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OPP IV - Exam 2 > 4: Clinical Lumbar > Flashcards

4: Clinical Lumbar Flashcards

1
Q

What is the first ligament to become tender with postural changes?

A

Iliolumbar

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2
Q

What ligament runs from the base of the occiput to the ANTERIOR sacrum?

A

ALL

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3
Q

Which ligament narrows as it descends?

A

PLL

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4
Q

How do you test for psoas spasm/tightness?

A

Thomas test

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5
Q

A straight leg raise of what degree indicates a sciatic problem?

A

35-70

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6
Q

A straight leg raise of greater than 70 degrees indicates what kind of problem?

A

Hip or joint

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7
Q

If a pt has dysfunction, when they raise one leg they should be creating pressure on the contralateral leg. If not, what’s happening? What’s this test called?

A

Malingering; Hoover test

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8
Q

What test indicates a weak gluteus medius?

A

Trendelenberg

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9
Q

What test will increase pain/Sx of a disc herniation?

A

Valsalva maneuver

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10
Q

What are the #1 and #2 most common areas for lumbar disc her nation?`

A 
#1 L5-S1
#2 L4-5
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11
Q

What is the pathogenesis of disc herniation?

A

Narrowing of PLL

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12
Q

What are the Sx of disc herniation?

A

Sharp low back pain
Radioculopathy in LEs (worse with Valsalva)
Motor sensory deficits possible

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13
Q

How do you name lumbar disc?

A

Named for the vertebra above it

Vertebra sits on its on disc ‘throne’ of same name

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14
Q

Herniation of a disc affect what nerve root?

A

The one below!

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15
Q

L4 reflex

A

Patellar reflex

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16
Q

L4 motor innervation

A 
Ant tibialis (inversion + dorsiflexion of foot)
Quads (extension)
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17
Q

L4 Sensory innervation

A

Medial leg + foot

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18
Q

L5 motor innervation

A

Extensor hallicus longus (dorsiflexion of big toe)

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19
Q

L5 sensory innervation

A

Lateral leg + dorsum of foot

20
Q

S1 reflex

A

Achilles reflex

21
Q

S1 motor innervation

A

fibularis longus + brevis (everstion and plantarflexion)

22
Q

S1 sensory innervation

A

Lateral foot

23
Q

Iliopsoas innervation

A

T12; L1-3

24
Q

Quadriceps innervation

A

Femoral nerve

25
Q

Hip adductor group innervation

A

Obturator (L2-4)

26
Q

Tibialis Ant. innervation

A

Deep fibular n. (L4)

Dorsiflexion + Inversion

27
Q

What would cause aching low back pain to lower legs that is worsened with extension and relieved by sitting?

A

Spinal stenosis

28
Q

What muscle is hypotonic in spinal stenosis?

A

Anal sphincter

29
Q

What would you see on Xray with spinal stenosis?

A

Osteophytes

30
Q

What would cause peripheral neuritis of the sciatic nerve?

A

Piriformis syndrome

31
Q

What could be caused by things like prolonged flexion, appendicitis, calculi, or salpingitis?

A

Psoas syndrome

32
Q

Which levels might be hyper flexed or extended in Psoas syndrome?

A

L1-2

33
Q

On what side are you going to have a positive pelvic shift test or a piriformis spasm with Psoas syndrome?

A

Contralateral side

34
Q

Sudden onset, severe low back pain without prior Hx could indicate what?

A

Dissecting aortic aneurysm

35
Q

Claudication Sx with back pain indicates what disease?

A

Spinal stenosis

36
Q

What could be indicated if a pt has pain that wakes them from sleep?

A

Malignancy

37
Q

Rapidly progressing neurological deficits could indicate what problem?

A

Epidural abscess or infection

38
Q

Spondylosis generally indicates what?

A

Degenerative changes

39
Q

A defect of the pars WITHOUT anterior displacement is known as what?

A

Spondylolysis

40
Q

How is a Dx of spondylolysis made?

A

Oblique XR

41
Q

Spondylolisthesis most commonly occurs where?

A

L5 on S1

42
Q

Grade I Spondylolisthesis

A

0-25% displacement

43
Q

Grade II Spondylolisthesis

A

25-50%

44
Q

Grade III Spondylolisthesis

A

50-75%

45
Q

Grade IV Spondylolisthesis

A

> 75%

46
Q

What is Tx contraindicated for Spondylolisthesis?

A

HVLA

OPP IV - Exam 2 (11 decks)

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