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OS III Midterm > DSA Back pain > Flashcards

DSA Back pain Flashcards

1
Q

What are 2 protective factors low back pain?

A
  1. Regular excercise

2. education

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2
Q

What are 3 risk factors for low back pain?

A
  1. lifting
  2. smoking
  3. depression
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3
Q

What is the most common cause of back pain?

A

Mechanical (90%)

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4
Q

2 % of low back pain is due to ?

A

visceral etiologies (GI organs, abdominal aorta , renal , endometriosis)

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5
Q

1 % of low back pain is due to ?

A

nonmechanical etiologies ( neoplasms. infection, inflammatory)

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6
Q

Strain of which 3 back muscles contributes to lower back pain?

A
  1. paraspinals (multiifidus / rotatores)
  2. erector spinae
  3. quadratus lumborum
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7
Q

Injury to what 2 ligament contributes to low back pain?

A
  1. iliolumbar

2. sacroiliac

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8
Q

Aching/ burining pain in gluteal region, paresthesia down posterior thigh is ________?

A

Piriformis syndrome

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9
Q

What makes the pain worse in piriformis syndrome?

A

sitting

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10
Q

What test is used to Dx piriformis syndrome?

A

FAIR test. (lie lateral recumbent, flex, adduct. internal rotation)

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11
Q

Patient with pain at thoracolumbar junction or hip pain at the insertion tendon is ?

A

psoas syndrome

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12
Q

Psoas syndrome is made worse by?

A

lumbar extension

standing straight

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13
Q

What tests are used to dx psoas syndrome?

A
  1. Thomas test

2. Pelvic Shift

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14
Q

A Patient with psoas syndrome on the left will have a _____ sided pelvic shift test?

A

RIGHT (it is opposite the dysfunction

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15
Q

If patients pelvis translates easy to the left they have a ______ sided. psoas syndrome/?

A

RIGHT

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16
Q

Short leg syndrome is due to ?

A

sacral base unleveling

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17
Q

Pt with scoliosis may be at increased risk for _____?

A

Short leg syndrome

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18
Q

Short leg syndrome pain is made worse by?

A

activity or walking

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19
Q

What test for short leg syndrome?

A

pelvic side shift. (does not resolve with manipulation)

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20
Q

A left anatomic short leg will have a ______ pelvic side shift test)

A

RIGHT

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21
Q

A flexible pt with short leg syndrome you will treat by adding ______‘inches every two weeks

A

1/8

22
Q

A fragile pt with short leg syndrome you will treat by adding ______ inches every two weeks

A

1/16

23
Q

If pt loses height right after surgery how should you approach treatment?

A

replace the full length immediately , you dont need to do increments

24
Q

bending forward, sneezing, coughing, can excacerbate someone who has?

A

Degenerative disc disease

25
Q

Discogenic pain is characteristic for?

A

Degenerative disc disease

26
Q

Defect or stress fracture of pars interarticularis?

A

spondylolysis

27
Q

Pain pattern for spondylolysis?

A

pain most common at L5

28
Q

Who is at increased risk for sponylolysis?

A

young athletes ( repetitive stress/ developing bones)

29
Q

What makes the spondylolysis pain worse?

A

hyperextension (posterior stress)

30
Q

Posterior stress makes ______ worse , Anterior stress makes _______ worse?

A

Spondylolysis, Degenerative disc disease

31
Q

Scotty dog finding on lumbar Xray?

A

spondylolysis

32
Q

Anterior displacement of vertebrae secondary to bilarteral pars defects?

A

Spondylolistheisis

33
Q

What are 2 things that increase risk for Spondylolistheisis?

A
  1. Age (osteoarthritis)

2. bilateral spondylolysis

34
Q

What makes the pain worse in Spondylolistheisis?

A

extension and activity

35
Q

How do you dx Spondylolistheisis?

A

palpable step off on PE

36
Q

What increases risk of compression fracture?

A

age <55
osteoporosis
menopause
malignancy (cancer)

37
Q

WHat makes a compression fracture pain worse?

A

sitting
spine extension
valsalva maneuveur

38
Q

Someone that presents with acute ATRAUMATIC PAIN, likely has ?

A

compression fracture

39
Q

Narrowing of the neural foramen or central canal?

A

spinal stenosis

40
Q

Unilateral numbeness of which nerve roots in spinal stenosis?

A

L4/L5/S1

41
Q

Standing/ walking make spinal stenosis ________, (better/worse) and sitting/lying down makes it _________

A

Worse, better

42
Q

Shopping cart sign is indicative of ?

A

spinal stenosis

43
Q

compression of nerve roots due to herniation of nucleous pulposis through annulus fibrosis?

A

Herniated disc

44
Q

Most common lumbar discs involved?

A

L4/L5 (L5 nerve roots

L5/S1 (S1 nerve roots)

45
Q

What motion makes herniated disc worse?

A

flexion

46
Q

CAuda equine is due to a ?

A

disc herniation

47
Q

What is the pain pattern of cauda equina?

A
  1. saddle anesthesia
  2. fecal / urinary incontinence
  3. numbness /tingling
48
Q

What increases risk of cauda equina?

A

TRAUMA

49
Q

When should you order imaging for low back pain?

A
  1. progressive neurologic deficit
  2. saddle anesthesia
  3. deep bone pain (neoplasms)
  4. fever/ chills (osteomylitis)
50
Q

What conditions make up Greenmans Dirty HalF dozen?

A
  1. Muscle imbalance- 100%
  2. lumbar spine type 2 -84%
  3. pubic symphisis dysfunction -75%
  4. short leg- 63%
  5. sacral extension- 48%
  6. innominate shear- 24%

OS III Midterm (6 decks)

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