Low back notes 2 Flashcards

1
Q

what is used to differentiate between neurogenic and vascular claudication?

A

bicycle or walking test

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2
Q

patients with neurogenic claudication find it easier to?

A

bicycle or walk farther when flexed

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3
Q

what is considered relative stenosis? absolute stenosis?

A

relative: 12mm
absolute: 10mm

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4
Q

what is useful for the different stenoses?

A

CT- bony

MRI- soft tissue

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5
Q

what can happen if you perform spinal manipulative therapy on someone with canal stenosis?

A

increase compression, causing exacerbation or worsening of symptoms

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6
Q

what happens if someone doesn’t respond to conservative care or the neurological deficits are severe?

A

warrants surgical consultation for possible decompression

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7
Q

most common spondylolisthesis in young

A

isthmic

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8
Q

most common spondylolisthesis in old

A

degenerative

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9
Q

what are symptoms of spondylolisthesis

A

asymptomatic or have low back pain made worse with extension

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10
Q

isthmic/spondylolytic spondylolisthesis is usually due to?

A

stress fracture of the pars interarticularis

repetitive hyperextension mechanisms

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11
Q

most common spondylolisthesis is?

A

L5

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12
Q

degenerative spondylolisthesis is associated with?

A

older age

facet arthrosis

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13
Q

degenerative spondylolisthesis is most common at?

A

L4

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14
Q

spondylolisthesis is primarily a?

A

radiographic diagnosis?

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15
Q

some patients may experience what with spondylolisthesis?

A

increased back or leg pain with a one legged balance test

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16
Q

palapation of spondylolisthesis?

A

prominent spinous process at the level with a steep sacral base angle

17
Q

how do you grade a spondylolistheiss?

A

meyerding’s method

18
Q

when might you need advanced imaging for a spondylolisthesis?

A

to evaluate ongoing stress chagnes

19
Q

name the types of neumann/wiltse classifications

A
1- dyslplastic (congenital)
2- spondylolytic (isthmic)
3- degenerative
4- traumatic
5- pathological
6- post surgical (iatragenic)
20
Q

what are the symptoms of AAA?

A

may be asymptomatic
may present with mid abdominal or low back pain
may be associated with leg complaint with exertion

21
Q

signs of AAA

A

may have a bulsatile abdominal mass &/or bruit
vascular calcification may be with or without dilitation
erosion of anteiror vertebral bodies
diagnostic ultrasound or CT exam

22
Q

when do you send out for an AAA?

A

if you see the vessel is larger than 3.5 or shows any focal change in contour, regardless of diameter

23
Q

what is the normal measurement of AA?

A

3.0cm

24
Q

Segmental dysfunction findings

A
Nonspecific history
Local tenderness
Variable restriction with AROM
End range restriction on PROM
MoPal: restriction
25
Q

Is radiography required for segmental dysfunction?

A

No

26
Q

Lumbosacral sprain/strain findings

A

Overstretch (acute event)
Radiating pain possible
Pain on AROM that involves muscles
PROM pain on end range

27
Q

When are radiographs needed for lumbosacral sprain/strain?

A

If there was significant trauma

28
Q

How do we help with lumbosacral sprain/strain?

A

Myofascial therapy
Ergonomic advice
Limited orthotic support
Preventative exercises and stretches

29
Q

how can you diagnose neuritis or radiculitis due to disc?

A

needs hard neurological evidence of nerve dysfunction

history of similar events with resolution, major or minor trauma possible

30
Q

signs/symptoms of neuritis or radiculitis

A

radiation of pain into leg and foot pain
valsalva radiation possible
pain worse with specific ROM
SLR, WLR, slump positive
deficit in corresponding dermatome, myotome and DTR
AROM: variable, weakness more in lower limb muscles

31
Q

what types of imaging can you use to diagnose neuritis or radiculitis?

A

radiographs

MRI if not resolved after 1 month

32
Q

signs of mechanical low back pain

A

no recent trauma
radiation of pain into buttocks or leg, not below knee
no orthos positive, may reproduce symptoms
no neuros positive, patient may have neurological complaints (numbness)

33
Q

what can you do with those with mechanical LBP?

A
radiography to assess biomechanical status
myofascial therapy
limited orthotic support
ergonomic advice
preventative exercises and streteches
34
Q

signs of facet syndrome

A

LBP with hyperextension or movement with local pain or referred pain into leg
pain could radiate down to leg, knee or foot
valsalva may be painful
kemp or hyperextension maneuvers positive
mopal: end range restriction to side of involved facet

35
Q

what should you do with those you suspect have facet syndrome?

A
radiographs
myofascial therapy
limited orthotic support
ergonomic advice
preventative exercises and stretches
avoid hyperextension initially
36
Q

what is the most common type of cancer for females? what kind of cancer is it usually?

A

breast

lytic

37
Q

what is the most common type of cancer for males? what kind of cancer is it usually?

A

prostate

blastic

38
Q

hypercalcemia can cause what symptoms?

A

nausea, confusion, constipation, polyuria, fatigue

39
Q

tetrad of multiple myeloma?

A
CRAB
calcium elevated
renal failure
anemia
bone lesions