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Flashcards in low back Deck (33):
1

Lumbar nerve roots exit above or below the vertebra

below

(Transition zone at C8 is where it changes from above to below)

2

what cancers are most likely to met to the spine?

lung, breast, GI, prostate

3

DDx for back pain that has nothing to do with the spine or it's structures

UTI, gallstone/kidney stone, pregnancy, AAA

4

Physical Exam:

inspection, palpation, ROM, strength, sensation, reflexes, special tests

5

what nerve: hip flexion

L2

6

what nerve: knee extension

L4

7

ankle dorsiflexion

L5

8

great toe flexion

L5, S1

9

great toe extensor

L5

10

knee flexor

L5, S1

11

plantar flexors

S1, S2

12

dermatome for medial malleolus

L4

13

dermatome for base of 2nd toe

L5

14

dermatome for base of 5th toe

S1

15

patellar reflex

L4

16

Achilles reflex

S1

17

Hamstring contraction

L5

18

This special test elicits low back pain when a leg is flexed by 30-70 degrees, often pain is worse when foot is passively dorsiflexed

strait leg raise

19

what would a positive strait leg raise test indicate?

sciatic nerve impingement, typically from disc herniation at L5

20

Pathological state of the spine (ex: arthritis)

Spondylosis

21

Fracture of the pars interarticularis

spondylolysis

22

slipping of one vertebrae over another

spondylolisthesis

23

What are the possible causes of "lumbar strain"

muscle, ligament, arthritic joint, disc problem

24

How long should a patient expect to wait before lumbar strain symptoms start to resolve?

2 weeks

25

5 ways to treat back pain

SLIME
sx, lifestyle, injections, meds, exercise

26

The _______test is done by having pt hyperextend the spine and rotate. If this reproduces pain, the pt likely has a problem with __________

Stork test, problem with facet joint or posterior spine

27

spondylolysis is most common in young (developing) athletes who repetitively hyperextend the spine, causing a fatigue fracture of the __________

pars interarticularis

28

What are you worried about in patients with spondylolisthesis?

nerve compression

29

what is one of the most common signs of disc herniation that is impinging on L5?

foot drop

30

Your patient has fallen and comes in complaining of feeling wobbly on her legs. She has not been able to urinate since the fall. What is the first thing you should do?

Perform DRE, anal sphincter will be lax (S1-S3) if there is compression of the cauda equina. Surgical decompression emergency. Do this prior to MRI

31

What does a positive grocery cart sign indicate?

Neurogenic claudication = spinal stenosis

32

What position exacerbates spinal stenosis?

spinal extension

33

When would you consider treating SS surgically? And what is the sx option?

If red flag s/s develop, consider decompression with laminectomy