Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
30 Cards in this Set
- Front
- Back
|
1. What does lordosis protect against?
2. Causes of hyperlordosis |
1. protects against sheer stress and torsional stress
|
|
|
What will occur first, vertebral fracture or disc rupture? |
vertebral fx > disc rupture |
|
|
What is the source of back pain in the first trimester?
pain is worsened by? |
sacroiliac hypermobility from secreted relaxin
worsened by standing |
|
|
What is the source of back pain in the third trimester? |
hyperlordosis from an enlarged uterus = pain while standing
nocturnal pain is due to the uterus partially blocking the inferior vena cava. |
|
|
pressure on L3 disk while:
sitting standing laying down |
sitting > standing > laying
sitting = 2atm standing = 1.5atm laying = 1atm |
|
|
The nuclear water content is ______ than the annulus and moves _______ with extension and ______ with flexion |
The nuclear water content is higher than the annulus and moves anterior with extension and posterior with flexion
|
|
|
Mechanism of disc herniation (3 steps) |
1. Minor back aches produce circumferential fissures that weaken the annular lamellae 2. multiple circumferential fissures will develop into a radial tear 3. nuclear herniation |
|
|
Most common site of disc herniation? Second most common? |
Most common = L4-L5
Next most common = L5-S1 |
|
|
Describe the characteristics of
1. referred pain 2. radicular pain; what makes radicular pain worse |
1. sclerotomal, aching and sore 2. dermatomal, sharp, burning or lancinating worsened at night or by valsalva maneuvers such as coughing, sneezing, & straining @ stool |
|
|
cauda equina syndrome |
Large central disc herniations affecting sacral nerve roots can produce
++urinary retention ++loss of rectal tone with or without constipation Associated with ++ “saddle anesthesia” and produces bilateral leg pain. |
|
|
Greater than ____% of disc herniations reduce spontaneously due to ? |
Greater than 50% of disc herniations reduce spontaneously due to dehydration and shrinkage of the disc material or regression into the annulus. |
|
|
typical pain of an osteoporotic fx? |
sudden, severe back pain and is aggravated by any movement, whether lying, sitting or standing
pain is bilateral and usually doesn’t radiate into the legs.
percussion tenderness over the involved segment |
|
|
LBP associated with infection presentation?
Typical type of organism? |
progressive, present even when lying still and it is associated with fever and shaking chills; percussion tenderness
usually bacterial, especially Staphylococcus |
|
|
Is muscle spasm usually a primary problem or secondary problem?
Typical presentation? |
most commonly a secondary phenomenon to disc disease, infection or fracture
associated with a list = appears to be bending to one side. One cannot fully extend or stand erect, & is relieved by lying down. |
|
|
Define:
Spondylosis Spondylolysis Spondylolisthesis |
spondylosis = degeneration of the disc &/or the joint.
Spondylolysis = defect in the pars interarticularis.
Spondylolisthesis = slippage of one vertebral body on another. |
|
|
Mechanism of LBP in spondylosis? |
disc narrowing increases pressure across the facet joint, leading to osteoarthritis of that joint.
degenerative disc disease eventually produces degenerative joint disease. |
|
|
Disc disease is aggravated by ____ and joint disease by ____ |
Disc disease is aggravated by sitting and joint disease by standing |
|
|
Degenerative spondylolisthesis mechanism? Where does it occur usually? |
produced primarily by subluxation of degenerated facet joints.
This usually occurs at L4-5 |
|
|
Where does spondylolisthesis due to spondylolysis usually occur? |
in young people occurs most commonly at L5-S1. |
|
|
mechanism of spinal stenosis |
combination of degenerative disc and joint disease with its accompanying disc bulging, spurs and thickening of the ligamentum flavum, causing narrowing of the spinal canal
walking increases blood flow through the venous plexus of the spine, which engorges and compresses the cord |
|
|
How does spinal stenosis differ from arterial insufficiency in terms of:
anatomic distribution walking distance relief |
Stenosis: anatomic distribution = prox to distal; butt and thigh walking distance = varies relief = with sitting/bending
Arterial insufficiency: anatomic distribution = always calf walking distance = same every time relief = standing still |
|
|
Classic presentation of chronic back pain due to:
fibromyalgia |
Generalized constant pain unrelated to time of day, position, or activity* assoc disturbed sleep, IBS, headaches, catastrophizing |
|
|
Classic presentation of chronic back pain due to:
Systemic Polyarthritis |
Relieved w/activity; Morning Stiffness ≥1hr; back pain usually sacroiliitis & often other jt pains |
|
|
Classic presentation of chronic back pain due to:
visceral organ (GI, GU, Aorta) |
GI- Pain w/ BM; colitis, ileitis ,colonic tumors
GU- Menstrual, CVA or micturition pain; kidney, prostate, uterus, ovaries
Aorta- Throbbing pain while supine; aneurysm |
|
|
Classic presentation of chronic back pain due to:
tumor |
Insidious, progressive, nocturnal, weight loss, >50 yo |
|
|
How do you differentiate sacroilliac pain from LBP? |
Sacroiliolitis requires 3 positive tests:
Patrick (FABER) test Gaenslen maneuver POSH Test REAB Test SI tenderness Iliac distraction Sacral thrust |
|
|
How do you differentiate trochanteric bursitis pain from LBP? |
produces pain and tenderness over the greater trochanter & pain on passive internal rotation or resistive external rotation of the hip |
|
|
How do you differentiate Hip joint synovitis pain from LBP? |
Hip joint synovitis causes groin pain, primarily, not buttock pain, produces a limp, and causes pain on passive internal rotation of the hip. |
|
|
Why shouldn't you initially image for LBP? |
Low yield of unexpected findings High incidence of false + MRIs |
|
|
When SHOULD you image |
1. Considering developmental abnormality or surgery 3. Considering a “red flag”: • Cancer |
