Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MS II > Exam 4: Lumbar (9-12) > Flashcards

Exam 4: Lumbar (9-12) Flashcards

1
Q

Lumbar spinal stenosis can be presented in the clinic in several ways. What are vast majority of ways that will be seen in the clinic

A

Facet joint
Lig. Flavum
Disc Bulge
VB flattening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which of the following treatment styles for spinal stenosis results in intermediate pain

A

Self help with positional change and OTC meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which of the following treatment styles for spinal stenosis results in between intermediate and stenosis pain

A

Self help with PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which of the following treatment styles for spinal stenosis results in stenosis pain

A

PT and injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What of the following treatment styles for spinal stenosis results in constant pain

A

surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 6 self help treatment for spinal stenosis

A 
Positional changes
Frequent breaks/sitting
Leaning forward
Shopping cart lean
OTC medications
Lifestyle changes/limit prolonged loading
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the results of Whitman’s RCT study in which 58 patients with lumbar spinal stenosis were divided into two 6week PT programs

A
  1. Both groups met the threshold to recovery
  2. But the manual therapy, exercise, and walking group showed the highest level of recovery at 62%, while the flexion exercises and walking group showed 41% recovery rates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 7 PT treatments used for LSS

A 
Education
Treadmill/incline
Cycling
Lumbar traction
Exercise/flexion based
Manual therapy
Neural tissue mobilization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

According to the louis gifford model, his four questions fall under which category of PT treatment for LSS

A

education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The (young/elderly) have more spinal stenosis surgeries

A

elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The fancy graph in the powerpoints are to used to provide pain neuroscience education to patients as well as to show a patient how a sensitive nervous system works. Within the graph a spot that shows there is little room for activity. How do we explain the best way to increase room for activity

A

Getting up and moving

This will increase blood flow and nerve play

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

During treadmill walking for LSS, should the patient’s body weight be supported or unsupported

A

either

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

During the treadmill walking for LSS, why is it important for the patient to be walking on an incline

A

It induces flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is cycling a good intervention of LSS

A

It is recumbent and makes the patient sit upright

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A study by Fritz showed that a subgroup of LSS patients may benefit from mechanical traction. What does the subgroup must be characterized by

A

Prescence of leg symptoms
Nerve root compression
Peripheralization with extension
Crossed SLR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What the five types of general exercises used for LSS

A 
flexion based
stabilization
stretches
aquatic 
aerobic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

True or False:

Clearance by a doctor is needed before performing aerobic exercises in patients with LSS

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Aquatic therapy can provide greater (short/long) term improvement in pain and function than conventional PT can in patients with LSS

A

short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

True or False:

Conventional PT can provide greater relief than aquatic therapy in patients with LSS

A

False, aquatic therapy is better. Especially in those who have limited exercise capacity on land.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

True or False:

In theory, stabilizing exercises in patients with LSS can increase space by pulling on the lig. flav.

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Manual therapy for treating LSS incudes (active/passive), (small/large) amplitude movements

A

passive; large

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does manual therapy help treat LSS

A

increases space and blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the best mobs for LSS

A

PA hip mobs to facilitate natural extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

There is a ___% increase in medicare expenditures for epidural steroid injections

A

629%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

One interventional approach for stenosis is to reduce inflammation. This can be done by ESI’s. Explain the benefits of ESI’s

A

It will reduce inflammation which can provide relief. Disc bulges can also benefit from a decrease in swelling after ESI’s. This can allow for more movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

True or False:

The rate of surgery for spinal stenosis alone increased 200% in the last decade

A

False, it increased 400%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

There are predictors used in deciding whether a stenosis surgery will have good or poor outcomes. List the predictors for a poorer outcome

A

Depression
Cardio comorbidity
Disorder influencing walking ability
Scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

There are predictors used in deciding whether a stenosis surgery will have good or poor outcomes. List the predictors for a good outcome

A

Better walking ability
Higher income
Less overall comorbidity
Male gender and younger age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Explain Cochrane’s idea on surgery or not in patients with LSS

A

There isn’t enough evidence to prove whether surgical or conventional is better for LSS. However there are no known side effects for conservative treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Long term outcomes show that (surgical/non surgical) interventions have the highest improvement in LBP, a decrease in predominant symptoms, and are more satisfied with current status

A

surgical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

The SI joint serves as the point of intersection between the ____ and the ___ ____ joints.

