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MSK Final > Thoracolumbar Spine IV- Acute IDDs > Flashcards

Thoracolumbar Spine IV- Acute IDDs Flashcards

1
Q

______ IDD is less common than persistent IDD

A

Acute

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2
Q

Acute IDD is rare in the ______ region

A

thoracic

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3
Q

With acute IDD it is MOST common in the _______ region

A

lumbar

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4
Q

Only ___-___% of IDDs are symptomatic

A

1; 3

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5
Q

Persistent IDD is the source of pain in < ___% of LBP

A

5

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6
Q

Acute IDD is MOSTLY involved with ___-____ year olds

A

30; 50

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7
Q

95% of acute IDD’s occur at ___-_____ region

A

L4; S1

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8
Q

With acute IDD, the _______ portion of the disc is the MOST common area

A

posterolateral

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9
Q

The posterolateral portion of an acute IDD is ______, thinner, and with MORE _______ and LESS ______ annular fibers

A

weaker

vertical

oblique

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10
Q

The posterolateral portion of the an acute IDD is just lateral to the _____ ______ ligament

A

posterior longitudinal

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11
Q

`What is the main etiology for acute IDD?

A

trauma

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12
Q

With acute IDD there is ______ compression

A

axial

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13
Q

With acute IDD, forward bending or stooping without or with twisting/lifting leads to…

LESS _________ disc compression

Unevenly distributed ______ tension

Increased and asymmetrical stress on weaker and thinner __________ annular and end plate fibers

Less fixated _____ _____

A

circumferential

annular

posterolateral

end plates

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14
Q

With acute IDD, forward bending or stooping without or with twisting/lifting leads to…

MORE ______ _______ shearing force due to the above plus pull of gravity, except less at ____, _____

A

anterior segmental

L5, S1

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15
Q

With acute IDDs

It is MORE commonly OUTER ______ ______ and ______ ______ avulsion

LESS commonly INNER ______ ______ and ______ ________ herniation

A

annular tearing; end plate
annular tearing; nucleus pulposus

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16
Q

With acute IDD, the disc structures are ____________ once damaged and a large _______ immune inflammatory response occurs

A

immunoreactive; AUTO

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17
Q

With an acute IDD, a Large AUTO immune inflammatory response occurs:

There is excessive _______ pressure OR increased ______ fluid pressure in and around disc and spinal n.

A

osmotic; static

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18
Q

With an acute IDD, a Large AUTO immune inflammatory response occurs:

Static fluid consists of increased _______ chemicals that sensitizes n. and structures to ______/_______

A

inflammatory

pressure; tension

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19
Q

With an acute IDD, a large AUTO immune inflammatory response occurs:

__________/________ S&S could occur

NO ________ vv. in PNS or CNS; results in poor drainage on its own

there is an ________ inflammatory phase

A

radiculpathy/radicular

lymphatic

EXTENDED

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20
Q

With acute IDD, the typical postlat IDD symptoms:

____/_____ spinal pain

*The annulus is highly _____ so very P!ful

There is significantly MORE swelling than cervical disc due to higher number of ______

A

dull; achy

innervated

GAGs

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21
Q

With acute IDD, the typical postlat IDD symptoms:

Radiculopathy has possible ________ paresthesia’s within 24 hrs. into the _______ extremity

A

segmental; distal

22
Q

A possible worse situation with acute IDD:

Presence of _______
Presence of coldness indicating greater _________ compromise

A

radiculopathy; circulatory

23
Q

With acute IDD, there is reffered pain into the _______ and _______

A

glutes; groin

24
Q

A patient with acute IDD will have _________ pain with lying and standing/walking

A. decreased
B. increased

A

A.

25
Q

A patient with acute IDD will have _________ LBP and paresthesia’s with FB/sitting/lifting; also coughing and sneezing

A. decreased
B. increased

A

B.

26
Q

With acute IDD, the 24 hr. behavior- ______ pain in the AM due to the pooling of _______ from sleeping in a static position

A

increased; swelling

27
Q

With acute IDD, you may observe that your patient has a lateral shift of _______ on ________

They typically ___ away from the P!

Counter contralateral _____ to level eyes

A

shoulders; pelvis

SB

SB

28
Q

With acute IDD and observation you rarely see a smaller _____ girth

Wasting likely at 4-6 weeks and indicative of severe _____ ______
( MORE of a sign for persistent _________)

A

calf; spinal n. compression

radiculopathy

29
Q

The Scan findings for Acute IDD:

ROM all may increase pain

_____ and possibly _____ away from injured area of disc is likely MOST limited and increases ______ and _______

A. ROT; FLX; extremity; LBP
B. EXT; FLX; extremity; LBP
C. FLX; SB; extremity; LBP

A

C.

