Health Assessment Quiz
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Questions and Answers

What must a patient do for their disability score to be considered valid?

  • Answer at least 8 of the 10 sections (correct)
  • Complete all 10 sections without skipping
  • Provide a complete medical history
  • Answer at least 5 of the 10 sections

    • What body temperature is regarded as 'normal'?

  • 38ºC
  • 37ºC (correct)
  • 36ºC
  • 39ºC

    • Which term describes rapid and shallow breathing?

  • Apnea
  • Hyperpnea
  • Tachypnea (correct)
  • Bradypnea

    • What is the common cause of bradypnea?

    <p>Drug-induced effects (B)</p> Signup and view all the answers

    What is the normal range for heart rate in adults?

    <p>60-100 beats per minute (D)</p> Signup and view all the answers

    What percentage does each written exam contribute to the overall grade?

    <p>35% (A)</p> Signup and view all the answers

    Which part is NOT included in the components of a health history?

    <p>Current medication (B)</p> Signup and view all the answers

    Which type of questioning starts broad and becomes more specific?

    <p>Guided questioning (D)</p> Signup and view all the answers

    What is a key principle of motivational interviewing?

    <p>Engage as an equal partner (A)</p> Signup and view all the answers

    Which of the following is NOT a component of the systems review?

    <p>Allergy history (D)</p> Signup and view all the answers

    What should a clinical record always include?

    <p>Date (D)</p> Signup and view all the answers

    What is an important practice during motivational interviewing?

    <p>Listen to understand the patient’s experience (B)</p> Signup and view all the answers

    Which of the following is an element of a well patient history?

    <p>Pain perception (C)</p> Signup and view all the answers

    What does the acronym FIFE represent in understanding a patient's experience of illness?

    <p>Feelings, Ideas, Function, Expectations (D)</p> Signup and view all the answers

    What is the primary purpose of collecting a patient's Ideas, Concerns, and Expectations (ICE)?

    <p>To ensure a patient-centered approach and enhance treatment compliance (A)</p> Signup and view all the answers

    Which of the following is NOT a type of patient questionnaire mentioned?

    <p>Patient Health Questionnaire (PHQ) (D)</p> Signup and view all the answers

    How is the score of the Oswestry Disability Index (ODI) calculated?

    <p>Summed score divided by the total possible score times 100 (C)</p> Signup and view all the answers

    What should be done if a question in the NDI is not answered by the patient?

    <p>Probe the patient for their response regarding that question (B)</p> Signup and view all the answers

    What does the 'S' in the SOAP format stand for?

    <p>Subjective (C)</p> Signup and view all the answers

    What is a characteristic of pain that is categorized as nociceptive?

    <p>It arises from actual or threatened damage to nonneural tissue. (C)</p> Signup and view all the answers

    What term describes a painful sensation due to a stimulus that does not usually provoke pain?

    <p>Allodynia (A)</p> Signup and view all the answers

    Which type of pain is caused by a lesion or disease in the somatosensory system?

    <p>Neuropathic pain (A)</p> Signup and view all the answers

    Pain that is perceived at a location different from the actual injury site is known as what?

    <p>Referred pain (D)</p> Signup and view all the answers

    What does hyperalgesia refer to?

    <p>Increased pain from a typically painful stimulus (B)</p> Signup and view all the answers

    What is the term for a burning or prickling sensation often experienced without a stimulus?

    <p>Paresthesia (D)</p> Signup and view all the answers

    What is the primary difference between referred pain and radicular pain?

    <p>Referred pain is nociceptive, while radicular pain is neuropathic. (C)</p> Signup and view all the answers

    What is tachycardia?

    <p>A rapid heart rate (C)</p> Signup and view all the answers

    What is the initial step when measuring blood pressure?

    <p>Estimate systolic pressure (B)</p> Signup and view all the answers

    What purpose does estimating systolic pressure serve?

    <p>To prevent discomfort from high cuff pressures (D)</p> Signup and view all the answers

    How should the blood pressure cuff be positioned for ankle systolic measurement?

    <p>2-3 cm above the point of arterial measurement (C)</p> Signup and view all the answers

    What does an Ankle Brachial Index (ABI) greater than 1.3 indicate?

    <p>Abnormal arterial calcification (B)</p> Signup and view all the answers

    What does non-specific low back pain refer to?

    <p>Pain without a determined anatomical cause (C)</p> Signup and view all the answers

    In assessing a patient's ability to hold a bridge position, what suggests a lack of endurance in trunk stabilizers?

