HNP and Low Back Pain

Question 1

possible problem to low back pain

Answer 1

cardiovascular referred pain
renal pain
respiratory pain
ectopic pregnancy
-trauma

Question 2

cauda equina syndrome

Answer 2

problem with low back pain

medical emergency

Question 3

straight leg test

Answer 3

is positive

Question 4

cause of lower back pain

Answer 4

local vs. radiating

Question 5

radiation below knee

Answer 5

some sort of neural involvement

Question 6

cauda equina syndrome

Answer 6

compression L1-S5

loss of bowel and bladder control

48 hours to have it decompressed
-emergency

Question 7

radiculopathy

Answer 7

herniated nucleus pulposus

Question 8

intervertebral foramen

Answer 8

normally 2-3x larger

-can be decreased in size due to variety of factors

Question 9

vertebral disc

Answer 9

mostly water

• center - nucleus propulsus
• surrounded by annulus propulsus

Question 10

adaptation of discs to weight applied

Answer 10

annulus fibrosis - does not deform much

• become dried out as we age
• fibrotic as we age

Question 11

protruded disc

Answer 11

annulus remains intact

Question 12

extruded disc

Answer 12

through annulus, but stays in disc space due to long ligament

Question 13

sequestered disc

Answer 13

free to roam spinal canal

Question 14

lumbar disc herniation

Answer 14

most herniations here

• more stress here
• not protected by thoracic page

Question 15

common disc herniation

Answer 15

S1 from L5 disc herniation

L5 by L4 disc herniation

Question 16

discs lower in lumbar spine

Answer 16

more affected by hernation

Question 17

radiculopathy

Answer 17

only severely bulging discs or herniations

Question 18

risk factors for herniated nucleus propulsus

Answer 18

tobacco, ethanol, age, bending/lifting

Question 19

L4 dermatome

Answer 19

crosses over knee

Question 20

achilles reflex

Answer 20

S1

Question 21

patellar tendon reflex

Answer 21

L4

Question 22

disc herniation

Answer 22

occurs posteriorly

-anterior longitud is thick/strong

Question 23

causes of pain with HNP

Answer 23

mechanical compression
chemical mediators
irritation of post long ligament

Question 24

OMT for HNP?

Answer 24

SDs aggravate radiculopathy

SD alter mechanical relationships

Question 25

musculoskeletal model

Answer 25

for looking at HNP in lumbar spine

connected to thorax and pelvis directly

Question 26

respiratory / circulatory model

Answer 26

area of restricted motion

• connect two important junctional areas
• thoracolumbar and lumbosacral
• both studry structural aspects of body

Question 27

acute HNP

Answer 27

lots of pain

-no OMT

Question 28

subacute/chronic HNP

Answer 28

may use direct OMT

-shy away from HVLA

Question 29

type II

Answer 29

single segment

keystone of type I

SB and rotate same

Question 30

type I

Answer 30

large group curves

SB and rotate opposite

Question 31

latissimus dorsi

Answer 31

upper extremity and low back pain connection

Question 32

quadratus lumborum

Answer 32

associated with low back pain

Question 33

iliopsoas

Answer 33

associated with low back pain

Question 34

surgery with low back pain?

Answer 34

if neuro deficit, muscle atrophy, reflex change, parasthesia