Exam 2

Question 1

How long until positive response to care

Answer 1

2 weeks is good general

Question 2

Referral for disc

Answer 2

Neurosurgeon

Question 3

Piriformis muscle referred pain facet

Answer 3

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

Question 4

Gluteus medius pain referral

Answer 4

Medial iliac bone, lateral butt, sacrum

Question 5

Primary areas of facet issues

Answer 5

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

Question 6

Symptoms facet

Answer 6

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

Question 7

Physical signs facet

Answer 7

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

Question 8

L5 thrust

Answer 8

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

PA-IS-ML

Question 9

Case management facet syndrome

Answer 9

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

Question 10

Stuck in extension vs more parallel disc presentation

Answer 10

Facet syndrome vs D1 disc

Question 11

Joints appearing most degenerating on films may actually be

Answer 11

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

Question 12

Stress fracture or defect of the pars in a vertebra

Answer 12

Spondylolythesis common cause

Question 13

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

Answer 13

Common cause spondylolysthesis

Question 14

Many people with a spondylolysthesis will have

Answer 14

No symptoms

Only revealedon x-ray

Question 15

Symptoms that may accompany spondylolysthesis

Answer 15

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

Question 16

Suspecting spondylolisthesis of L5

Answer 16

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

Question 17

Subluxation correction of spondylolisthesis

Answer 17

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

Question 18

Only adjust a spondylolisthesis if it is

Answer 18

Symptomatic

Question 19

Most common treatment for the correctino of scoliosis

Answer 19

Surgery

Question 20

Thoracic curve is made up by

Answer 20

Height of vertebral body

Body is bigger in the back and smaller in the front

Discs are level

Question 21

mostly PA an dLM adjustmetn only with limited IS

Spinous contact for simple listing must be properly made

Answer 21

T4 to T8

Question 22

TP contacts for rotary listings

Answer 22

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

Question 23

ROM flexion extension

Answer 23

Most lower thoracic/L5/L1

least upper thoracic

Question 24

Lateral flexion

Answer 24

Least L5/upper and middle thoracic

Most at lower thoracic and L1

Question 25

Rotation

Answer 25

Most in upper thoracic spine

Question 26

Subluxate posterior and superior

Answer 26

T4-8

Question 27

Articulations thoracic vertebrae has

Answer 27

10-12 2 discs, 4 facets, costovertebral and costotransverse

Question 28

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

Answer 28

Structural scoliosis

Question 29

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

Answer 29

Functional scoliosis

Question 30

Sitting coupled motion

Answer 30

Everythign couple rotates away from side of bend

Question 31

Standing or sitting up straight coupled motion

Answer 31

Lumbars couple rotate to teh same side of bend

Question 32

Pelvic unleveling

Answer 32

A right short leg should produce a right scoliosis

Question 33

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

Answer 33

2 mm Calculation is called an actual deficiency or AD

Question 34

Heel lift rules

Answer 34

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

Question 35

Scoliosis what table

Answer 35

Knee chest

Question 36

Rod

Answer 36

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

Question 37

Indications knee chest

Answer 37

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

Question 38

Contraindications knee chest

Answer 38

``` 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 ```

Question 39

What segment has most flexion and extension in lumbar spine

Answer 39

L5

Question 40

What percentage of population is born with spondylolytic spoondylolysthesis

Answer 40

Zero

Question 41

Medical treatment of choice for facet syndrome is

Answer 41

Spinal manipulation

Question 42

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

Answer 42

Sacrum with BP listing

Question 43

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

Answer 43

Side posture on pelvic bench

Question 44

Contraindications for adjusting spondylo

Answer 44

Asymptomatic

Question 45

Facet syndrome shows all except

Answer 45

Paresthesia into lower extremities

Question 46

Facet syndrome occurs because of

Answer 46

Degenerated disc shifts weight bearing into facet

Question 47

Goal of gonstead adjustment of a symptomatic spondylolysthesis is

Answer 47

Level the endpaltes and get motion in facet joints

Question 48

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

Answer 48

Prone on a hi lo with thoracic piece locked

Question 49

Contraindicationfor adjusting on knee table include

Answer 49

Spondylo Acut low back Facet

Question 50

Which spinous processes are traditionally considered long and imbricated

Answer 50

T5-9

Question 51

Idiopathic

Answer 51

Structural

Question 52

Anatomical short leg

Answer 52

Fucntional

Question 53

Hemi vertebra

Answer 53

Structural

Question 54

Antalgia

Answer 54

Functional

Question 55

Compression fracture

Answer 55

Structural

Question 56

Postural

Answer 56

Functional

Question 57

Which vertebrae subluxate posterior superior

Answer 57

T4-8

Question 58

What area of spine has most rotation

Answer 58

T1-3

Question 59

Structures make up thoracic kyphosis

Answer 59

Shape of vertebral bodies

Question 60

Heel lift should be considered if

Answer 60

Patient is fully formed and under the age of 45