30
Q

Flx and possibly SB away from injured area of disc likely MOST limited and ↑s extremity and LBP due to…

Swelling
being pushed toward ______

There is tension on torn ______, _______, and ______

A

spinal n.

annulus; endplate; dura

31
Q

The Scan findings for Acute IDD:

______ and _______ toward injured area of disc possibly less limited

May ↑ LBP due to increased _______ pressure on end plate fx and high ________ pressure of disc

A. ROT; EXT; hydrostatic; osmotic
B. EXT; SB; hydrostatic; osmotic

A

B.

32
Q

The Scan findings for Acute IDD:

Ext and possibly SB toward injured area of disc possibly LESS limited and it may….

________ extremity P! especially with repetition by squeezing _______ away from the spinal n.

A

Centralize; swelling

33
Q

With acute IDD, which motion is NOT consistent with affecting symptoms?

A

ROT

34
Q

___________ is the abolition of distal and/or spinal P! in a distal to proximal direction in response to repetitive motion(s) or sustained position

A

Centralization

35
Q

Rare central and posterior IDD S&S

Cord or _____ _____ S&S

Typically ___-____ level

_________ and emergency referral

A

cauda equina

L1; L2

Immobilization

36
Q

_________ ______ and ______ developed by Robin McKenzie, PT

is based on the belief that MOST spinal pain comes from injuries to the disc which is not supported in the research

Classification system depending primarily on symptoms:
- _______ of symptoms
- ________ that decrease symptoms

A

Mechanical Diagnosis; Therapy

Location; Positions

37
Q

The McKenzie method (Mechanical Diagnosis and Therapy) determines a __________ ________

A

directional preference

38
Q

The McKenzie method (Mechanical Diagnosis and Therapy) may be associated with _________, decreasing severity, and improving ________

You should match up with _____ and ______ positions

A

centralization; function

exercise; ADL

39
Q

The MOST common directional preference with the McKenzie method is ______/________

A

EXT/Hyperext

40
Q

3 classification syndromes with Mechanical Diagnosis and Therapy:

_______- focuses on correcting poor posture

_______- focus on stretches to improve end range motion

_______- focus on using end range motion to improve the theoretical nucleus deformation in disc herniations

A

Postural

Dysfunction

Derangement

41
Q

Mechanical Diagnosis and Therapy

  1. Dynamic disc theory
    - ________ NOT migration in a normal disc
A

Deformation

42
Q

Remember this!

A
43
Q

The dynamic disc theory is ONLY predictable in ________ lumbar spines when the annulus is intact and with normal hydration

A.symptomatic
B. asymptomatic

A

B.

44
Q

The dynamic disc theory is limited and has a contradictory finding in the symptomatic disc AND _____-_____ ____ disease with annular changes

A

Age-related disc

45
Q

With Mechanical Diagnosis and Therapy:

there could be increasing hydrostatic pressure through repetitive motions; MOST often_______

A

Extension

46
Q

PT Rx with Mechanical Diagnosis and Therapy is NOT _____ to other treatments for acute LBP/disability

A

superior

47
Q

Acute IDD PT Rx:

MET- focuses on tissue _____ and _____ with local muscles

________ walking

A

proliferation; stabilization

unweighted

48
Q

How should we squat and pick up items to minimize excessive stresses and maximize stability for the disc?

Equalize ______ body and _____ pressure

MORE circumferential disc ________ and evenly distributed annular _______ with greater ______ flexion and ______ pelvic tilt

LESS anterior segmental _______ with less _______

A

vertebral; disc

compression; tension; lumbar; posterior

shearing; stooping

49
Q

Prognosis for acute IDD:

_____% start improve by ____ weeks resolve by _____ weeks

_____ will NOT require sx

It is a _______ process but the same overall outcomes without sx

A

90
6
12
MOST
slower

50
Q

With acute IDD, the typical postlat IDD signs:

Resistance and MMT- _______

Possible + stress tests with ________/_______/________/_______

Neuro tests possibly + depending on severity and timing
- diminished _______
- DTR- __________
- ________ FATIGUE
- + ________ mobility tests

A

variable

compression; distraction; PA pressures; torsion

dermatomes

hyporeflexive

Myotomal

neurodynamic

MSK Final (30 decks)

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