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Flashcards in Red Flags and Emergencies Deck (20):

What are red flags in back pain?

age <20 or >60- first back pain
on-mechanical, constant pain
Hx of cancer
Hx of steroids
systemic symptoms- malaise; fever; unexplained weight loss
structural deformity
sadlle anaesthesia/parasthesai +/- loss of bowel or bladder control
severe pain longer than 6 weeks


What are back pain emergencies?

cauda equina syndrome
fracture with deteriorating neurology


What are hte symptoms of cauda equina?

painless retention with overflow- full bladder and dont know


What is the problem with diagnosing cauda equina?

most patients present atypically- need high index of suspicion


What is ivolved in the intial assessment of spinal fractures?

immobilise and x-ray and do not forget other injuries
neuro exam


What is important in an initial neurological assessment of spinal fracture?

to establish a motor and sesory level and to pay particular attention to the saddle area


What is needed in injuries to the cervical spine?

make sure X-ray shows C7/T1
rigid collar
rememebr other injuries


What is needed with thoracocolumbar injuries?

visualise the whole spine and have a rigid spine board


Where is the most common spinal fracture?



What can cause secondary cord damage in fractures?

cord swelling; oedema; ischaemia; thrombosis of small vessels and venous obstruction
stretching; compression; undue movement; infection


What is needed in spinal fractures to prevetn secondary cord damage?

make sure the pt it well perfused and oxygenated


What is the Frankel/ ASIA grading of spinal injuries?

1-complete motor and sensory loss
2- complete motor and incomplete sensory
3- incomplete motor- no practical use
4- useful motor and incomplete sensory
5- normal motor and sensory function


When is spinal surgery undertaken?

within 7-10days- need to let swelling and tissue perfusion improve; postural reduction; internal fixation and grafting; late reconstruction


What needs to be monitred in children with growth plate disturbance?

damage to a growth plate an cause premature fusion and cessation of growth- kyphosis


What is a chance fracture and who is it seen in?

in adolescents- a very unstable fracture with ligamnet disruption due to presence of growth plates and cartilaginour rims


What should be suspected in a patient with ank, spon with any sort of back injury

fracture until proven otherise- soft porotic bone


In the cervical spine in patients with ank. spon what do you have to be careful about?

maybe made worse by collars- as natural ank. spon position is extended rather than the fixed flexion of neck collars


What is Heuter-Volkmann's law?

increased pressure across an epiphyseal plate inhibits growth


What can cause secondary scoliosis?

neuromuscular- eg muscular dystrophy
spina bifida


What is the difference between spondylolysis and spondylolithesis?

spondylolysis is failure of union of various ossification centres whereass spondylolisthesis is slippage of one vetebra onto another