UE 2

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  1. Pulmonary S/S
    • SOB
    • Cough
    • Fatigue
    • Elderly shoulder pain/ little off: PNA
  2. Gastrointestinal presented as Neck Pain
    • Esophagitis
    • Esophageal cancer
    • GERD, most common issue
    • ----But if have difficult swallowing then may have progressed to esophageal CA
    • ----Ask about changes in last week
  3. GI S/S
    • Increased HR/temp
    • ----Elevated temp if infection
    • For all pts
    • ----Should have some improvement in 3-4 sessions
    • ----Re-evaluate or refer out
  4. Infection presented as Neck Pain
    • Vertebral osteomyelitis
    • Meningitis
    • Lyme disease
    • Retropharyngeal abscess (post-steroid injection)
  5. Non-NMS Neck Pain
    • 1. Cervical lymphadenitis (inflammation of lymph nodes)
    • ----Due to active infection/CA
    • ----Pain in neck region that has nothing to do with how they move
    • ----ROM doesn’t change how they feel
    • 2. Rheumatoid
    • ----Other jt pain (smaller jts > larger jts)
    • ----Have upper cervical laxity
    • ----Manip contraindicated
    • 3. Osteoporosis
    • 4. Fibromyalgia
    • 5. Thyroid disease
    • ----Heat/cold intolerance, weight gain/loss
    • ----Graves disease
    • 6. Psychogenic
    • ----Chronic pain
    • ----We can help them but other factors have to be addressed
    • 7. Fracture
    • ----Just it is muscle skiel but we cant tx
    • ----Osteoporosis
    • ----Female, >70 /o, short stature
    • ----Traumatic onset
    • 8. Viral myalgias (muscle pain due to virus)
    • ----Fever
    • ----Other constitutional S/S
  6. Viscerogenic Thoracic Pain
    • Cancer
    • CV
    • Pulm
    • GI
    • Infection
    • Renal
  7. Cancer (Viscerogenic Thoracic Pain)
    • 1. Mediastinal tumors
    • ----Great risk to metastasize to the spine
    • 2. Metastatic extension
    • 3. Pancreatic cancer
    • 4. Breast cancer
    • 5. Multiple myeloma
    • ----Bone marrow cancer
    • ----High risk to effect the spine
  8. mediastinum
    • all the structures from the thoracic outlets to the diaphragm and btwn the lungs (lungs not part of mediastinum)
    • heart
    • great vessels
    • thymus gland
    • pericardium
    • CA can occur here and go into the spine
  9. Cardiovascular (Viscerogenic Thoracic Pain)
    • 1. Angina
    • ----Pain dissipates with cessation of activity (3-5 min after)
    • 2. MI
    • ----Elephant on chest (not stabbing pain on chest → anxiety)
    • 3. Aortic aneurysm
  10. Pulmonary (Viscerogenic Thoracic Pain)
    • 1. Chronic bronchitis
    • ----Inflammation of bronchi, productive cough
    • 2. Pleurisy
    • ----Has to do with infection
    • ----Inflammation of pleura
    • ----Unchanged with CPA
    • ----Increase pain in supine →Better sitting or leaning forward
    • ----Increased demand/ deep breathing
    • 3. Pneumothorax
    • ----Looks like pleurisy after puncture
    • ----Punch of chest cavity
    • ----Can be from broken rib
    • 4. Empyema
    • ----Pus filled area in lungs, has to do with constitutional S/S, has to due to infection
    • 5. Pneumonia
  11. Renal (Viscerogenic Thoracic Pain)
    • 1. Acute pyelonephritis
    • ----Deadly
    • ----Murphy’s percussion on kidney
    • ----Write IE/progress note to physician of negative findings
    • 2. Kidney disease
    • S/S based on
    • ----Electrolyte and water balance
    • ----One kidney can do it on its own so one kidney has to get really bad before you know there is something wrong
  12. Gastrointestinal (Viscerogenic Thoracic Pain)
    • 1. Severe esophagitis
    • ----Bc it is smooth striated muscle
    • ----Pain/ difficulty swallowing
    • 2. Esophageal spasm
    • 3. Gastric (1 hr after intake)/duodenal ulcers
    • ----Hurts more when they eat
    • ----Bc acid is released
    • ----If it hurts earlier on when eat then gastric
    • 4. Peptic ulcer
    • 5. Acute cholecystitis
    • ----Inflammation of gallbladder
    • ----Usually bc of disease
    • ----Can bc block
    • ----When eating high fat foods
    • 6. Pancreatic disease
    • ----Very unlikely
    • ----Pain in abdomen
    • 7. Biliary colic
    • ----Pain associated with block
    • ----“colic”
    • --------cyclic nature of pain
    • --------(regular occurrence after meal)
  13. Infection (Viscerogenic Thoracic Pain)
    • 1. Vertebral osteomyelitis
    • ----Signs of infection of constitutional symptoms
    • 2. Herpes zoster
    • 3. HIV
    • 4. Epidural abscess
  14. Infections occur in these populations
    • 1. Immunocompromised
    • 2. Recent surgery
    • 3. Suffering from alcoholism
    • 4. IV drug users
Author
ID
320932
Card Set
UE 2
Description
UE 2
Updated
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