of cauda equina

A

MRI. Emergency- spinal immobilization, surgical debridement within 48 hours. treat underlying cause

61
Q

how many nerve roots does cauda equina involve

A

at least 2 of the nerve roots

62
Q

most common causes of cauda equina syndrome

A

disc herniation and central canal spinal stenosis. also pregnant, infection, trauma, spondylolisthesis

63
Q

what cervical fractures are unstable vs. stable

A

jefferson’s-highly unstable and hangman’s-unstable. clay shovelers- stable

64
Q

fracture of C1 that occurs when there’s vertical compression through occipital condyles to the lateral masses of the atlas

A

jefferson’s fracture

65
Q

traumatic spondylolysis of C2 fracture caused by cervicocranium thrown in extreme hyperexxtension from sudden deceleration

A

hangman’s fracture

66
Q

fracture of spinous process in lower cervical vertebrae from sudden deceleration causing forced neck flexion

A

clay shovelers fracture

67
Q

burst fracture aka

A

jeffersons fracture

ORTHO- Clin Med Fall 2013 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions