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GONSTEAD ME > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

How long until positive response to care

A

2 weeks is good general

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2
Q

Referral for disc

A

Neurosurgeon

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3
Q

Piriformis muscle referred pain facet

A

Lateral greater trochanter, lateral sacrum on same side, back of butt and thigh

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4
Q

Gluteus medius pain referral

A

Medial iliac bone, lateral butt, sacrum

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5
Q

Primary areas of facet issues

A

Lumbar and cervical spine because of the curve and facets can become compromised

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6
Q

Symptoms facet

A

Hip and buttock pain - diffuse, achy, stiff, tight, sore
Cramping leg pain - primarily above the knee
Low back stiffness, especially in the morning or with inactivity
Absence of paresthesia

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7
Q

Physical signs facet

A 
Local paralumbar tenderness
Pain on hyperextension of the lumbar spine
Absence of neurologic deficit
Hip, buttock or back pain on SLR
Absence of root tension signs
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8
Q

L5 thrust

A

PA-IS according to facet joint angle then
PA SI to reduce posterior translation.

PA-IS-ML

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9
Q

Case management facet syndrome

A

Facet joint motion will end the pain presentation (3-5 visits)
This subluxation should take about 8-12 visit
Patient must be put on exercises to reduce extension loading

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10
Q

Stuck in extension vs more parallel disc presentation

A

Facet syndrome vs D1 disc

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11
Q

Joints appearing most degenerating on films may actually be

A

Least responsible for pain production which may be secondary to the fact that movement is completely restricted at that segment

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12
Q

Stress fracture or defect of the pars in a vertebra

A

Spondylolythesis common cause

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13
Q

Due to repetitive movements of extension and rotation which leads to an increase in shear forces in the lumbar spine

A

Common cause spondylolysthesis

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14
Q

Many people with a spondylolysthesis will have

A

No symptoms

Only revealedon x-ray

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15
Q

Symptoms that may accompany spondylolysthesis

A

Sore pain in the low back, especially after exercise
Increased lordosis
Pain and/or weakness in one or both thighs or legs
Reduced ability to control bowel and bladder functions
Tight hamstring musculature
Lumbar muscle spasms
Unlikely to have paresthesias or radicular pain

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16
Q

Suspecting spondylolisthesis of L5

A

Patient presents with hyperlordotic posture
Motion restricted at L5
Spinous is more palpable with lots of edema under it

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17
Q

Subluxation correction of spondylolisthesis

A

Side posture adjustment is delivered to the segment below through the plane line of the disc grade 1 and 2

Grade 3 and 4 this adjustment is done prone on the hi-lo with the thoracic piece locked

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18
Q

Only adjust a spondylolisthesis if it is

A

Symptomatic

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19
Q

Most common treatment for the correctino of scoliosis

A

Surgery

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20
Q

Thoracic curve is made up by

A

Height of vertebral body

Body is bigger in the back and smaller in the front

Discs are level

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21
Q

mostly PA an dLM adjustmetn only with limited IS

Spinous contact for simple listing must be properly made

A

T4 to T8

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22
Q

TP contacts for rotary listings

A

TP is contacted very close to the spinous with LM through the center of the vertebral body

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23
Q

ROM flexion extension

A

Most lower thoracic/L5/L1

least upper thoracic

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24
Q

Lateral flexion

A

Least L5/upper and middle thoracic

Most at lower thoracic and L1

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25
Q

Rotation

A

Most in upper thoracic spine

26
Q

Subluxate posterior and superior

A

T4-8

27
Q

Articulations thoracic vertebrae has

A

10-12

2 discs, 4 facets, costovertebral and costotransverse

28
Q 
Idiopathic
Neuromuscular
Myopathic
Congenital
Failure of segmentation
Neurofibromatosis
Mesenchymal disorders
Rheumatoid disease
Trauma
Extraspinal contractures
Infection of bone
Metabolic disorders
Tumors
A

Structural scoliosis

29
Q

Postural scoliosis
Hysterical scoliosis
Nerve root irritation - herniation, tumors
Segmental and postural positional dyskinesia
Inflammatory (appendicitis)
Related to leg length inequality
Related to contracture about the hip

A

Functional scoliosis

30
Q

Sitting coupled motion

A

Everythign couple rotates away from side of bend

31
Q

Standing or sitting up straight coupled motion

A

Lumbars couple rotate to teh same side of bend

32
Q

Pelvic unleveling

A

A right short leg should produce a right scoliosis

33
Q

For every 5 mm of AS or PI measured on x-ray, it will change the leg length by

A

2 mm

Calculation is called an actual deficiency or AD

34
Q

Heel lift rules

A

The subluxation is unstable
The AD is more than 6 mm
Lumbar convexity is to the short leg side
Lumbar body rotation is to the short leg side
Patient is fully formed and under the age of 45

35
Q

Scoliosis what table

A

Knee chest

36
Q

Rod

A

Rod is because of progressive scoliosis

Did adjust on hi lo with pelvis piece locked in area of rod

Grade 2 spondylo adjusted on hi lo with abodminal piece locked only when symptomatic

37
Q

Indications knee chest

A 
Pregnancy
Elderly (rigid)
Osteoporosis
Patient is larger, especially if larger than doctor
Children
Straightened lumbar spine
Flat back/thoracic lordosis
38
Q

Contraindications knee chest

A 
Pain on extension (acute low back)
Very flexible patient
Knee/hip problems
Spondylolysthesis
Knife clasp
Scoliosis
Emotionally unable to handle the table
Hyperkyphosis of thoracic and hi lo
39
Q

What segment has most flexion and extension in lumbar spine

A

L5

40
Q

What percentage of population is born with spondylolytic spoondylolysthesis

A

Zero

41
Q

Medical treatment of choice for facet syndrome is

A

Spinal manipulation

42
Q

What bone would be adjusted if a patient had an L5 spondylo and what listing

A

Sacrum with BP listing

43
Q

Table of choice for symptomatic spondyl that is grade 2 or below

A

Side posture on pelvic bench

44
Q

Contraindications for adjusting spondylo

A

Asymptomatic

45
Q

Facet syndrome shows all except

A

Paresthesia into lower extremities

46
Q

Facet syndrome occurs because of

A

Degenerated disc shifts weight bearing into facet

47
Q

Goal of gonstead adjustment of a symptomatic spondylolysthesis is

A

Level the endpaltes and get motion in facet joints

48
Q

According to gonstead system, preferred talbe graer than grade 2 is

A

Prone on a hi lo with thoracic piece locked

49
Q

Contraindicationfor adjusting on knee table include

A

Spondylo
Acut low back
Facet

50
Q

Which spinous processes are traditionally considered long and imbricated

A

T5-9

51
Q

Idiopathic

A

Structural

52
Q

Anatomical short leg

A

Fucntional

53
Q

Hemi vertebra

A

Structural

54
Q

Antalgia

A

Functional

55
Q

Compression fracture

A

Structural

56
Q

Postural

A

Functional

57
Q

Which vertebrae subluxate posterior superior

A

T4-8

58
Q

What area of spine has most rotation

A

T1-3

59
Q

Structures make up thoracic kyphosis

A

Shape of vertebral bodies

60
Q

Heel lift should be considered if

A

Patient is fully formed and under the age of 45

GONSTEAD ME (5 decks)

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