Lumbar Spine Assessment Flashcards

1
Q

Fryette’s law

A
  1. in neutral SB opposite to rotation
  2. In felxion/extension SB same side as rotation
  3. movement in 1 plane decreases movement in others
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2
Q

type 1 dysfunction

A

found in neutral position
multi segment >3
adaptive : repetitive mvt, imbalances, tightness
corrected in both flex or ext

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3
Q

type 2 dysfunction

A

1 segment
traumatic
likes flex FRS
likes ext ERS
corrected in what they like

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4
Q

facet info with law 1 and 2

A

same facet as side bend is closed

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5
Q

how common is low back pain

A

80%

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6
Q

what can influence the onset of LBP

A

environmental and personal factors
psychosocial causes

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7
Q

risk factors for LBP (psychosocial) (6)

A

low educational status
stress
anxiety
depression
job dissatisfaction
low levels of social support in the workplace

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8
Q

most common form of back pain

A

non-specific

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9
Q

several structures can be the cause of the pain

A

true

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10
Q

history taking for LBP should include

A

questions on substance exposure
detailed health history
work
habits
psychosocial factors

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11
Q

is it recommended to do imaging within the first 6 weeks

A

no unless red flags

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12
Q

Lumbar spine pathologies

A

Stenosis
spondylosis
spondylolisis
ankylosing spondylitis
biomechanical restrictions

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13
Q

stenosis

A

narrowing of vertebral space
Better with flexion

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14
Q

spondylosis (DDD)

A

begins in 20’s
overall OA and stenosis
age related wear and tear

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15
Q

spondylolisis

A

90% at L5/S1
excessive lordosis
posturale ache
tight psoas and hamstrings
stress fx or complete fx

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16
Q

ankylosing spondylitis

A

inflammatory disorder of spine
morning stiffness
pain with exercise
leading to decrease vertebral movement, bones of spine can fuse

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17
Q

radicular pain

A

evoked from inflamed or lesioned dorsal root or its ganglion

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18
Q

radicular pain location

A

often back to butt down legs

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19
Q

most common cause of radicular pain

A

disc herniation

20
Q

radiculopathy

A

impairs the conduction down a spinal nerve or its root

21
Q

radiculopathy affects

A

sensory changes, motor fibers, and possible reflexes

22
Q

can radicular pain occur without radiculopathy

A

yes

23
Q

most common disc pathology

A

posterior disc herniation

24
Q

Facet joints

A

large amount of free and encapsulated nerve endings that activate nociceptive fibers
Can be a cause of CLBP

25
Q

facet joint syndrome

A

responsible for up to 30% of chronic low back pain

26
Q

common complaints of facet joint syndrome

A

pain off to the side
possible radicular symptoms
pain increased with extension, rotation and SB and walking uphill
worse when waking up or sitting for long periods

27
Q

cause of stenosis

A

inflammatory/scar tissue after spine surgery
disc herniation
thickening of ligaments
osteophytes

28
Q

common S/S of stenosis

A

midline back pain
radiculopathy
eased with flexion sitting lying
worse standing lumbar extension

29
Q

what can increase risk of DDD

A

diabetes

30
Q

S/S of spondylosis

A

general neck pain and stiffness
can be associated with radiculopathy

31
Q

spondylolisthesis

A

anterior translation of the vertebral body relative to the other, and secondary to an abnormality of the pars interarticularis

32
Q

chief complaints of spondylolisthesis

A

can be asymptomatic
gradual onset that is worsened with activity involving hyperextension or rotation of L/S
radiculopathy can occur

33
Q

spondylolisthesis can affect load sharing

A

inc shearing forces
higher sacral slope, pelvic tilt
inc pressure on discs, facet joints, leading to DD
muscle spasm of ES to protect

34
Q

differential diagnosis

A
35
Q

how do postural muscles react to injury

A

tightness in the form of spasms or adaptive shortening

36
Q

how do phasic muscles react to injury

A

atrophy

37
Q

difficulty sitting associated with

A

lumbar instability or muscle spasm

38
Q

discogenic pain

A

flexion for extended periods of time

39
Q

special tests for L/S (11)

A

SLR (1-5)
Slump
corssover sign/well leg raise (SLR 5)
PKB
valsalva
quadrant test
stork
mckenzie side glide
pheasant
passive lumbar extension
H and I

40
Q

Pain in back with SLR

A

most likely from disc herniation

41
Q

pain in leg with SLR

A

pathology causing pressure on neurological tissues more laterally

42
Q

SLR 1 nerve

A

sciatic and tibial

43
Q

SLR 2 nerve

A

tibial

44
Q

SLR 3 nerve

A

sural

45
Q

SLR4 nerve

A

common peroneal

46
Q

SLR 5 nerve

A

nerve root