Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Backache and Spinal Deformity > Flashcards

Backache and Spinal Deformity Flashcards

1
Q

what are some types of causes of back pain?

A 
viscerogenic
spondylogenic
discogenic
neurogenic
psychogenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

name a serious viscerogenic cause of back pain?

A

abdominal aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

abdominal causes of back pain?

A 
renal
pancreatitis
some gall bladder symptoms
peptic ulcer disease
uterine/ovarian
colonic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

presenting symptoms of a back problem?

A

back pain
leg pain
neurological symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

2 types of back pain?

A

mechanical

non-mechanical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

3 presentations of back pain?

A

possible spinal pathology
nerve root pain
mechanical back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Qs to ask in back pain?

A

SOCRATES

was there as precipitating incident? (cough, injury, lifting etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

2 types of leg pain?

A

referred

root pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

where does nerve root pain distribute?

A

dermatomal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

describe referred pain?

A

dull
posterior thigh and buttock
rarely below the knee
ill defined sensory symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

root pain?

A

sharp shooting pain
invariably below the knee to foot and ankle
anatomical sensory/motor symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

is sciatica root or referred pain?

A

root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

give a neurological symptoms of back pain?

A

bowel/urinary

  • incontinence/loss of control or awareness
  • perineal/saddle anaesthesia
  • bilateral/unilateral/no leg symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

give another 3 neurological symptoms

A

parasthesia
numbness
weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

are neurological symptoms red flag signs?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what non medical things must be considered in a history?

A

litigation
social
age
occupation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

name 4 red flags

A

non-mechanical pain
systemic upset
major, new neurological deficit
saddle anaesthesia +/- bladder or bowel upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

name 4 red flags

A

non-mechanical pain
systemic upset
major, new neurological deficit
saddle anaesthesia +/- bladder or bowel upset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

give some possible spinal pathologies which can cause back pain

A

fracture (often Osteoporosis associated)
tumours (usually mets)
infection
inflammatory (AS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what cancers commonly metastasise to bone?

A 
Bad - breast
Boys - bronchus (lung)
Pee - prostate
Through - Thyroid
Kidneys - renal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the most common primary tumour in the spine?

A

myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what in a history suggests a tumour?

A 
weight loss
fatigue
anaemia
insidious onset (no precipitating event)
fairly constant pain (night pain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what features of history would indicate an infection?

A

high temp
fever
recent foreign travel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

pathogenesis of disc prolapse?

A

disc loses water in ageing > disc prone to damage by load, torsion, shear > disc fissure > prolapse, extrusion, sequestration > compression of nerve roots (depending on vertebral canal) > pain etc > loss of disc height and facet arthropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is a protrusion?

A

where the IV disc is intact but bulges out when under pressure

26
Q

what is an extrusion?

A

where the outer annulus fibrosis ruptures, allowing the inner nucleus pulposis to bulge out

27
Q

what is a sequestration?

A

where the outer annulus fibrosis ruptures, allowing the nucleus pulposis to bulge through and a piece of the nucleus breaks off

28
Q

how can the diameter of the vertebral canal affect pain?

A

large space = can accommodate disc prolapse etc and wouldn’t cause sciatica/leg pain
small space = not enough room so nerve roots get compressed by e.g prolapsed disc and will cause sciatica/leg pain etc

29
Q

what physiological changes can occur in disc prolapse over time?

A

loss of disc height
facet arthropathy - can collapse
back pain +/- canal stenosis

30
Q

what is degenerative disc disease?

A

loss of IV disc structure (water) in ageing

can loose height can cause stenosis

31
Q

how can degenerative disc disease cause narrowing of the vertebral foramen?

A

facet joints made for a certain disc height so when this is lost they don’t really fit together causing the vertebral canal to narrow

32
Q

most common back pain?

A

mechanical

33
Q

how is mechanical back pain diagnosed?

A

by exclusion
no nerve root problem
no underlying pathological process

34
Q

2 uncommon causes of mechanical pain?

A

spondylolysis

spondylolisthesis

35
Q

what is spondylolysis?

A

linear crack in pas interarticularis

looks like a collar on the dog shape of vertebra

36
Q

what is spondylolisthesis?

A

break in pas interarticularis allowing vertebra to slide

37
Q

examination of back pain?

A 
observation
range of movement
neurological assessment
nerve root irritation
distraction testing
38
Q

observation features of spine?

A

straight spine
kyphosis/lordosis
scapula/iliac crest symmetrical

39
Q

what can cause loss of lumbar lordosis?

A

scoliosis

ankylosing spondylitis

40
Q

what can cause a bulging out on one side on forward bending?

A

scoliosis

41
Q

what does extension of the spine show function of?

A

facet joints

42
Q

what are the myotomes?

A

L1/2 = hip flexion
L3/4 = knee extension
L5 - foot dorsiflexion
S1/2 = ankle plantarflexion

43
Q

what 4 things are tested on neurological examination?

A

myotomes
dermatomes
reflexes
nerve irritation

44
Q

what 3 reflexes are tested?

A

knee jerk
ankle jerk
plantar reflex

45
Q

how is nerve irritation tested?

A

straight leg test

would produce shooting pain along the dermatome

46
Q

what is pain drawing?

A

where the patient marks on a picture where their pain in

can show whether dermatomal, non-anatomical etc

47
Q

what is overt pain behaviour?

A

how the patient reacts in response to their pain

  • guarding
  • bracing
  • rubbing
  • grimacing
  • sighing
48
Q

waddell behavioural responses?

A 
superficial/non-anatomical tenderness
simulation
distraction
over-reaction to examination
regional - sensory disturbance, giving way
49
Q

what is a distraction test?

A

if a patient claims they cant perform a straight leg test because of pain, ask them to sit upright and they will do it fine
- shows they are exaggerating pain

50
Q

important examination to determine cause for back pain?

A

PR exam

- altered sensation around anus or loss of anal sphincter tone can suggest cauda equina problem

51
Q

are X rays useful in diagnosis of mechanical back pain?

A

no (in most cases)

52
Q

when would an X ray be useful in mechanical back pain?

A

if you suspect spinal pathology

53
Q

is an MRI diagnostic?

A

no

can confirm a previously though diagnosis or locate it but can give false positives

54
Q

what specialised investigations are used in mechanical back pain?

A 
MRI (beware)
diagnostic facet injection
Contrast enhanced CT
provocation discography
selective discography
selective nerve block/ablation
55
Q

what is sciatica?

A

any sort of buttock or leg pain not obviously coming from hip, knee or ankle
in a specific dermatomal distribution accompanied by neurological disturbance
- root leg pain

56
Q

when is surgery performed in disc prolapse?

A

only for leg pain

not for back pain

57
Q

does disc prolapse surgery improve neurology symptoms which are associated?

A

unpredictable

can often not regain reflexes

58
Q

common presentations of disc prolapse?

A

episodic back pain
onset of leg pain +/- neurology
leg pain becomes dominant
myotomes and dermatomes distribution

59
Q

how is disc prolapse treated?

A

not an emergency as 90% resolve within 18-24 months

only treated with surgery if cauda equina or consider surgery if it doesn’t settle within 3 months

60
Q

how is backache managed conservatively?

A

short bed rest (debatable)
anti inflammatory +/- muscle relaxants
mobilisation
physiotherapy

61
Q

second line treatment for backache?

A 
education/reassurance etc
physiotherapy
osteopathy
TENS/psychology
surgery

MSK (66 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions