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MSK LQ > L Spine Exam & Eval > Flashcards

L Spine Exam & Eval Flashcards

1
Q

L spine physical exam must include assessment of NMSK and vascular structure of

A

L spine
pelvic region
hip region
LEs

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2
Q

which back/abdominal related impairment is suspect for 10-20 yo?

A

spondylolisthesis

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3
Q

which back/abdominal related impairment is suspect for >65 yo?

A

cancers
compression fxs
stenosis
AAA

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4
Q

which back related impairment is suspect for 15-40 yo?

A

disc herniation/dysfunction

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5
Q

which back related impairment is suspect for >45 yo?

A

OA/spondylosis

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6
Q

T/F: most pts with acute LBP present with at least one red flag (>80%)

A

T

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7
Q

what is the ultimate goal of treating LBP?

A

self-management by the pt

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8
Q

which approach works better with spine dysfunction: structure-based (Cyriax) or Treatment-based (McKenzie & Maitland)

A

Treatment-based (McKenzie & Maitland)

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9
Q

piriformis syndrome is typically a diagnosis of

A

exclusion

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10
Q

which motions increase sx with piriformis syndrome?

A

stooping or lifting

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11
Q

spondylolysis is a defect in the

A

pars interarticularis (isthmus)

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12
Q

which level does spondylolysis usually occur?

A

L5

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13
Q

which position does spondylolysis pts prefer?

A

flexion

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14
Q

list the susceptibility to compression of spinal structures in order of most to least

A

END-PLATE
vertebral body
disc

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15
Q

disc protrusion

A

disc bulge without annulus fibrosus rupture

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16
Q

disc prolapse

A

only outer layers of AF contain NP

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17
Q

disc extrusion

A

AF perforated and disc material moves into epidural space

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18
Q

disc sequestration

A

disc fragments from AF & NP disconnect

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19
Q

sx of end-plate fx

A

acute pain/spasm
- SLR
+ compression test

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20
Q

sx of internal disc disruption

A

LBP and/or referred hip/upper leg pain
- SLR
dx with discogram

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21
Q

sx of disc protrusion and prolapse (contained)

A

LBP and/or referred hip/upper leg pain
pain w/ cough & sneeze
- SLR

22
Q

sx of disc extruision and sequestration

A

LBP
pain with cough and sneeze
TRUE SCIATICA (radicular pain)
+ SLR

23
Q

nerve compression (via disc) usually affects which nerve root

A

lower segment
Ex: L4/L5 –> effects L5

24
Q

S&S of spinal stenosis

A

persistent buttock pain
limping
lack of sensation in LEs (claudication)
decreased walking/standing ability

25
Q

is localized or referred pain more common with facet joint dysfunction?

A

localized

26
Q

what is the hallmark sign in instability (for any joint)?***

A

inconsistent symptomology

27
Q

how is fibromyalgia diagnoses?

A

11/18 tender points w/o other reason for tenderness

28
Q

when is herpes zoster contagious?

A

when sores open and oozing

29
Q

what rash is in a dermatomal pattern?

A

herpes zoster

30
Q

impairments with acute or sub-acute LBP with mobility deficits

A

segmental or global hypomobility
pain in back, buttock, groin, or thigh
impaired functional movements
- neuro test!!
onset of sx < 3 mo

31
Q

impairments with acute, sub-acute, or chronic LBP with movement coordination impairments

A

pain worsens with end range movements
+ prone instability test

32
Q

impairments with acute LBP with referred LE pain

A

+ repeated measures test
onset of sx < 3 days
hypo or hyper mobile

33
Q

impairments with acute or sub-acute LBP with radiating pain

A

+ neuro exam
+ neurodynamic tests
+ repeated measures tests
radiating pain in dermatomal pattern

34
Q

impairments with acute or sub-acute LBP with related cognitive or affective tendencies

A

inconsistent MSK exam results
onset of sx <3 months
+ Waddell’s test
high FABQ scores

35
Q

impairments with chronic LBP with related generalized pain

A

no structural issue for pain
inconsistent with MSK dysfunction
changes in brain & sensory structures
onset of >3 mo
high FABQ scores

36
Q

manual therapy criteria

A

no sx distal to knee
less than 16 days
score of less than 19 on FABQ-W
at least 1 hypomobile segment in L spine
at least 1 hip w/ >35 deg IR

37
Q

stabilization criteria

A

<40 yo
post-partum
SLR >91 deg
instability catch or aberrant movements during flx/ext ROM
+ prone instability test

38
Q

post-partum criteria for instability

A

+ posterior pelvic provocation
+ ASLR
+ modified Trendelenburg test
OR
pain with palpation of long dorsal SI lig or pubic symphysis

39
Q

criteria for extension direction-specific

A

sx distal to buttock
symptoms centralize with L ext
symptoms peripheralize with L flx
direction preference for ext

40
Q

criteria for flexion direction-specific

A

> 50 yo
directional preference for flex
L spinal stenosis

41
Q

criteria for lateral shift direction-specific

A

visible frontal plane shift of shoulders relative to pelvis
directional preference for lateral translation movements of pelvis

42
Q

T/F: pt does not have to have radiating pain for directional preference category

A

F

43
Q

interventions manual therpay category

A

lumbopelvic HVLAT
L and LE ROM exercises

44
Q

interventions for stabilization

A
  • isolated contraction and co-contraction of deep stabilizer (multifidi and TA)
  • strengthen large spinal stabilizers (ES, internal & external obliques)
45
Q

interventions for extension preference

A

end range extension exercises
mobilize to promote extension
avoid flexion

46
Q

interventions for flexion preference

A

mobilize & manipulate spine
strength & flexibility exercises
body-weight supported treadmill training
(non WB exercises)

47
Q

interventions for lateral shift preference

A

exercises to correct lateral shift
traction

48
Q

which impairment must be addressed first before categorizing (if present)?

A

lateral shift

49
Q

____% of patients fit >1 classification group

A

25%

50
Q

presence of ___ & ______ weaken a treatment effect

A

psychosocial factors & co-morbities

MSK LQ (18 decks)

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