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MPT1 > Spine One - ends with OA/DJD > Flashcards

Spine One - ends with OA/DJD Flashcards

1
Q

What needs to be assessed if it is a cervical or thoracic complaint?

A

scapular stabilizers

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2
Q

What needs to be asses if it is a lumbar complaint?

A

hips

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3
Q

in the upper cervical spine, forward head posture __________ the facets and causes tendency towards facet ___________

A

compression, hypomobility

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4
Q

With FHP, there can be a possible compression of the _________ which refers pain in headache patterns

A

greater occipital nerve

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5
Q

in the mid-lower cervical/ upper thoracic, FHP causes the facets to go ______ and ________ and causes a tendency for facet _______

A

up and forward, hypomobility

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6
Q

FHP causes a ________ in lower cervical lordosis and _________ in C/T junction kyphosis

A

decrease, increase

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7
Q

upper janda cross syndrome is the same as

A

FHP

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8
Q

With FHP or UJCS (upper janda cross syndrome), what are the weak/inhibited muscles?

A

anterior: deep cervical flexors (esp longus coli!!)
posterior: lower trap and serratus ant.

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9
Q

With FHP/UJCS what are the facilitated/tight muscles?

A

anterior: SCM/pectoralis
posterior: upper trap/levator scap

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10
Q

What happens with the shoulder girdle in UJCS?

A
  • protracted shoulders
  • shortening of pecs and other IR (lats, teres major, subscap)
  • lengthening of scap retractors (rhomboids, mid/lower traP)
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11
Q

With FHP, the abdominal wall ______

A

constricts

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12
Q

What are the consequences of abdominal wall constriction with FHP?

A
  • lessens diaphragmatic breathing
  • facilitates increased activity of accessory muscles (like serratus, scalenes, SCM)
  • elevated 1st rib (thoracic outlet risk)
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13
Q

What muscles are inhibited/weak in lower janda cross sydrome (LJCS)

A

anterior: abs
posterior: glute min/med/max

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14
Q

What muscles are facilitated/tight/overworked in LJCS

A

anterior: rec fem/iliopsoas
posterior: thoraco-lumbar extensors

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15
Q

who is posterior pelvic tilt common in?

A

people who sit/slouch at a desk all day (desk job/video games)

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16
Q

What part of disk weakens with posterior pelvic tilt?

A

posterior aspect (increases risk for disc bulge)

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17
Q

What are the causes/results of posterior pelvic tilt?

A

tight hamstrings
forward head posture

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18
Q

who is anterior pelvic tilt common in

A

weak abs, tight iliopsoas, or overweight

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19
Q

thoracic kyphosis (weakening scapula) can be the cause/result of ________

A

anterior pelvic tilt

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20
Q

anterior pelvic tilt _________ facet joints in lumbar spine which can lead to _____, ______, and ________.

A

compress, DJD, DDD, stenosis

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21
Q

What are the overall general causes of spine pain?

A
  • stressful living and working habits
  • decline in physical fitness
  • stress and poor nutrition
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22
Q

What faulty body mechanics can cause spine pain?

A

lifting with back flexed
twisting without a pivot

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23
Q

What are 3 things you should ask about with cervical spine pain

A
  • dizziness
  • headache
  • TMJ pain
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24
Q

What are 2 things you need to ask about with lumbar pain?

A
  • bowl/bladder incontinence
  • saddle paresthesia
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25
Q

yellow flags

A

psychosocial factors (ex. emotional distress, hypervigilance, pain catastrophizing, etc.)
could indicate poor prognosis

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26
Q

What scales do we use to assess yellow flags?

A
  • pain catastrophizing scale (overestimate get effects of pain)
  • FABQ, Tampa Scale, Kinesiophobia (elevated fear avoidance beliefs)
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27
Q

Blue flags

A
  • injured workers
  • patient’s perception of work and conditions that may impair return-to-work (low job satisfaction)
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28
Q

Black flags

A
  • social and financial issues
  • reimbursement incentives to remain disables, secondary gain, litigation
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29
Q

true or false: a single red flag may be predictive of a serious disease

A

false, must make clinical decision on clusters of findings

30
Q

what are 5 red flags that may increase the likelihood of cancer

A

history of cancer
night pain or pain with rest
unexplained weight loss
age >50 or <17
failure to improve over the predicted time interval following treatment

31
Q

red flags that may suggest diskitis or osteomyelitis

A

patient is immunosuppressed
a prolonged fever with a temp >100.4
history of IV drug abuse
history of recent UTI, cellulitis, or pneumonia (other infections)

32
Q

red flags suggesting an undiagnosed vertebral fracture

A
  • prolonged use of corticosteroids
  • mild trauma >50
  • age >70
  • known history of osteoporosis
  • recent major trauma at any age (MVA or fall >5ft)
  • bruising over the spine following trauma
33
Q

red flags for an abdominal aortic aneurysm

A
  • pulsating mass in abdomen
  • history of atherosclerotic vascular disease (smoking)
  • age >60
34
Q

Why should we not use waddells signs?

