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Pt. presents with severe back pain, numbness when they sit, and trouble initiating urination.  

What syndrome are you concerned this pt. has?  

What are other typical signs of this syndrome?

Cauda equina 

Sx: bladder/bowel dysfunction, saddle numbness, severe pack pain, bilateral leg pain, motor weakness



T/F: Cauda equina is not a medical emergency.


Cord compression is not a medical emergency 

Cauda equina IS a medical emergency


Pt. presents with a hyper-reflexive,  weakness in her LE, and also has difficulty initiating urination.

What syndrome are you concerned this pt. has?  

What are other typical signs of this syndrome?

Cord compression 


- Motor changes: increased tone, weakness, unsteady gait

- Sensory changes: N/T, paresthesia

- Hyper-reflexive

- +/- bladder/bowel dysfunctions

- +/- pain 


The 5 D's of vertebral artery symptoms

1. Drop attack - LOB/falling w/o loss of consciousness

2. Dizziness

3. Diplopia (double vision)

4. Dysarthria (difficulty talking)

5. Dsyphagia (difficulty swallowing)


Why would you scan a peripheral joint for a spine condition?

LE joints may contritue to spinal conditions over time


Check peripheral joints closest to the spine (i.e. shld and hip girdle)


What information is gained from applying OP?

Information about the passive structures of the joint


Describe the difference between MMT and myotome testing 

MMT tests muscle integrity.  Consistent weakness would be indicative of a musculoskeletal issue.


Myotome tests neurological integrity.  Fatiguing weaknes would be indicative of a neurological issue 


Whenever a load is applied to a muscle only ____% of the available MU are activated



Describe the difference between consistent and fatiguing weakness

Consistent weakness: repeated testing will elicit the same strength response because the mm is switching which (20%) MUs are active


Fatiguing weakness: repeated testing will result in a rapid drop in strength because the MUs that are use are depeleted until all MU are used up


Describe the difference between PPIVM and PAIVM

PPIVM: passive physiological intervertebral motion is equivalent to osteokinematics


PAIVM: passive accessory intervertebral motion is equivalent to arthrokinematics


What are the parts of the assessment?

1. SINS statement

2. Problem list

3. Tx goals

4. Prognostic factors


If treating a unilateral spine condition which side should you treat first?

Painful side first


If treating with rotation for a spine condition which side should you treat first?

Treat painful side up 


If treating for pain what parameters would you use for mobilization?

Choose the least painful technique 

Shorter duration: 1-2 bouts, 15-30 seconds


If treating for resistance what parameters would you use for mobilization?

Treat most painful level first at the end range

Increase vigor as tolerated, quicker speed

Longer duration: 3-5 bouts, 45-60 sec


When can disc degeneration begin?

In your 30s


What percent of the load do the lumbar facet joints bare during neutral posture?



How is CNR classified?

As a type of sciatica


T/F: MSI focues more on treating the source as opposed to correcting movement patterns.

False: flip it


T/F: Motor control is key in MSI.



T/F: According to MSI strengthening along is sufficient to affect timing and recruitment.

False: also need motor control 


T/F: According to MSI how you move can be more important thatn how far you move.

True: look at if impaired movement exists even if the amount of motion is not functionally limiting 


T/F: You always want to stretch a painful muscle.

False: not always, you may not want to add tension to a already painful/stiff muscle