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OMM M1T2 E2 > Evaluation of Lower Back Pain > Flashcards

Evaluation of Lower Back Pain Flashcards

1
Q

90% of all low back pain will resolve in ____ weeks without intervention

A

6

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2
Q

99% of all low back pain will resolve in ____ weeks

A

12

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3
Q

What are the goals of lower back pain treatment?

A

Hasten recovery
Control pain
Facilitate rehabilitation

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4
Q

What is the first question in the initial approach to back pain?

A

What is the most serious thing this could be?

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5
Q

What are some indicators of ominous history?

A 
Bilateral radicular pain
Saddle area anesthesia
Urinary incontinence
Urinary retention
Increased urinary frequency
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6
Q

What is the treatment for cauda equina syndrome?

A

Surgical decompression within 24-48 hours

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7
Q

What to rule out if pt presents with weak and rapid pulse?

A

Retroperitoneal hemorrhage

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8
Q

What to rule out if pt presents with low blood pressure?

A

Retroperitoneal hemorrhage

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9
Q

Make a mark on the skin midway between the PSIS
Make a mark 5 cm down from this point
Make a mark 10 cm up from initial point
With trunk flexed, should stretch to a minimum of 20 cm

A

Shober test

< 20 cm indicates significant loss of lumbar motion

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10
Q

Gluteus medius innervation

A

L5 root

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11
Q

What does a positive Trendelenberg test indicate?

A

Weakness of gluteus medius (compromise of L5 nerve root)

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12
Q

Straight Leg Raising Test produces no symptoms to 90 degrees of hip flexion. What does this indicate?

A

Normal straight leg raising test

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13
Q

Pt has low back pain and cannot stand on toes due to muscle weakness. Which nerve root is compressed?

A

S1

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14
Q

Pelvic rock test reproduces pt’s pain. What is the most likely diagnosis?

A

Sacroiliitis

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15
Q

Pt with low back pain presents with fever and percussive pain at L1, L2, L3, and L4. What is the most like diagnosis?

A

Osteomyelitis

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16
Q

Which of the following muscles is innervated by L2-L4?

Extensor digitorum brevis
Extensor hallucis longus
Gluteus medius
Quadriceps
Tibialis anterior
A

Quadriceps

17
Q

Which test looks for the same pathology as the Valsalva?

A

Naffziger test

18
Q

Shober test shows post flexion number of 16 cm. Most likely dx?

A

Ankylosing spondylitis

19
Q

Lower extremity weaknes
Low back pain
Neck pain
Left Babinski response

Most likely dx?

A

Multiple sclerosis

20
Q

Grade 0 muscle strength is defined as…

A

Flaccid paralysis

21
Q

Which test will exacerbate symptoms of any space-occupying lesion in the spinal canal?

A

Valsalva

22
Q

Which test will determine the presence of an extension lumbar spine somatic dysfunction?

A

Sphinx test

23
Q

In which test will pain radiating down the anterior thigh imply femoral nerve entrapment or disease?

A

Nachalas

24
Q

What is a relative contradindication for OMT for low back pain?

A

Herniated nucleus pulposus

25
Q

Which muscle is the most overlooked cause of low back pain?

A

Quadratus lumborum

26
Q

Rapidly alternating muscle contraction and relaxation upon dorsiflexion of ankle indicates with diagnosis?

A

A disconnect between upper and lower motor neurons

27
Q

Weakness of both gastrocnemius and soleus muscles indicates compression of which nerve root?

A

S1

28
Q

Positive Gaenslen test indicates which condition?

A

Sacroiliitis

29
Q

What is the best indication for OMT for low back pain?

A

Somatic dysfunction

30
Q

Tibialis anterior is associated with which reflex?

A

Patellar

31
Q

Extensor hallucis longus is associated with which reflex?

A

There is no reflex associated

32
Q

Which test will determine the presence of a lumbar somatic dysfunction?

A

Sphinx test

33
Q

Which imaging modality would most accurately image herniated nucleus pulposus?

A

MRI

34
Q

Herniated nucleus pulposus is most likely found at which level?

A

L4-L5

35
Q

Loss of sensation in the web space between first and second toes would indicate compression of which nerve root?

A

L4-S1

36
Q

With pt supine, you restrain the sternum and passively flex the neck. This reproduces pain in the lower thoracic region. Which test is this?

A

Soto Hall

OMM M1T2 E2 (4 decks)

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