I always work hard session 2

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I always work hard session 2 by Mind Map: I always work hard session 2

1. Step 6

1.1. Review session 1

1.1.1. Summary of step 5

1.2. Report new knowledge

1.2.1. Anatomy of the lower back Sacral and lumber vertebral column Lumber and sacral plexuses

1.2.2. Common injuries in labors

1.2.3. Mechanism and diagnosis of disk herniation how can it cause sciatic nerve injury picture

2. Step 7

2.1. Inquiry plan and info gathering

2.1.1. Chief complaint Male working in lifting came to the hospital limping because of a back pain after lifting a box, the pain is radiated to the leg and foot. age? middle age man

2.1.2. History of presenting complain SOCRATES Site Onset Characteristic Radiation Associated symptoms Timing Exacerbation / alleviation Severity

2.1.3. Previous medical / surgical history a bit of bad back as long as he remembers no previous surgeries no cancer twisting and stumbling to one side while unloading a truck

2.1.4. Drug history / allergy took pain killers "parasitamol" not allergic to drugs

2.1.5. Family history no chronic dieseases in the family

2.1.6. Social / occupational history been working for many years has a distress , not satisfide with work no drug abuse no smoking or drinking

2.1.7. Systemic review No problems in urinating No wight loss No fever No morning stiffness

2.1.8. Physical examination vital signs are normal BMI is not known Looks depresses inspection loss of lumber lordosis no swellings no redness no atrophy no scars gait palpation mild tenderness wormth Range of motion in the lumberspine Knee and hip are normal Special tests straight leg neurological examination L5 S1

2.1.9. tests results MRI Sagittal Axial Coronal

3. Step 8

3.1. Diagnostic decision

3.1.1. large L5 / S1 disc prolapse (disk herniation)

3.2. Mechanism

3.2.1. nature of the work

3.2.2. herniation that irritates the nerve roots

3.2.3. depressing

3.2.4. aging

3.2.5. long duration of work

3.2.6. the twisting

3.3. Presentation

3.3.1. Back pain

3.3.2. pain in the posterior thigh, shooting threw the leg (sciatica)

3.3.3. loss of sensation of lateral foot

3.3.4. limping

3.4. Supporting data

3.4.1. MRI shows strong herniation

3.4.2. positive straight leg test