Chapter 14 Flashcards
(123 cards)
1
Q
Many mechanical causes of back pain resolve in
A
1-4 weeks
2
Q
SI pain can mimic low back pain and discover if disease effecting pain
A
Below the knee to the foot
3
Q
SI dysfunction is the primary cause of low back pain in
A
30% of cases with low back pain
4
Q
RA effects the ____ early but may go unrecognized at first
A
C spine
5
Q
Although the ____ of back pain caused by NSAIDS is low, the ________ in PT clinics is high
A
Incidence, prevalence
6
Q
What is the most important part of the history in relation to back pain
A
History of cancer - long ago
7
Q
_____ to ____ of increasing back ache often may be a signal of ______ especially with a history of _____
A
6 weeks to 6 months, lumbar metastasis, cancer
8
Q
Long term use of _______ can lead to vertebral compression fractures
A
Corticosteroids
9
Q
_________ (antibiotic) can cause neck, chest or back pain
A
Fluoroquinolones
10
Q
Age risk factors for viscerogic or systemic causes of back pain
A
Under 20 or over 50
11
Q
Most cases of back pain in the adult is due to
A
Age related degenerative process, physical loading and musculoligamentous injury
12
Q
Typically systemic back pain is ___ relieved by recumbency
A
Not
13
Q
Bone pain of metastasis or myeloma tends to be more ______ when the client is in this position
A
Continuous, progressive and prominent when the client is recumbent
14
Q
Unable to lie still with pain indicates
A
Systemic origin
15
Q
Visceral diseases often have a systemic backache that causes the client to go into these positions
A
Curl up, sleep in a chair or pace the floor at night
16
Q
Review of systems questions
A
Fevers, excessive weight gain or loss and appetite loss should be followed up with additional questions
17
Q
Red flag age:
A
Less than 20 or over 50
18
Q
Red flag previous history of…
A
Cancer
19
Q
Red flag signs of infection:
A
Constitutional symptoms
20
Q
Red flag recent ____
A
Urinary tract infection
21
Q
Red flag history of _____ drug use
A
Injection
22
Q
Red flag _______ condition
A
Immune compromised
23
Q
Red flag failure to improve with
A
Conservative care in 4-6 weeks
24
Q
Red flag pain is not relieved by
A
Rest or recumbency
25
Red flag pain at this time of day
Night
26
Red flag neurological symptom
Saddle parasthesia
27
Red flag back pain Accompanied by
Abdominal, pelvic or hip pain
28
Red flag trauma or
History of falls
29
Red flag significant ____ stiffness with limitation in ___ spinal movements can indicate ____
Morning, all, ankylosing spondylitis
30
Red flag skin _____
Rash
31
Primary headaches include
Migraine, tension headache, cluster headache.
32
Secondary headache is
Cervicogenic headache
33
Cervicogenic headache is defined as
Referred pain in any part of the head caused by musculoskeletal tissues innervated by cervical nerves c1-c4
34
Cervical genie headaches are frequently associated with
Chronic tension or acute whiplash, intervertebral disc disease, or progressive facet joint arthritis
35
Sudden severe headache is a classic symptom of
Temporal vasculitis
36
Important measure to take when assessing vascular induced headache
BP
37
Headaches due to cancer are worse in the
Upon awakening due to differences in CNS drainage in the supine or prone position, and goes away after they stand up
38
Headache due to cancer is intensified when
There is an activity that increases intracranial pressure
39
Migraines may present with _____ mimicking a stroke
Paralysis or weakness on one side
40
Physical therapy is most effective for migraines when combined with
Thermal biofeedback and relaxation training
41
Radicular symptoms accompanied by weakness, coordination impairment, gait disturbance, bowel or bladder retention or Incontinence and sexual dysfunction can occur where
Cervical myelopathy occurs
42
Torticollis of the sternocliedomastoid may be a sign of underlying
Thyroid involvement
43
___ neck pain that is worse with _____ and ______ may be present with thyroiditis
Anterior, swelling and turning the head
44
Anterior disc bulge into the esophagus or pharynx or an osteophyte of the vertebrae may give sensations of ____ and should be followed up with screening what cranial nerves
