10- low back pain Flashcards

Question

what is indicative of "tripod sign" in straight leg test? ( leaning backward and supporting himself with his outstretched arms on the exam table.)

Answer 1

structural disease test is positive if pain radiates down the posterior/lateral thigh past the knee. This radiation indicates stretching of the nerve roots (specifically S1 or L5) over a herniated disc.

Answer 2

abdominal: auscultate (aneuryms) and palpate for tenderness Passive Straight Leg Raise cross leg raise test FABER muscle atrophy

Answer 3

raise the leg to the point of pain, lower slightly, then dorsiflex the foot. If there is no pain with dorsiflexion, the patient's hamstrings are tight.

Answer 4

malingering! no disc herniation

Answer 5

asymptomatic leg is raised Test is positive if pain is increased in the contralateral leg; this correlates with the degree of disc herniation. Such results imply a large central herniation. Cross SLR test is much less sensitive (0.25) but is highly specific (about 0.90). Thus, a negative test is nonspecific, but a positive test is virtually diagnostic of disc herniation.

Answer 6

Flexion, Abduction, and External Rotation looks for pathology of the hip joint or sacrum flexing the hip and placing the foot of the tested leg on the opposite knee. Pressure is then placed on the tested knee while stabilizing the opposite hip. The test is positive if there is pain at the hip or sacral joint or if the leg cannot lower to the point of being parallel to the opposite leg from pathology of the hip, sacrum or sacroiliac joint.

Answer 7

exacerbation when sitting or bending; and relief while lying or standing. increased pain with coughing and sneezing pain radiating down the leg and sometimes the foot paresthesias muscle weakness, such as foot drop

Answer 8

cauda equina syn

Answer 9

typically self-limited and usually resolves in two to four weeks,

Answer 10

urinary retention Saddle anesthesia Anal sphincter tone decreased or fecal incontinence Bilateral lower extremity weakness or numbness Progressive neurologic deficits

Answer 11

Major muscle weakness (strength 3 of 5 or less) | Foot drop

Answer 12

``` Prolonged use of corticosteroids Mild trauma over age 50 years Age greater than 70 years History of osteoporosis Recent significant trauma at any age Previous vertebral fracture ```

Answer 13

``` Persistent fever (temperature over 100.4 F) History of intravenous drug abuse Recent bacterial infection, particularly bacteremia (UTI, cellulitis, pneumonia) Immunocompromised states (chronic steroid use, diabetes, HIV) ```

Answer 14

``` History of cancer Unexplained weight loss >10 kg within 6 months Age over 50 years or under 17 years old Failure to improve with therapy Pain persists for more than 4 to 6 weeks Night pain or pain at rest ```

Answer 15

if tumor or infection is suspected.

Answer 16

``` History of trauma Strenuous lifting in patient with osteoporosis Prolonged steroid use Osteoporosis Age <20 and >70 History of cancer Fever/chills/weight loss Pain worse when supine or severe at night Spinal fracture, tumor, or infection ```

Answer 17

Worsening or unremitting neurologic deficit or radiculopathy Progressive major motor weakness Cauda equina compression (sudden bowel/bladder disturbance) Suspected systemic disorder (metastatic or infectious disease) Failed six weeks of conservative care not associated with clinical benefit

Answer 18

nerve conduction studies can be used in the evaluation of patients with radicular pain and lumbar spinal stenosis. confirm the existence of radiculopathy (level of nerve involvement)

Answer 19

Meds: Aspirin/NSAID and/or muscle relaxants heat/cold Activity: stay active or PT

Answer 20

A. Surgery B. It has only been five weeks, continue with current treatment C. Acupuncture

Answer 21

lumbosacral sprain/strain.

10- low back pain Flashcards

(46 cards)