T/L Midterm Flashcards
components of the chiropractic subluxation
- pathophysiology
- neuropathophysiology
- myopathology
- histopathology
- spinal kinesiopathology
abnormal motion or position of the spinal bones is described by which component of the chiropractic subluxation
kinesiopathology
abnormal nervous system function is described by which component of the chiropractic subluxation
neuropathophysiology
abnormal muscle function is described by which component of the chiropractic subluxation
myopathology
abnormal soft tissue function is described by which component of the chiropractic subluxation
histopathology
abnormal function of the spine and body is described by which component of the chiropractic subluxation
pathophysiology
4 conditions related to myotomes
- trigger pionts
- fibromyalgia
- myofacial pain syndrome
- overuse syndrome
back pain that is so bad it makes the patient sick
autonomic pain
deep diffuse pain
sclerotome pain
pain that follows vascular routes rather than nerve distribution
sclerotome pain
how does activity affect sclerotome pain
exacerbates pain
annulus fibrosis is involved with which type of pain
sclerotome pain
nucleus pulposus is involved with which type of pain
dermatomal pain
dermatomal pain is aka
radicular pain
what are the three sensory fibers
- A Alpha
- A Delta
- C fibers
large, myelinated fibers; the fastest
A alpha
fibers that carry vibration and proprioception
A alpha
medium to large, myelinated fibers; medium speed
A delta
fibers that carry temperature
A delta
small, unmyelinated, slow fibers
C fibers
fibers that carry pain
C fibers
which fibers carry light touch and pressure sense?
alpha, delta, and c fibers
4 areas of concern for new beginning doctors
- omission
- wrong synthesis
- inadequate synthesis
- premature closure
found to occur when the available data contradicted the conclusion
wrong synthesis
noted when an important clinical clue was simply ignored
omission
occurs when conclusions could be supported by data, but were not
inadequate synthesis
when the diagnosis of the patient’s condition is less than justified by the existing data
premature closure
the tendency of persons to retain early hypotheses in spite of subsequent information
anchoring
fear of harming the patient by losing control of the care; performance anxiety, is a phenomenon known as
countertransference
the 6 history taking problems by beginning docs
- omission of probing “life situation” type of questions
- primarily using “leading questions”
- use of complex vocabulary
- not enough time allowed for the patient to explain the clinical complaint
- ignoring “silences”
- missing non-verbal signals
goals of clinical interviewing
- gathering information
- establishment of effective communication
- building rapport and empathy
- development of trust
- provision of information
acute pain
a week or less
sub acute pain
up to 7 weeks
chronic pain
at 7 week mark
the “patientspeak” dictionary, according to scott and weiner, converts commonly misunderstood medical terms into what
“plain english”
4 osseous causes of low back pain
- facet degeneration
- stenosis of the nerual foramina
- spinal canal stenosis
- lateral recess stenosis
what age group and gender are thoracic disc herniations more likely to occur
males in 5th decade of life
which levels in the thoracic spine are most prone to disc herniation
9th, 10th, and 11th (11th disc space has 1/4 of all disc herniations)
A of A.R.T.
asymmetry
R of A.R.T.
ROM
T of A.R.T
tissue texture
What percentage of population
will incur back pain in their
lifetime?
60-80%
Percentage if LBP that self resolves in under 2 weeks
70-90%
6 types of Myofascial Pain Syndrome
Glute Max Glute Min Piriformis Hamstrings Quadratus Lumborum TFL
Fibromyalgia Diagnosis
Widespread pain
11 of 18 trigger point areas (painful, 4 kg pressure)
Dermatome Pain
Sharp
Lancinating
Internal Disc
Factors predicting chronic pain patients
returning to work following injury
length of sickness/absence men return more often then women need for analgesics patient attitude pain in C/T/L spine after work fatigue
BPCS
evaluation of functional vs organic problems of back pain
sympathy
I am sorry for you
empathy
I am with you, and you are not alone
endogenous opiates
modulate pain
prostaglandins
vasodilation/warmth
thromboxane
vasoconstriction
leukotrienes
inflammation
development of focal trigger points
substance P
pain
enkephalins
short lasting
endorphins
long lasting
partial articular pain
some movements cause pain, others do not
full articular pain
all movement will hurt
LBP vs Myofascial Pain
LBP= less active, more narcotics, higher levels of motor pain
skin distraction technique
non-invassive way to measure flexion and lateral bend.
mark 100 mm above PSIS and 50 mm below. Put pt through range of motion then remeasure distance.
fixation: Bogduk
meniscoid entrapment
fixation: Panjabi
nuclear displacement
fixation: sandoz
annulus fibrosis separation
fixation: Mootz
fibrous restrictions/ligamentous adhesions
