assessment of lumbar spine Flashcards

1
Q

flexion ROM

A

0-80 deg

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2
Q

extension ROM

A

0-25 deg

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3
Q

lateral flexion ROM

A

0-35 deg

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4
Q

rotation ROM

A

0-45 deg

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5
Q

end feel for all 4 motions

A

firm

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6
Q

loose packed position

A

midway between flexion and extension

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7
Q

close packed position

A

full extension

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8
Q

capsular pattern

A

side bend = rotation > extension

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9
Q

osteoporotic vertebral compression fracture or wedge deformity critera

A

age > 52
no leg pain
BMI < 22
does not exercise regularly
female

2 or less criteria rule out
4 or more criteria rule in

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10
Q

iliac crests

A

L4-5 interspace

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11
Q

PSIS

A

med and inf from iliac crest
helper line: S2 is between PSIS

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12
Q

ischial tuberosity

A

start at gluteal folds until you feel a bony prominence

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13
Q

sacral sulcus

A

from PSIS move sup and med
dip inward

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14
Q

inferior lateral angle

A

inferior to PSIS
where bone drops off

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15
Q

coccyx

A

top of gluteal cleft

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16
Q

sacrotuberous ligaments

A

from ILA to ischial tuberosity

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17
Q

spinous processes

A

L5: start at PSIS and move medial and superiorly at a 30-45 deg angle
L1-4 count superiorly

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18
Q

transverse processes

A

move lateral from SP
farther out than you think

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19
Q

T12 SP

A

locate L5 and count sup
slightly smaller than L1

20
Q

12th rib

A

move laterally from T12 SP

21
Q

quadratus lumborum

A

in quadrant created by lumbar SP, 12th rib, iliac crest

22
Q

ASIS

A

distal and med from iliac crest

23
Q

psoas

A

from midpoint between ASIS and umbilicus, apply direct pressure toward spine

24
Q

iliacus

A

from ASIS move med and apply pressure downward to ilium

25
pubic tubercles
pt places thumb on abdomen and slides down to pelvis. examiner places thumbs on top of pt's
26
greater trochanter
have pt ER/IR hip to assist
27
piriformis
helper line: PSIS to greater trochanter 1-2 cm inferior to middle 1/3 of helper line
28
sciatic nerve
helper line: ischial tuberosity to greater trochanter medial 1/3 to halfway of helper line
29
spinalis
most medial
30
longissimus
middle
31
ilicostalis
most lateral
32
goni ROM: flexion/extension
fulcrum over greater trochanter flexion: 80 extension: 25
33
goni ROM: lateral flexion
fulcrum over SP of S1, follow SP of c7 normal: 35
34
goni ROM: rotation
fulcrum on center of cranium normal: 45
35
inclinometer
take the difference between S1 and T12 flexion: 60 extension: 25
36
trunk flexion strength test
0: no muscle activity 1: muscle activity without movement 2: depression of rib cage toward pubic symphysis 3: completes ROM with arms outstretched 4: completes ROM with arms crossed over chest 5: completes ROM with hands behind head scapula must clear the table
37
trunk extension strength test
0: no muscle activity 1: muscle activity without movement 2: completes partial ROM from full body on table 3: completes ROM with arms at side of body 4: may waver, hands behind head 5: holds position with out wavering
38
trunk rotation strength test
0: no muscle activity 1: muscle activity without movement 2: client unable to complete motion, but rib cage depresses 3: scapula clears table with arms outstretched 4: scapula clears table with arms crossed the chest 5: scapula clears table with hands behind head
39
lower abdominal strength test
arms folded across chest posteriorly tilt pelvis until lower back flat hold low back flat as slowly lowering the legs 90-75 = fair 75-60 = fair + 60-45 = good - 45-30 = good 30-15 = good + 15-0 = normal
40
mytomes
L2 - hip flexion L3 - knee extension L4 - ankle dorsiflexion L5 - great toe extension S1 - plantar flexion S2 - knee flexion
41
reflexes
patellar: L4 achilles: S1
42
dermatomes
L1 - upper anterior thigh L2 - mid anterior thigh L3 - medial femoral condyle L4 - medial malleolus L5 - dorsum of great toe S1 - lateral malleolus or heel S2 - popliteal fossa ask "same, different, or none"
43
central PA glides (spring test)
elbow extended over spinous process use small areas of hand to lessen sensory overload
44
unilateral PA glides
contact over facet joints on both sides
45
straight leg raise
hold above malleolus and above knee clinician raises client's leg and feels for resistance pos requires all three: reproduction of symptoms symptoms different than other side symptoms affected by distant movement
46
slump test
client slumps flex cervical spine actively extend good leg first gently extend head postive: reproduction of symptoms symptoms different than other side symptoms affected by distant movement
47
prone instability test
provides PA glide client lifts both legs off the floor positive: pain disappears with legs off the floor