Spinal + Pelvic Injuries

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Questions and Answers

What are some spinal subjective red flags for potential serious conditions?

History of malignancy, age >50, failure to improve with treatment, unexplained weight loss, pain at rest, night pain, fever/PM sweats, risk factors for infection, chest pain or heaviness, abdominal pain, SOB, cough

What are some cardiac subjective red flags for potential serious conditions?

Pain that persists and is not relieved by position change, usually brought on by aerobic activity and relieved by rest, aggravated by extreme heat/cold, may be relieved by glyceryl trinitrate, family history

What are some conditions associated with pleural pain?

Pneumonia, pneumothorax, pleural effusion, pulmonary infarction

What are some potential causes of shoulder pain related to respiratory conditions?

Pneumothorax, pleural pain referred to shoulder due to fascial connections to cervical transverse processes Signup and view all the answers

What are common thoracic spine pathologies resulting from trauma to the chest?

Costo-vertebral joint pain, intervertebral disc prolapse, lumbar spine fractures involving thoracolumbar region, wedge fractures, burst fractures, chance fractures, fracture-dislocations, stress fractures Signup and view all the answers

What is the clinical condition associated with increasing kyphosis over 1-2 months in the lower thoracic spine?

Scheuermann’s disorder Signup and view all the answers

What are some symptoms associated with Scheuermann’s disorder?

Pain in the thoracic region, wedging of vertebrae with pain on bending, short hamstrings Signup and view all the answers

What are some treatment options for Scheuermann’s disorder?

Explanation/education/support, extension exercises, postural correction/retraining, avoiding sports with lifting/bending, brace/surgery Signup and view all the answers

Explain the treatment options for pelvic fractures and the potential complications associated with them.

Treatment options for pelvic fractures may include internal/external fixation and stabilizing the sacroiliac joint (SIJ). Patients may be instructed to be partial weight-bearing on the affected side, and sitting may be restricted to around 60 degrees if the acetabulum is involved. Complications of pelvic fractures may include hemorrhage, ischemia in one leg, injury to the bowel or bladder, paralytic ileus, limb shortening, neurological damage, and persistent SIJ or pubic symphysis instability. Signup and view all the answers

Discuss the differences in management considerations between pelvic fractures and spinal fractures.

Management considerations for pelvic fractures include precautions related to weight-bearing status, transfer techniques, assessment for neurological deficits, identification of pain location, evaluation of urological involvement, patient education, and possible complications such as hemorrhage, ischemia, and bowel or bladder injury. Spinal fractures may involve different precautions related to spinal stability, nerve compression, and spinal cord injury, as well as considerations for spinal immobilization and specialized transfer techniques. Signup and view all the answers

Describe the etiology and common mechanisms of ACL injuries in pediatric patients.

ACL injuries in pediatric patients can occur non-contact during deceleration movements, rapid changes in direction, landing from a jump, twisting, and hyperextension, or through direct contact to the lateral aspect of the knee. These injuries are commonly associated with sports involving pivoting, changing direction, landing, and twisting, such as netball, AFL, and skiing. Growth spurts, typically around age 12, can increase the risk of ACL injury. Signup and view all the answers

Explain the incidence and associated risks of ACL injuries in pediatric patients.

The incidence of ACL injuries in pediatric patients is high, with 96% occurring in individuals aged between 10-14 years. This incidence continues to increase, with the risk being further elevated during growth spurts. ACL injuries are commonly associated with meniscal tears, PCL injury, and LCL injury. Signup and view all the answers

Explain the McKenzie classifications for back pain syndromes.

The McKenzie classifications for back pain syndromes include postural syndrome (poor posture), dysfunction (the stiff spine), and derangement (disc bulging or prolapse). Signup and view all the answers

What are the clinical indicators used for facet joint syndrome?

Clinical indicators used for facet joint syndrome include localized back pain, pain with extension, and pain with rotation. Signup and view all the answers

What are the functions of the vertebral column?

