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T4 CONA > wk 1 & 2 quiz diagnosis and LBP > Flashcards

wk 1 & 2 quiz diagnosis and LBP Flashcards

1
Q

__: decision regarding the pt complaint; the act of identifying a dx or a condition from s/s

A

diagnosis

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2
Q

____: a test that detects a symptom or sign

A

positive findings

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3
Q

_____: condition/ diagnosis given the signs and symptoms

A

indications

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4
Q

___: presence of specific S/S suggesting with almost certainty that the target condition is present

A

pathongnomic

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5
Q

_____: ability of a test to identify those WITH the dx (true pos. rate)

A

test sensitivity

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6
Q

___: ability of a test to identify those w/o the dx (true neg. rate)

A

test specificity

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7
Q

____: the use of current best evidence in making decisions about the care of a pt.

A

evidence based medicine

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8
Q

____: a list of cc that are possible given a particular set of s/s/ clinical finings

A

differential diagnosis

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9
Q

___:” A working hypothesis” formulated from significant items in hx, and physical findings, a tentative dx; or a working dx

A

clinical Impression

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10
Q

_____: any s/s that may suggest the presence of a serious health cc that may be life threatening or disabling

A

red flag

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11
Q

most LBP is ___ and recovers in ___wks

A

uncomplicated and recovers in 6 wks

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12
Q

2012 Prospective study: there was ___ of surgery for thoe who went to a chiro first

A

reduced odds

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13
Q

Which etiology caused LBP the most

A

disc disruption (39%)

5% of those are herniations

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14
Q

Which pop under goes spinal stenosis the most

A

older pop –> degeneration process

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15
Q

origin of LBP is often assumed to be ____, but it might not be mechanical LBP. It might be from ____ factors

A

thought to be: degenerative conditions

but might be: biochemical and inflam factors

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16
Q

in nonmechanical LBP a study was conducted that concluded 37% of disc herniations where caused by ___

A

bacteria (p.acnes)

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17
Q

bact. may be the cause of __% of chronic LBP

A

40%

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18
Q

Central portion of the disc is called: ___

derived from the cells of ___

A

called: nucleus pulposus
from: primitive notocord

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19
Q

outer portion of the disc is called ___

A

caled: annulus fibrosis

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20
Q

What are the two parts of the annulus fibrosis connected to :

A

inner fibers: cartilagenous endplate

outer Sharpy fibers: attached to the VB

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21
Q

What are shapy fibers?

A

the outer portion of the annulus fibrosis that are attached to the VB

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22
Q

What two lig.s strengthen the disc space

A

ALL (stronger- resist extension)

PLL (resist flexion)

23
Q

Which is stronger? ALL vs. PLL

- what do they attach to?

A

ALL - resist extension

attach to: annulus fibrosis

24
Q

Herniation occurs when the ___ moves through the torn ___

A

nucleus pulposus moves through the annular disc

25
Q

___: any dx that affects the spinal N roots

A

radiculopathy

26
Q

What is the first change of an aging disc

A

in the nucleus–> from soft gel to fibrous lumps

27
Q

the strength of a disc is contributed to:

A

fluid and proteoglycans in the disc

28
Q

____: gradual deformation of the disc when under constant load

A

creep

29
Q

a primary cause of disc degeneration is :

A

failure of the nutrient supply to the disc cells

30
Q

(5) factors that can affect blood supply to the VB

A 
o	Atherosclerosis
o	Long term exercise or lack of it 
o	Mechanical stress/ injury 
o	Major risk factors: heavy physical work, lifting, truck driving, obesity and smoking 
o	Genetic
31
Q

3 phases of progressive degenerative changes in the annulus nuclear complex:

A
  1. dysfunction: tears
  2. instability: internal disruption
  3. restabilization: osteophytes and traction spurs = stenosis
32
Q

____ tears: from shear stress from loading in bending and torsion

A

circumferential tears

33
Q

__:avulsion of annulus w/ sclerosis and osteophytosis of the bone

A

rim lesion

the annulus is attached to the VB, so it takes the bone with it

34
Q

___disruption: inward buckling

A

internal disc disruption

35
Q

____fissures: starting in inner annulus

A

radial fissures

36
Q

_: displaced nuclear mat. Causing the outer annulus to bulge

A

annular protrusion

37
Q

__:nuclear mat. Escapes from disc

A

nuclear extrusion

38
Q

____: Nucleus protrudes through inner but not outer layer of annulus

A

contained disc

39
Q

___: nuclear mat. Penetrates through annulus

A

non-contained disc

40
Q

_____: mild displacement of the annular fibers, PLL is intact

A

bulge

41
Q

___: fibers of the annulus are thinned with some tearing , PLL intact

A

protrusion

42
Q

_____: rupture of the annular fibers → nuclear mat. Emerges through the annulus , NP remains confined by the PLL

A

Extrusion

Pt with severe Back pain and sciatica are 3x more likely to have this

43
Q

o Pt with severe Back pain and sciatica are 3x more likely to have :____

A

disc extrusion

44
Q

_____: PLL is disrupted and the nucleus protrudes into the epidural space → disc tiss is expelled from disc and no longer attached

A

sequestration

45
Q

98% of lesions are to __ or ___ in the back

A

L4-L5 or L5-S1

46
Q

If a lesion is present in the L5-S1 what are three probable signs

A

Pain in S1 area : sciatic

patho. achilles DTR
(s) deficit in S1 dermatome

47
Q

If a lesion is present in the L4-L5 what are three probable signs

A

weak ext. hallicus weakness
pain in post/lat thigh and calf
(s) deficit of L5 dermatome

48
Q

During a bulging disc there will be an increase during ___ motion and ___ is absent

A

pain incr with flexion

No Dejerine’s triad

49
Q

What is dejerine’s triad

A

pain during: cough, sneeze, or bowel movement

50
Q

name 5 test for Lower Lumbar Radiculopathy/ Sciatica (L4-S3)

A
  • SLR
  • Bowstring
  • Bragard’s
  • Lasegue’s
  • Sicard’s
51
Q

name 2 test for Lower Lumbar radiculopathy/ femoral N: (L2-L4)

A
  • Femoral N traction test

* Nachlas Test

52
Q

(2) imaging techniques used to diagnosis disc degeneration

A

MRI and CT

53
Q

___ testing is used to test for Decr motor and sensory potentials in extrusion and sequestration

A

electrodiagnostic testing

54
Q

What management technique is used when patient has primary leg pain or pain that is too severe for less invasive management

A

epidural steroid injections

T4 CONA (5 decks)

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