Upper Quarter Red Flags Flashcards
1
Q
fractures/dislocation S/Sx
A
- trauma, sufficient energy exchange (MVA, falls, direct blow or impact)
- severe limitations of motion all planes (muscular spasm, unwillingness to move)
- deformity may be present
- must be ruled-out by diagnostic imaging
2
Q
spinal neoplasm S/Sx
A
- medical history (+) for cancer, even if cleared or thought to be in remission
- night pain/other atypical pain manifestations
- worsening pain
- unexplained weight loss
- fatigue, malaise, unwellness
- no response to conservative management
- inconsistent reproduction of neck pain
3
Q
inflammatory/systemic disease S/Sx
A
- body temperature > 100°F
- blood pressure > 160/95 mmHg
- resting pulse > 100 bpm
- resting respiration > 25
- redness, warmth, swelling
- discoloration (e.g. jaundice)
- fatigue, malaise, unwellness
- Hx of past infection
- post surgical complaints
4
Q
referred cardiac pain
A
- left chest, neck, arm pain
- jaw, posterior thorax (T3/4 - T7), epigastrium pain
- classically left-sided/C8 distribution
- angina
- associated symptoms: dyspnea, LE edema, SOB, fatigue, syncope
5
Q
referred gall bladder pain
A
- recurrent right thoracic/lower rib region, right inferior scapular region
- increased intensity following meals (fatty, greasy foods tend to worsen Sx)
- at risk → obese women in 40s
- associated Sx → nausea/heartburn, vomiting/diarrhea, difficulty swallowing, jaundiced, rectal bleeding/stool changes
6
Q
referred lungs and associated structures pain
A
- thoracic and chest regions
- possibly cervical region/shoulders (pancost tumors)
7
Q
referred pulmonary disease pain
A
- rarely manifests purely as pain
- infections, pleurisy, cancer
- difficulty with respiration, cough
- hoarseness, sore throat, wheezing
- “I feel like my lungs are rubbing against something.”
8
Q
5 D’s and 3 N’s
A
- dizziness
- diplopia (double vision)
- dysphagia
- dysarthria
- drop attacks
- nystagmus
- nausea/vomiting
- numbness/paresthesia
9
Q
red flags symptomatic concerns (besides 5 D’s and 3 N’s)
A
- headaches (headache + neuro Sx = stroke)
- facial Sx
- altered consciousness
- quad/hemiparesis
- gait/balance disturbances
- multi-segmental weakness
10
Q
compressive cervical myelopathy
A
- more common in cervical region than thoracic region
- any neurological deficits resulting from compression of spinal cord in cervical spine
- gait and balance disturbances, generalized weakness (“I’m falling”)
- may not be associated with any radiating pain (bilateral pain/numbness in arms and/or legs, may have local radicular involvement)
- (+) signs of UMN involvement (Hoffman’s, Babinkski, hyper-reflexic DTRs, Clonus)