    <p>Pain and fatigue while holding the position (A)</p> Signup and view all the answers

    Which of the following is NOT associated with the definition of mechanical low back pain?

    <p>Pathoanatomical causes identified (A)</p> Signup and view all the answers

    What condition is characterized by the presence of trigger points that lead to spontaneous pain and referred pain?

    <p>Myofascial Pain Syndrome (A)</p> Signup and view all the answers

    What is the primary outcome of performing Ely's Test?

    <p>To determine femoral nerve or quadriceps issues (B)</p> Signup and view all the answers

    Which test is used to check for reduced range of motion indicating a tight glute med/min or tensor fasciae latae?

    <p>Ober's Test (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of active trigger points?

    <p>Pain only when compressed (C)</p> Signup and view all the answers

    What is a common symptom of Myofascial Pain Syndrome?

    <p>Muscle/fascia pain at rest (D)</p> Signup and view all the answers

    Which of the following does not belong in the category of special tests for DGS?

    <p>Squat Test (A)</p> Signup and view all the answers

    What describes a latent trigger point?

    <p>Pain only when compressed (D)</p> Signup and view all the answers

    Which treatment is included in a comprehensive boot camp for non-operative management?

    <p>Manual therapy (C)</p> Signup and view all the answers

    Study Notes

    Review Lecture - October 28, 2024

    • The lecture was given by Dr. Marissa Lee, DC, HBSc, MSc
    • The contact email for the presenter is [email protected]
    • The date of the lecture is October 28, 2024
    • The location of the lecture is Canadian Memorial Chiropractic College (CMCC)

    Written Exam

    • Each written exam is worth 35%
    • The first exam is scheduled for January 17, 2025
    • The second exam is scheduled for May 12, 2025

    Lecture Hours 1-6 History Taking

    • Key components of a patient history include well patient history, report writing, pain-based history and pain perception, and pain questionnaires.

    Quote

    • "Listen to your patient. He is telling you the diagnosis." - Sir William Osler, co-founder of Johns Hopkins School of Medicine

    Guided Questioning

    • Move from open-ended questions to focused questions
    • Use questions that elicit a graded response
    • Ask a series of questions, one at a time
    • Offer multiple answer choices
    • Clarify the patient's meaning
    • Use encouraging phrases (continuers)
    • Use echoing

    Components of a Health History

    • Identifying patient data (source, reliability)
    • Chief complaint(s)
    • Present illness
    • Past history
    • Family history
    • Personal and social history
    • Review of systems

    Systems Review

    • General
    • Skin
    • Head, Eyes, Ears, Nose, Throat
    • Neck
    • Breasts
    • Respiratory
    • Cardiovascular
    • Gastrointestinal
    • Peripheral vascular
    • Urinary
    • Genital
    • Musculoskeletal
    • Psychiatric
    • Neurologic
    • Hematologic
    • Endocrine

    Motivational Interviewing

    • This is a guiding interviewing style that helps patients understand their need for change.
    • Ask open-ended questions (ASK)
    • Listen to understand the patient (LISTEN)
    • Provide information, and ask for implications (INFORM)

    Motivational Interviewing - Do's and Don'ts

    • Do engage with the patient as an equal partner
    • Do be patient
    • Don't give unsolicited advice
    • Refrain from instructing, directing, or warning

    Clinic Records

    • Follow your regulatory college's standards (Nov 12, 2014.qxd (cco.on.ca))
    • Justify your diagnosis and plan of management
    • Protects you from malpractice claims
    • For patient care and continuity

    The Clinical Record

    • Must include date, patient's name and identifiers, practitioner's name, clinic name, and address

    SOAP Format

    • The SOAP format (Subjective, Objective, Assessment, Plan) is common for progress notes.
      • S = subjective
      • O = objective
      • A = Assessment
      • P = Plan

    Pain

    • An unpleasant sensory and emotional experience associated with actual or potential tissue damage
    • Subjective, thus difficult to measure
    • A vital protective sensory phenomenon
    • Not always tied to a stimulus
    • Perceived intensity and severity of tissue damage are not always correlated

    TABLE 1.2 Differentiation of Systemic and Musculoskeletal Pain

    • Systemic pain characteristics: disrupts sleep, throbbing, reduces with pressure, and constant/wave-like during spasms. It isn't often worsened by mechanical stress.
    • Musculoskeletal pain characteristics: typically lessens at night, sharp/superficial, often decreases with cessation of activity, usually continuous or intermittent, often aggravated by mechanical stress.
    • Lists different pain types and their associated structures (e.g., cramping/dull/aching = muscle, sharp/shooting = nerve root)

