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Flashcards in Low Back Exam Deck (49):
1

What are the goals of a PE?

1. Determine the symptoms do not represent life or function threatening

2. Where pain is coming from

2

What are the four causes of LBP?

1. Referred pain
2. Activity related pain
3. Non-activity related
4. Psych

3

What is lumbago?

LBP

4

What is sciatica?

Pain in the lower back and hip, radiating down the thigh and into the leg. Is a descriptive term for a distribution of pain, not a diagnosis.

5

What is the cause of sciatic nerve neuropathy?

Piriformis tightness

6

Foot and ankle paresthesias = ?

Peroneal neuropathy

7

What causes a leg radiculopathy?

L5/S1 nerve compression by herniated disc

8

SI joint ligament pattern can cause what?

Sciatica

9

Steadily increasing back pain, especially in the elderly, could suggest what?

Malignancy

10

Continuous pain, not altered by posture or movement is suspicious for what?

Renal stones
Psychogenic causes

11

True or false: isolated pain in the upper lumbar region is generally not concerning

false--could be AAA

12

What is spondylolysis?

Breakage of a vertebral segment

(scottie dog)

13

Scottie dog appearance on x-ray = ?

spondylolysis

14

Why is coughing or sneezing that worsens back pain concerning?

Increased abdominal pressure leads to pressure on the spine

15

Back pain with lying down or wakes up at night (not relieved by turning over) is concerning for what?

Bone CA

16

Why is asking about function important with LBP?

See how bad it really is
Assess what needs to be done

17

Pt failing to improve is suspicious for what?

Psychosocial issues

18

Heel and toe walking assess what?

L5/S1 nerves

19

What does the Adam's forward bending test check for?

Scoliosis

20

Flexion of the spine loads the anterior or posterior parts of the spine?

Anterior

21

Extension of the spine loads the anterior or posterior parts of the spine?

Posterior

22

Flexion of the spine stretches the anterior or posterior parts of the spine?

Posterior

23

Extension of the spine stretches the anterior or posterior parts of the spine?

Anterior

24

What does side-bending spine load?

The facets of either sides, closing the neural foramen

25

What does ROM of the spine check for?

Non specific muscles

26

What is the capsular pattern for the lumbar spine?

limited ROM in all directions

27

What does capsular pain indicate?

Capsule inflammation/irritation

28

Toe walking = which nerve root?

S1, S2

29

Heel walking = which nerve root?

L4, L5

30

Single leg calf raises checks for what nerve levels?

S1, S2

31

Weakness or inability to perform heel/toe walking without an explanable condition =?

Acute plantar fasciitis

32

Why is fixation of the back in lordosis with flexion of the lumbar spine concerning?

may indicate fusion of the spine, like ankylosing spondylitis

33

What does the slump test check for?

Dural tension for the sciatic nerve root

34

True or false: when looking at reflexes we need to look for only the maximal response

False--one that is most reproducible (and maximal)

35

What if LE MSR are brisk?

Look at UE reflexes to localize the issue

36

True or false: symmetric absence of Achilles is increasingly common with age

True

37

When are reflexes/sensory signs particularly concerning?

Asymmetry

38

What does the FABER test check for?

SI joint pain

39

What are the positive signs for the FABER test?

Anterolateral hip region (hip path)
Posterior (sacroiliac) pain

40

SLR tests for what?

L4, L5, or S1 nerve root irritation vs hamstring pain

41

Positive SLR is what?

Pain that goes down the back of the leg and into the foot/ankle

42

What is Bragard's test?

Dorsiflex the foot in SLR. Confirms positive or ambiguous SLR

43

SLR is a sign of what?

Dural tension/pulling on sciatic nerve roots

44

How can you quickly assess for claudication?

check peripheral pulses

45

What is the buttock sign?

hip flexion more painful than SLR

46

Femoral nerve stress test is what?

Positive is what?

Checks for femoral nerve irritation (L2, L3, or L4)

Positive = pain or paresthesias along anterior/medial leg

47

False positives with femoral nerve stress test is what?

Axial spine pain d/t facet joints

OA of the hip

48

Step-off signs along the spine indicates what?

Spondylolisthesis

49

What are the 4 causes of activity related pain?

-Discogenic pain
-Facet joint pain
-Stenotic pain
-Arthritic pain