10 - 45 yo M with low back pain Flashcards
in patients with central spinal stenosis, what maneuver will reduce the pain?
squatting
patellar tendon reflex tests what nerve root(s)?
L3, 4
medial hamstring reflex tests what nerve root(s)?
L5
achilles tendon reflex tests what nerve root(s)?
S1
where is pin prick done to test the L3 nerve root?
- lateral thigh
- medial femoral condyle
where is pin prick done to test the L4 nerve root?
- medial leg
- medial ankle
where is pin prick done to test the L5 nerve root?
- lateral leg
- dorsum of foot
where is pin prick done to test the S1 nerve root?
- posterior calf
- sole of foot
- lateral ankle
what is the functional test for L3 nerve root?
squat down and rise
what is the functional test for L4 nerve root?
walk on heels
what is the functional test for L5 nerve root?
walk on heels
what is the functional test for S1 nerve root?
walk on toes
squatting and rising tests what nerve root(s)?
L3
walking on heels tests what nerve root(s)?
L4, L5
walking on toes tests what nerve root(s)?
S1
pain that improves with supine positioning suggests what musculoskeletal conditions?
- spinal stenosis
- disc herniation
decompression should be performed within what time frame for cauda equina syndrome?
72 hours
what is the role of EMG studies in radicular pain and lumbar spinal stenosis?
useful to confirm existence of radiculopathy (level of nerve involvement) and to exclude the presence of other peripheral nerve disorders
when is diagnostic imaging indicated for acute back pain?
diagnostic testing, especially imaging, is not indicated until after 4-6 weeks of conservative treatment