A

spine; LE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

True or False:

The SI joint is very well understood so it has a simple treatment plan

A

False, it is the least understood making it controversial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The configuration of the SI joint is extremely _____ from person to person.

A

variable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

True or False:

Differences in morphology and mobility of the SI joint from person to person are not pathological, but normal adaptation

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

True or False:

It is not normal for an individual to be asymmetrical in regards to the SI joint

A

False, it is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the prevalence of people seeking care for LBP as a result of SI joint pain

A

9%

1 in every 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What two bones articulate at the SI joint

A

sacrum and ilium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

The (anterior/posterior) side of the SI joint is synovial and has hyaline cartilage

A

anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

The (anterior/posterior) side of the SI joint articulates with the PLL

A

posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What nerve innervates the SI joint and has nociceptors throughout the joint

A

sciatic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

The SI joint has a very (small/large) amount of movement. Approximately (4/84) %

A

small; 4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

The ligaments of the SI joint are some of the (weakest/strongest) ligaments of the body

A

strongest and toughest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the major ligaments on the anterior side of the SI joint

A

Dorsal Sacral lig.
Interosseus lig.
Anterior sacroiliac lig.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the major ligaments on the posterior side of the SI joint

A

Dorsal sacral lig.
Sacrospinous lig.
Sacrotuberous lig.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

How many muscles attach directly to the sacrum and/or innominate

A

35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Are the 35 muscles that attach to the sacrum and/or innominate for mobility or stabilization purposes. Why?

A

stability

It would be bad for the sacrum to move that much bc we would then compensate for a lot of unnecessary movement

47
Q

What muscles are involved in the outer unit of the SI joint

Think about ant. post. lateral. and deep longitudinal systems

A

lats, glute max, glute med, thoracodorsal fascia, ext/int obliques, contralateral hip adductors, and intervening abdominal fascia, ES, sacrotuberous lig. and Bicep femoris

48
Q

What is another name for the term “pelvic floor muscles” and what are the three muscle groups involved

A

levator ani is the other term

Muscle groups: pubococcygeus, puborectalis and iliococcygeus

49
Q

The levator ani musles joint the _____ muscles to complete the pelvic floor

A

coccygeus

50
Q

What are the 5 functions of pelvic floor muscles

A 
Increase intra-abdominal pressure
Provide rectal support during defecation
Inhibit bladder activity
Support the pelvic organs
Assists in lumbopelvic stability
51
Q

The inner SI unit is like a ____. The bottom is the pelvic floor and the top is the diaphragm

A

cylinder

52
Q

What are the muscles of the inner unit of the SI joint

A

multifidus, transverse abdominis, diaphragm, and pelvic floor

53
Q

True or False:

It is unclear how the anterior and posterior aspects of the SI joint are innervated

A

True

54
Q

Even though it is unclear how the anterior and posterior aspects of the SI joint are innervated, it is most likely to receive innervation from the (anterior/posterior) rami of the ____ roots.

