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35 Cards in this Set
- Front
- Back
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Name the areas of vertebrae/regions of the spine?
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cervical
thoracic lumbosaccral coccyx |
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What are the 2 major spinal ligamental supports.
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anterior and posterior longitudinal ligaments
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What 5 muscles surround and support the spine.
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multifidi
spinalus longissimus illiocostalus erector spinae |
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Name 2 parts of the spinal cord.
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conus medullaris
cauda equina |
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What are the 3 categories of LBP?
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-non-specific (no nerve involvement, not 2ndary to another dx process)
-LBP assoc. often assoc. with radiculopathy or spinal stenosis -LBP assoc. with other dx processes |
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musculo-ligamentous strain; osteoparthritis (DJD) scoliosis, fibromyalgia, sacroiliac inflammation; compression fracture, spondylolysis is what type of LBP?
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non-specific
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A pt. with disc herniation wit nerve root impingement; spondylosisthesis with spinal stenosis; cauda equina syndrome, has what type of LBP?
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LBP aith radiculopathy or spinal stenosis
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A pt with LBP and multiple myeloma; cancer mets from other sights; Pott's dx, Ankylosing Spondylitis, AAA, prostatitis, psoas muscle infection or pylonephritis has what type of LBP?
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LBP due to other disease process
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TB of the spine is called?
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Pott's disease; which is LBP due to other disease process (very serious)
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Pain worsening when upright that improves by leaning forward is often related to?
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spinal stenosis
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What are the 4 "red-flag" symptoms of LBP?
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fever
foot drag weight loss loss of bowel or bladder control |
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Hx of CA + weight loss + no improvement after 1 month + >age 50 =
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increased risk of CA mets
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Depression, job dissatisfaction, disputed comp claim is a predictor of ?
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potentially worse outcome
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Sciatic pain radiating below knee (not just back pain) is sensitive for?
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nerve impingement
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What neurological PE should you do?
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check strength, sensation, and reflexes
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What imaging and labs are routinely done in pt's with nonspecific LBP?
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none imaging does not improve outcome, also a high incidence of false positives/false negatives
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Asymptomatic people have a high incidence of ?
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disk abnormatlities
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Pt.s with persistent LBP with symptoms of radiculopathy or spinal stenosis routinely have what imaging studies done?
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imaging is not indicated unless the pt. is a candidate for surgery or epidural injections
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Which is preferred imaging test, MRI or CT?
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MRI gives better visualization of soft tissues, spinal cord, nerve roots and disks
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In what pt. population is plain film imaging indicated in?
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pt's at high risk for compression factures
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Pt's with osteoporosis or that use oral steroids are at high risk for what type of LBP?
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related to compression fracture
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T/F
Bed rest is usually helpful for pt's with LBP |
false; is not usually helpful
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Non-specific LBP often improves in __ weeks
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4 weeks
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What NSAID and/or COX 2 can help with LBP?
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Motrin 600mg 1 po q6 hours
Celebrex 100mg po BID |
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What is a common muscle relaxer that helps with LBP?
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flexeril 10mg TID (cyclobenzaprine)
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What 2 meds can be helpful in pts with LBP with radiculopathy?
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TCA-amitryptylline 25mg po qhs
Gabapentin (neurontin) 300mg po qhs |
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What non-medication therapies can help pt's with LBP?
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heat
omt epidural injections TENS unit Cognitive Behavioral Therapy |
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You should not combine Soma and narcotics due to what?
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high risk of abuse and over sedation
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disk problems tend to occur ?
-suddenly -gradually |
suddenly
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pain below the knee, parasthesias, and weakness of the lower leg are commonly associated with ?
-MS strain -Low back fracture -Ankylosing Spondlitis -nerve compression |
nerve compression such as disk protrusion or herniation
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pt's with unilateral LBP and butt pain that gets worse with standing in one position may be suffering from ??
-lumbar stenosis -SI joint derangement -spinal stenosis |
SI joint derangements
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chronic back pain is defined as back pain lasting longer than __ weeks.
-4 -8 -12 -16 |
12 weeks
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where do 95% of lumbar disk herniations occur at what 2 levels?
-L2-L3 -L3-L4 -L4-L5 -L5-S1 -a & c -c& d -b & a |
c & d
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what treatment can be of benefit in radicular pain and in spinal stenosis?
-injections -surgery -PT -medications |
injections
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__ syndrome requires immediate surgery.
-cauda equina -spinal stenosis -disk herniation |
cauda equina
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