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Med Screening > Screening Sacrum, SIJ, and Pelvis > Flashcards

Screening Sacrum, SIJ, and Pelvis Flashcards

1
Q

what is critical when someone tells you they are having sacral pain

A

a history

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2
Q

what about a patient’s hx are you looking for if they have sacral pain

A

minor trauma in hx to r/i mechanical pain of pelvis

look for medical issues if not able to mechanically recreate pain

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3
Q

how can lifting cause sacral pain

A

twisting

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4
Q

what is the most common cause of SIJ pain

A

referred from back

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5
Q

what are 4 ex of minor traumas that can cause sacral pain

A

trip off curb
fall
childbirth
lifting hx

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6
Q

why is sacral pain more common in women than men

A

anatomy
hormones

leading to inc laxity of certain ligaments and joints

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7
Q

what medical issues could explain sacral pain if not able to recreate pain (4)

A

cancer
gyn issues
rheumatic issues
large intestine issues

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8
Q

what rheumatic issues could cause sacral pain (2)

A

anky spond- in men
reiters

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9
Q

what large intestine issues could cause sacral pain (2)

A

crohns
IBS

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10
Q

what medical dx are related to pelvic pain (5)

A

gyn
infection - pelv inflam dz (PID)
vascular
cancer
GI

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11
Q

what types of sacral fx (3)

A

traumatic
insufficient
pathological

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12
Q

what are risk factors for a traumatic sacral fx

A

younger:
- stress fx
- military
- overtraining
- volleyball
- running

older - falls

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13
Q

what are risk factors for an insufficiency sacral fx (3)

A

radiation
osteoporosis
chronic steroid use

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14
Q

why are osteoporosis and chronic steroid use risk factors for an insufficiency sacral fx

A

poor bone mineralization

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15
Q

what is a risk factor for a pathologic sacral fx

A

cancer related

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16
Q

describe the location of pain in a sacral fx and what is an aggravating factor

A

pain in lower back, buttocks, hips, front thigh and groin

worse w WBing - esp if acute fx

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17
Q

what are 4 sx of a sacral fx

A
  1. pain
  2. bruising/swelling in sacral area
  3. bowel/bladder conditions, sexual problems
  4. resultant weakness in lower limbs d/t compression/swelling
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18
Q

triage a suspected sacral fx

A

urgent imaging needed

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19
Q

what are risk factors for reiter’s syndrome (2)

A

men 20-40yo
bacterial infection
- venereal dz or GI infeciton

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20
Q

what are 3 sx of reiter’s syndrome

A

arthritis (LB or sacral pain)
conjunctivitis
urethritis

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21
Q

what are 2 risk factors for ankylosing spondylitis

A

men <40yo, onset 20s
chronic prog inflam dz

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22
Q

what are 5 sx of ankylosing spondylitis

A

SI stiffness
- prog to morning pain >1hr x3mo

fever
fatigue
loss of appetite
red eyes

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23
Q

triage suspected reiter’s syndrome

A

PCP for blood tests and dx
- looking for genetic markers

24
Q

triage suspected ankylosing spondylitis

A

PCP for blood tests and dx
- looking for genetic markers

25
Q

what are the 7 most common causes of pelvic pain

A

MSK
NM
gyn
infectious
vascular
cancer
GI

26
Q

what current medical hx inc risk of pelvic pain (4)

A

IUD use
- risk of infection bc foreign body
peri or menopause
STD
pregnancy, parity/gravida

27
Q

what is parity

A

births

28
Q

what is gravida

A

pregnancy

29
Q

why do we care ab the amt of parity and gravida

A

some internal scarring from multiple gravida (pregnancies) but not parity (births)
- also scarring from multiple parity (births)

30
Q

what are 8 risk factors from PMH that can lead to pelvic pain

A
  1. reproductive, colon, or breast cancer
  2. painful periods - dysmennorhea
  3. STD
  4. parity vs graivda
  5. sexual assault
  6. difficult labor (ie tearing of pelvic floor)
  7. multiple births
  8. varicose veins in LE
31
Q

what are 4 pelvic pain sx that indicate a NM/MS source

A
  1. aggravated by exercise, WB
  2. aggravated by trunk rotation
  3. relieved by rest or stretching
  4. resolution of sx w ms release techniques
32
Q

what are 5 possible causes of ant pelvic pain

A
  1. associated w hip dysfunction
  2. psoas abscess
  3. stress fx - pubis, ilium
  4. instability
  5. femoral hernia
33
Q

what populations do you see a stress fx leading to ant pelvic pain in (3)

A

military
runners
volleyball

34
Q

what can cause instability leading to ant pelvic pain (3)? how can this be tested?

A

birth
stress fx
osteoporosis

SLS inc sx

35
Q

where would a femoral hernia be located and what is a risk factor for this

A

lateral pelvic wall
surgery

36
Q

what are 8 reasons for gynecologic pelvic pain (not NM or MSK in nature)

A

pregnancy
multiparity
complicated L&D
rectocele
cystocele
endometrosis
PID - infections
pelvic congestion (vascular)

37
Q

rectocele vs cystocele

A

rectocele: men & women
- bulging of ant wall of rectum
- prolapsed rectum

cystocele: women
- bulging of ms wall b/w bladder and vaginal canal
- prolapsed bladder

38
Q

what is endometriosis

A

uterine tissue outside uterus but w/i pelvic cavity

39
Q

how does endometriosis pain present

A

cyclical LBP and sacral pain
- 1x a mo w period

40
Q

what is pelvic inflammatory dz (PID)

A

general term for pelvic infections

bacterial infection of uterus
- STD, childbirth
- acute or chronic

41
Q

what is the majority of PIDs

A

2/3 are STDs
- chlamydia or gonorrhea

42
Q

what is a big risk factor for PID

A

ectopic pregnancy

43
Q

what can PID lead to

A

scarring
fertility issues

44
Q

what is pelvic congestion syndrome (PCS)

A

varicose veins of ovaries

45
Q

describe pain w PCS

A

worse w prolonged standing
- better w rest

46
Q

what is PCS associated w for risk factors (2)

A

PVD
kidney removal (donor or dz)

47
Q

what is the most common gyn cancer

A

endometrial - uterine

48
Q

what are 3 risk factors for endometrial - uterine cancer

A

women 50-70yo
post-menopausal
tamoxifen use (estrogen blocker used w breast cancer)

49
Q

what are 3 pelvic cancers

A

endometrial - uterine
cervical
ovarian

50
Q

what dx tool for cervical cancer

A

pap smear

51
Q

rank how common the pelvic cancers are

A
  1. endometrial - uterine
  2. ovarian
  3. cervical
52
Q

what are 2 risk factors for cervical cancer

A

women 30-40yo
HPV related

53
Q

prognosis for ovarian cancer

A

poor

54
Q

what are 5 risk factors for ovarian cancer

A

women 40-70yo
no birth, birth >35yo
family hx - BRCA1 or 2 genes
early periods
obesity (BMI>31)

55
Q

what are red flags for medical attention when screening the sacrum, SIJ, and pelvis (4)

A

fx
infection
cancer
ectopic pregnancy
- check for PID hx

56
Q

what are yellow flags for medical attention when screening the sacrum, SIJ, and pelvis (3)

A

pap smear
- 21 yo bi annually if neg, annually if pos

failure to respond to PT
- and other constitutional sx

cancer

Med Screening (17 decks)

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