    Pain Terminology

    • Allodynia: Pain due to a stimulus that does not normally provoke pain
    • Dysesthesia: Unpleasant abnormal sensation, spontaneous or evoked
    • Hyperalgesia: Increased pain from a stimulus that normally provokes pain
    • Neuropathic pain: Pain caused by a lesion or disease of somatosensory system
    • Phantom pain: Perception related to a limb/organ not physically present

    Pain Terminology (Continued)

    • Nociceptive pain: Pain from actual or threatened damage to non-neural tissue
    • Sensitization: Increased responsiveness of nociceptive neurons to normal input
    • Paresthesia: Burning or prickling sensation
    • Hyperesthesia: Excessive/increased physical sensitivity
    • Hypoesthesia: Diminished/decreased physical sensitivity
    • Anesthesia: Insensitivity to pain

    Referred Pain vs. Radicular Pain

    • Referred pain: Segmental nociceptive pain perceived away from the original injury site
    • Radicular pain: Neuropathic pain caused by compression/inflammation of spinal nerve roots/dorsal root ganglion

    Pain Modulation

    • The process by which the body alters a pain signal as it is transmitted along the pain pathway

    Pain Modulators (Endogenous)

    • Bind to opioid receptors and modulate pain signals; Enkephalins, Endorphins, Dynorphins
    • Neurotransmitters; Serotonin, Norepinephrine

    Pain Modulators (Drugs)

    • Analgesics: Acetaminophen (Tylenol), NSAIDs (Ibuprofen, Naproxen, Acetylsalicylic Acid), Opioids (Morphine, Fentanyl, OxyContin, Vicodin)
    • Anesthetics

    Pain Modulators (Cannabinoids)

    • Delta-9-tetrahydrocannabinol (THC)
    • Cannabidiol (CBD)
    • Reduce inflammatory and neuropathic pain

    Pain-Based History - Goals

    • Gather information related to the patient's current illness
    • Understand how the illness affects their lives
    • Formulate a list of potential diagnoses
    • Guide the physical examination
    • Formulate a management/treatment plan

    Symptom Attributes (OLD CARTS)

    • Onset: When did the pain start?
    • Location: Where is the pain located?
    • Duration: How long has the pain lasted?
    • Character: Describe the pain (sharp, dull, burning)
    • Aggravating/Alleviating Factors: What makes the pain worse/better?
    • Radiation: Does the pain spread?
    • Timing: When does the pain occur (e.g., morning, evening)?
    • Severity: Rate the pain on a scale of 0-10

    Severity

    • Pain scale: 0-10, with 0 being no pain and 10 being the worst pain imaginable.

    Explore the Patient's Perspective (Disease vs. Illness)

    • Feelings, Ideas, Function, Expectations

    Patient's Perspective (ICE)

    • Gathering info for a patient-centered approach
    • Reason for the patient's encounter
    • Clue to correct diagnosis
    • Aids in shared decision-making
    • Aids in patient compliance

    Patient Questionnaires

    • Purpose: baseline status, aid in diagnosis, monitor pain over time to gauge recovery

    Types of Patient Questionnaires

    • Oswestry Disability Index (ODI)
    • Neck Disability Index (NDI)
    • Symptom Diagram
    • Visual Analog Scale (VAS)
    • Lower Extremity Functional Scale (LEFS)
    • Quick DASH
    • McGill Pain Questionnaire (MPQ)
    • Roland Morris Disability Questionnaire (RMDQ)
    • Tampa Scale of Kinesiophobia (TSK)
    • Rivermead Post-Concussion Symptoms Questionnaire (RPQ)

    Scoring the ODI

    • Summed score/total possible score x 100
    • Probe patient if a question isn't answered; reduce denominator by 5 if not applicable
    • Use the highest scored statement if multiple statements apply

    Interpreting the ODI

    • 0%-20%: Minimal disability
    • 21%-40%: Moderate disability
    • 41%-60%: Severe disability
    • 61%-80%: Crippled
    • 81%-100%: Bed-bound or exaggerating symptoms

    NDI Scoring

    • Summed score/total possible score
    • May or may not convert to %
    • Probe patient if a question isn't answered; reduce denominator by 5 if not applicable
    • Score is not valid unless at least 8 of 10 sections are answered

    NDI Interpretation

    • 0-4: No disability
    • 5-14: Mild disability
    • 15-24: Moderate disability
    • 25-34: Severe disability

