Red Flags

oz.dawjee
Mind Map by oz.dawjee, updated more than 1 year ago
oz.dawjee
Created by oz.dawjee about 6 years ago
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Description

Bachelors Degree in Physiotherapy Vertebral Manipulation Mind Map on Red Flags, created by oz.dawjee on 07/08/2014.

Resource summary

Red Flags
1 Cord
1.1 symptoms
1.1.1 gait disturbances
1.1.2 bilateral/quadrilateral/unilateral paraesthesia
1.1.3 bladder & bowel dysfunction
1.1.3.1 urinary & faecal incontinence, urinary retention
1.1.4 hyperreflexia may be present
1.2 signs
1.2.1 Babinski
1.2.1.1 normal-all toes plantarflex
1.2.1.2 abnormal-D/F big toe P/F other toes
1.2.2 Clonus
1.2.2.1 + response-intermittent contract & relax with sustained TA stretch
1.2.2.2 Gastrocs tested, knee straight
2 Cauda Equina
2.1 Symptoms
2.1.1 bladder/bowel sphincter weakness
2.1.1.1 urinary & faecal incontinenece, sexual dysfunction
2.2 Signs
2.2.1 Saddle anaesthesia/paraesthesia
2.2.2 Hyporeflexia
3 VBI
3.1 Symptoms
3.1.1 5 Ds
3.1.1.1 Dizzines
3.1.1.2 Diplopia-double vision
3.1.1.3 Drop attacks
3.1.1.4 Dysphagia-swallowing
3.1.1.5 dysarthria-speech
3.1.2 3 Ns
3.1.2.1 Nystagmus- rhythmical oscillations of the eyeballs
3.1.2.2 Nausea
3.1.2.3 Numbness- facial/ oral
3.2 Screening
3.3 Provocative testing
3.3.1 minimum test
3.3.1.1 end range Cx rotation to left & right
3.3.1.1.1 Maintain EROM position- 10 sec
3.3.1.1.1.1 10s held @ EROM left rotation- then to neutral 10s-observe
3.3.1.1.1.1.1 then other side
3.3.1.1.1.1.1.1 Hold @ EROM rotation 10s UNLESS symptoms reproduced sooner
3.3.1.1.1.1.1.1.1 looking for 5Ds & 3Ns
4 Special Questions
4.1 general health-DEARTHCO
4.2 Cord
4.3 Cauda/ Dizziness
4.4 Medication
4.5 steroids
4.6 unexplained weight loss
4.7 tests & investigations
4.8 night pain
5 severe pain in <25/>55
6 recent trauma- possible fractures
7 Constant pain- inflammatory/ malignancy
8 Contra-indications to mobilzations
8.1 Malignancy-vertebral column
8.2 Cord/ Cauda Equina signs/symptoms
8.3 active inflammatory & infective arthritis
8.4 diseases of the spinal cord
8.5 fracture
8.6 VBI
9 Thoracic pain-visceral pathology eg. cardiac
10 hx of malignancy- possible recurrence
11 prolonged corticosteroid use- decrease bone density
12 night pain-malignancy (esp. 3 hrs into sleep), inflammatory
13 night sweats/ fever-infection, TB
14 widespread neuro symptoms-multiple level neuro involvement
15 structural deformity-fracture
16 unexplained weight loss >10 % pts body weight under 6 months
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