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Spring 2022 classes > lower extremity spine > Flashcards

lower extremity spine Flashcards

1
Q

what history ? is especially important for
LBP?

A

numbness + tingling b/c could be serious or permanent

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2
Q

what muscles contribute to muscle tone of spine

A

paraspinals

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3
Q

what may cause scoliosis

A

neuromuscular dysfunction, congenital, idiopathic

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4
Q

kyphosis def

A

posterior curve

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5
Q

kyphosis causes

A

congenital, muscle imbalance, osteoporosis

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6
Q

lordosis def

A

excessive anterior curve

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7
Q

lordosis causes

A

congenital factors, muscle imbalance

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8
Q

cafe au lait macules def

A

spots or darkened area of skin pigmentation, may be collagen disease

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9
Q

faun’s beard def

A

tuft of hair that indicates spina bifida

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10
Q

what does congenital malformation of faun’s beard result in

A

incomplete closure of spinal vertebrae

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11
Q

how many lumbar vertebrae are there

A

5

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12
Q

lumbarization def

A

first sacral verebrae doesn’t unite w/ sacrum, leads to L6

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13
Q

sacralization def

A

when 5th lumbar vertebra becomes fused to sacrum and appears to be only 4 lumbar vertebrae

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14
Q

when someone says they threw their back out what does that usually mean

A

sprain a ligament of the back

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15
Q

intervertebral disc outer potion

A

annulus fibrosis

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16
Q

intervertebral disc inner portion

A

nucleus pulposus

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17
Q

annulus fibrosis composition

A

multilayered, thin posteriorly

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18
Q

nucleus pulposus composition

A

mostly made of water, very elastic

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19
Q

how many intervertebral discs are there

A

23

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20
Q

muscles involved with flexion of spine

A

rectus abdominis, external oblique, internal oblique

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21
Q

muscles involved with extension of spine

A

illiocostals, longissimus, spinalis, quadratus lumborum, semispinalis, rotatores, multifidi, interspinalis

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22
Q

which side of the muscles are involved with flexion and extension to that side

A

the same side ex) lateral flexion to right side uses right side of muscles

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23
Q

which side of muscles are used for rotation to the right

A

right side of muscles with the exception of left internal oblique

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24
Q

which side of muscles are used for rotation to the left

A

left side of muscles with the exception of right internal oblique

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25
Q

T12-L5 innervates what muscles

A

LUMBAR: anterior and medial muscles of thigh, medial leg, foot

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26
Q

L2-L4 posterior branches form what nerve

A

femoral nerve

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27
Q

L2-L4 anterior branches form what nerve

A

obturator

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28
Q

sacral plexus innervates what muscles

A

buttocks, posterior femur, lower leg

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29
Q

why are lumbar region reflexes so important

A

check bilaterally b/c a nerve could be compressed and cause major problems

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30
Q

what indicates scoliosis during a test

A

asymmetrical hump observed along the lateral aspect of the thoracolumbar spine and rib cage

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31
Q

should patient be sitting or standing for scoliosis test

A

standing and bend forward

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32
Q

valsalva maneuver test set up

A

patient seated, hold deep breath while bearing down to increase intrathecal pressure

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33
Q

+ valsalva maneuver test

A

increased spinal or radicular pain

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34
Q

what does + valsalva maneuver test indicate

A

herniated disc or other space occupying lesion

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35
Q

hoover test set up

A

patient supine, AT cup the heels of patient as their legs are extended

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36
Q

hoover test perform

A

straight leg raise as AT cups heels

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37
Q

hoover test +

A

lack of downward pressure felt in the opposite hand during the SLR

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38
Q

hoover test indicates

A

malingering patient

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39
Q

SLR set up

A

supine, one hand under the heel when the other is on the anterior knee to ensure full extension

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40
Q

+ SLR test

A

radiating pain in the involved leg

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41
Q

when are findings of SLR test highly significant

A

if elicited less than 30 deg hip flexion

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42
Q

what does + SLR test indicate

A

sciatic nerve compression/irritation

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43
Q

well SLR indicates

A

pain experienced on opposite side being raised= herniated disc or space occupying lesion

44
Q

brudzinskis test set up

A

supine, SLR with cervical flexion

45
Q

+ brudzinskis test

A

pain or radicular symptoms relieved w/ knee flexion

46
Q

+ brudzinskis test indicates

A

disc herniation

47
Q

milgram test set up

A

supine, perform bilateral SLR 2-6 inches above table and hold for 30 sec

48
Q

+ milgram test

A

can’t hold position or experiences pain

49
Q

why is milgram test bad

A

could mean disc herniation or could just mean weak core muscles

50
Q

slump test set up

A

pt end of table and slumps forward will keeping spine neutral, knees extended and ankle dorsiflexed

51
Q

+ slump test

A

sciatic pain or reproduction of neurological symptoms

52
Q

tension sign test set up

A

supine with hip and knee flexed 90 deg

53
Q

+ tension sign test

A

tender with possible sciatic symptoms

54
Q

+ tension sign test indicates

A

sciatic nerve irritation

55
Q

quadrant test set up

A

feet shoulder width apart, patient extends spine and side bends and rotates to the affected side