    • 35: Complete disability

    VAS Examples

    • Visual Analog Scale (VAS) for pain rating from 0-10
    • Verbal scale correlation with visual scale:
      • 1-3: Mild pain, minimal impact on ADLs
      • 4-6: Moderate pain, moderate impact on ADLs
      • 7-10: Severe pain, major impact on ADLs

    Summary

    • Shows which questionnaire is associated with the body part
    • Indicates the high score means for each questionnaire

    Lecture Hours 7-8 Vital Signs

    • This section covers the aspects of taking vital signs

    Vital Signs

    • Temperature
    • Respiratory rate
    • Heart rate
    • Blood pressure

    Methods of Taking Temperature

    • Oral
    • Axillary
    • Rectal
    • Tympanic
    • Temporal artery

    Temperature

    • Body core temperature: 37°C
    • Pyrexia (Fever): Elevated body temperature
    • Hyperpyrexia: Elevated above 41.1°C
    • Hypothermia: Abnormally low temperature below 35°C rectally

    Respiratory Rate

    • Rate (breaths/minute)
    • Rhythm (consistency)
    • Depth (shallow/deep)
    • Effort of breathing
    • Normal range: 12-20 breaths/minute

    Terms used to describe breathing

    • Tachypnea: Rapid, shallow breathing
    • Hyperpnea: Rapid, deep breathing
    • Bradypnea: Slow breathing

    Heart Rate

    • Use radial pulse, index and middle fingers
    • Count rate for 30 seconds and multiply by 2
    • Normal range: 60-100 beats per minute
    • If irregular rhythm, further examination is needed.
    • Auscultate at the cardiac apex

    Terms used to describe heart rate

    • Tachycardia: Rapid heart rate
    • Bradycardia: Slow heart rate

    Blood Pressure

    • Procedure: Estimate systolic pressure first, palpate radial artery and rapidly inflate, read pressure and add 30 mmHg, deflate promptly and wait 15-30 seconds

    Blood Pressure - Purpose of Estimate

    • Prevents discomfort from unnecessarily high cuff pressures
    • Avoids occasional error caused by an auscultatory gap, which is a silent interval between systolic and diastolic pressures

    Ankle Systolic Blood Pressure

    • Locate posterior tibial artery
    • Apply cuff 2-3cm above artery
    • Ensure center of bladder is above artery
    • Inflate 30mmHg above previously taken arm SBP
    • Deflate at 2-3 mmHg per second
    • Read manometer after first audible sound
    • Calculate ABI (Ankle Brachial Index)

    ABI Measurement

    • 1.3: Abnormal arterial calcification/incompressible vessels

    • 1.0-1.29: Normal value
    • 0.90-0.99: Borderline PAD
    • 0.60-0.89: Mild PAD
    • 0.40-0.59: Moderate PAD
    • <0.39: Severe PAD, rest pain, and focal tissue necrosis

    Body Mass Index (BMI)

    • Use height and weight to calculate BMI
    • BMI incorporates estimated but more accurate body fat measurements than weight alone

    Lecture Hours 9-20 Low back and Pelvis

    • Standard low back exam
    • Mechanical low back pain (MLBP)
    • Differential diagnoses for MLBP
    • Red and yellow flags
    • Disability determination

    Observation: Gait

    • Normal gait
    • Tandem gait
    • Walking on heels
    • Walking on toes

    Observation: Markings

    • Café-au-lait spots
    • Tuft of hair

    Neurological Exam: Reflexes

    • Deep tendon reflexes (DTRs)
    • 2 primary DTR: patellar (L3-4), Achilles (S1-2)
    • DTR tests integrity of associated nerve root

    DTR Response and Grading

    • Patellar: knee extension
    • Achilles: ankle plantar flexion
    • Jendrassik maneuver: used to enhance difficult-to-elicit reflexes
    • Grading scale: 0-Absent (areflexia), 1-Diminished (hyporeflexia), 2-Average (normal), 3-Exaggerated (brisk), 4-Clonus, very brisk (hyperreflexia)

    Pathological Reflex: Babinski Reflex

    • Use reflex hammer to stroke lateral sole of foot medially across ball
    • Normal: plantar flexion (foot pointing downwards)
    • Positive: big toe extends and fans out; abnormal; possible upper motor neuron lesion

    Neurological Exam: Myotome Testing

    • Testing muscle power for neurological weakness
    • Myotome locations for lumbar and sacral spines

