Brainscape's Knowledge GenomeTM

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


See full index

Clinical Dx & Case Management 1 > Thoracic and Lumbar Complaints (Exam 2) > Flashcards

Thoracic and Lumbar Complaints (Exam 2) Flashcards

1
Q

What is the ddx for a sudden thoracic flexion injury?

A

compression or chance fracture

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

What is the ddx for an older patient with thoracic pain after coughing, sneezing, or stepping off a curb?

A

compression fracture

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

What is the ddx for a blow to the chest?

A

rib fracture

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

What is the ddx for pain radiating around the chest?

A

-intercostal strain
-intercostal neuritis
-herpes zoster
-diabetes
-neurofibroma
-DJD

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

What is the ddx for pain that radiates around the chest and has associated skin lesions?

A

herpes zoster

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

What is the ddx for someone with thoracic pain increased with stretching or yawning?

A

intercostal strain

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

What is the ddx for someone with thoracic pain that gets worse at night and is unrelieved with rest?

A

-osteoid osteoma
-cancer
-rib fracture

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

What is the ddx for someone with thoracic pain that gets worse at night and is unrelieved with rest but aspirin helps?

A

osteoid osteoma

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

What is the ddx for someone with thoracic pain that gets worse at night, unrelieved with rest, and is more difficult to lie on back?

A

rib fracture

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

What is the ddx for chest or abdominal pain?

A

referral or radiation from chest or abdominal disease

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

What is the ddx for epigastric pain?

A

-pelvic ulcer
-esophagitis
-pancreatitis

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

What is the ddx for URQ abdominal pain?

A

cholecystitis or lithiasis

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

What is the ddx for chronic thoracic pain?

A

-myofascial pain due to poor posture
-ergonomic strain at work
-fibromyalgia
-depression

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

What is the ddx for someone who is seated with forward head posture?

A

postural syndrome

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

What is the ddx for someone with middle or upper scapular pain?

A

postural syndrome

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

What is the ddx for pain all over the body or both sides of thorax?

A

fibromyalgia

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

What is the ddx for pain associated with globally restricted thoracic spine movement?

A

ankylosing spondylitis

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

What is the ddx for an observed thoracic deformity?

A

-postural kyphosis
-scheuermann’s ds
-compression fracture
-scoliosis
-scapular winging due to nerve damage

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

What is the ddx for someone with a sudden onset of a hunched appearance or gradual height loss in a senior?

A

compression fracture (osteoporosis, trauma, or pathology related)

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

What is the ddx for an adolescent constantly hunched forward?

A

postural syndrome or scheuermann’s disease

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

What is the ddx for a curving back with a high shoulder or bulging ribs?

A

scoliosis

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

What is scheuermann’s disease?

A

-vertebrae grow unevenly with respect to the sagital plane
-causes anterior wedging shape of the vertebrae
-typically 13-17 years old
-complains of midback pain and fatigue
-may have increase kyphosis

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

What is osteoid osteoma?

test q

A

-benign bone tumor usually affecting a long bone (femur/tibia) but some affect the spinal lamina, pedicle, facet, or SP
-typically younger patients
-complaining of well-localized midback pain with the pain being worse at night be relived by aspirin

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

What is a compression fracture?

A

-typically older patients will have sudden onset of thoracic or lumbar pain after a minor event (stepping off a curb or sneezing)
-typically younger patients have trauma (fall on butt, hyperflexion injury)
-may be secondary to osteoporosis, menopause, long term corticosteroid use, hyperthyroidism, or malignancy

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

What is postural syndrome?

A

-caused by imbalance between anterior and posterior muscles
-often accentuated by various postures that emphasize a hunched forward head position
-constant aching pain in the middle and upper thoracic regions
-made worse by forward engaging postures
-usually relieved with activity

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

What is thoracic outlet syndrome (TOS)?

A

-neurologic or neurovascular compromise of the brachial plexus and or subclavian axillary vessel in the space
-can be caused by injury, trauma, poor posture (rounded shoulders), anatomical abnormalities (cervical rib), tight muscles (scalene or pec minor)
-diffuse symptoms down arm (numbness/tingling) usually medial arm to 4th/5th digits unilaterally
-gets worse with overhead and repetitive activities

27
Q

What is scoliosis?

A

-lateral bending and or rotary deformation of the spine, named for the side of convexity
-can be classified as congenital, idiopathic (idiopathic subtypes are infantile, juvenile, adolescent, or adult according to onset), or secondary to primary condition like spina bifida, neurofibromatosis, cerebral palsy, etc

28
Q

Which scoliosis is the most common?

A

idiopathic

29
Q

What is tietze syndrome?

A

-rare msk condition
-causes mostly unilateral localized chest pain, tenderness, swelling at the costochondral junction typically at the 2nd or 3rd costochondral joints
-can be associated with chronic excessive coughing, trauma/impact to the chest, viral or bacterial infections

30
Q

What is the ddx for someone who was in an MVA, fall, or lifting injury?

A

-disc lesion
-lower back muscle strain
-facet injury
-lumbar fracture

31
Q

What is the ddx for falling on butt?

A

compression or coccygeal fracture

32
Q

What is the ddx for a sudden hyperflexion injury?

A

compression or chance fracture

33
Q

What is the ddx for pain that appears while lifting or with sudden twisting?