The functions of the vertebral column include providing a framework for bony attachment, enabling support and weight transmission, protecting the spinal cord, muscle attachment, and general bone function such as calcium storage. Signup and view all the answers

Explain the Denis classification of stability for spinal injuries.

The Denis classification of stability for spinal injuries is based on a three-column system, including the anterior column (anterior longitudinal ligament and anterior 2/3 of vertebral body/IV disc), middle column (posterior 1/3 of vertebral body/IV disc, posterior longitudinal ligament), and posterior column (posterior elements, ligamentum flavum, neural arch, and interconnecting ligaments). Stable injuries involve one column, intermediate or grey zone injuries involve two columns, and unstable injuries involve three columns with loss of height >50% or excessive angulation. Signup and view all the answers

What are the different categories of thoracolumbar spinal fractures?

The different categories of thoracolumbar spinal fractures include compression fracture, burst fracture, flexion/distraction fracture (also called chance fracture or seatbelt fracture), and fracture dislocations. Signup and view all the answers

What are the management strategies for derangement syndrome according to McKenzie approach?

The management strategies for derangement syndrome according to the McKenzie approach include reducing the derangement with repeated movement of opposite or aggravating/derangement posture, maintaining the reduction with regular movement into the desired position, and preventing recurrence with exercise. Other interventions such as manual therapy, different exercises, and side gliding (if lateral shift is present) may also be required. Signup and view all the answers

Explain the difference between stable and unstable spinal injuries according to the thoracolumbar guidelines.

Stable spinal injuries are those in which the spinal cord is not considered to be at risk and movement of the spine will not cause damage to the spinal cord. Bracing may still be required. Unstable spinal injuries involve the risk of spinal cord damage or could be damaged with movement. Signup and view all the answers

What are the subjective and objective findings associated with McKenzie's dysfunction syndrome?

Subjective findings for McKenzie's dysfunction syndrome include gradual onset due to poor posture or trauma, pain with end of range activity, and objective findings include end range pain and restricted range with active range of motion (AROM). Signup and view all the answers

What are the McKenzie approach exercise progressions for extension?

The McKenzie approach exercise progressions for extension include extension in lying for reducing posterior derangement and stretching extension dysfunction, and extension in standing for maintaining reduction in post-derangement and for curve reversal in postural syndrome. Signup and view all the answers

What are the subjective and objective findings associated with McKenzie's postural syndrome?

Subjective findings for McKenzie's postural syndrome include constant or intermittent pain, usually sudden onset, often related to poor posture or repeated flexion activity, and objective findings include pain with movement and better or worse pain with active range of motion (AROM) and repeated movements. Signup and view all the answers

What are the different types of thoracolumbar spinal fractures according to the severity score?

The different types of thoracolumbar spinal fractures according to the severity score include compression fracture, burst fracture, flexion/distraction fracture (also called chance fracture or seatbelt fracture), and fracture dislocations. Signup and view all the answers

What are the management strategies for McKenzie's postural syndrome?

The management strategies for McKenzie's postural syndrome include stretching the stiff movement (e.g., flexion or extension) and elongation without microtrauma, as well as preventing recurrence with exercise and maintaining reduction with regular movement into the desired position. Signup and view all the answers

What are the management options for thoracic spine dysfunction?

Explanation, reassurance, anti-inflammatories, mobilizations/manipulations, electrotherapy, taping, exercise programs, and preventative advice. Signup and view all the answers

What are some other dysfunctions to consider in addition to thoracic spine dysfunction?

ZPJ translation/abnormalities, Schmorl’s node, and costovertebral joint synovial inclusions. Signup and view all the answers

What symptoms can thoracic disc pathology, including discogenic disc protrusion, cause?

Back pain, radicular pain, and spinal cord compression symptoms. Signup and view all the answers

What is T4 syndrome and what symptoms does it involve?

