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What is the spurlings test?

Extention/Axial rotation of neck causes arm/shoulder pain

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Thoracic involvment of Metastatic DZ includes what S/S?

Band like pain around chest

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Clay shovelers fracture

Spinous processes fx of C6-7 + T1-2

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TXT of Lumbar stenosis

NSAIDS, PT, water active
Meds
Surg

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Surg indications of scoliosis? degrees

> 45-50

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AKA for Anklylosing spondylitis

Bamboo spine (late)

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TXT meds for seronegativearthopathies

NSAIDs,
Immunomods
TNF inhibitors

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Indications for MRI in scoliosis pt?

Cafe Au lait spots
Neuro finds
Spinal pain
Cavus feet
hair tuff
L- Side curve (ABNL)

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MC ass/w condition w/ kyphosis?

Scheuermans DZ

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Distal end of spinal cord

Conus medullaris terminates L1 - L2

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spondylosis indicates?

DEGEN - OA (Pars interarticulars defect)

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Cervical/Lumbar Metastatic DZ have what additional S/S?

Radiculopathy

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TXT Cervical Radiculopathy

Spon resolution 2-8 weeks
NSAIDS
Head halter/PT

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MRI is good for

Eval disc DZ or lig injury - spinal cord and nerve roots

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PT CI for MRI w/ CES - 2nd line DX test?

CT/Myelogram -confirms

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Other DX tests for Cervical Radiculopathy?

EMG/NCV

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What sports players may develop spondylo -lysis/listhesis

Football, GYmnastics, swimmers

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CES radiographs

AP/LAT - spondylothesis

Flex/Ext - spondylothesis high sens

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Flex/ext cervical XR should only be used after

3 view series is cleared

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What is the hall mark of a flexion-distraction or burst fracture of V. Body?

Hematoma, Step-off, gap between Spinal processes

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When to refer spondylo -lysis/listhesis

<10yo - Rheum consult

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What relieves Metastatic DZ Pain?

Lying down

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Lhermitte sign indicates?

Electirc shock thru spine, arm, legs w/ neck flexion = cervical myelopathy(spondylosis)

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When is eval required for Scoliosis in respect to degree measurement?

<5-7 degrees

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What sign can be sign with Metastatic DZ in what DX test?

Winking owl sign in AP - pedical loss

Lateral degenerative changes at L5-S1 cause?

L5 compression

SPondylolisthesis is?

Fx of pars

Angle used to determinge Standard of degree in scoliosis

Cobb angle

What does hoffman sign indicate w/in Cervical Radiculopathy?

UMN lesion - other test is Babinski's

CT is good for

Fx/bone eval

Which tendons have enesthesitis in Reiters?

Achilles and plantar fascia

What extra articular findings are there with Anklylosing spondylitis

IBS, Uveitis

What DX test is a reflext to AP/LAT for spondylo -lysis/listhesis?

Bone scan

What can occur within muscles w/ Cervical Radiculopathy

Muscle spasms/fasciculations in myotomes

What is best screening tool for Metastatic DZ?

Technetium Tc-99m

Classic traid fo reiters syndrome

Cant - see, pee, tree - uveitis - sterile pyruia - Enthesitis

TXT for CES

Surgical ER decompression

When is resp fxn affected w/ kyphosis?

>90-100

What is ABNL for lateral curvature of spine?

>10

EMG/NCV is good for?

ID nerve dysfx location

When does a fx vertebrae not req bracing?

Simple, Stable w/ <20 wedging w/ no other involvement

Dx test for thecal sac compression of CES?

MRI

CES causes/is

Compression causing paralysis w.out spasticity

Simple fractures of anterior half of veretebral body are stable or unstable?

Stable

What meds can be used to TXT Lumbar stenosis?

Epidural CCS INJ 3x(6mo)

Adam forward bends test good for?

Scoliosis/Kyphosis (lat view)

What DX tests for cervical spondylosis/myeopathy?

Everything

Spot lateral view is good for?

Eval lumbosacral jx

RED/REF kyphosis pts?

<10yo - rheum

Is back pain common with scoliosis?

NO - neither neuro

What sign can be seen with Lumbar stenosis?

Shopping cart sign

DIfficulty buttoning blouse may indicate?

Early cervical myelopathy (cervical spondylosis)

What causes increased Lumbar stenosis

Back extention

Is CES a ER?

Yes

Types of seronegativearthopathies

PAIR

What does female menses indicate for growth/development?

