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Evidence Based Managment > L7 FINAL > Flashcards

L7 FINAL Flashcards

1
Q

pain assessment tools of the low back

A

oswestry
rolland morris
back bournemouth
VAS
NPRS
pain diagram

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2
Q

___% of people experience low back pain in their lifetime

A

80%

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3
Q

back pain can be a result of

A

obesity
age
discogenic
spondy
muscle/ligament
congenital

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4
Q

congenital causes of back pain

A

facet tropism
spina bifida
transitional vertebrae

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5
Q

clasp knife deformity is exacerbated in what condition

A

extension

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6
Q

type ii A transitional vertebrae increases

A

chance of herniation above and at level

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7
Q

management of congenital conditions chiropractically

A

understand underlying pain generator to treat effectively

strengthen
MSTM
core stability
avoid painful motions

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8
Q

lumbar strain most likely due to

A

lifting or sudden twisting

30% of people cannot recall a precipitating event

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9
Q

lumbar sprain is due to

A

sudden traumatic injury or overuse to ligamentous structures

(chronic poor posture)

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10
Q

clinical evaluation of lumbar sprain/strain

A

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

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11
Q

chiropractic management of the lumbar spine sprain/strain

A

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

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12
Q

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

A

degeneration
microtrauma
extension activities

hypertonic muscles try to protect joint but only exacerbate pain

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13
Q

symptoms of facet syndrome of lumbar spine

A

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

better with walking flexing and knee ben

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14
Q

medical management of facet syndrome

A

radiofrequency ablation
facet injections
nerve blocks
NSAIDS

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15
Q

lumbar facet syndrome chiropractic management

A

pain relief with continued activity

supine knee to chest

MSTM

shockwave

mobilization

once out of acute phase, strengthen surrounding muscles

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16
Q

what are some characteristics of spondylolisthesis

A

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

17
Q

causes of spondylolisthesis

A

isthmic
degenerative
pathological
developmental

18
Q

isthmic spondylolisthesis

A

mc at L5 and common in children in sports

concern is for stability

19
Q

symptoms of spondylolisthesis

A

LBP worse after exercise/extension/rotation

tight hamstrings
increased lordosis

20
Q

one leg extension test is used to help diagnose

A

Spondylolisthesis

21
Q

chiropractic management of spondylolisthesis

A

control pain

stabilize core

E-stim for pain

do not adjust at the level of the defect

22
Q

most common disc herniation locations

A

L4/L5
L5/S1

23
Q

lumbar disc derangement steps

A

annular fissure (radial)
migration of nucleus

24
Q

lumbar disc derangement symptoms

A

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

25
Q

chiropractic management of lumbar disc derangement

A

mckenzie
F/D
traction
soft tissue
rehab to core, glutes

may adjust if patient can tolerate it

26
Q

standing radiculopathy tests

A

neri
lewin standing
advancement tests

27
Q

chiropractic management of lumbar radiculopathy

A

ST

traction

F/D

mckenzie

nerve flossing

rehab

may adjust with symptomatic side up

28
Q

spinal stenosis

A

central canal, lateral recess stenosis

15-27mm in diameter
<12mm results in stenosis
<10mm diagnostic

29
Q

spinal stenosis is not a contraindication for treatment unless

A

signs of myelopathy or cauda equina syndrome

30
Q

symptoms of spinal stenosis

A

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

31
Q

clinical evaluation of spinal stenosis

A

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

32
Q

chiropractic management of spinal stenosis

A

Do not adjust into extension

rehab
flexion and distraction
traction
flossing
ergonomic

33
Q

cauda equina syndrome

A

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

34
Q

3 variations of cauda equina syndrome

A

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

35
Q

four S’s of CES red flags

A

bilateral Sciatica, saddle anesthesia, sphincter dysfunction, sexual dysfunction

36
Q

evaluation of CES

A

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

lower motor neuron symptoms

37
Q

mc cause vascular claudication

A

atherosclerosis

38
Q

chiropractors can only manage ____ claudication

A

neurogenic claudication

39
Q

management of neurogenic claudication

A

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

Evidence Based Managment (8 decks)

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