T4 syndrome involves hypomobility at the T4 level, causing arm pain, discomfort, and neck pain, which can be relieved with mobilization and manipulations. Signup and view all the answers

What characterizes Thoracic Outlet Syndrome, and what are its potential causes?

It is characterized by compression of the neurovascular bundle and can have various causes, including bony and soft tissue pathologies. Signup and view all the answers

How many specific symptoms/signs are required for the diagnosis of Thoracic Outlet Syndrome?

At least 3 out of 4 specific symptoms/signs. Signup and view all the answers

What does shoulder neuro rehabilitation involve testing for?

Biceps, scapular dyskinesia, impingements, SLAP lesions, and UL neural provocation. Signup and view all the answers

What symptoms are aimed to be elicited during testing for UL neural provocation?

Symptoms such as stretching, aching, pain, burning, and tingling. Signup and view all the answers

How do peripheral nerves adapt to different positions?

Through elongation, longitudinal movement of the nerve trunk, and an increase/decrease of tissue relaxation at the level of the nerve trunk. Signup and view all the answers

What do neuropathodynamic mechanisms involve?

Mechanical interface dysfunctions and pathoanatomical dysfunctions that can exert pressure on neural structures and innervated tissue. Signup and view all the answers

Explain the management of peripheral neuropathic pain and the importance of gliding of nerves.

The management of peripheral neuropathic pain involves considering stretch vs. gliding of nerves, with gliding being essential to dissipate forces. Signup and view all the answers

What is neurodynamic testing and what does it involve?

Neurodynamic testing involves quantifying range of motion and comparing affected to unaffected limbs, with potential differences between test sequences. Signup and view all the answers

What is the focus of the McKenzie approach for low back pain?

The McKenzie approach for low back pain involves utilizing repeated movements or exercises to promote centralization and improve mobility. Signup and view all the answers

What are the precautions to mobilization in the McKenzie approach?

Precautions to mobilization in the McKenzie approach include constant unremitting pain, symptoms in specific areas, malignancy, and certain medical conditions. Signup and view all the answers

What does the Quebec Task Force categorize spinal pain based on?

The Quebec Task Force categorizes spinal pain based on radiation and neuro signs, ranging from no radiation to limb radiation with neuro signs. Signup and view all the answers

What does the McKenzie approach emphasize in terms of patient education and treatment?

The McKenzie approach emphasizes early education and self-treatment by the patient, with a hands-off approach and a focus on mechanical diagnosis. Signup and view all the answers

What types of syndromes are included in the McKenzie syndromes?

McKenzie syndromes include Posture Syndrome, characterized by pain from poor posture, and Dysfunction Syndrome, related to adaptive soft tissue shortening. Signup and view all the answers

What innervated tissue abnormalities can be related to neural dysfunctions?

Innervated tissue abnormalities can include motor control dysfunctions, muscle imbalances, local hyperactivity/trigger points, and inflammation. Signup and view all the answers

What did a study find regarding neural tissue management over 2 weeks?

A study found that neural tissue management over 2 weeks resulted in reduced cervical and arm pain and self-reported activity limitations. Signup and view all the answers

What are some of the precautions to mobilization in the McKenzie approach related to medical conditions?

Diagnosis of bone disease, rheumatoid arthritis, infective arthritis, spondylosis, or spondylolisthesis are among the precautions to mobilization. Signup and view all the answers

What types of factors can neural dysfunctions be related to?

Neural dysfunctions can be related to sliding, tension, hypermobility/instability, pathoanatomical, and pathophysiological factors. Signup and view all the answers

Describe the criteria for surgery in cases of posterior ligament disruption in spinal fractures.

The criteria for surgery in cases of posterior ligament disruption in spinal fractures include significant disruption of the ligament complex, leading to spinal instability and neurological compromise. Signup and view all the answers

What are the common causes of cervical fractures and how are they managed?