    TABLE 9.14 Myotomes of the Lower Limb

    • Table listing nerve roots and their associated muscle and testing actions

    Myotome Testing-Interpretation

    • Table categorizing grades of muscle strength with corresponding values and movement grades

    Neurological Exam: Sensory Testing

    • Dermatomes: areas of skin innervated by a single spinal nerve root

    Light Touch

    • Lightly touch skin with cotton wisp, filament, or fingertip
    • Compare sensation in different areas
    • Anesthesia, hypesthesia, hyperesthesia

    Pain

    • Use suitable tool to test pain sensation (e.g., broken tongue blade)
    • Ask patient if sharp or dull
    • Analgesia, hypalgesia, hyperalgesia

    Special Tests for Lumbar Radiculopathy

    • Straight leg raise (SLR)
    • Well leg raise test
    • Bragard's test
    • Bowstring test
    • Modified SLR
    • Slump test
    • Valsalva

    Well Leg Raise Test

    Bragard's Test

    Bowstring Test

    Modified SLR

    Slump Test

    Valsalva

    Kemp's Test

    Observation: Step Deformity

    • Spondylolisthesis
    • Spondylosis
    • Spondylolysis

    A Note about Fractures

    • Spinous percussion: using a reflex hammer or manual percussion to gently percuss the spinous process
    • Positive finding: significant pain due to vibration
    • Fracture suspected with positive finding

    Special Tests for Spondylolisthesis and Hypermobility

    • Spinal "Instability" Cluster
    • Apprehension Sign
    • Instability Catch Sign
    • Painful Catch Sign
    • Prone Instability Test

    Lumbar Hypermobility

    • Hypermobility is not synonymous with instability
    • Lumbar hypermobility is not technically instability
    • Instability typically requires surgical stabilization due to risk of neurological or vascular compromise

    Functional Stability

    • Joint centration is essential for optimum spine movement
    • Requires muscle strength and dynamic coordination

    Spinal Stabilizers (Anteriorly)

    • Core musculature
    • Transverse Abdominus
    • Obliques

    Spinal Stabilizers (Posteriorly)

    • Erectors Spinae, Iliocostalis, Longissimus, Spinalis
    • Multifidus

    These stabilizers generate intra-abdominal pressure aiding in spinal stability

    Other Tests

    • Active SLR: raise leg to assess for hypermobility, also assess speed, tremor, trunk rotation and verbal/nonverbal responses
    • Bridging Maneuvers: assess patient's ability to hold a prone or supine bridge

    Non-specific Low Back Pain/ Mechanical Low Back Pain

    • Terminology used in evidence-based medicine (used when pathoanatomical cause of LBP cannot be determined)
      • Examples: lumbar facet joint syndrome, lumbar sprain/strain, sacroiliac joint (SIJ) syndrome, thoracolumbar syndrome

    Non-Specific Low Back Pain (Continued)

    • Refers to back pain originating from the spine, intervertebral discs, or surrounding soft tissues
    • Non mechanical lBP is caused by factors like Cauda equina syndrome, facture, infection or malignancy

    More Specific Diagnoses

    • Lumbar facet joint syndrome
    • Lumbar sprain/strain
    • Sacroiliac Joint (SIJ) syndrome
    • Thoracolumbar syndrome

    Lumbar Facet Joint Syndrome (Clinical Prediction Rule)

    • Localized unilateral back pain
    • Pain aggravated/reproduced by pressure on facet joint or TVP
    • No nerve root symptoms; pain does not extend beyond the knee
    • Eased by flexion
    • Reduced movement on painful side; unilateral muscle spasm over facet joint; pain on extension and extension with lateral flexion/rotation to the same side.

    Laslett et al.'s Clinical Prediction Rule (Sacroiliac Joint)

    • These are sacroiliac joint (SIJ) provocation tests: Compression, Distraction, Sacral Thrust, Thigh Thrust, Gaenslen's Test, Pain on palpation medial to PSIS.
    • If 2 of the first 4 tests or ≥3 of the 6 tests are positive → sacroiliac joint pathology

    Flamingo Test

    Pubic Symphysis

    Leg Length Test

    FABER/Patrick's Test

    Trendelenburg Sign

    Trendelenburg Gait

    • Observe patient walking away from you
    • Pelvis drops on unaffected side; trunk shifts to affected side.
    • Indicates L5 nerve root paresis or glute medius weakness