Peak growth

Loss of vibration or proprioception indicates what type of defecits?

Posterior column defecits

XR for Cervical Radiculopathy is good for

ID regions of Spondylosis/DEGEN

What is a head halter?

Head traction

DX tests for Cervical Radiculopathy?

MRI/CT w/ intrathecal contrast + correlate w/ S/S = high false+ MRI

MC level of Spondylosis?

What should be screened w/ spondylo -lysis/listhesis

Polyarthralgias Uveitis IBS Inconteninace

What organisms are ass/w Reiters syndrome?

Campylobacter Salmonella Shigella

How long should someone use a C-Collar w/ persistant pain but NL PE?

7-10D

Scapular pain pain w/ no UE radiation indicates

Root pressure above C5

Do you brace kyphosis?

NO - PT core muscles

Stopping when walking stops neurogenic claudication?

NO - (only vascular claudication)

What is a sentinal S/S of spondylitis?

IBS

Vertebral body collapse can indicate?

Kyphosis

What score can be used to tell if Pt has stopped growing?

Risser score

What DX test helps eval cervicothoracic jx

Swimmers view XR

What PE test is appropriate for Cervical Radiculopathy?

Spurlings test

What is Scheumers DZ?

Ant wedging of >3 vert (Schmorl nodes) >5 degree ang | irreg/frag endplates

Cause if Cervical Radiculopathy in older adults?

Foramen narrowing + arthritis = lateral nerve entrapment

What muscles weak w/ CES

Quads/hip ext | Dorsi/plantar-flex - cant walk heel to toe

Hangman fx is

C2 separation from posterior elements | Pedicle/Pars fx bilaterally

Bracing indication for scoliosis? degrees

>25

What type of braces are use for spinal fx?

Jewett | Thoracolumbar corset

7 degrees on scoliometer equals how much w/in XR?

20 degrees

Surg indication for kyphosis? degrees

>90 | Fail

Cauda equina location/composed

Spinal canal of L2 - S4 nerve roots

DX tests of Lumbar stenosis

AP | Lat

Jefferson fx is

bursting fx of C1 ring

What neuro tests are potentially impaired w/ Lumbar stenosis?

Proprioception - Rombergs

Dx tests for Anklylosing spondylitis

POS Fabers, SI pain

When should an MRI be given for spondylo -lysis/listhesis?

Red flags, <10yo, or >6weeks S/S

Condition w/ symmetric footdrop

CES

Lumbar stenosis is typically a

Degen DZ (MC) L2-3 L3-4 L4-5

UMN inolvement w/ Cervical Radiculopathy means?

Spinal cord compression

SPinal cord DZ related to Scoliosis?

Neoplasms | Syrinomyelia

WHich seronegativearthopathies is ass/w HLA-B27?

Anklylosing spondylitis

Cervical Radiculopathy is

Neurogenic pain in cervical root map (w/ or w/out numb/weak/areflexia)

What may confound DX CES?

Narcotic injection causing urinary retention

Common S/S of Lumbar stenosis

Neurogenic claudication

Surg wound complications w/ Metastatic DZ

radiation | CCS

Kyphosis ABNL degrees?

>40 | >50 = hyperkyphosis

TXT for cervical spondylosis

NSAIDS - Doxepin/amitriptyline - sleep | Cervical pillow

Psoritatic arthritis - key points

Monoarticular - knee - asymmetric progress | Nail pitting/tenosynovitis of digits

Lumbar stenosis must be what to have S/S?

Severe

Cause if Cervical Radiculopathy in young adults?

Cervical herniation - entrapping in foramen

Highest rate of Metastatiz DZ of spine include what carcinomas?

BLTKP | P- prostate

What labs taken for CES?

CBC, CRP, ESR

Lateral veiws are good for

Looking at HGT of spine vertebrae

What scale is used to assess hypermobility of scoliosis?

Beighton scale 4/9

DX tests for Metastatic DZ

AP/LAT - radiopaque marker at TTP Odontoid if cervical Lumbar - include T10 to Coccyx tip Spot lat view

Lateral XR of cervical spine must include

Occiput to T1

Radiculopathy is bilateral or unilateral w/ Cervical Radiculopathy?

Unilateral

Sacral roots controlling Bladdar/Anal

S2-S4

What classification is used for spondylo -lysis/listhesis?

Meyerding classification ( Type I-II do fine)

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