Term
| Categories of Non-ortho medical conditions |
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Definition
cardiovascular
pulmonary
GI
integumentary
neurological |
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Term
| ___ pts dx c MI do NOT have chest pain on presentation |
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Definition
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Term
| What to do when presented c pt dx c heart disease |
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Definition
| eval risk factors, BMI, BP, HR |
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Term
| What to do when presented c cardiovascular pt dx c fever |
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Definition
| auscultate for pleural rub (pericarditis) |
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Term
| Signs of pulmonary disease (c thoracic symptoms) |
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Definition
hx of CA
smoker
productive cough
fever (pneumonia)
sharp stabbing pain on inhalation (pneumothorax) >> AUSCULTATE
recent surgery/immobility (PE) |
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Term
| Diff Dx: thoracic spine v. GI |
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Definition
Hx of CA
N&V c pain in R upper quadrant (cholecystitis)
unexplained wt loss (>10lb/mo)
pain related to eating
symptom relief c antacids
use of NSAIDs (gastric ulcer; >3mos of >1600mg/day)
Melena (gastric ulcer) |
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Term
| Relationship of pain to eating: cause of pain relieved by eating |
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Definition
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Term
| Relationship of pain to eating: cause of pain increased by eating |
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Definition
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Term
| Relationship of pain to eating: cause of pain incr p eating fatty foods |
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Definition
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Term
| Diff Dx: thoracic spine v. integumentary |
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Definition
rash on extensor surfaces (psoriasis) (usually asymm)
rash in dermatomal distribution on thorax (shingles) |
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Term
| Diff Dx: thoracic spine v. neurological |
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Definition
UMNL
bladder/bowel changes |
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Term
| Types of acute spinal fx (4) |
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Definition
compression
burst
fx dislocation
flexion-distraction |
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Term
| _____ of pts involved in traumatic accident are presumed to have SCI until shown otherwise |
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Definition
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Term
|
Definition
injures ant column
NO neurological deficit
e.g. osteoporotic fx |
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Term
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Definition
injures middle column
retropulsion of bone fragments may >> spinal canal
50% have neuro injury
most common at thoracolumbar jxn |
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Term
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Definition
involves all three spinal columns
force often involves rotation & shear
75% have neuro injury
high incidence of associ. intra-abd injury |
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Term
| flex-distraction fx: columns involved |
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Definition
| involves post column alone OR all 3 columns ant fulcrum (i.e. lapbelt) unstable if ALLigt fails |
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Term
| Extension injury of spine |
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Definition
compression of post elements
STABLE |
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Term
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Definition
surgical intervention (dependent on degree of cord compromise, instability, deformity)
rigid bracing |
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Term
| Fx 2º to osteoporosis: prevalence (gender) |
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Definition
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Term
| Rate of bone loss in post-menopausal females |
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Definition
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Term
| osteoporotic fx: spinal column usually affected |
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Definition
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Term
| Osteoporosis: risk factors |
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Definition
caucasian
thin build
immobility
decr Ca intake
excess use of caffeine or alcohol
early menopause
liver/thyroid/renal disease |
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Term
|
Definition
acute pain in thoraco-lumbar region
no neuro signs
kyphosis (progressive; >20º can denote instability) |
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Term
| Osteoporosis: Dx instruments |
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Definition
XRay (only if >30-50%)
DEXA |
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Term
|
Definition
compares pt's BMD to optimal 30yo
views vertebrae, forearm, hip |
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Term
|
Definition
osteoporosis <-2.5
osteopenia -1.1 to -2.4 |
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Term
| Rx of osteoporotic fx: surgical |
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Definition
fusion (0.05% of cases, 2º to neuro deficit)
kyphoplasty (inject collapsed vertebra c bone cement) |
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Term
| Rx of osteoporotic fx: medical |
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Definition
analgesics
anti-resorptive agents
bone formation agents
diet |
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Term
| examples of anti-resorptive agents (for osteoporosis) |
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Definition
estrogen
Fosamax (alendronate sodium)
Actonel (risedronate sodium)
Evista (raloxifene)
Miacalcin (calcitonin)
Reclast (zoledronic acid) |
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Term
| Suggestions for diet in osteoporotic pt |
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Definition
Ca (doses <500mg)
Vit D
Vit K
Mg
Phosphorus |
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Term
| Rx of osteoporotic fx: PT |
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Definition
rigid orthosis (acute)
ext ex (as tolerated)
paraspinal strengthening
walking
balance ex
postural correction
breathing ex (2º to decr in FVC)
education |
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Term
| Timeframe for osteoporotic fx recovery |
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Definition
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Term
| **PT recommendation for osteoporosis screening** |
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Definition
presence of risk factors
pt >65yo
loss of ht, incr kyphosis, or protuberant abdomen
hx of chronic LBP
hx of wrist fx |
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Term
|
Definition
traumatic (fall, MVA, etc)
pathological (metastatic lesion)
stress fx (elite rowers) |
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Term
|
Definition
pain c inspiration
sometimes palpable/visible deformity |
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Term
| Reason of importance to obtain XRay for rib fx |
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Definition
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Term
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Definition
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Term