    Skin Rolling Test for TL Syndrome

    • Assess the skin roll of thoraco-lumbar fascia for possible TL/Maigne Syndrome

    Lumbar Spinal Stenosis

    • Stenosis: narrowing
    • Lumbar spinal stenosis (LSS): narrowing of the spinal canal
    • Results in pressure on the spinal cord and nerves

    Neurogenic Claudication

    • Most common symptom of LSS: painful cramping/weakness in the legs
    • Differentiate from vascular claudication

    Vascular Claudication

    • Calf muscle pain on exertion, relieved by rest.
    • Associated with peripheral arterial disease (PAD)

    Peripheral Arterial Disease (PAD)

    • Narrowed arteries = reduced blood flow to legs/arms
    • May have mild/no symptoms
    • Pain ends with rest

    PAD Risk Factors

    • Smoking
    • Diabetes
    • Family history of PAD, heart disease, or stroke
    • High blood pressure
    • High cholesterol
    • Age >65 or >50 if other risk factors present
    • Obesity

    Differentiating Neurogenic & Vascular Claudication

    • Table comparing various findings and symptoms/characteristics for neurogenic vs. vascular claudication

    Physical Exam for LSS

    • Observation: Check ROM, tandem gait
    • Neurological Exam: Nerve tension test
    • Maintain Active Extension
    • Functional Tests

    ROM

    • Pain with lumbar extension
    • Relief with lumbar flexion

    Tandem Gait

    Romberg Test

    Sustained Active Extension

    Sphinx Test

    Functional Tests

    • Squat
    • Stand/hop on one leg

    Non-Operative Management

    Comprehensive Boot Camp

    Myofascial Pain Syndrome

    Myofascial Pain Syndrome (MPS)

    • Acute or chronic musculoskeletal condition characterized by sensory, motor and autonomic findings; associated with trigger points
    • Symptoms include muscle/fascia pain at rest.
    • Trigger points are localized, taught regions of muscle and fascia.
    • Fascia is thin layer of connective tissue covering/supporting organs, vessels, bones and muscles.

    Active Trigger Points

    • Spontaneous pain
    • Tenderness in taut band
    • Familiar pain (twitch response when stimulated manually)
    • Referred pain

    Latent Trigger Points

    • Focus of hyperirritability
    • Local twitch response
    • Tenderness
    • Refered pain
    • No pain unless compressed; can become active trigger points

    Special Tests for DGS Summarized

    • Hibb's Test
    • SLR with internal/external rotation
    • FAIR
    • Pace Sign
    • Seated Piriformis Test

    Quadratus Lumborum Syndrome

    Ober's Test

    Iliopsoas Syndrome

    Ely's Test

    Thomas Test

    Coccydynia

    Internal Coccyx Mobilization/SMT

    Waddell Signs

    • 8 Clinical physical signs
    • History of use
    • Detect psychogenic manifestations of LBP
    • Not used to detect credibility of patient complaint
    • Not used to detect malingering
    • Not used to detect non-organic causes of LBP

    Waddell Signs (continued)

    • Superficial tenderness
    • Non-anatomical tenderness
    • Axial loading
    • Acetabular rotation
    • Distracted SLR discrepancy
    • Regional sensory disturbance
    • Regional weakness
    • Overreaction

    Low back physical exam- AS tests

    • Occiput-wall distance
    • Chest expansion
    • Modified Schober's

    Non-Musculoskeletal Differential Diagnoses for Low Back Pain

    Red Flags

    • Indicators of potential serious physical pathology
    • Contraindication to manual therapy

    Examples of Red Flags

    • Previous history of cancer
    • Intravenous drug use/urinary infection
    • Long-term corticosteroid use
    • Age <40, chronic morning stiffness lasting >30-60 minutes
    • Numbness in groin

    Yellow Flags - Psychosocial Risk Factors

    • There are 4 yellow flags that indicate a delayed recovery:
    1. Belief that back pain is harmful and severely disabling,
    2. Fear avoidance behavior,
    3. Depressed or low mood or social withdrawal,
    4. Expectations that passive treatment will help recover.

    Good Luck on your Mod 2 Exams!

    • Health history
    • Questionnaires
    • Vitals
    • Low back exam
    • Differential diagnoses
    • Dr. Rocco Guerriero takes over lecturing in Mod 2
    • Dr. Lee resumes lectures in Mod 3

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    Description

    Test your knowledge on health assessment principles, including patient history, vital signs, and interviewing techniques. This quiz covers essential topics that are crucial for understanding patient care and communication. Ideal for students in healthcare-related fields.

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