56
Q

+ quadrant test

A

reproduction of symptoms

57
Q

radicular symptoms after quadrant test indicate

A

nerve root compression, facet joint pathology, SI joint dysfunction

58
Q

single leg stance test/standing stork test set up

A

patient standing, instruct patient to lift one leg and hyperextended the trunk

59
Q

+ single leg stance test

A

pain in lumbar spine or SI area

60
Q

+ single leg stance test indicates

A

a spondy

61
Q

bilateral pars fractures result in pain when either leg is lifted for which special test

A

single leg stance

62
Q

long sit/supine sit test set up

A

supine, grasp malleoli and ask patient to perform glute bridge

63
Q

long sit/supine test +

A

involved leg goes from longer/shorter when supine to shorter/longer when sitting after glute bridge

64
Q

+ long sit/supine test indicates

A

SI joint dysfunction

65
Q

FABER test set up

A

patient supine with foot of involved side crossed over opposite thigh, place one hand on ASIS and the other on medial aspect of the flexed knee

66
Q

+ FABER test

A

reproduction of symptoms in SI joint

67
Q

gaenslen test set up

A

patient lying close to side of table and instruct to pull knee to chest, AT applies pressure near leg forcing the hip into extension

68
Q

gaenslen test +

A

pain in SI region

69
Q

SI joint compression test

A

patient side lying w/ painful side up, repeat on other side too, place hands on lateral aspect of pelvis and apply downward force

70
Q

SI joint distraction test

A

place one hand on iliac crest, apply pressure through anterior portion of ilium spreading anterior portions of SI joints

71
Q

sacral thrust test set up

A

prone, hands on top of each other over sacrum, apply anterior force through the sacrum

72
Q

spring test set up

A

prone, hyopthernar eminence of one hand over spinous process to be tested, apply anterior force feeling for vertebral translation

73
Q

+ spring test

A

vertebra does not spring or move excessively

74
Q

+ spring test indicates

A

lumbar segmental hypomobility or hypermobility

75
Q

lumbar contusion s/s

A

decreased ROM, spasm, stiffness, swelling

76
Q

what is important to rule out for lumbar contusion

A

trauma to kidney and other organs

77
Q

MOI lumbar sprains

A

direct trauma, sudden loading, rotational movement, extension and rotation, poor lifting mechanics

78
Q

risk factor for lumbar sprains

A

weak abs

79
Q

lumbar strain MOI

A

sudden contraction or stretching of musculature, poor lifting mechanics

80
Q

tx lumbar strain

A

RICE, pain free strengthening, improve mechanics and muscular endurance

81
Q

spinal stenosis

A

narrowing of spinal canal or intervertebral foramen, collapse of disc space

82
Q

when is spinal stenosis common

A

50-60 years old

83
Q

MOI spinal stenosis

A

degenerative

84
Q

s/s spinal stenosis

A

pain w/ walking, absence of pain when seated, N+T, radiating pain

85
Q

disc herniation def

A

extrusion of nucleus pulposus through annulus fibrosis

86
Q

lumbar disc pathology MOI

A

repetitive loading, poor mechanics, posture, weak musculature

87
Q

lumbar disc pathology special tests

A

SLR, Milgram, Slump, valsalva, kernig, brudzinski

88
Q

what part of lumbar disc pathology eval requires immediate referall

A

cauda equina syndrome

89
Q

facet joint dysfunction def

A

dislocation, subluxation, degeneration of facet

90
Q

MOI facet joint dysfunction

A

gradual or acute, extension, rotation, lateral bending of vertebrae

91
Q

+ test for facet joint dysfunction

A

quadrant test

92
Q

tx facet joint dysfunction

A

williams flexion exercises, steroid injection, MRI

93
Q

facet joint dysfunction s/s

A

localized pain over facet, muscle spasm, pain w/ extension

94
Q

spondylalgia def

A

pain arising from vertebrae

95
Q

spondylitis

A

inflammation of vertebrae

96
Q

spondylolisthesis

A

forward slipping of vertebrae onto the one below it

97
Q

spondylolysis

A

degeneration of vertebral structures

98
Q

spondylopathy

A

disorder of vertebrae

99
Q

spondylosis

A

arthritis or osteoarthritis of vertebrae placed on vertebral nerve roots

100
Q

spondlylosis vs spondyloisthesis

A

pars interarticularis, collared scotty dog, localized pain
progression of ^, separation of vertebra, decapitated scotty dog

101
Q

MOI spondylopathies

A

repeated extension

102
Q

risk factor spondylopathies

A

adolescence, gymnast, weightlifters

103
Q

s/s spondylopathies

A

pain, radiating, tender, spasm

104
Q

+ test for spondlypathies

A

spring, standing stork

105
Q

mobility of ___ mm or less indiciates SI dysfunction

A

2 mm

106
Q

MOI SI dysfunction

A

fall on butt, stp into hole, gradual

107
Q

risk factor women SI joint dysfunction

A

hormonal changes

Spring 2022 classes (22 decks)

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