Common causes of cervical fractures include trauma from motor vehicle accidents, falls, and sports injuries. They are managed through a combination of immobilization, pain management, and possibly surgical intervention depending on the severity of the fracture and associated neurological symptoms. Signup and view all the answers

Explain the specific treatment approach for crush, spinous process, and fracture dislocation of the cervical spine.

The specific treatment approach for crush, spinous process, and fracture dislocation of the cervical spine may involve surgical stabilization, reduction of dislocation, and postoperative rehabilitation to restore function and mobility. Signup and view all the answers

What is a Jefferson fracture and how is it treated?

A Jefferson fracture is a specific type of fracture involving the ring of the first cervical vertebra. It is typically treated with immobilization using a cervical collar or halo vest, and in some cases, surgical fusion may be necessary to stabilize the fracture. Signup and view all the answers

Discuss the causes and treatment options for an odontoid fracture.

An odontoid fracture often results from high-energy trauma or in older individuals due to degenerative changes. Treatment options may include conservative management with immobilization or surgical fixation depending on the type and stability of the fracture. Signup and view all the answers

What are the surgical interventions and physiotherapy options for cervical fractures?

Surgical interventions for cervical fractures may involve spinal fusion, instrumentation, or decompression procedures. Physiotherapy options focus on restoring mobility, strengthening the supportive muscles, and improving overall functional capacity. Signup and view all the answers

What are the causes of pelvic fractures and how are they classified?

Pelvic fractures can occur due to falls from height, motor vehicle accidents, or crushing injuries. They are classified into avulsion, stable, and unstable fractures based on the pattern and degree of displacement. Signup and view all the answers

Differentiate between stable and unstable pelvic fractures and their respective treatment approaches.

Stable pelvic fractures exhibit minimal displacement and can often be managed conservatively with pain control and early mobilization. Unstable pelvic fractures involve significant displacement and instability, requiring surgical fixation and close monitoring for potential complications. Signup and view all the answers

Explain the treatment approach for an open book fracture of the pelvis.

An open book fracture of the pelvis, characterized by separation of the symphysis pubis, may require surgical stabilization with internal fixation to realign the pelvic bones and restore stability. Close monitoring for potential pelvic organ injuries is essential in such cases. Signup and view all the answers

What are the management strategies for avulsion fractures of the pelvis?

Management strategies for avulsion fractures of the pelvis include rest, activity modification, and possibly physical therapy to promote healing and prevent complications. In some cases, surgical intervention may be necessary if there is significant displacement or disruption of surrounding structures. Signup and view all the answers

Discuss the role of neurological assessment and mobilizing tips in the outpatient management of cervical fractures.

Neurological assessment helps to monitor for any changes in sensation, strength, or reflexes, indicating potential nerve damage or compression. Mobilizing tips focus on safe and gradual progression of movement to prevent complications and promote functional recovery in the outpatient setting. Signup and view all the answers

Outline the outpatient management approach for cervical fractures.

Outpatient management for cervical fractures involves close monitoring of symptoms, regular follow-up visits, appropriate pain management, and tailored rehabilitation programs to promote recovery and prevent long-term complications. Signup and view all the answers

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Study Notes

Spinal Fractures and Pelvic Fractures: Causes and Treatments

Increased kyphosis due to loss of height and affected columns
Posterior ligaments disruption criteria for surgery
Treatment for burst fractures depends on neurological involvement
Avulsion of transverse processes and treatment
Common causes and management of cervical fractures
Specific treatment for crush, spinous process, and fracture dislocation of Cx
Jefferson fracture and its treatment
Hangman's fracture and its treatment
Odontoid fracture and treatment options
Surgical interventions and physiotherapy for cervical fractures
Neurological assessment and mobilizing tips for cervical patients
Outpatient management for cervical fractures
Causes of pelvic fractures: fall from height, MVA, crushing injuries
Classification of pelvic fractures: avulsion, stable, and unstable
Treatment for avulsion fractures of pelvis
Differentiating stable and unstable pelvic fractures
Treatment for open book fracture of the pelvis

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