Flashcards in low back Deck (33):
Lumbar nerve roots exit above or below the vertebra
(Transition zone at C8 is where it changes from above to below)
what cancers are most likely to met to the spine?
lung, breast, GI, prostate
DDx for back pain that has nothing to do with the spine or it's structures
UTI, gallstone/kidney stone, pregnancy, AAA
inspection, palpation, ROM, strength, sensation, reflexes, special tests
what nerve: hip flexion
what nerve: knee extension
great toe flexion
great toe extensor
dermatome for medial malleolus
dermatome for base of 2nd toe
dermatome for base of 5th toe
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
what would a positive strait leg raise test indicate?
sciatic nerve impingement, typically from disc herniation at L5
Pathological state of the spine (ex: arthritis)
Fracture of the pars interarticularis
slipping of one vertebrae over another
What are the possible causes of "lumbar strain"
muscle, ligament, arthritic joint, disc problem
How long should a patient expect to wait before lumbar strain symptoms start to resolve?
5 ways to treat back pain
sx, lifestyle, injections, meds, exercise
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
spondylolysis is most common in young (developing) athletes who repetitively hyperextend the spine, causing a fatigue fracture of the __________
What are you worried about in patients with spondylolisthesis?
what is one of the most common signs of disc herniation that is impinging on L5?
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
What does a positive grocery cart sign indicate?
Neurogenic claudication = spinal stenosis
What position exacerbates spinal stenosis?