Clin Med- Low Back II Flashcards

1
Q

________ _______ is a type of spondyarthropathy or spondyloarthride

A

Ankylosing Spondylitis

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2
Q

Ankylosing Spondylitis etiology:

Genetics- ___% are + for ____ -______ antigen blood test

Environmental

A

90

HLA-B27

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3
Q

Ankylosing Spondylitis is almost as common as ____

Onset < ____ and typically between ____-______ yrs.

A

RA

40

18; 30

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4
Q

With Ankylosing Spondylitis, it is usually 2-3x more common in ______

A

MALES

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5
Q

With Ankylosing Spondylitis, it is MOST common in the _________ region

A

lumbosacral

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6
Q

With _______ ________ pathogenesis, there is chronic inflammation at cartilage, tendon, ligament, and synovium attacments to bone (entheses)

A

Ankylosing Spondylitis

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7
Q

With _______ ________ , it has erosive bony overgrowth and osteopenia

A

Ankylosing Spondylitis

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8
Q

Osteopenia is ______ bone

A

weakened

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9
Q

Ankylosing Spondylitis leads to ______ of involved joints

A

fusion

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10
Q

With Spondyloarthropathies or Spondyloarthritides and multiple joint inflammation and pain:

> ____ min. of P!/stiffness after prolonged positions

Improved P! with ____ and _____ movement

Chronic inflammation and p! of _____ skeleton MOST often

_________ or unilateral extremity involvement to a lesser degree (typically smaller extremity joints)
- Localized to ______ or insertions of ligaments, tendons, and fascia

A

30

early; regular

axial

asymmetry

entheses

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11
Q

With Spondyloarthropathies or Spondyloarthritides common S&S:

_______ predisposition

__________ involvement of eyes, skin, GI tract, and renal and cardiac systems

A

Famial

Extraarticular

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12
Q

With Spondyloarthropathies or Spondyloarthritides common S&S: some describe it as…. “hurts to”

A

see, pee, and bend my knee

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13
Q

With Ankylosing Spondylitis, progressive LBP primarily from greatest influence on __________ joints > neck and lumbar regions

A

sacroiliac

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14
Q

With Ankylosing Spondylitis, it is ________ lasting for > ____ months

A

insidious; 3

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15
Q

With Ankylosing Spondylitis, there could be:

no _______ with rest

______ pain from static positioning

_______ and hip p!

A

change

night

buttock

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16
Q

What would you observe possibly with someone who has ankylosing spondylitis?

A

hyper kyphosis

loss of lumbar lordosis

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17
Q

With Ankylosing Spondylitis, in the Scan and biomechanical exam:

Multiple directions of ________ ROM/accesory motion of involved joints (possibly fused)

Combined motion- _________ block

Limited ______ excursion with manubrial and rib springs, possibly compromising cardiopulmonary function

_______ Berlin and Inflammatory Back Pain CPRs

A

limited

consistent

thorax

positive

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18
Q

With ankylosing spondylitis it is an ______ referral to what specialist?

A

urgent; rheumatologist

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19
Q

_________ _________ is a “Do Not Want To Miss” condition in any young adult with low back pain

A

ankylosing spondylitis

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20
Q

What condition is indicated?

Berlin Criteria- ≥2 =… 3, 4-6
88% probability

70% sensitive

AM stiffness

P! with rest AND relief with exercise

Awakening with LBP during 2nd half of night

Alternating buttock P!

A

Ankylosing Spondylitis

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21
Q

What condition is indicated?

IBP Criteria (≥ 4 = 80% sensitive /72% specific)

< 40 yrs. of age

Gradual onset

Relief with exercise

No change with rest

Night P! with improvement getting up

A

Ankylosing Spondylitis

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22
Q

What are some PT Rx with Ankylosing Spondylitis?

Be sensistive to _____ in patients with AS diagnosis

______ prevention

Gentle ______, ______ therapy, and ______ considering fragility

Postural ________

A

trauma

fall

ROM; manual, MET

education

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23
Q

Name some complicated conditions that may occur with Ankylosing spondylitis?

A

Osteoporosis

Fractures

Stenosis

Fusion in an upright or MORE often forward bent position

Cardiopulmonary disorders

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24
Q

__________ is a reproductive gland below the bladder that aids sperm function

A

prostate

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25
An american man is at risk for what condition with these factors? Age and ethnicity Genetics Chemical exposure High fat, red meat diet Obesity Alcohol consumption
prostate cancer
26
________ cancer is ONLY in biological males and typically > _____ years of age
Prostate; 65
27
What cancer is the 2nd MOST common cancer and death in American men?
Prostate
28
Prostate cancer is typically more _______ americans
African
29
Pathogenesis of prostate cancer: _______ gland cells infiltrate the prostate
disorganized
30
With prostate cancer, they typically have ________ P!
lumbopelvic
31
With prostate cancer, men can have what two dysfunctions?
bladder; sexual
32
Prostate cancer is more a _______ tumor
metastatic
33
Men after the age of ______ should get Prostate Specific Antigen (PSA) screening yearly
55
34
______ _______ muscle training has an overall benefit for bladder dysfunction
Pelvic floor (PFMT)
35
Prostate cancer is an _______ MD referral
urgent
36
__________ is toxicity to pancreas cells
pancreatitis
37
With pancreatitis, the _________ bille refluxes into pancreas and causes ________ and possible ________
gallbladder inflammation fibrosis
38
With pancreatitis there is a sharp ______ upper quadrant P! that radiates to the _______ region
right; thoracolumbar
39
With pancreatitis, it can worsen by _____ meals or drinking ______ due to difficult digestion
fatty; alcohol
40
With pancreatitis what position relieves the symptoms?
knees closer to the chest
41
With pancreatitis, the patient could become ______ or yellowed and experience ______ and vomitting
jaundiced; nausea
42
With pancreatitis, Grey-Turner sign indicates....?
swollen flanks
43
With pancreatitis, Cullen sign indicates...?
swollen umbilicus
44
With pancreatitis, it could progress to ______ S&S and vital/mental status changes
infection
45
With pancreatitis, it may lead to scarring in the _______ region and be unmodifiable to JM's
thoracolumbar
46
With pancreatitis, it is an _______ and possible _______ MD referaal depending on severity
urgent; emergent
47
________ are weakening's in a vessel wall
aneurysms
48
What is the MOST common site for an aneurysm?
aorta
49
Abdominal aortic aneurysm is more common in biological ______
males
50
With Abdominal aortic aneurysms it is increasing frequency due to ______ populations
aging
51
These are risk factors for what condition? Smoking > 50 yrs. of age Biological male Vascular diseases i.e., atherosclerosis and collagen disorder- weakens vessel walls Genetics- family hx of AAA
AAA
52
What are the 3 etiologies for AAA?
trauma vascular disease infection
53
Pathogenesis of AAA? Weakening of ______ in vessel walls
elastin
54
Clinical manifestation S&S with AAA: Often ________ MOST often _____ and possibly _______ and flank P!, especially with activity Searing, ripping, or tearing back or abdominal P! that stops all _______ (may indicate rupture)
asymptomatic LBP; abdomen activity
55
What would you observe MOST likely with AAA?
abdominal heartbeat
56
Palpation with AAA: ___-______ palpable mass (≥ 3cm) that pulses; typically just _____ of midline from umbilicus
non-tender left
57
With AAA you would hear a ______ auscultation sound over AA
bruit
58
With AAA there will be absent or _______ pulses elsewhere
diminished
59
With AAA it is a “Do Not Want To Miss”condition and is an ________ referral *MOST die before getting to a hospital
EMERGENCY
60