Lab 2 Flashcards
Length of acute symptoms:
Length of subacute:
Length of chronic:
3-4 weeks
<12 weeks
> 12 weeks
Pain w/ increased intrathecal pressure (coughing/sneezing/laughing) could indicate what?
A compression somewhere in the spinal cord
When is disc herniation most common?
What about ankylosing spondylitis?
15-40
18-40
When is OA/degenerative spondylosis most common?
What about Spinal tumor?
45+
50+
What gender is LBP more common in?
Women
What are the 3 kinds of pain?
Localized
Referred
Radiating
What is a potential diagnosis for someone with back pain who is 70+ with bruising over the spine and a recent trauma
Vertebral fracture
In which direction do people typically lean with a disc problem?
Away from the bulge
What are we thinking if a patient has a tuft of hair at the level that they have back pain?
potential Spina-bfida
Sway back posture has ___________ pelvic tilt, with the hips hyperextended and thoracic kyphosis
posterior
A LQ scanning exam is to rule _____
a lumbar exam is to rule ______
out
in
If a patient can preform a full double limb squat with no pain or compensatory patterns, what does this likely indicate
that there is no issue with the hip knee foot or ankle joints
In the case of doing a lumbar ROM exam, from what position should you preform resisted isometrics for a patient?
From the end range if there is no pain
Test from neutral position if the patient had pain with AROM
What part of the vertebrae does quadrant testing focus on?
The facets
When attempting to centralize a patients symptoms, what needs to be examined and possibly corrected first
A lateral shift
How many reps of repeated extension/flexion should a patient do?
10 reps and then reassess
What is the easiest position to do repeated extensions from?
Prone (easiest)
standing (most difficult)
What is the easiest position to do repeated flexion testing from?
Supine is easiest
sitting is more difficult
standing is the most difficult
Repeated motion testing only helps with what kind of pain?
Radiating pain
Most patients who need repeated motions testing respond to which direction best?
extension
If we are having a patient do their repeated motions testing to centralize symptoms, and they say it has made the pain worse in their back, what should we do?
They still complete all 10 reps, goal is to stop the symptoms from radiating, it may be worse temporarily
Always check the ______________ when assessing a joint for a problem
Joints above and below (AKA T-Spine and Hips for lumbar)
How long does a paitent need to hold the sorenson test to test for back endurance?
4 minutes
How should you test a myotome for fatiguability?
hold each 5 seconds, if the patient got weaker overtime, do 3-5 repetitions to see if they fatigue
what myotome does toe walking test?
Where should the PT be?
S1-S2
Behind the patient
What myotome does heel walking test?
What position should the PT be in relation to the patient?
L4
Viewing the patient from the front
How do you test Piriformis flexibility?
Below 90 degree hip flexion + IR
Above 90 degree hip flexion + ER
Well/crossed SLR sign is an indication of what?
Large space ocuppying lesion in the spinal cord, contralateral to the raised leg
If the patient has radiating pain to both legs at all times what is likely?
If the patient has radiating pain to each leg sometimes, what is likely?
CNS problems
Vertebral instability (sometimes it irritates one side and sometimes it irritates the other)
How do you bias the tibial nerve in the SLR test?
Add DF and EV
How do you bias the sural nerve (medial) in the SLR test?
DF + INV
How do you bias the fibular nerve/peroneal in the SLR test
PF + INV
A positive prone knee bend test is between what ROM of knee flexion?
What nerve does it test?
How do you eliminate gravity in this test?
80-100
Tests femoral nerve
Sidelying
How do you preform the Prone Instability test?
Apply lumbar mob to area with suspected instability with patient in prone and feet supported (patient should have their pain increase if they have spinal instability, but that’s not the end of the test)
Then try the same mob while the patient turns on their extensors to lift their legs
A (+) test is decreased pain with muscles working, because the muscles increase the stability
What does the bicycle or stoop test measure?
Intermittent claudication
Pt bicycles on recumbent bike upright, record time until pain
patient then bicycles with a stooped posture, record time until pain
+ test is indicated if there’s less pain w/ stooped posture
What are the 5 components of Waddell’s test
How many out of 5 need to be true, what does it test for?
- Stimulation- light axial compression and hip rotation irritate lumbar symptoms
- Regional - sensory and weakness deficit s
- tenderness- superficial
- distraction improves symptoms
- overreaction (less reliable than other signs)
3+/5 need to be true
Tests for non-organic symptoms
