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OMM M1T2 test 2 > Differential Dx of Neck Pain part 2 > Flashcards

Differential Dx of Neck Pain part 2 Flashcards

1
Q

What are the red flag for possible infection?

A 
Age Over 50 Years
Age Under 20 Years
Fever or Chills
Pain worse supine
Recent Urinary Tract Infection
IV Drug Abuse
Immune Suppression
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2
Q

What are some red flags for cervical infection in the physical examination?

A

Fever

Spinous process percussive pain (only C2, C7, T1)

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3
Q

What are some red flags for cervical infection that could be seen in lab test?

A

Elevated WBC count

Elevated erythrocyte sedimentation rate

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4
Q

What are some infections that cause cervical neck pain?

A 
Sinusitis
Cervical Adenitis
Parotitis
Lyme Arthritis
Osteomyelitis
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5
Q

What are the red flag for possible tumor in the cervical region?

A 
Age over 50 years
Age under 20 years
Unexplained Weight Loss
Pain worse when Supine
Severe Nocturnal Pain
History of cancer (has metastatic cancer until proven otherwise)
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6
Q

When doing the physical exam for circulatory disorders what should you look for and auscultate?

A

BP, Pulse Rate
Palpate Carotid Pulses (presence, character, thrill)
Heart (murmurs)
Carotid Arteries (bruits)
Vertebral Arteries at mastoid processes (bruits)
Ophthalmic Arteries over the eyeballs (bruits)

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7
Q

What are the red flags for vertebrobasiliar artery compromise?

A

Acute anxiety or panic on the part of the patient during any part of the examination or treatment (Ischemia)
Sitting pt look up toward the ceiling then turn the head to right

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8
Q

What test is NOT recommended for possible vertebrobasiliar artery compromise?

A

DeKleyn Test

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9
Q

What would ellict a wallenburg syndrome and what are its symptoms?

A

Vertebrobasiliar thrombosis
Homolateral face pain and paresthesia, contralateral loss of pain and temp sensation, vertigo w/ vomiting, unilateral paralysis of palate, pharynx and vocal cords

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10
Q

What is the history finding for mechanical abnormalities?

A

Insidious onset

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11
Q

What are some mechanical abnormalities of the cervical spine?

A 
Somatic Dysfunction
Kyphosis with Anterior Head Carriage
Scoliosis
Poor Posture
Poor Muscle Tone 
Scapulo-Costal Syndrome
Hypermobility
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12
Q

What constitutes about 30% of all neck and shoulder complaints in mid-life?

A

Scapulo-costal syndrome

Also called: fatigue postural paradox syndrome or levator scapulae syndrome

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13
Q

What does the posture look like in scapulo-costal syndrome?

A

Inc kyphosis with anterior head carriage with muscular neck, shoulder and back pain

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14
Q

Where does the pain localize to in scapulo-costal syndrome?

A

Superior medical corner of the scapula

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15
Q

What exacerbates the pain in scapulo-costal syndrome?

A

Elevation and adduction of the humerous

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16
Q

What sound could you hear if someone has scapulo-costal syndrome?

A

Crepitance due to facial scarring when circumducted

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17
Q

What is the treatment for scapulo-costal syndrome?

A 
Correct Kyphosis
Correct Scoliosis
Correct Associated Cervical, Thoracic, Costal and Clavicular  Somatic Dysfunctions 
Balance Shoulder muscle tension
Trigger Point Treatment
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18
Q

What are some counterstrain treatments for scapulo-costal syndrome?

A 
Counterstrain
Muscle Energy
Deep Inhibitory Pressure
Spray & Stretch
Injection of Lidocaine/Corticosteroids
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19
Q

What is intern’s neck and what is it caused by?

A

Neck and shoulder pain
Excessive Pull on the Suspensory Muscles of the shoulders
Due to overloading white coat pockets

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20
Q

How can you releive some of the pain in intern’s neck?

A

Transfer the weight off the shoulders onto pelvis

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21
Q

Where can hypermobility occur and what could cause it?

A

Anywhere

Laxity of ligaments due to genetic factors, degenerative discs, ligament trauma

22
Q

What are the treatments for localized hypermobility?

A 
OMT
Exercise
Bracing
Prolotherapy
Surgical fusion
23
Q

What is Elhers-Danols syndrome?

A

A group of inherited disorders that affect connective tissue due to defects in collagen production

24
Q

What type of Ehlers-Danols is hypermobility and what are the symptoms?

