Spinal conditions Flashcards

1
Q

Spinal or intervertebral stenosis - etiology

A

narrowing of spinal canal or intervertebral forament coupled with hypertrophy of the spinal lamina and ligamentum flavum or facets

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2
Q

Spinal or intervertebral stenosis - results in

A

vascular and/or neural compromise

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3
Q

Spinal or intervertebral stenosis - s/s

A

Bilateral pain and paresthesia in back, buttock, thigh, calves and feet
Pain dec with flex, inc with ext
Pain inc with walking
Pain relieved with rest

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4
Q

Spinal or intervertebral stenosis - clinical tests

A

bicycle (van Gelderen’s test) will help identify and differentiate it from intermittent claudication

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5
Q

Spinal or intervertebral stenosis - PT traction

A

C spine positioned at 15 of flex to provide optimum opening of intervertebral foramina

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6
Q

Spinal or intervertebral stenosis - PT traction - contraindications include

A
joint hypermobility
pregnancy
RA
down syndrome 
or any other systemic disease that impacts ligamentous laxity
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7
Q

Disc conditions - internal disc disruption - most commmon where

A

lumbar

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8
Q

Disc condition - internal disc disruption - s/s

A

constant deep, achy pain, and inc with mvmnt

No objective neuro findings but pt may have referred pain in LE

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9
Q

Posterolateral bulge/herniation - most common observed disc disorder of ____ spine due to

A

Lumbar
Post disc is narrower in height than anterior
Post longitudinal lig is not as strong and only centrally located in lumbar spine
Post lamellae of annulus are thinner

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10
Q

Posterolateral bulge/herniation - results from

A

overstretching and/or tearing of annular rings, vertebral endplate and/or ligamentous structures from high compressive forces or rep. microtrauma

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11
Q

Posterolateral bulge/herniation - results in

A

loss of strength
radicular pain
paresthesia
inability to perform ADLs

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12
Q

Posterolateral bulge/herniation - PT intervetion

A

Positional gapping for 10 minutes to inc space within region of space occupying lesion
Traction

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13
Q

Posterolateral bulge/herniation - PT intervention - positional gapping - if left posterolateral lumbar herniation is present - have pt

A

sidelying on R side with pillow under R trunk to accentuate R sidebending
Flex both hips and knees
Rotate trunk to left (or pelvis to R)

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14
Q

Central posterior bulge/herniation - more commonly observed where

A

cervical spine but can be seen in lumbar

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15
Q

Central posterior bulge/herniation - results in

A
loss of strength
radicular pain
paresthesia
inability to perform ADLs
possible compression of spinal cord - CNS s/s (hyperreflexia, pos babinski)
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16
Q

Anterior bulge/herniation

A

VERY RARE due to structural integrity of anterior IVD

17
Q

Facet joint conditions - DJD results in

A

bone hypertrophy
capsular fibrosis
hyper or hypomobility of joint
proliferation of synovium

18
Q

Facet joint conditions - DJD s/s

A

Reduction of mobility of spine
pain
possible impingement of associated nerve root
loss of strength and paresthesias

19
Q

Facet joint conditions - facet entrapment (acute locked back) - caused by

A

abnormal movement of fibroadipose meniscoid in facet during extension
meniscoid does not properly reenter joint cavity and bunches up, becoming a space occupying lesion which distends capsule and causes pain

20
Q

Facet joint conditions - facet entrapment (acute locked back) - flexion vs. extension

A

Flexion is most comfortable for patient

Extension increases pain

21
Q

Acceleration/Deceleration injuries of C spine - whiplash - early s/s

A

HA, neck pain, limited flexibility, reversal of lower cervical lordosis and dec of upper cervical kyphosis, vertigo, changes in vision and hearing, irritability to noise/light, difficulty swallowing

22
Q

Acceleration/Deceleration injuries of C spine - whiplash - late s/s

A
Chronic head and neck pain
limitation in flexibility 
TMJ dysfunction
limited tolerance to ADLs
disequilibrium
anxiety and depression
23
Q

Hypermobile spinal segments - due to

A

insufficient soft tissue control

24
Q

SIJ dysfunction - clinical tests

A
Gillet's 
Ipsilateral anterior rotation test
Gaenslen's
Long sitting (supine to sit)
Goldthwait's
25
Q

Repetitive/cumulative trauma to back - rep trauma disorders account for what percent of all reported occupational diseases

A

48%

26
Q

Back tumors - primary tumors include

A
multiple myeloma 
ewing's sarcoma
malignant lymphoma
chondrosarcoma
osteosarcoma
chondromas
27
Q

Metastatic bone cancer has primary sites in

A

lungs, prostate, breast, kidney and thyroid

28
Q

Visceral tumors - Esophageal cancer s/s may include

A

pain radiating to back, pain with swallowing, dysphagia, weight loss

29
Q

Visceral tumors - pancreatic cancer s/s includes

A

deep, gnawing pain that may radiate from chest to back

30
Q

GI conditions - Acute pancreatitis may manifest itself as

A

mid epigastric pain radiating through to the back

31
Q

GI conditions - cholecystitis may present with

A

abrupt, severe abdominal pain and righ tupper quadrant tenderness, nausea, vomiting, and fever

32
Q

Cardiovascular and pulmonary conditions - heart and lung conditions can refer pain to

A

chest, back, neck, jaw, UE

33
Q

Abdominal aortic aneurysm usually appears as

A

nonspecific lumbar pain

34
Q

Kidney, bladder, ovary, and uterus disorders can refer pain to

A

trunk, pelvis, and thighs