Spinal Radiculopathy

Question 1

What is close packed position ?

Answer 1

It’s the joint position in which articulating bones have their maximum area of contact with each other

Question 2

What is capsular pattern ?

Answer 2

The pattern of limitation in ROM exhibited by specific joints when inflamed (a specific predictable restriction of joint movement that occurs when the joint capsule is inflamed)

Question 3

What’s the closed packed position of the spine ?

Answer 3

Full extension

Question 4

What’s the capsular pattern of the spine ?

Answer 4

Extension - side flexion and rotation (equally limited)

Question 5

In cervical spine, nerve roots exit above the corresponding vertebrae ex: C5 exits between C4-C5. True or False

Answer 5

True

Question 6

In lumbar spine, nerve roots exit below the corresponding vertebrae ex: L3 exits between L3-L4 . True or False

Answer 6

True

Question 7

A clinical description of when a nerve root in the spine becomes compressed or inflamed resulting in neurological function change, what is this called ?

Answer 7

Spinal Radiculopathy

Question 8

What are the causes of spinal radiculopathy

Answer 8

spinal stenosis
spinal spondylosis
Disc herniation

Question 9

A degeneration (arthritis) of the spine (joints, discs, bone) is called ?

Answer 9

Spinal spondylosis

Question 10

What’s the typical age of onset of spinal spondylosis

Answer 10

> 50 years (gradual onset)

Question 11

Signs & Symtpoms of spondylosis

Answer 11

• morning pain, stiffness, rigidity
• numbness or tingling in arm / leg
• muscles weakness in arm / leg
• loss of lordosis

Question 12

narrowing of the spinal canal or intervertebral foramen which compresses the spinal cord or nerve root is called

Answer 12

Spinal stenosis

Question 13

Narrowing of the spinal canal / Compression of the spinal cord is which kind of stenosis

Answer 13

Central stenosis

Question 14

Narrowing of the intervertebral foramen which compresses/ compression of the nerve root is which type of stenosis

Answer 14

Lateral stenosis

Question 15

Stenosis is typically caused by

Answer 15

• osteophytes
• thickening of ligament flavum

Question 16

Age of onset for stenosis is

Answer 16

> 60 years (gradual onset)

Question 17

Signs & symptoms of spinal stenosis

Answer 17

• numbness or tingling in arm/leg
• muscles weakness in arm / leg
• walking and balance problems (severe cases)
• postural changes (increased thoracic kyphosis and decreases lumbar lordosis)
• shopping cart sign (leaning forward)

Question 18

In spinal stenosis, symptoms worsen with flexion but are better with extension. true or false

Answer 18

False (they worsen with extension and are better with flexion)

Question 19

Spinal stenosis is neurogenic clarification while in the cardiopulmonary section there is intermittent clarification. True or False

Answer 19

True

Question 20

What test can we perform to differentiate between lumbar stenosis and intermittent claudication?

Answer 20

Bicycle test

Question 21

Spinal stenosis intervention

Answer 21

• flexion exercise program (widens spinal canal) ex: knee to chest
• stretching exercises (flexibility increase) ex: iliopsoas & rectus femoris stretch
• strengthening exercises (to improve imbalance in hip region caused by pain) ex: lower ab, hip abductor, hip extensor
• traction

Question 22

Best sleeping position for spinal stenosis

Answer 22

Fetal

Question 23

Age of onset for disc herniation

Answer 23

30-50 years (acute onset)

Question 24

4 stages of disc herniation

Answer 24

Degeneration > prolapse > extrusion > sequestration

Question 25

Signs & symptoms of disc herniation

Answer 25

- shooting, sharp arm/ leg pain - radiating numbness & tingling - lateral shift away from the side of pain

Question 26

In disc herniation, symptoms worsen with extension and get better with flexion , and when coughing sneezing pain worsens due to increase in intra-abdominal pressure . True or False

Answer 26

False (pain worsened with flexion and is better with extension) / last part is true

Question 27

Most common area of disc herniation

Answer 27

L4-L5 & L5-S1

Question 28

Disc herniation intervention

Answer 28

- extension program - cervical retraction - traction - night lumbar support roll (used to increase lumbar lordosis)

Question 29

What are tests we can use for cervical radiculopathy ?

Answer 29

- spurling test (foraminal compression test) - cervical distraction test

Question 30

What test can we use to test for lumbar radiculopathy

Answer 30

Slump test Straight leg raise test Bowstring test

Question 31

What is the crossover sign in the straight leg raise test

Answer 31

The patient feels the pain in the other leg (unaffected leg) which can indicate a large disc bulge

Question 32

What is the buttocks sign in straight leg raise test

Answer 32

During SLR, once you reach the point of restriction, the therapist flexes the knee to see if there is any ability to increase the hip flexion (if not this can be an indication of hip tumor, abscess, bursitis)

Question 33

What’s the neuro dynamic test for sural nerve

Answer 33

Inversion - dorsiflexion

Question 34

What’s the neuro dynamic test for tibial nerve

Answer 34

Enversion - dorsiflexion

Question 35

What’s the neuro dynamic test for peroneal nerve

Answer 35

Inversion - plantarflexion

Question 36

For spinal spondylosis and stenosis the intervention plan for both of them is traction and flexion program, true or false

Answer 36

True