spinal conditions

Question 1

what happens to spinal diameter during flexion and extension

Answer 1

Ext - IVF narrows (inferior glide)

Flex - IVF opens (superior glide)

Question 2

nerve compression from

Answer 2

ext
osteophyte
disc herniation
swelling

Question 3

Signs and symptoms of nerve compression

Answer 3

pain, tingles, numb
loss of nerve condition
loss of neural mobility

Question 4

how do we test nerve conduction

Answer 4

reflexes
myotomes
dermatomes

Question 5

T/F need intact annulus for normal biomechanics

Answer 5

tre

Question 6

nucleus pulpous migrates __ to the direction of the movement

Answer 6

opposite

Question 7

during flexion where does nucleus pulpous migrate

Answer 7

posteriorly

Question 8

whats worst thing that can happen after traetemtn

Answer 8

leg pain

Question 9

clinical presentation of disc lesion

Answer 9

age
central low back pain referred to butt/leg

loss off normal lordosis

aggravated by flexion, coughing, sneezing

eased by ext

Question 10

lateral shift named based on

Answer 10

what the shoulder are doing in relation to pelvis

Question 11

where do you stand when naming the shift

Answer 11

behind the patient

Question 12

positions that inc intradiscal pressure

Answer 12

sitting, leaning fowd

standing, leaning fwd

Question 13

activities that increase intradiscal presure

Answer 13

cough / sneeze
valsalva
breath holding
bearing down

Question 14

positions that decrease intradiscal pressure

Answer 14

lying down, knees supported
side lying
lying prone
standing with one leg on step
sitting lumbar supported

Question 15

what to do for disc lesions

Answer 15

centralise pain
correct shift
support lordosis 
educate patient on posture
avoid flexion

ergonomics, exercise, prevention

Question 16

when to refer to physician disc lesion

Answer 16

neurological sign is present

worsening (loss of reflex, mytome, sensation)

Question 17

should you peripheralize symptoms

Answer 17

no centralize

Question 18

do you want to increase or decrease intradiscal pressure

Answer 18

dec

Question 19

t/F x ray helpful in investigating for disc lesion

Answer 19

no but you can see the disc space narrowing

Question 20

t/f MRI / CT scan helpful disc lesion

Answer 20

yes you can see nerve compression

Question 21

stenosis means

Answer 21

narrowing

Question 22

spinal stenosis

Answer 22

bone spurs creating narrowing

Question 23

who gets spinal stenosis

Answer 23

older hx of low back pain

Question 24

where is pain in spinal stenosis s

Answer 24

can be central

can radiate bilaterally

Question 25

what aggrevates spinal stenosis

Answer 25

positons that dec IVF (standing , walking)

Question 26

pain relieved by what in spinal stenosis

Answer 26

positions that inc IVF, sitting, standing, lean fwd

Question 27

treatment of spinal stenosis

Answer 27

avoid positions of ext education on positions pace back to activities address mm imbalance (ab strength, hamstring flexibility)

Question 28

what can x ray show in spinal stenosis

Answer 28

spurs / narrows

Question 29

what can MRI/ CT scan show for spinal stenosis

Answer 29

where there is neurological compromise if SIGNS worsening

Question 30

whats an objective measure that shows worsening in patient with spinal stensos

Answer 30

clonus, babinksi

Question 31

spondyloliothesis

Answer 31

the gymnast fwd slippage of one vert decreases IVF

Question 32

hows spondylolthesis graded

Answer 32

grade 1-4

Question 33

clinical presentation fo spondylolisthese

Answer 33

``` gymnast, dancer hyperextension activiteis central low back pain, referred weak abs tight hamstrings aggravated by ex eased by flexion ```

Question 34

treatment of spondlolisthesisi

Answer 34

``` address low quadrant mm imbalance focus on ab strengthening (TA) education miomechs avoid hyperexntion ```

Question 35

X-rays in sponolishtsis

Answer 35

useful in standing to visualize slippage can confirm clinical suspicions get if its a career decidier

Question 36

MRi for spondolisthesis

Answer 36

not needed unless worsening neurological signs

Question 37

do spondolisthesis need specalist

Answer 37

not unless worsening neurological signs of significant slippage

Question 38

optimum lumber spine posture _____

Answer 38

supports the normal lumbar lords

Question 39

why do we need to know optimal posture | clinical relevance?

Answer 39

understand pathology of abnormal posture understand effect on spinal diameter understand condition specific limitations

Question 40

postrural back pain clinical presentaiton

Answer 40

``` any age group pain increases with prolonged postures poor posture/ ergonomics not caused by flex/ext better in AM, worse in PM ``` associated with decreased fitness no neuro signs

Question 41

treating postural back pain

Answer 41

``` address posture / ergonomics address mm imbalance address fitness add spinal suport educate on rest postures ```

Question 42

guidelines for treatment of impairments with flexion bias

Answer 42

avoid ext if it increases neurological /pain rest /support in positions of flexes when it reduces neurological /pain reducate on posture return to activity

Question 43

why flexion bias

Answer 43

widens IVF, decreases pressure on roots reduces effects of derangement in joint

Question 44

why extension bias

Answer 44

reduces disc derangement facilities centralization of pain if flexion is contraindicated

Question 45

how does extension facial centralization

Answer 45

by encouraging anterior migration of nuclear material | decreases stress on posterior annulus

Question 46

guidelines for management of impairments with an extension bias

Answer 46

rest / support in extension if it helps re educate on posture return to activities

Question 47

some components of patient education

Answer 47

``` lifting standing avoid prolonged sitting flexiblity / strength pillows, chairs ```

Question 48

likely treatment for postural back pain

Answer 48

they can do flex and ext

Question 49

likely treatment for disc pathology

Answer 49

do ext first progress to flex after they can sit n reach fwd

Question 50

spondyloslisthesis likely treatment

Answer 50

give them flexion, avoid ext because an instabilty in anterior direction

Question 51

spinal stenosis likely treatment

Answer 51

flexion , avoid ext