Trigger - Neck and back Flashcards

1
Q

what are indications for a lumbar XR in acute lower back pain

A
  • significant trauma
  • atypical pain (?)
  • nocturnal pain
  • night sweats
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2
Q

MCC of lost work time and disability in young adults. Also MC strained area of the body.

A

acute lower back pain

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3
Q

associated stiffness is a hallmark finding for what

A

chronic LBP

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4
Q

fracture of the base of odontoid is considered what type of C2 fracture classification

which fractures are most/least stable

A

Type 2 is the answer. this has high risk of non-union

type 1 - fx of upper odontoid peg (rare and unstable)
type 2 - fx of base of odontoid (unstable, high risk of non-union)
type 3 - through odontoid and into lateral masses of C2 (best prognosis)

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5
Q

what is the initial care of a cervical strain

A
  1. soft cervical collar, mild narcotic and/or NSAIDs x 1-2wks
  2. muscle relaxers if muscle spasm
  3. cervical pillow

usually resolved in 4-6 wks but can take up to 12

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6
Q

what test indicates Indicates a long-tract spinal cord lesion

A

ankle clonus and babinski!!

babinski could also indicate upper motor neuron lesion

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7
Q

what are waddell’s tests and how many must be positive to indicatelow likelihood of success w injections/surgical intervention

A
  1. superficial tenderness (marked pain w light touch over lumbar spine)
  2. axial loading (increased lumbar pain w downward pressure on pts head)
  3. distraction test (no pain w seated SLR while pt is distracted)
  4. regional disturbanecs (nonanatomic sensory/motor impairement)

3/4 = low likelihood of help w steroids or sugery

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8
Q

bilateral fractures of the pedicles r pars interarticularis on C2 is known as what

A

hangmans fx

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9
Q

where is the Odontoid (dens) fracture

A

C2

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10
Q

how would nerve root impingement and spinal crod injury both present differently in a patient with cervical spine fractures

A
  • nerve root impingement = focal UE numbness/tingling
  • Spinal cord injury = global sensory/motor deficits
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11
Q

gap or step off between spinous processes suggests what

A
  • fracture of the pars of the vertebre
  • ligamentous injury
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12
Q

what are signs of instability on a cervical XR

A
  • translocation of a vertebral body >3.5mm
  • 11 degrees of angulation of adjacent vertebral bodies
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13
Q

what is used for symptom relief in an isolated transverse process fracture of the thoracic or lumbar spine

A

thoracolumbar corset

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14
Q

when do we use Thoracolumbosacral orthosis (TLSO) for 8-12 weeks

A
  • stable, simple compression fractures <20 degrees
  • also use oral narcotics for pain at this point
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15
Q

what is the treatment for severe thoracolumbar vertebral fractures?

burst fx, severe compression fx, flexion-distraction/dislocation

A

sugrical decompression

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16
Q

what is the MSK SE of haldol and reglan?

A

torticollis

17
Q

Enthesitis with chronic inflammation via T-cells

A

ankylosing spondylitis

18
Q

Enthesopathy is the hallmark of ……

A

ankylosing spondylitis

19
Q

can present with anterior uveitis, pulmonary fibrosis and cardiac disease

A

ankylosing spondylitis

20
Q

associated with Paraspinal spasms
and Occipital Headaches

A

cervical strain