ECR Back pain Flashcards Preview

ECR 2012 > ECR Back pain > Flashcards

Flashcards in ECR Back pain Deck (29):

What part of spine is concave curve?

cervical and lumbar spine


what part of spine is convex curve?

thoracic and sacrococcygeal spine


What does tenderness as you palpate teh spinous process suggest?

fracture os dislocation if preceded by trauma, underlying infection, or arthritis


Which vertebrae would be tender in arthritis?

C5 and C6 feacet joints


What does Step-offs indicate?

Sondylolisthesis or forward slippage of one vertebra, which amy compress the spinal cord.


What is vertebral tenderness suspcicous for?

fracture or infection


What doees tenderness over teh sacroiliac joing suggst?



Ankylosing spondylitis

may produce scroiliac tenderness

Ankylosing spondylitis is a long-term disease that involves inflammation of the joints between the spinal bones, and the joints between the spine and pelvis.

These joints become swollen and inflamed. Over time, the affected spinal bones join together.


What is presentation of scoliosis?

lateral and rotatory curvature of the spine to bring teh head back to midline

Scoliosis often becomes evident during adolescence, before symptoms appear


What does undequal shoulder heigth suggest?

Sprengel's deformity fo the scapulat (From attachement of extra bone or band between scapula and C7)

winging of the scapula from loss of innervation of serratus anterior m. by long thoracic nerve

contralateral wekaness of trapezius


What does unequal heights of the iliac crests or PELVIC TILT

suggests unequal lengths of the legs and disappear when a block is placed under the short leg and food

Scoliosis and hip abduction or adduction may also cause a pelvic tilt

Listing of the trunk to one side is seen with a herniated lumbarr disk


"Listing" of the trunk to one side

seen witha herniated lumbar disc


Birthmarks, port-wine stains, hariry patches, lipomas

often overlie bondy defects such as SPINA BIFIDA


Cafe aua lait spots (discolored patches ffo skin) , skin tags, and fibrous tumours in



Pain or percussion may arise from....

osteoporosis, infection, or malignancy


What roots do the sciatic nerve arise from

L4, L5, S1, S2, S3 (L4-S3

Nerve lies midway between greater trochanter and ishial tuberosity )


When do spasms occur

in degenerative and inflammatory processes of muscles, prolonged contraction from abnromal posture, or anxiety


What does scieatic nerve tenderness suggest?

herniated disc or mass lesion impinging on the contributing nerve roots


What specific discs, when herniated, may produce tenderness of the spinous processes, intervertebral joints, paracertebral muscles, sacrosciatic notch, and the sciatic nerve?

L5-S1, L4-L5


What is Torticollis?

muscle spasm that may cause limiations in range of motion


What is the most mobile protion of the spine?

teh neck

it supprots 10-15 poinds


How do you measure FLEXION of the spine?

mark the spine at the lumbosacral junction, then 10 cm aboce and 5 cm below this point

a 4cm increase between teh two upper marks

distance bewteen teh lower two marks should be unchanged


Cuase of Sciatica (Radiuclar Low Back Pain)

usualy from herniated intervertebral disc with compression or tractino of ner roots

Involves L5-S1 roots in 95% disc hernation


Physical Signs of Sciatica

disc herniation most likely if calf asting, weak ankel dorsiflexion, absent ankle jerk , positive straight leg raise


What is lumbar spinal Stenosis

Pseudclaudication pain in the back or legs with walking that IMPROVES WITH REST, lumbar flexion (which decomrpresses spinal ord) or both

Pain vague but bilateral with parasthesis in one or both legs


Causes of lumbar spinal stenosis

Arises from hypertorphic degeneative disease of one or more vertebral, facets, and thickening of ligamentaum flavum

anrrowign of spinal canal centrally or in lateral recesses
More common after age 60


Physical signs of Lumbar Spinal Stenosis

Lumbar may be flexed forward, with lower extemity weakness and hypoflexia

Straight leg test usually negative


Patterns of Mechanical Neck Pain

Aching pain in the cervical paraspinal msucles and ligaments with associated muscle spasm; stiffness and tightness in upper back and shoulder, lasitng up to 6 weeks;
no radiation, paresthesisas or weakness
Headache may be present


Possible causes of mechanical neck pain

possible sustained muscle contraction

Ass with poor posture, stress, poor sleep, poor head position during activties such as computer use, watching tv, driving