A

posterior; L2-S2

55
Q

Explain why there is a very diffuse pattern of pain referral from the SI joint

A

The joint is highly variable and differs among individuals, making it complex to pin point the exact nerve roots involved

56
Q

Studies show that __% of sacra are found to have a sacralized L5 and __% are found to have a lumbarized S1

A

33; 24

57
Q

is it more common to have a lumbarized S1 or L5

A

L5

58
Q

What are the sagittal plane motions of the SI joint

A

Nutation/flexion

Counter-Nutation/extension

59
Q

The small amount of Sagittal plane movement occurs when both feet are (in the air/on the ground)

A

on the ground

60
Q

Is there more nutation or counter nutation

A

nutation

61
Q

What are the terms used in Snijders and Vleeming’s research of SI joint kinetics

A

Form closure and force closer to describe the passive and active forces that help stabilize the pelvis and the sacroiliac

62
Q

The more weight bearing, the (looser/tighter) the fit between the pelvis and sacrum creating a strong stabilization of the SI joint

A

tighter

63
Q

What term is used when describing the appropriate amount of force between the sacrum and pelvis creating strong stabilization

A

key stone

64
Q

SI joint stabilizing works in (parallel/cross) patterns

A

cross

65
Q

The SI joint is basically a friction device. A “____” effect must be slightly unlocked to move functional. This effect is made possible because the SI joint (smoot/rough)

A

clutching; rough

66
Q

SI joint dysfunction is generally caused by moving too little or moving to much. Match the patient population with whether the SI joint tends to move too little or too much

A

Men moves too little

Women moves too much

67
Q

The SI joint moving too little can also be caused by aging. List the 5 conditions that aging impacts the SI joint moving too little

A 
OA
Shortened SIJ ligaments 
RA
Decreased function
Ankylosing spondylitis
68
Q

List some conditions that can cause the SI joint to move too much

A 
Hormones/pregnancy
Ligamentous laxity 
Excessive lumbar lordosis 
Leg length 
Ankylosing spondylitis
69
Q

What type of pain will occur in patients in regards to ligaments moving too little at the SI joint

A

vague, posterior local ache

70
Q

What type of pain will occur in patients in regards to intraarticular structures causing too little movement at the SI joint

A

Deep, posterior pain

and possible groin pain

71
Q

Is sacroiliitis a form of the SI joint moving too little or too much

A

too much

72
Q

Sacroiliitis can occur with hormonal changes and pregnancy. List the physical characteristic that would be seen in sacroiliitis in pregnant women

A

Increased ptosin levels
Increased laxity of the SIJ lig.
Increased lumbar lordosis
Shifts weight posterior towards SIJ

73
Q

Sacroiliitis can be caused by an increased stiffness from adjacent joints. What are the conditions that would cause increased stiffness

A 
Lumbar surgery
Hip OA
Scoliosis
Lumbar spine degeneration
Ankylosing spondylitis
74
Q

What is the gold standard of managing SI joint pain after lumbar fusion

A

anesthetic block under fluoroscopic

75
Q

The SI joint is a synovial joint with (very little/abundance) of innervations which can contributed to LBP and referred pain in the ____

A

abundance; LE

76
Q

What are the symptoms of sacroiliitis

A

Localized sharp stabbing pain. Can even be dull or throbbing

77
Q

Is sacroiliitis bilateral or unilateral

A

unilateral

78
Q

True or False:

There are neurological symptoms in patients with sacroiliitis

A

False, there is not

79
Q

List the sacroiliitis provocation studies referral patterns in order from most referred to least referred

A 
Buttock
Lumbar
LE
Below Knee
Groin (more proximal than distal)
80
Q

True or False:

Sacroiliitis does not usually present with radiculopathy pain

A

true

81
Q

Which dermatome will be responsible for pain that goes down the posterior entire leg but doesn’t reach the top of the foot or the front of the leg

A

S2

82
Q

What is referral pattern for an S2 dermatome

A

Pain the posterior leg that stops before it reaches the top of the foot

83
Q

What are the aggs of a SI joint that moves too little

A

Prolonged walking/loading that puts strain on the ligs. and joints.
Rotational tasks
Morning pain due to OA

84
Q

What are the eases of a SI joint that moves too little

A

Little bit of movement
Stop training task
Unloading

85
Q

What are the aggs of a SI joint that moves too much

A 
Loading with standing or walking
Transistional movements like stairs
Later in the day
Prolonged WB like running
Extension
Cough/Sneeze
86
Q

