back pain

Question 1

whats good for back pain

Answer 1

NSAIDS

diclofenc PR - works like a dream

Question 2

DX back pain you dont want to miss

Answer 2

1. CES
2. AORTIC DISSECTION
3. PYELNONEPHRITIS
4. MSK- TRAUMA

Question 3

A MAN COMES IN WITH BACK PAIN WHAT TO ASK HIM

Answer 3

any erectile dysfunction or ejaculation problems as it could be used to rule out CES

Question 4

Investigations for back pain

Answer 4

1. PR exams - looking for anal tone and sensation
2. x ray of the spine
3. physical exam feel
4. straight leg test

Question 5

neuro exams back pain

Answer 5

1. test power
2. tone
3. reflxes esp achiles
4. Derma and myotomes

Question 6

Which nerves control erection

Answer 6

Pudendal
Hypogastric /genitofemeiral

Question 7

Why do we do the straight leg test and what is a positive result

Answer 7

Lower back pain
To check for limbo sacral root irritation
Lumbar disc hernia Timon most common causes but other causes can produce a positive response

Positive
1. Tingling down leg
2.pain down leg
Due to pulling on the sciatica nerve roots

Question 8

If suspecting Ces what to free

Answer 8

Orthopaedics

Question 9

Describe sciatica

Answer 9

Triad of buttocks low back and leg pain

Question 10

Is sciatica usually bilateral

Answer 10

No usually only affects one leg

Question 11

Sciatica vs CeS

Answer 11

Ces / usually both legs

Sciatica / no saddle

Question 12

Symptoms of sciatica

Answer 12

Pain
Tingling
In some case weakness making it difficult to do tasks
Pain aggravation / sitting, coughing, sit

Question 13

Should you feel pain on the opposite leg to the lesion in straight leg test

Answer 13

No typically it only affects the same leg but if you do get it in the other leg then could be a large dis herniation

Question 14

Most csuses of lumbar back pain roots

Answer 14

L4 l5 s1

Question 15

Femoral nerve stretch explain how you do it and what nerve roots

Answer 15

L2-l4

Question 16

Which parts of the spine have lordosis and khyposis

Answer 16

Cervical ~lordosis

Thoracic - khyposis

Lumbar ~ lordosis

Question 17

Movement tests for spine physical exam and which order would you do it in and why

Answer 17

Do cervical and lumbar first cos easier to do and also thoracic you need patient to sit down as it’s mainly a rotational job however if standing up the rotation also comes from the pelvis so we need to be able to sit the patient down so we know it comes from the spine (James gill) sit them down with arms crossed and rhyme rotate

Cervical

Head flex and extension (atkanto occipital joint )
Nod head
Turn to the side - Salam Salam (Atlanto axial joint

Lumbar

Side to side
Rukoo touch toes