1a - Red and Yellow Flags Flashcards
(55 cards)
what are the 3 categories of med screening
appropriate for PT
yellow - appropriate w consult
red - not appropriate
what are clinical yellow flags (per this class definition)
pain associated psych distress that adversely influence outcomes for MSK pain
what type of factors are clinical red flags (per this class definition)
biomedical factors
what cases is the classification of neck pain into 4 groups especially helpful
if imaging isn’t showing a particular path
- can base treatment off of their clinical presentation instead
what are the steps per the CPGs when a pt comes in w neck pain
- med screening - appropriate for PT?
- classify neck pain into 4 groups
- determine condition stage (acute/subacute/chronic)
- intervention
what are the 4 groups that neck pain can be classified as
- neck pain w mobility deficits
- neck pain w HAs
- neck pain w movement coordination impairments (ie WAD)
- neck pain w radiating pain (ie radicular)
what are the 4 groups that neck pain can be classified as
- neck pain w mobility deficits
- neck pain w HAs
- neck pain w movement coordination impairments (ie WAD)
- neck pain w radiating pain (ie radicular)
how will acute neck pain present
highly irritable
- pain at rest or w initial to mid-range spinal movements (ie before tissue resistance)
time component to pain
- pain won’t stop after stopping activity
- will take good amt of time to recover
how will subacute neck pain present
mod irritability
- pain w mid-range motions that worsens w end-range spinal movements (ie w tissue resistance)
how will chronic neck pain present
low degree of irritability
- pain worsens w sustained end-range spinal movements or positions (ie overpressure into tissue resistance)
urgent vs emergent referral
urgent - not emergency/911, but needs follow up
- ex: neck pain w gait disturbance/LOB
emergent - 911
- ex: chest pain w exertion, cardiac issue, stroke - concern for cervical/arterial dissection, VBI
what is the OSPRO-ROS
Optimal Screening for Prediction of Referral and Outcome - Review of Systems
- identify red flags w high accuracy
what are 8 cervical red flags
- neoplastic conditions
- cervical fx
- upper cervical ligamentous injury/instability
- systemic inflammatory disease
- infection
- cardiac
- cervical vascular path
- cervical myelopathy*
pt comes in complaining of severe neck pain or HA unlike any other, what is likely the path
arterial
pt comes in not feeling well, fever, chills - what is likely the path
infection
pt has pain on exertion, what is likely the path? what should you do?
cardiac
check VS
pt isn’t improving in PT for over a month now, what do you do
reason for a referral
- could be a medical issue that needs to be treated
what are 2 systemic inflammatory diseases and why are these red flags in the neck
ankylosing spondylosis, RA
could make condition worse, more sensitive
** more ligamentous laxity in upper cervical spine - esp transverse lig***
- more cautious in upper c-spine, esp AA region
what is myelopathy
dz/neurologic deficit related to spinal cord
what is degenerative cervical myelopathy
aka compressive cervical myelopathy; cervical spondylitic myelopathy
- compression of SC caused by narrowing of spinal canal from degenerative changes, disc herniation, or osteophyte formation
what is radiculopathy
any dz of spinal nerve roots and spinal nerves
- pain and/or neuro deficit in a specific nerve root distribution resulting in motor loss, sensory changes, and sometimes depression of reflexes
what are 3 etiologies of cervical myelopathy
acquired
traumatic
spinal cord tumor
how are cervical myelopathy typically acquired
cervical spinal stenosis -degenerative dz superimposed on congenitally narrow canal
what are 6 traumatic etiologies of cervical myelopathy
spinal shock
hematomyelia
spinal epidural hematoma
barotrauma
electrical injuries
compression by bone fx
- could be minor trauma after setting of spinal stenosis
