L7 FINAL

Question 1

pain assessment tools of the low back

Answer 1

oswestry
rolland morris
back bournemouth
VAS
NPRS
pain diagram

Question 2

___% of people experience low back pain in their lifetime

Answer 2

80%

Question 3

back pain can be a result of

Answer 3

obesity
age
discogenic
spondy
muscle/ligament
congenital

Question 4

congenital causes of back pain

Answer 4

facet tropism
spina bifida
transitional vertebrae

Question 5

clasp knife deformity is exacerbated in what condition

Answer 5

extension

Question 6

type ii A transitional vertebrae increases

Answer 6

chance of herniation above and at level

Question 7

management of congenital conditions chiropractically

Answer 7

understand underlying pain generator to treat effectively

strengthen
MSTM
core stability
avoid painful motions

Question 8

lumbar strain most likely due to

Answer 8

lifting or sudden twisting

30% of people cannot recall a precipitating event

Question 9

lumbar sprain is due to

Answer 9

sudden traumatic injury or overuse to ligamentous structures

(chronic poor posture)

Question 10

clinical evaluation of lumbar sprain/strain

Answer 10

ROM
Kemps localized back pain
rule out SI
FABER cause LBP
joint restrictions

Question 11

chiropractic management of the lumbar spine sprain/strain

Answer 11

MSTM
E stim
Acupuncture
Stretching
manipulation (if not in spasm)
taping
ergonomics

Question 12

causes of facet syndrome can be due to these three pathologies:

Answer 12

degeneration
microtrauma
extension activities

hypertonic muscles try to protect joint but only exacerbate pain

Question 13

symptoms of facet syndrome of lumbar spine

Answer 13

forward antalgia
localized facet pain
pain worse with extension, rot, LF and prolonged standing

better with walking flexing and knee ben

Question 14

medical management of facet syndrome

Answer 14

radiofrequency ablation
facet injections
nerve blocks
NSAIDS

Question 15

lumbar facet syndrome chiropractic management

Answer 15

pain relief with continued activity

supine knee to chest

MSTM

shockwave

mobilization

once out of acute phase, strengthen surrounding muscles

Question 16

what are some characteristics of spondylolisthesis

Answer 16

slippage of vertebrae
most common at L5
50% have no symptoms

Question 17

causes of spondylolisthesis

Answer 17

isthmic
degenerative
pathological
developmental

Question 18

isthmic spondylolisthesis

Answer 18

mc at L5 and common in children in sports

concern is for stability

Question 19

symptoms of spondylolisthesis

Answer 19

LBP worse after exercise/extension/rotation

tight hamstrings
increased lordosis

Question 20

one leg extension test is used to help diagnose

Answer 20

Spondylolisthesis

Question 21

chiropractic management of spondylolisthesis

Answer 21

control pain

stabilize core

E-stim for pain

do not adjust at the level of the defect

Question 22

most common disc herniation locations

Answer 22

L4/L5
L5/S1

Question 23

lumbar disc derangement steps

Answer 23

annular fissure (radial)
migration of nucleus

Question 24

lumbar disc derangement symptoms

Answer 24

back pain
leg pain
valsalvas
worse with flexion
better laying on back
antalgic lean

Question 25

chiropractic management of lumbar disc derangement

Answer 25

mckenzie F/D traction soft tissue rehab to core, glutes may adjust if patient can tolerate it

Question 26

standing radiculopathy tests

Answer 26

neri lewin standing advancement tests

Question 27

chiropractic management of lumbar radiculopathy

Answer 27

ST traction F/D mckenzie nerve flossing rehab may adjust with symptomatic side up

Question 28

spinal stenosis

Answer 28

central canal, lateral recess stenosis 15-27mm in diameter <12mm results in stenosis <10mm diagnostic

Question 29

spinal stenosis is not a contraindication for treatment unless

Answer 29

signs of myelopathy or cauda equina syndrome

Question 30

symptoms of spinal stenosis

Answer 30

variable pain radiating down legs extension exacerbates the symptoms easier to upstairs

Question 31

clinical evaluation of spinal stenosis

Answer 31

red flags: wide based gait, bowel/bladder dysfunction, saddle anesthesia, bilateral lower extremity weakness ROM MRS nerve tension tests are negative unless specific nerve root is involved kemps SI claudications

Question 32

chiropractic management of spinal stenosis

Answer 32

Do not adjust into extension rehab flexion and distraction traction flossing ergonomic

Question 33

cauda equina syndrome

Answer 33

usually follows a large lower lumbar herniation can occur with congenital stenosis and bulge

Question 34

3 variations of cauda equina syndrome

Answer 34

rapid onset without previous history acute bladder dysfunction with a history of LBP chronic LBP with sciatica and gradually progressing CES

Question 35

four S's of CES red flags

Answer 35

bilateral Sciatica, saddle anesthesia, sphincter dysfunction, sexual dysfunction

Question 36

evaluation of CES

Answer 36

positive SLR, WLR weakness of lower extrem loss sensation decreased DTR lower motor neuron symptoms

Question 37

mc cause vascular claudication

Answer 37

atherosclerosis

Question 38

chiropractors can only manage ____ claudication

Answer 38

neurogenic claudication

Question 39

management of neurogenic claudication

Answer 39

flexion based exercises F/D traction do not adjust into extension rehab flossing