Week 1: Red Flags and Thoracic Flashcards

1
Q

Clinical red flags system
(Red, yellow, orange, blue, black)

A

Red: signs and symptoms of serious pathology
Yellow: psychological, social and environmental factors
Orange: psychiatric conditions
Blue: work and occupational factors
Black: socio-occupational factors and system or contextual obstacles

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2
Q

General red flag characteristics

A

Severe and/or progressive symptoms
Non-mechanical pain
Night pain or pain at rest
Systemic symptoms (fever, weight loss)

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3
Q

Cancer red flags

A

Unexplained weight loss
History of cancer
Age over 50
Pain that is unrelenting and worse at night

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4
Q

Infection red flags

A

Fever
Recent bacterial infection
Intravenous drug use
Immune suppression

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5
Q

Fracture red flags

A

History of trauma or fracture
Osteoporosis
Prolonged corticosteroid use
Age >50
Severe, localised pain
Presence of contusion or abrasion

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6
Q

Cauda Equina red flags

A

Severe low back pain
Saddle anesthesia
Bladder or bowel dysfunction
Bilateral leg pain and weakness
Neurological deficits (loss of sensation, weakness, numbness)

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7
Q

2 structures of IV disc

A

Annulus Fibrosus
Nucleus Pulposus

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8
Q

Annulus fibrosus
(Description, composition, function)

A

outer layer of IV disc
Made up of tough, fibrous rings of collagen
Provides strength and flexibility, allowing for movement and weight bearing

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9
Q

Nucleus Pulposus
(Description, composition, function)

A

Inner core of IV disc
Made of gelatinous material rich in water and proteoglycans
Acts as shock absorber to distribute pressure across the disc

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10
Q

Types of Thoracic Pain

A

Muscular strain
Facet joint dysfunction
Herniated thoracic disc
Thoracic outlet syndrome
Referred pain from visceral organs
Osteoporosis or vertebral fracture

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11
Q

Thoracic pain - muscular Strain signs and symptoms

A

localised pain and tenderness in thoracic muscles
stiffness and limited ROM
pain exacerbated by movement or touch
Imaging not required unless trauma suspected

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12
Q

Thoracic pain - Facet joint dysfunction signs and symptoms

A

localised pain often described as aching or sharp
pain worsened by twisting or bending movements
Possible referred pain to shoulder or abdomen

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13
Q

Thoracic pain - Herniated Disc signs and symptoms

A

Radicular pain radiating around the chest or abdomen is common
Numbness, tingling or weakness in the affected dermatomes if radiating pain
Severe case may involve myelopathy
MRI to confirm herniation

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14
Q

Thoracic pain - Osteoporosis and vertebral fractures signs and symptoms

A

sudden onset of severe pain which worsens with activities and improves with rest
localised tenderness and possible deformity. Pain upon palpation of affected vertebrae
height loss, reduced ROM and kyphotic posture
X-ray to identify fracture
DEXA scan to assess bone density

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15
Q

Prolonged use of ___ can contribute to osteoporosis and vertebral fractures

A

corticosteroids

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16
Q

Thoracic pain - Thoracic Outlet Syndrome signs and symptoms

A

pain, numbness and tingling in the arm and hand
weakness and swelling in the affected limb
symptoms worsen with overhead activities

17
Q

What is thoracic outlet syndrome

A

compression of neurovascular (blood vessels and nerves) structures in the thoracic outlet (space between clavicle and first rib)

18
Q

What test will be positive if you have Thoracic outlet syndrome

A

Positive Adson’s test

19
Q

Thoracic pain - referred pain from visceral organs signs and symptoms

A

pain radiating to the thoracic spine
associated systemic symptoms
pain may vary with meals or respiratory movements

20
Q

4 types of exercises for thoracic pain treatment

A

Mobility
Strength
Work capacity
Motor control

21
Q

When to consider surgery for thoracic pain treatment

A

symptoms persist despite adequate trialling of conservative treatments (3-6 months)

Progressive neurological symptoms (weakness, atrophy, numbness or tingling)

Vascular symptoms

22
Q

Thoracic spine loose packed position

A

neutral to slight flexion

23
Q

Thoracic spine closed packed position

A

extension

24
Q

Normal ROM thoracic flexion

A

20-45 degs

25
Q

Normal ROM thoracic extension

A

25-45 degs

26
Q

Normal ROM thoracic rotation

A

70 degrees

27
Q

Normal ROM thoracic lateral flexion

A

20-40 degs

28
Q

Techniques to increase thoracic spine unilateral rotation ROM

A

Transverse glide
unilateral PA
Rotation PPIVM
Thoracic rotation MWM

29
Q

Techniques to increase thoracic extension ROM

A

Central PA
Thoracic PPIVM (Extension)

30
Q

Techniques to increase thoracic flexion ROM

A

Thoracic PPIVM (flexion)
Thoracic superior glide T1-T4