Flashcards in ortho week 2 -QA Deck (72)
what 5 general things can go wrong in the spine
tissue damage, pain, functional problems, associated symptoms, complicating factors.
if something is feeling week, rule out the most dangerous first
brain stem, spinal cord, nerve roots, perepheral nerves
muscle test is to test what?
perepheral nerve, muscle function
irritation of nerve root can do what
make it hyper reflex
umbrella term for issues of the nerve root like compression and irritation
irritation of nerve root.
what percent have disk herniation without problems?
seventy to 80%
pain is caused by what three things?
nociceptive, peripheral sensitization, central sensitization
what are associated symptoms for cervical spine issues
like limping or compensating from pain that can cause other problems
what is a complacating factor?
something that would impede healing, surgery, fusion, tissue damage, etc
what does orthapedic testing do?
what is the first thing we do?
observe the person see how they are moving
what do we do after observation, the first movement thing?
Active range of motion, AROM.
why do we do AROM before passive or resisted?
so that we know where their limits are. This can change the rest of the tests., this way you are not touching them untill you think it may be safe.
what is PROM
passive range of motion, they lay down, you move their head.
from what position is RROM done
the head should be in neutral, sitting up.
Rusts sign is what?
this isn't a test, it?s a sign where they have to hold their head up with their hands.
Bakodys sign is what?
this could be a test. Person has relief of pain if arm is relaxed on top of head.
what does bakodys sign relieve?
relieves nerve root irritation,
what if you can examine someone because they are in to much pain
Don?t diagnose. Wait. Send for imaging,
what is importaint about he cervical tests?
lots of false positives, classic positives and non classical positives, and non of the tests give diagnosis independently
what is importain about charting
super specific for location using doctor directions and metric.
what should be done with all positives?
they should be qualified, include nerve root number, type of pain, where it went, what its associated with.
why include pertentenet negatives, what are they.
they are what you are using to say it isn't something more serious.
what is the spinous percussion test?
tapping reflex hammer on cervical spinous processes to see if it causes lingering pain.
what could a positive spinous percussing indicate?3
vertebral fracture if there was trauma, metastic disease if history of cancer or constitutional symptoms., or disk impingment.
what is the valsalva maneuver used to confirm?
suspicion of herniated disc or space occupying lesion in spinal cord or IVF
how is the valsalva maneuver done?
patient is to bear down for 2-3 seconds.
what does the valsalva maneuver do?
increases intrathecal and intradical pressure which increases expansion of herniated nucleus pulposus and increases peripherial signs or symptoms.