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OPP Midterm > low back pain > Flashcards

low back pain Flashcards

1
Q

MSK Ddx for low back pain

A 
muscle strain
SD
compression Fx
spondylosis
spondylolysis
spondylolisthesis
annulus fibrosis tear
herniated nucleus pulposus
arthritis, ankylosing pondylitis, osteomyelitis, vertebral cancer, vertebral ischemia, discitis, degenerative disk, paget's
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2
Q

What are the cardio Ddx for low back pain

A 
MI
thrombus
embolus
aortic abdominal aneurism
arterial-venous malformation
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3
Q

What are the GI Ddx for low back pain

A 
constipation
flatus
necrotizing enterocolitis
volvulus
intussuseption
perforation
colitis
diverticulitis
IBS, IBD
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4
Q

what are the renal Ddx for low back pain

A

nephrolithiasis
hydronephrosis
infection
polycystic kidney disease

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5
Q

what are the neuro Ddx for low pack pain

A 
cauda equina syndrome
tumor
impingement syndromes
neuritis
trauma
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6
Q

What are the respiratory Ddx for low back pain

A

lower lobe pneumonia

diaphragmatic abscess

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7
Q

what are the repro Ddx for low back pain

A

endometriosis

ectopic pregnancy

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8
Q

what are the other Ddx that should be on your list for low back pain

A

trauma
autoimmune
infection

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9
Q

low back pain that stays above knee is most likely what

A

non-specific muscular or ligamentous injury, SD, degenerative disease, fracture, spondylolysis

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10
Q

low back pain that radiates below knee is most likely what

A

radiculopathy
spinal stenosis
cauda equina syndrome
associated piriformis syndrome

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11
Q

spinal nerve root compression caused cauda equine syndrome usually causes dysfunction where

A

bowel or bladder

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12
Q

what is the Tx for cauda equina syndrome

A

surgical decompression

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13
Q

What can cause radiculopathy

A 
herniated nucleus pulposus
tumor
exostoses
spinal stenosis
infection
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14
Q

foramen are usually how much larger than exiting nerves

A

2-3x

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15
Q

Vertebral discs are mainly what material

A

water so affected by hydrostatic pressures

and alot of GAGs

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16
Q

Describe a protruded herniated disc

A

annulus fibrosis still intact

17
Q

describe an extruded herniated disc

A

through annulus but posterior longitudinal ligament maintains disc within vertebral space

18
Q

describe a sequestered herniated disc

A

free to roam spinal canal

19
Q

where do most herniated discs occur and why

A

lumbar because most stress

thoracic spin is protected by movement of thoracic cage

20
Q

Which nerve is most commonly affected by disc herniation

A

S1 because disk L5

posterior longitudinal ligament gets thinner as descend spine

21
Q

what type of discs cause radiculopahty

A

bulging or herniations

22
Q

what are risk factors for herniated nucleus pulposus

A

advancing age, tobacco, ehtanol, history of back pain, bending or lifting, professions that require weight bearing activity

23
Q

what mm and reflexes are affected if disc levels L3L4 herniate

A

so n L4
tibialis anterior
patellar

24
Q

what mm and reflexes are affected if disc levels L45 herniate

A

so on L5

extensor digitorum longus

25
Q

what mm and reflexes are affected if disc levels L5S1 herniate

A

so on S1
fibularis longus
achilles tendon

26
Q

What cause the pain in herniated nucleus pulposus

A

mechanical compression of nerve root
chemical mediators
irritation of posterior longitudinal lig

27
Q

What are SD affects on herniated nucleus pulpossu

A

pre-dispose or aggravate radiculopathy

alter mechanical relationships

28
Q

What are the junctional areas of body for respiratory and circulatory

A

thoracolumbar and lumbosacral

29
Q

What techniques are used to Tx acute herniated nucleus pulposus

A

myofascial… HVLA and ME contraindicated

30
Q

what are the Tx types for subacute and chronic HNP

A

probably not direct techniques… but not contraindicated

31
Q

What are the type II mechanics of lumbar spin

A

single segment
short restrictos
S R same side
non neurtral

32
Q

What are the type I mechanics of lumbar spine

A 
multiple levels
neutral, S and R opposite
S predominates
long restrictor like erector spine
directed motion from vertebra and discs
33
Q

What areas are treatable with OMT for lumbar spine

A

ribs and diphragm and cranium

34
Q

low back pain with shoulder pain could be what m

A

lats

35
Q

When is surgery the proper Tx

A

neurological deficit
increase in severity of symptoms despite conservative care
pain +2 or 3 with parasthesia, reflex change and muscle atrophy

OPP Midterm (5 decks)

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