Difficulty swelling, lump in throat, V-VIII
45
A sign that a patient has Vertebral artery syndrome caused by structural changes in the cervical spine is characterized by
The client turning the whole body rather than just the neck
46
VBI occurs when
There is decreased vertebral height, osteophyte formation, postural changes and ligamentous changes reduce the foraminal space and encroach on the vertebral artery
47
Systemic origins of musculoskeletal pain in the thoracic spine is usually accompanied by
Constitutional symptoms
48
What are the three most likely cardiac causes of thoracic pain
Thoracic aortic aneurysm, angina and acute MI
49
Peptic ulcer can refer pain to the mid thoracic spine between
T6 and T10
50
What kind of disorders can cause scapular pain
Cardiac, pulmonary, renal and GI
51
Sacral or sacroiliac pain in the absence of _____ and in the presence of negative____ must be evaluated more closely
Trauma, spring test
52
The most common cause of serious pathology in the sacral or sacroiliac region is
Spondyloarthropathies
53
Spondyloarthropathies are characterized by
Morning pain accompanied by prolonged stiffness that improves with activity. Limitation of movement in all directions and tenderness over the spine and sacroiliac joints
54
The most significant finding in ankylosing spondylitis is that the client has
Night pain in the back and morning stiffness. They may have asymmetric SI involvement radiating to the buttock and thigh
55
Colicky pain is associated with
Spasm of a hollow viscus
56
Severe tearing pain with sweating and dizziness may originate from
An expanding abdominal aortic aneurysm
57
Burning pain may originate from a
Duodenal ulcer
58
Muscle spasm and tenderness along the vertebrae may be elicited in the presence of
Visceral impairment
59
Spasm on the right side at the 9th and 10th costal cartilages can be a symptom of
Gallbladder problems
60
The spleen can cause spasm and tenderness at.....
Level of t9 through 11 on the left side
61
The kidneys are likely to cause tenderness, spasm and possible pain or sensitivity at the level of
The 11th and 12th ribs
62
Rad ocular pain results from
Irritation of axons of a spinal nerve or neurons in the dorsal root ganglion
63
Referred pain results from
Activation of nociceptive free nerve endings in somatic or visceral tissue
64
Neurological signs are produced by
Conduction block in motor and sensory nerves, but conduction block does not cause pain.
65
Finding the cause of back pain will also identify the neurological symptoms true or false
False
66
Systemic origins of musculoskeletal pain in the thoracic spine is usually accompanied by
Constitutional symptoms
67
What are the three most likely cardiac causes of thoracic pain
Thoracic aortic aneurysm, angina and acute MI
68
Peptic ulcer can refer pain to the mid thoracic spine between
T6 and T10
69
What kind of disorders can cause scapular pain
Cardiac, pulmonary, renal and GI
70
Sacral or sacroiliac pain in the absence of _____ and in the presence of negative____ must be evaluated more closely
Trauma, spring test
71
The most common cause of serious pathology in the sacral or sacroiliac region is
Spondyloarthropathies
72
Spondyloarthropathies are characterized by
Morning pain accompanied by prolonged stiffness that improves with activity. Limitation of movement in all directions and tenderness over the spine and sacroiliac joints
73
The most significant finding in ankylosing spondylitis is that the client has
Night pain in the back and morning stiffness. They may have asymmetric SI involvement radiating to the buttock and thigh
74
Colicky pain is associated with
Spasm of a hollow viscus
75
Severe tearing pain with sweating and dizziness may originate from
An expanding abdominal aortic aneurysm
76
Burning pain may originate from a
Duodenal ulcer
77
Muscle spasm and tenderness along the vertebrae may be elicited in the presence of
Visceral impairment
78
Spasm on the right side at the 9th and 10th costal cartilages can be a symptom of
Gallbladder problems
79
The spleen can cause spasm and tenderness at.....