A

almost all chronic pain people have these symptoms

35
Q

how many questions are on the neck disability index (NDI)

A

10

36
Q

what score is the NDI out of? is higher or lower score more disability? what is the MDC? MCID?

A

out of 50 points
higher is more disability
MDC = 10.2 (20%)
MCID = 10

37
Q

Difference between NDI and oswestry disability index?

A

MDC for oswestry is 5 points
oswestry for low back pain and NDI for neck pain

38
Q

xrays are used to identify (in general)

A

arthritis, fractures, and dislocations

39
Q

How many views of the spine do we need?

A

3, at minimus 2

40
Q

What does an AP view of the spine show?

A

vertical shape
osteophytes
disk space
scoliosis
rib symmetry

41
Q

What does an oblique view of the spine show?

A
  • neural foramen and fascia
  • osteophytes
  • stenosis
42
Q

What does a lateral view of the spine show?

A
  • integrity of ALL
  • lordosis/kyphosis
  • collapsing or wedging (compression fracture)
  • osteophytes
  • forward shift of C1 on C2 (may indicate instability)
43
Q

pathologies common in the whole spine

A

muscle strain
capsular restrictions
spondylosis
stenosis
radiculopathy

44
Q

What accompanies most spine pathologies

A

muscle guarding

45
Q

an acute muscle strain will have ________-

A
  • a MOI
  • s/s will ease with rest
  • pain referred over several spinal levels
  • uncommon as true/only cause of pain
46
Q

normal stress to normal tissue

A

no immediate increase in pain

47
Q

abnormal stress to normal tissue…

A

may produce pain without causing damage
becomes abnormal when sustained and causes damage to tissues

48
Q

normal stress applied to abnormal tissue

A

will produce pain

49
Q

abnormal stress applied to abnormal tissue

A

will increase pain

50
Q

trigger point

A

palpable nodule in the taut bands of the skeletal muscle fascia

51
Q

jump sign

A

behavioral response to pressure on a trigger point

52
Q

local twitch response

A

visible or palpable contraction of muscle and skin

53
Q

referred pain

A

pain perceived at a location other than the site of the painful stimulus
does not follow myotomes, dermatomes, or nerve roots

54
Q

true or false: capsular restrictions are associated with most pathologies

A

true and they’re usually chronic

55
Q

What causes capsular restrictions

A

poor posture, past trauma, repeated inflammation

56
Q

what are some subjective findings with capsular restriction

A

limited mobility
pain only at end range of motion
no reduction of pain with rest
no weakness
no numbness or tingling

57
Q

objective findings with capsular restriction

A
  • limited AROM/PROM that open facets during flexion
  • during flexion, may deviate to same side
  • cervical - limited contralateral SB and ROT
    = lumbar = limited contralateral SB and ipsilateral rot
  • hypomobility with passive accessory
58
Q

what are 4 names for spondylosis

A

arthritis
osteoarthritis
DDD
DJD

59
Q

What does AO and DJD most commonly affect?

A

facet joints and discs at any level

60
Q

def of DDD

A
  • thickening of subchondral bone/capsule
  • increased ca deposites
  • joint surface erosion and or irregularities (spurs)
61
Q

DDD def

A
  • hardening of NP
  • leads to decreased disc height and decreased annular strength
  • vertebral approximation
62
Q

with OA/DID you have _____ blood suppl

A

decreased

63
Q

what 2 things increase the risk of OA/DJD

A
  • loss of movement (movement causes synovial fluid to provide nutrients)
  • hypermobility (puts more wear and tear on joints)
64
Q

T/F OA DJD only occurs in older people

A

F, can occur at any age and is typically a chronic condition

65
Q

What age is peak back health

A

25

66
Q

Is OA/DJD reversible?

A

yes, if it is early dysfunction with minor involvement of discs/facets

67
Q

intermittent instability with OA DJD

A
  • laxity of joint capsule and ligament
  • annular loss of proteoglycans (decreased flexibility of disc/more stiff)
  • permanent instability and bony changes with time
68
Q

final stabilization with OA DJD

A
  • fibrosis of joint and capsule
  • joints become hypermobile to compensate
  • stiff and may not really be painful
  • stenosis may occur
69
Q

cumulative injury cycle

A

tissue trauma
inflammation
muscle spasm
adhesions (stiffness)
altered neuromuscular control (trouble activating)
muscle imbalance
back to beginning of cycle

70
Q

subjective findings with OA/DJD

A
  • stiffness (esp in morning)
  • pain (in morning, with too much movement or at end ranges)
  • mobility/activity decreases with pain
71
Q

objective findings with OA/DJD

A
  • both hypo and hypermobility
  • pain with sitting (disk -DDD)
  • pain with standing and walking (facet/DJD)
  • radiographs (symptomatic versus asymptomatic)

MPT1 (10 decks)

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