| Schuermann's Disease: prevalence |
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Definition
10% of population
pubescent athletes
M=F |
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Term
| Schuermann's Disease: condition |
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Definition
>> thoracic kyphosis, vertebral wedging
pain c ext & rot
assoc c Schmorl's nodes
postural deformity = main complaint |
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Term
|
Definition
ex to prevent further kyphosis
± brace |
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Term
|
Definition
idiopathic
fxnl
structural
sciatic |
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Term
| Types of idiopathic scoliosis |
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Definition
infantile
juvenile
adolescent |
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Term
| ST causes of thoracic pain |
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Definition
IVDs
facet jts
costotransverse jts
mm
ANS |
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Term
| Motion that incr thoracic disc pain |
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Definition
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Term
| Most painful motion in thoracic disc issue |
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Definition
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Term
| Number of mvmts limited in thoracic disc issue |
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Definition
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Term
| Thoracic neuroma or neoplasm suspected if this combo of motions/symptoms: |
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Definition
sidebend away from pain = painful
rotation = painfree |
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Term
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Definition
UE pain
pain reproduced by scap retr & C flex
placing hand behind head = painful
neuro signs = serious disease |
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Term
| Most common disc lesion in thoracic spine |
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Definition
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Term
| Thoracic zygapophyseal jts: innervation |
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Definition
| med branches of thoracic dorsal rami (innervates synovium) |
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Term
| Thoracic zygapophyseal jts: nociceptors develop 2º to... |
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Definition
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Term
| Causes of costotransverse jt dysfxn |
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Definition
ankylosing spondylitis
assoc c SI pain
RA affect
unusual symptoms (2º to proximity to sympathetic trunk) |
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Term
| Primary v. Secondary thoracic mm pain |
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Definition
1º: source = lesion of mm attachment
2º: lumbar injury >> reflex spasm of erector spinae |
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Term
| ANS: contributions to thoracic pain/dysfxn |
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Definition
sympathetic trunk; likely to be stretched by flex/lat flex
common site of osteophytes |
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Term
| Miscellaneous causes of chest wall pain |
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Definition
adiposa dolorosa
herpes zoster (shingles)
postherpetic neuralgia
mastalgia
Mondor's disease
intercostal neuralgia
rib cartilage strain
Tietze's syndrome
posterior primary rami
T4 syndrome & sympathetic trunk |
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Term
|
Definition
painful subq fatty tumors
on medial arms, knees, back |
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Term
| Adiposa dolorosa: predominant population |
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Definition
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Term
| Adiposa dolorosa: dominant complaint |
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Definition
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Term
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Definition
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Term
|
Definition
burning pain
(2-3 days later)
rash in unilat dermatomal pattern
(lasts 5 days)
(clear in 2 weeks) |
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Term
|
Definition
acyclovir for 7-10 days;
NSAIDs (pain)
NO heat modalities |
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Term
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Definition
developed by 20% of pts c shingles
pain/hyperesthesia lasting for >1 mo p rash
frequency incr c age |
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Term
| Postherpetic neuralgia: pain resolution |
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Definition
spontaneous;
50% within 3 mos
78% in 1 yr
98% in 5 yr |
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Term
| Postherpetic neuralgia: Rx |
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Definition
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Term
| Mastalgia: often related to... |
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Definition
| changing hormonal levels (2º to monthly cycle) |
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Term
|
Definition
thrombophlebitis of subq vv in chest (incl thoracoepigastric v)
lat chest wall pain
minimal inflammation; no fever/chills
symptoms resolve in 1-10wk
insidious onset
3x more common in women |
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Term
|
Definition
intercostal neuroma 2º to thoracotomy/mastectomy/fx rib
tenderness at neuroma, c burning pain >> thorax/abdomen |
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Term
| Intercostal Neuralgia: Rx |
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Definition
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Term
| Rib cartilage strain: S/Sx |
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Definition
sharp pain @ costochondral jxn (2º to thorwing)
pain may last ≤6 wk |
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Term
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Definition
interferential e-stim
bracing |
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Term
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Definition
idiopathic costochondral pain
possible inflammation
pain incr c ex |
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Term
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Definition
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Term
| Rib fx v. Rib sublux: S/Sx |
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Definition
rib fx: point tender along rib
rib sublux: pain primarily at rib articulations |
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Term
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Definition
rib fx: NO brace
rib sublux: may brace |
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Term
| Referral pattern of T11-12 post primary rami: |
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Definition
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Term
| Referral pattern of T7 post primary rami: |
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Definition
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Term
| Referral pattern of [unspecified] post primary rami: |
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Definition
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Term
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Definition
T2-T6 = UE sympathetic innervation;
trauma/irritation here >> vague UE pain & sensory ∆s |
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Term
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Definition
glove/stocking symptoms
T2-6 segmental ROM >> aggravation
(+) ULTT
(+) slump
r/o TOS
F:M = 3:1 |
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