Level of t9 through 11 on the left side
80
The kidneys are likely to cause tenderness, spasm and possible pain or sensitivity at the level of
The 11th and 12th ribs
81
Back pain has been linked to atherosclerotic changes in the
Posterior wall of the abdominal aorta
82
Continuous ______ can be a symptom of MI especially in ____ women with a positive family history
Mid thoracic, post menopausal
83
Spondylogenic back pain is characterized by
Bone tenderness and pain on weight bearing
84
Associated signs and symptoms of spondylogenic impairment
Weight loss, fever, deformity, and night pain
85
The most common primary malignancy involving the spine is
Multiple myeloma
86
Multiple myeloma often results in
Diffuse osteoporosis and pain that is not relieved in recumbent position
87
The two areas of the spine most effected by oncologic causes
Thoracic and lumbosacral
88
As a general rule thoracic Pain must be screened for
Metastatic carcinoma
89
Metastasises spread to the spine via
The para vertebral venous plexus
90
Heart is innervated by
C3-t4
91
Neurogenic/vascular back or leg pain is alleviated by rest within 1 to 3 minutes
Vascular
92
Activity will bring back or leg pan on in 3 to 5 minutes if it is vascular or neurogenic?
Vascular
93
Neurogenic or vascular symptoms often occur immediately with use of the affected body part or with certain positions
Neurogenic
94
It is not likely that positions of the spine will relive pain if it is of a ___ origin
Vascular
95
Auto splinting is
When the patient prefers to lie on the involved side
96
Pancoast's tumor may invade the brachial plexus causing pain in this region
C8-t1
97
The reproductive organs are where the ___ are in the adult in utero
Kidney
98
Lower urinary tract infections will refer pain to the
Low back, pelvic, or sacral areas not shoulder
99
Upper urinary tract may refer pain to the shoulder because
It comes in contact with the diaphragm
100
Acute pyelonephritis refers pain to
Muscles lateral to t12-l1
101
Most common visceral origin of back pain
GI
102
What is the pain pattern for epigastic pain from esophagitis
Starts anterior, radiates around the Chest wall to the back around t5/T6
103
Stomach and duodenum refers pain at the level of lesion in what areas
T6-T10
104
Small intestines shally refers pain around the
Umbilicus
105
Back pain from being pregnant usually begins
In second trimester, 5-7 months
106
The risk of developing chronic back pain postpartum doubles with use of
Epidural anesthesia
107
Vertebral osteomyelitis affects most commonly the
First and second lumbar vertebrae
108
The most common organism responsible for vertebral osteomyelitis
MRSA
109
Pudendal nerve entrapment is characterized by
Pain relief when sitting on a toilet seat or standing
110
Three most likely muscles to refer pain to the pelvic area
Abdominals, quadratus lumborum, and iliopsoas
111
Muscle that acts as a sling around pelvic structures
Puborectalis
112
Most common gynecological cancer in women
Endometrial / uterine cancer
113
Endometrial cancer typically occurs in those
Between 50 and 70, obesity, endometrial hyperplasia, prolonged estrogen therapy and tamoxifen used for,breast cancer
114
Majority of endometrial cancers occur
Post menopausally
115
Most common presentation of endometrial cancer is
Abnormal vaginal bleeding or discharge
116
Most common complaint in PT of those with endometrial cancer is
Pelvic pain without abnormal bleeding
117
Second most commonly reported gynecological cancer is
Ovarian cancer
118
Ovarian cancer incidence peaks between th ages of
40 and 70
119
Factors that may influence the development of ovarian cancer besides the obvious
Nulliparity, giving birth to fewer than 2 children, giving birth for first time after age 35, bRCA1 or 2 gene, infertility, early menopause
120
Extra ovarian primary peritoneal carcinoma is a ___
Abdominal cancer without ovarian involvement . It Aries in the peritoneum and mimics the symptoms, appearance and pattern of spread of ovarian cancer
121
Third most common gynecological cancer
Cervical cancer
122
Most common cause of death from gynecological cancer is
Cervical cancer
123
A sexually active female with back or shoulder pain of unknown cause should be screened for
Ectopic pregnancy
