Spine Quiz Material

Question 1

exam findings of lumbar disk herniation/radiculopathy

Answer 1

Peripheralized with flexion
Possible neuro s/s
Centralized with extension
May have lateral shift
Positive slump/SLR
Reduced sx with unloading
Imaging with clinical correlation
Lateral Shift

Question 2

exam findings of degenerative spinal stenosis

Answer 2

Reduced sx with repeated flexion
Possible neuro s/s
Increased sx with extension
Reduced extension ROM
Imaging with clinical correlation
Positive two stage treadmill test

Question 3

exam findings for spondylolisthesis

Answer 3

Pain with loading
Step off deformity
Increased pain with repeated extension Imaging with clinical correlation

Question 4

exam findings of lumbar disk degenration

Answer 4

Clinical correlation with imaging
No directional preference
General stiffness with PA

Question 5

exam findings of facet joint degenration

Answer 5

Pain with lumbar quadrant
Reduced pain with flexion
Pain with PA

Question 6

exam findings of cervical disk hernation

Answer 6

Positive Spurlings test
Positive ULTT A
Reduced sx with unloading Reduced ROM ipsilateral
Possible neuro s/s (Could be a cause of myelopathy) Increased muscle tone (guarding)
Imaging clinical correlation

Question 7

exam findings of cervical degenerative stenosis

Answer 7

Increased sx with extension
Increased with ipsilateral flexion
Reduced with unloading Neuro s/s (Could be a cause of myelopathy)
Distal symptoms changed with cx pain/motion
Imaging clinical correlation

Question 8

exam findings of locked facet

Answer 8

Rotation reduced primarily in 1 direction (right or left)
Pain with ipsilateral quadrant (right rotation/ext/side bend)
Sharp pain with motion, minimal pain at rest

Question 9

exam findings of cervical headache

Answer 9

Headache changed by cervical motion
Sx changed with sub-occipital pressure
Restricted upper cervical rotation
Trigger point pressure reproduces symptoms

Question 10

exam findings of cervical myelopathy

Answer 10

(B) UE and or LE symptoms increase with cx flexion
Reduced sensation ((B) UE and or LE)
Increased reflexes (DTR, Hoffman’s, Clonus, Babinski)
Bowel/bladder dysfunction
Imaging clinical correlation EMG

Question 11

exam findings of thoracic disk hernation

Answer 11

Sx changed with thoracic PA
Sx reduced with unloading
Imaging clinical correlation

Question 12

exam findings of costochondritits

Answer 12

Pain with palpation of costal cartilage

Pain with PA of rib

Question 13

exam findings of compression Fx

Answer 13

Pin point pain with PA/Palpation
Flexion deformity
Reduced flexion ROM with pain
Imaging clinical correlation

Question 14

difference between herniation and radiculopathy

Answer 14

herniated disc= “slipped”. one of the disces is damaged and has pused back into the exterior structures of the spine

radiculopathy= disease of the nerve root. condition due to a compressed nerve that can cause pain, numbness and tingling

Question 15

history of lumbar disk herniation

Answer 15

Under 60 years old
(most common 35-45)
Sudden onset
Possibility of neuro s/s
Pain below the knee
Worse in AM
Reduced pain with standing/walking
Increased pain with
• sitting
• static weight bearing
• lifting/twisting

Question 16

history of lumbar degenerative spinal stenosis

Answer 16

Over 60
Gradual onset
Possibility of neuro s/s
Increased walking-better with shopping cart
Better uphill walking
Quickly better with sitting
Calf pain

Question 17

history of lumbar spondylolisthesis

Answer 17

Teens and 20s
Female > Male	
Flexible                                                                
Reduced sx with flexion
Involved in extension activities                            
 Possibility of neuro s/s
Heavy loading 
Increased sx with extension

Question 18

history of lumbar disk degeneration

Answer 18

Over 60	
Family history   
Gradual onset                                       
Better when unloaded (lying down)
Increased pain with flexion
Increased pain with loading activities

Question 19

history of lumbar facet joint degernation

Answer 19

Over 60
Pain with extension
Pain sometimes with rotation
No pain below knee

Question 20

history of cervical disk herniation

Answer 20

Under 60 years old
(most common 35-45)

Sudden onset (can be gradual)                                     Possibility of neuro s/s  Pain below the elbow                                                Pain in shoulder/scapula                             Reduced pain with arms supported                     Increased pain with loading

Question 21

hisotry of cervical degenerative stenosis

Answer 21

Over 60 Gradual onset
Possibility of neuro s/s (could lead to myelopathy)
Improved laying down
Pain with extension and Lateral flex
Chronic stiffness
Arm and possibly LE symptoms

Question 22

history of cervical locked facet

Answer 22

More common middle aged and younger	
Acute                              
 Significant reduction in motion (specific direction) 
Less pain at rest               
May be associated with headache

Question 23

history of cervical headache

Answer 23

Women > Men
May start in sub-occipital area
Ram horn distribution
Related to neck position/movement
Unilateral

Question 24

history of thoracic disk hernation

Answer 24

More common middle aged and younger
Localized thoracic pain
Radiation around rib
Chest pain
May have dermatomal sensory loss

Question 25

history of costochondritis

Answer 25

Woman > Men Sharp chest pain near bone/cartilage junction Pin point pain Pain with deep breathing Increased with coughing

Question 26

history of compression fx

Answer 26

Women>Men, older, thin build Deep boring pain Localized pain lying supine Sudden onset (although can be gradual) Increased with flexion Increased with compression

Question 27

classification for stabilization exercises

Answer 27

hypermobile patients with symptoms

Question 28

movement implications for lumbar spinal stenosis

Answer 28

``` try FLEXION situps knee to chest draping body over physioball seated forward bends ```

Question 29

what might you find on examination to indicate a spondylolisthesis?

Answer 29

aberrant motion step off deformity worse with extension

Question 30

movement implications for spondylolisthesis

Answer 30

NO extension; will cause disc to move forward | emphazie flexion

Question 31

what is clinical instability

Answer 31

loss of the spines ability to maintain its patterns of displacement under physiologic loads so there is no initial or additional neurological deficit no major deformity

Question 32

clinical instability signs

Answer 32

catch in the back painful arc moving into and returning from flexion Gowers sign

Question 33

factors in favor of stabilization

Answer 33

``` Younger Age + Prone Instab Test Aberrant motions Greater SLR ROM Hypermobility with spring test Increasing episode frequency Three or more prior episodes ```

Question 34

factors in favor of manipulation

Answer 34

``` Recent pain onset (35 degrees IR) Hypomobility of at least one segment in L spine LBP only FABQ score less than 19 At least one hip with >35 degrees IR ```

Question 35

factors against manipulation

Answer 35

Leg symptoms No pain with spring test Increasing episode frequency Peripheralization with motion testing

Question 36

factors for specific exercise

Answer 36

Strong preference for sitting or walking Centralization with motion testing Peripheralization in direction opposite to centralization

Question 37

factors against specific exercise

Answer 37

LBP only | Status quo with all movements