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MSK LQ > 2B > Flashcards

2B Flashcards

1
Q

What is the chance of someone experiencing LBP in their lifetime

A

90%

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2
Q

T or F: There are NO strong risk factors to predict outcomes of effective treatments for LBP

A

T

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3
Q

T or F: Presence of radiating pain is always a higher amount of complexity when it comes to treating LBP

A

T

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4
Q

When should a patient with LBP immedialely be referred to a PT

A

When positions, postures, activities, movements increase or decrease the patients symptoms or produce sciatica

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5
Q

If a patient has evidence of a serious, systemic problem, drop foot, loss of B&B function, areflexia, hyperreflexia, unexplained weight loss, or a psychosomatic component….

who does the patient need to go see?

A

Refer to specialist before PT

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6
Q

what does boney pain feel like in the back?

what does nerve pain feel like in the back?

A

Deep ache/ boring pressure \

sharp, knife-like, shooting, burning, tingling, numbness, weakness

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7
Q

what age range is most affected by spondylolithesis?

what age range is most affected by disc herniation/dysfunction

A

10-20

15-40

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8
Q

At what age range are people susceptible to cancer, compression fx, stensis, or AAA

at what age range are people susceptible to OA/Spondylosis

A

65+

45+

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9
Q

what is an important question to ask patients regarding their pain, when it comes to making goals

A

What is the impact of the symptoms, what is the pain preventing them from doing

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10
Q

The presence of serious pathologies in patients with LBP is ____________

how many LBP patients present with atleast 1 red flag?

A

Low

80%

Examine findings for consistent patterns and multiple red flags

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11
Q

What is the ultimate goal of therapy for patients with LBP

A

Self managment

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12
Q

How is piriformis syndrome commonly diagnosed

what test will come back positive for patients with piriformis syndrome

A

Dx of exclusion

+ SLR test

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13
Q

Spondylolysis is a defect in ________________ , usually asymptomatic

Typically occurs at ___ vertebrae

patients prefer what position

A

par interarticularis

L5

flexion over extension

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14
Q

What is spondylolisthesis?

How is it graded?

A

Fx of pars interarticularis and slip of the vertebrae forward. Leads to instability

grade 1: 1-25% slip
grade 2: 26-50%
Grade 3: 51-75%
grade 4: 76-100%
grade 5: over 100% slippage

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15
Q

When is surgical intervention indicated for spondylolisthesis

A

when conservative managment has failed

when patient has progressive neurological symptoms

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16
Q

What parts of the vertebrae/disc are most susceptible to compression injury

A
  1. End Plate
  2. vertebral body
  3. Disc
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17
Q

Disc Protrusion:

Prolapse:

Extrusion:

Sequestration:

A

Disc Protrusion: disc buldge w/o AF rupture

Prolapse: only outer layer of AF contains the NP

Extrusion: AF has now perforated the NP and moved into epidural space

Sequestration: disc fragments have escaped the AF and are broken off into the epidural space

18
Q

How does an End plate fx present?

SLR test?

Compression Test?

A

Trauma/speicifc MOI

Acute pain/spasm

Negative SLR test

positive compression test

19
Q

Will an internal disc disruption have a positive or negative SLR test?

A

negative

20
Q

Disc protrusion/prolapse (contained) will present how?

SLR test?

A

Some AF and PLL are intact

LBP referred to hip/upper leg

pain w/ cough and sneeze

negative SLR

21
Q

Disc Extrusion and sequestration (uncontained) will present how?

A

LBP

Pain w/ cough and sneeze

true sciatia (radicular pain)

POSITIVE SLR

22
Q

a disc pathology at L3-L4 will compress what nerve?

A

L4

23
Q

A disc pathology at L4-L5 will compress what nerve?

A

L5

24
Q

Facet joint _______mobility is more common

A

hypo

25
Q

Loss of normal passive restraints

Inconsistent symptoms

Positive prone instability test

reports of catching/locking of back

A

Instability

26
Q

In what population is anklyosing spondylitis most common?

A

Males 30+

90-95% of pts have human leukocyte antigen B27

27
Q

What is the most common kind of scoliosis?

A

Idiopathic scoliosis

28
Q

How is fibromyalgia diagnosed?

A

11 out of 18 total tender points w/o reason for tenderness

29
Q

Should you treat a patient w/ herpes zoster

A

Halt PT until rash is no longer contageous

30
Q

What are the 6 ICF lowback pain categories

A

Acute/subacute LBP w/ mobility decifits

Acute, Sub-acute, chronic LBP w/ movement coordination deficit

Acute LBP w/ related (referred) LE pain

Acute/ Subacute/ chronic LBP w/ radiating pain

Acute/Subacute LBP w/ Related cognitive or affective tendencies

Chronic LBP w/ related generalized pain

31
Q

Impaired functional movements

Segmental Hypomobility

Pain in back/buttock/groin/thigh

negative neuro tests

onset of symptoms less than 3 months

A

Acute or subacute LBP w/ mobility deficits

32
Q

Segmental/global instabilities

Pain in back/buttock/groin/thigh

decreased NM control

Muscle weakness

Impaired activity tolerance and functional movements

positive prone segmental instability test

A

Acute/subacute/chronic LBP w/ movement coordination impairments

33
Q

Significant pain in back/butock/groin/thigh

segmental or global hypomobility

postural deficit

decreased activity tolerance and impaired functional movements

onset of symptoms under 3 days ago

POSITIVE repeated movement test

A

Acute LBP w/ related (referred) LE pain

34
Q

Segmental hypomobility/instability

Radiating pain in dermatomal pattery

muscle weakness

decreased activity tolerance and functional movements

Positive neuro exam

Positive neurodynamic testing

Positive repeated movement test

A

Acute/Subacute/chronic LBP w/ radiating pain

35
Q

Sensitivity to noxious stimuli

Pain in leg/buttock/groin/back/lower leg

High score on FABQ

decreased activity tolerance

impaired functional movements

inconsistent MSK exam

Onset of symptoms less than 3 months

Positive Waddell’s test

A

Acute or subacute LBP w/ related cognitive or affective tendencies

36
Q

Generalized pain

changes in brain and sensory structure

high score on FABQ

Decreased activity tolerance

Inconsistent MSK findings

Onset of symptoms over 3 months

A

Chronic LBP w/ generalized pain

37
Q

Manual Therapy Classification Criteria

Anatomical location of symptoms:

Duration:

Score on FABQ:

Results of mobility test:

Hip Internal Rotation:

A

No sx distal to knee

Less than 16 days

Score of less than 19

Atleast 1 hypomobile joint

Hip Int rotation over 35 in atleast 1 hip

38
Q

Stabilizaton criteria:

Age:

Flexibility:

Movements in lumbar:

Lumbar instability test:

Patients who are……….

A

Younger age: <40

Greater flexibility SLR over 91

Abberant movements: Instability catch

Positive Prone Instability test

Post-Partum with posterior pelvic pain provacation, ASLR, modified trendelenberg test

Pain W/ palpation along long dorsal SI ligament or pubic symphysis

39
Q

Patients with a lateral shift are typically also restricted into __________

A

extension

40
Q

Extension criteria patient

Anatomical location:

A

Distal to buttock

41
Q

Flexion preference patient classification:

Age:

Imaging evidence of:

A

Over 50

Lumbar Spinal Stenosis

42
Q

When patients classify for more than 1 type of treament group, how should we decide the treatment

A

Prioritize order based on: level of risk, psychosocial factors, comorbidities

Presence of psychosocial factors and comorbidities weaken treatment effects

MSK LQ (26 decks)

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