2B Flashcards

(42 cards)

1
Q

What is the chance of someone experiencing LBP in their lifetime

A

90%

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2
Q

T or F: There are NO strong risk factors to predict outcomes of effective treatments for LBP

A

T

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3
Q

T or F: Presence of radiating pain is always a higher amount of complexity when it comes to treating LBP

A

T

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4
Q

When should a patient with LBP immedialely be referred to a PT

A

When positions, postures, activities, movements increase or decrease the patients symptoms or produce sciatica

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5
Q

If a patient has evidence of a serious, systemic problem, drop foot, loss of B&B function, areflexia, hyperreflexia, unexplained weight loss, or a psychosomatic component….

who does the patient need to go see?

A

Refer to specialist before PT

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6
Q

what does boney pain feel like in the back?

what does nerve pain feel like in the back?

A

Deep ache/ boring pressure \

sharp, knife-like, shooting, burning, tingling, numbness, weakness

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7
Q

what age range is most affected by spondylolithesis?

what age range is most affected by disc herniation/dysfunction

A

10-20

15-40

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8
Q

At what age range are people susceptible to cancer, compression fx, stensis, or AAA

at what age range are people susceptible to OA/Spondylosis

A

65+

45+

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9
Q

what is an important question to ask patients regarding their pain, when it comes to making goals

A

What is the impact of the symptoms, what is the pain preventing them from doing

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10
Q

The presence of serious pathologies in patients with LBP is ____________

how many LBP patients present with atleast 1 red flag?

A

Low

80%

Examine findings for consistent patterns and multiple red flags

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11
Q

What is the ultimate goal of therapy for patients with LBP

A

Self managment

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12
Q

How is piriformis syndrome commonly diagnosed

what test will come back positive for patients with piriformis syndrome

A

Dx of exclusion

+ SLR test

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13
Q

Spondylolysis is a defect in ________________ , usually asymptomatic

Typically occurs at ___ vertebrae

patients prefer what position

A

par interarticularis

L5

flexion over extension

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14
Q

What is spondylolisthesis?

How is it graded?

A

Fx of pars interarticularis and slip of the vertebrae forward. Leads to instability

grade 1: 1-25% slip
grade 2: 26-50%
Grade 3: 51-75%
grade 4: 76-100%
grade 5: over 100% slippage

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15
Q

When is surgical intervention indicated for spondylolisthesis

A

when conservative managment has failed

when patient has progressive neurological symptoms

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16
Q

What parts of the vertebrae/disc are most susceptible to compression injury

A
  1. End Plate
  2. vertebral body
  3. Disc
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17
Q

Disc Protrusion:

Prolapse:

Extrusion:

Sequestration:

A

Disc Protrusion: disc buldge w/o AF rupture

Prolapse: only outer layer of AF contains the NP

Extrusion: AF has now perforated the NP and moved into epidural space

Sequestration: disc fragments have escaped the AF and are broken off into the epidural space

18
Q

How does an End plate fx present?

SLR test?

Compression Test?

A

Trauma/speicifc MOI

Acute pain/spasm

Negative SLR test

positive compression test

19
Q

Will an internal disc disruption have a positive or negative SLR test?

20
Q

Disc protrusion/prolapse (contained) will present how?

SLR test?

A

Some AF and PLL are intact

LBP referred to hip/upper leg

pain w/ cough and sneeze

negative SLR

21
Q

Disc Extrusion and sequestration (uncontained) will present how?

A

LBP

Pain w/ cough and sneeze

true sciatia (radicular pain)

POSITIVE SLR

22
Q

a disc pathology at L3-L4 will compress what nerve?

23
Q

A disc pathology at L4-L5 will compress what nerve?

24
Q

Facet joint _______mobility is more common

25
Loss of normal passive restraints Inconsistent symptoms Positive prone instability test reports of catching/locking of back
Instability
26
In what population is anklyosing spondylitis most common?
Males 30+ 90-95% of pts have human leukocyte antigen B27
27
What is the most common kind of scoliosis?
Idiopathic scoliosis
28
How is fibromyalgia diagnosed?
11 out of 18 total tender points w/o reason for tenderness
29
Should you treat a patient w/ herpes zoster
Halt PT until rash is no longer contageous
30
What are the 6 ICF lowback pain categories
Acute/subacute LBP w/ mobility decifits Acute, Sub-acute, chronic LBP w/ movement coordination deficit Acute LBP w/ related (referred) LE pain Acute/ Subacute/ chronic LBP w/ radiating pain Acute/Subacute LBP w/ Related cognitive or affective tendencies Chronic LBP w/ related generalized pain
31
Impaired functional movements Segmental Hypomobility Pain in back/buttock/groin/thigh negative neuro tests onset of symptoms less than 3 months
Acute or subacute LBP w/ mobility deficits
32
Segmental/global instabilities Pain in back/buttock/groin/thigh decreased NM control Muscle weakness Impaired activity tolerance and functional movements positive prone segmental instability test
Acute/subacute/chronic LBP w/ movement coordination impairments
33
Significant pain in back/butock/groin/thigh segmental or global hypomobility postural deficit decreased activity tolerance and impaired functional movements onset of symptoms under 3 days ago POSITIVE repeated movement test
Acute LBP w/ related (referred) LE pain
34
Segmental hypomobility/instability Radiating pain in dermatomal pattery muscle weakness decreased activity tolerance and functional movements Positive neuro exam Positive neurodynamic testing Positive repeated movement test
Acute/Subacute/chronic LBP w/ radiating pain
35
Sensitivity to noxious stimuli Pain in leg/buttock/groin/back/lower leg High score on FABQ decreased activity tolerance impaired functional movements inconsistent MSK exam Onset of symptoms less than 3 months Positive Waddell's test
Acute or subacute LBP w/ related cognitive or affective tendencies
36
Generalized pain changes in brain and sensory structure high score on FABQ Decreased activity tolerance Inconsistent MSK findings Onset of symptoms over 3 months
Chronic LBP w/ generalized pain
37
Manual Therapy Classification Criteria Anatomical location of symptoms: Duration: Score on FABQ: Results of mobility test: Hip Internal Rotation:
No sx distal to knee Less than 16 days Score of less than 19 Atleast 1 hypomobile joint Hip Int rotation over 35 in atleast 1 hip
38
Stabilizaton criteria: Age: Flexibility: Movements in lumbar: Lumbar instability test: Patients who are..........
Younger age: <40 Greater flexibility SLR over 91 Abberant movements: Instability catch Positive Prone Instability test Post-Partum with posterior pelvic pain provacation, ASLR, modified trendelenberg test Pain W/ palpation along long dorsal SI ligament or pubic symphysis
39
Patients with a lateral shift are typically also restricted into __________
extension
40
Extension criteria patient Anatomical location:
Distal to buttock
41
Flexion preference patient classification: Age: Imaging evidence of:
Over 50 Lumbar Spinal Stenosis
42
When patients classify for more than 1 type of treament group, how should we decide the treatment
Prioritize order based on: level of risk, psychosocial factors, comorbidities Presence of psychosocial factors and comorbidities weaken treatment effects