A

Type III
Loose connective tissue and chronic joint pain
Also called Benign Hypermobility Syndrome or Arthrochalasis Multiplex Congenita

25
Q

What type of Ehlers-Danols is the classical case and what are the symptoms?

A

Type I and II
Highly Elastic, Velvety Skin
Fragile Skin that Bruises and Tears Easily
Slow and Poor Wound Healing Leading to Scarring
Non-cancerous fibrous growths on pressure areas such as elbows and knees
Fatty Growths on Shins & Forearms
Loose Joints, Prone to Dislocation, Delayed Development of Large-Motor Skills

26
Q

What type of Ehlers-Danols is the vascular case and what are the symptoms?

A

Type IV
Fragile Blood Vessels and Organs that are Prone to Rupture
Thin, Fragile Skin that Bruises Easily
Veins Visible Beneath the Skin
Distinctive Facial Features Including Protruding Eyes, Thin Nose & Lips, Sunken Cheeks and Small Chin
Loose Joints Usually Limited to Fingers & Toes

27
Q

What type of Ehlers-Danols is the Kyphoscoliosis case and what are the symptoms?

A

Type VI
Progressive Scoliosis
Fragile Eyes That are Easily Damaged
Severe, Progressive Muscle Weakness

28
Q

What type of Ehlers-Danols is the Arthrochalasia case and what are the symptoms?

A 
Type VII A and B
Very loose joints and dislocations, involving hips, which may delay development of large motor skills
Stretchy Skin that’s Prone to Bruising
Early Onset Arthritis
Increased Risk of Osteoporosis
29
Q

What type of Ehlers-Danols is the Dermatosparaxis case and what are the symptoms?

A

Type VII C
Extremely fragile and sagging skin
Loose joints, may see large motor delay

30
Q

How would you diagnose Ehlers-Danols?

A

Genetic tests
Skin biopsy
Cardiac ultrasound

31
Q

What are some complications of Ehlers-Danols?

A 
Prominent Scarring
Difficulty with Surgical Wounds Healing
Chronic Joint Pain
Early Onset Arthritis
Premature Aging with Sun Exposure
Rupture of major blood vessels, intestines, uterus
Eye problems
Osteoporosis
Premature delivery of fetus
Premature rupture of fetal membranes
32
Q

What are some causes that lead to temporomandibular joint dysfunction

A 
Joint disease
Dental malocculsion
Dysfunction of muscles of mastication
Head carriage
Cranial somatic dysfunction
Physiological issues
33
Q

In the history of someone with degenerative diseases what should you look for?

A

Insidious onset

Age over 50

34
Q

What are some causes of degenerative disease?

A

Cervical spondulosis
Diffuse idiopathic skeletal hyperostosis (DISH)
Osteoarthritis of the shoulder or TMJ

35
Q

In cervical spondylosis what complaint is common and what accompanies that complaint?

A

Headache with cervical disc disease

36
Q

Should you declare the etiology of headaches based on the X-rays?

A

No they must correlate with with the physical findings

37
Q

What can DISH lead to?

A

Ossification of the posterior longitudinal ligament

38
Q

When looking at a spine that has suffered from DISH what do you expect it to look like?

A

Candle wax osteophytes

39
Q

What could DISH be heavily associated with?

A

Diabetes mellitus type II

40
Q

What could be some causes of thoracic outlet syndrome?

A

Anterior scalene syndrome
Costo-clavicular syndrome
Pectroaliz minor syndrom
Somatic dysfunction of the cervical area, 1st or 2nd rib or clavicle

41
Q

How could you test for toxic and metabolic disorders?

A

Lab screening of CBC, urinalysis, blood chemistries

42
Q

What are the signs of hyperthyroidism?

A

Muscle weakness & Atrophy

43
Q

What are the signs of hypothryroidism?

A

Brisk reflex contraction with slow relaxation

44
Q

What are the signs of hypokalemia?

A

Muscle weakness, cramping, fasciculations

45
Q

What are the signs of hypomagnesemia?

A

Weakness, tetany, carpopedal spasm, positive chvostek sign

46
Q

What is chvostek sign?

A

Facial muscle involuntarily contract when the facial nerve is percussed

47
Q

What causes refered pains to the breast?

A

C5/C6 nerve room (myotomal)

48
Q

What causes refered percordial pain?

A

C5/C6 nerve room (myotomal)

49
Q

What can cause face pain?

A

Trigeminal neuralgia

50
Q

What are some causes of refered pain to the neck and head?

A 
Cardiac pain
Complex regional pain syndrom
Dental pain
Myfascial trigger points
Occipital neuralgia
Ocular pain

OMM M1T2 test 2 (9 decks)

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