A

disc lesion or muscle strain

34
Q

What is the ddx for sudden extension injury?

A

lumbar facet injury

35
Q

What is the ddx for lbp that continues into butt or leg?

A

-disc lesion
-tumor
-stenosis
-referral from facet
-piriformis syndrome

36
Q

What is the ddx for lbp that extends below the knee?

A

nerve root pain due to disc, stenosis, or tumor

37
Q

What is the ddx for lbp that extends into the butt or knee?

test q

A

lumbar facet issue or sciatica

38
Q

What is the ddx for someone with difficulty urinating or pooping with lbp?

A

-cauda equina syndrome
-prostate disease
-disc lesion (valsalva effect)
-constipation

39
Q

What is the ddx for lbp with numbness around groin or genital area?

A

cauda equina syndrome

note: this is a lumbar red flag!!!!

40
Q

What is the ddx for leg pain when pooping, coughing, or sneezing?

A

space occupying lesion indicating tumor or disc lesion

41
Q

What is the ddx for lbp with often urination and or having difficulty stopping/starting?

A

prostate cancer

42
Q

What is the ddx for lbp with abdominal pain?

A

genitourinary cause or abdominal aneurysm

43
Q

What is the ddx for lbp with abdominal pain associated with mensuration?

A

-dysmenorrhea
-endometriosis
-PID

44
Q

What is the ddx for lbp with abdominal pain that radiates around to the groin?

A

kidney infection or kidney stones

45
Q

What is the ddx for lbp with abdominal pain associated with weakness in the legs?

A

abdominal aortic aneurysm (AAA)

note: this is a red flag for lumbars!!!

46
Q

What is the ddx for marked weight loss with past hx of cancer, night pain, or pain unrelieved with rest?

A

cancer

47
Q

What is the ddx for any weakness in the legs with activity?

A

neurogenic or vascular claudication

48
Q

What is the ddx for weakness in legs with activity that is quickly relieved with rest?

A

vascular claudication

49
Q

What is the ddx for weakness in legs with activity that is better when flexed and or relieved 15-20 min later when resting?

A

neurogenic claudication (canal stenosis)

50
Q

What is a disc lesion with radiculopathy?

A

-lbp and leg pain generally below the knee
-sudden onset from bending and or twisting motion
-often there is a past history of several bouts of lbp that resolved
-numbness, tingling, and paresthesia
-radiates though dematome
-gets worse with extension and better with flexion

51
Q

What is facet syndrome?

A

-localized lbp with some hip, butt, or leg pain generally above the knee
-sudden onset after a misjudged movement or arising from a flexed position
-increased pain with extension, decreased with flexion

52
Q

What is a lumbar sprain/strain?

A

-decreased mobility, stiffness and or muscle spasm from acute traumatic overstretching of lumbar spine
-may result from overuse, repetitive tasks or trauma (sports injury or MVA)
-muscle strains are painful with active and isometric movements
-ligamentous sprains are painful with active and passive ROM

53
Q

What is canal stenosis?

A

-generally older patients 50+
-complains of back and leg pain
-pain can be unilateral or bilateral diffuse
-onset of leg pain with walking (neurogenic claudication) and relief after resting 15-20 min or by maintaining a flexed postured (bicycle posture)

54
Q

What is a spondylolisthesis?

A

-asymptomatic or have lbp made worse with extension
-in older patients it may cause stenosis

55
Q

What is the most common type of spondylolisthesis?

A

isthmic

56
Q

What is an SI sprain?

A

-pain over SI joint after straightening up from a stooped posture (often while lifting)
-pain may radiate down the leg
-pain is often sharp and stabbing

57
Q

What is known as “fat wallet sciatica”?

A

piriformis syndrome

58
Q

What is piriformis syndrome?

A

-compression of SI joint
-butt and posterior leg pain w a non-traumatic onset
-risk factors= sitting all day, fat wallet

59
Q

What is ankylosing spondylitis?

A

-chronic lbp and stiffness with occasional radiation of pain into the butt, anterior, or posterior thighs
-feels stiffness upon rising and generally have some relief with mild to moderate activity

60
Q

What is reactive arthritis (reiter’s syndrome)?

A

-lbp that began after the onset of urethritis, conjunctivitis, and skin lesions on the soles of feet/palms of hands

“cant see, pee, or dance with me”

61
Q

What is multiple myeloma?

A

-usually an older patient 50+ with complaints of persistent back pain that is unrelieved by rest
-pain seems to be worse at night

62
Q

What is metastatic carcinoma?

A

-insidious onset of pain that is persistent, worse at night and not mechanically affected
-often an accompanying history of weight loss and fatigue

63
Q

What is infectious spondylitis?

A

-deep back pain
-often recent hx of a respiratory or urinary tract infection
-patient is usually antalgic and complains of fever and difficulty sleeping due to pain

64
Q

What are the red flags that could indicate need for immediate radiograph, special studies, or referral out?

A

-severe trauma
-fever or recent bacterial infection
-saddle anesthesia (anything that touches a saddle is numb)/signs of cauda equina syndrome
-severe or progressive neurologic complaints
-recent onset of bladder dysfunction in association with the lbp
-unexplained weight loss
-prior hx of cancer, IV drug use or immunosuppression
-pain that is worse with recumbency or worse at night

Clinical Dx & Case Management 1 (6 decks)

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