What are the eases of a SI joint that moves too much

A 
Rest
Unloading
Stabilization belt
Flexion
Muscle energy
87
Q

Evidence available over the SIJ is (some/worth considering/still searching) regarding pain pattern generation and MOI

A

some

88
Q

Evidence available over the SIJ is (some/worth considering/still searching) regarding provocation stresses

A

worth considering

89
Q

Evidence available over the SIJ is (some/worth considering/still searching) regarding where to palpate for bone position or palpation for joint mobs

A

Still searching

90
Q

Based on a review by Simopoulos, the evidence for dx accuracy of SIJ injection is (good/fair/limited)

A

Good

91
Q

Based on a review by Simopoulos, the evidence for provocation maneuvers is (good/fair/limited)

A

fair

92
Q

Based on a review by Simopoulos, the evidence for imaging is (good/fair/limited)

A

limited

93
Q

True or False:

Even though there are many provocation tests for SI joint pain, the research shows that none of them are valid and/or do not have significant specificity or sensitivity

A

true

94
Q

Explain the results of Dreyfuss study regarding SIJ provocation tests

A

None of the 12 tests demonstrated worthwhile diagnostic value

95
Q

Explain the results of Slipman’s study regarding SIJ provocation tests

A

Positive predictive values were shown as long as at least 3 tests were positive. Two of the three positive tests had to be Patrick’s test and Ipsilateral sacral sulcus

96
Q

Explain the results of Laslett’s provocation test regarding SIJ pain

A

This study showed high sensitivity and specificity and 2 of the 4 tests showed the best predictive value:
-Distraction, compression, thigh thrust, Gaenslen’s test, sacral thrust

97
Q

Laslett’s study in regards to SIJ provocation tests had a sensitivity of 91%, Explain the significance of this

A

If all tests are negative, we can be 91% sure it is not an SIJ problem

98
Q

What mobs should be performed on a patient whose SIJ moves too little

A

Unilateral PA
Central PA
Rotation

99
Q

What manipulations should be performed on a patient whose SIJ moves too little

A 
Anterior innominate (CPR)
Rotational manipulation
100
Q

The SIJ can either move too little or too much. What are the three general subcategories under the SIJ moving too much

A

mechanics, treat above and below, and stabilization

101
Q

What are the mechanical interventions for treating SIJ that moves too much

A

Leg length
Orthotics
Taping
Bracing

102
Q

What are the interventions used to treat above and below an SIJ that moves too much

A

Mobs and Manips to the lumbar spine and hip joint

103
Q

What are the stabilization interventions for an SIJ that moves too much

A

exercises for the inner and outer units

104
Q

What are the symptoms of piriformis syndrome

A 
Sciatic nerve pathology
Numbness from mechanical pressure
Local pain
Deep buttox pain
Trigger points
Altered neurodynamics
105
Q

What are the interventions used to treat piriformis syndrome

A 
stretches
soft tissue treatment
trigger point therapy
neurodynamics
mobs/manips for S1,S2
106
Q

Which neurotag structure is responsible for organizing and preparing movements

A

premotor/motor cortex

107
Q

Which neurotag structure is responsible for concentration and focus

A

Cingulate cortex

108
Q

Which neurotag structure is responsible for problem solving and memory

A

prefrontal cortex

109
Q

Which neurotag structure is responsible for fear, fear conditioning, and addiction

A

amygdala

110
Q

Which neurotag structure is responsible for Which neurotag structure is responsible for sensory discrimination

A

Sensory cortex

111
Q

Which neurotag structure is responsible for stress responses, autonomic regulation, and motivation

A

Hypothalamus/thalamus

112
Q

Which neurotag structure is responsible for movement and cognition

A

cerebellum

113
Q

Which neurotag structure is responsible for memory, spatial recognition, and motivation

A

hippocampus

114
Q

Which neurotag structure is responsible for gating from the periphery

A

spinal cord

MS II (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions