LBP I & II Flashcards
HNP or herniated disk will most likely be found where?
L4-L5
You should always* check for what first?
Always check for RED FLAGS***
HNP would be best discovered by?
MRI- soft tissue
The Sphinx test is for what?
To test if the patient has extension lumbar spine
The most overlooked cause of LBP is what?
Quadratus Lumborum
what test will exacerbate the symptoms of any space occupying lesion in the spinal canal
Valsalva Test
Ominous signs are patient wet themselves, can’t feel btw both thighs, and has LBP, you are thinking they have what and the treatment is?
Spinal Stenosis and immediate surgical decompression
If you are performing an OMT technique on a patient that has LBP but it only improves slightly, you can encourage the patient that_________>
Since this appears to be a coexisting problem it will be 12 weeks until recovery most likely
You recognize infection mainly by?
Temperature and percussion to pxn: scan will most likely be negative.
90% of all back pain will resolve within?
99% of all coexisting back pain will resolve within?
4-6 weeks
12 weeks
Name some ominous history you don’t want to see
Bilateral Radicular pxn Saddle area anesthesia Urinary Incontinence Urinary Retention Increased urinary frequency Overflow Urinary Incontinence (pee issues)
What are some major bad stuff you hope its not?
Cauda Equina Syndrome massive multi nerve compression large central disc herniation hemmorrhage into spinal canal growing tumor
Cauda Equina Syndrom
def/treatment
Is a LMN lesion that is one of the few LOWER BACK PAIN EMERGENCIES
-immediate surgical decompression
How do you rule out a possible fracture?
Is the patient _________?
- had a major trauma
- Fallen from a height
- a female over 50 or has osteoporosis
How would you rule out an infection?
Is the patient_________?
- over 50
- under 20
- have a fever or chills
- have worse pain when laying supine (on back)
- had a recent UTI
- IV drug abuser
What is the best way to rule out infection?
Do they have a temp? and is there a (+) Spinous process percussive pain?
How would you rule out a tumor?
Is the patient___________?
- over 50
- under 20
- have unexplained weight loss*
- have worse pain when lying down (supine)
- have severe nocturnal pain*
If a patient has a weak or rapid pulse then you’re thinking?
Possible retroperitoneal hemorrhage
If a patient has a low blood pressure then you are thinking?
Possible retroperitoneal hemorrhage
The Shober test
Measures from?
cm requirement
Where the dr marks the PSIS, then 5cm below and 10 cm above. The pt then bend over and then length should be at a minimum 20 cm.
- if less then significant loss of motion
Trendenlenberg Test
Tests for weakness in the__________
which is innervated by__________
What could cause this?
Gluteus medius/L5
disc herniation, spinal tumor, intraspinal abscess ( anything that can PUSH)
This test is used to test the Sciatic Nerve. Hamstring tightness and pain may be mistaken for sciatic nerve pain.
Straight leg raising.
A positive Lloyd sign would be indicative of what? It is used in what test?
Possible renal pathology/ Seated Percussion
Alternating muscle contraction and relaxation in rapid succession and indicates UMN and LMN
Clonus
What are the reflexes for L1-L3
There are none
Patellar?
L5?
L4
None
S1
Achilles
Superficial Anal Reflex?
S2,3,4
This indicates a disconnect between the upper and lower motor neurons. Possible MS or ALS.
Babinski sign
Can you name the Muscle strength ( 0-5)? Reflex grading ( 0-4)
check notes
Write down the muscle strength* for Iliopsoas, quadriceps, hip adductors
tibialis anterior, EHL, EDB and Longus, gluteus medius
Fibularis longus and brevis, gluteus maximus, gastrocenemious
check flash card
Most overlooked dysfunction is the ________ as the cause of LBP.
Quadratus Lumborum
_____________is the area most back problems occur
Multifidus triangle
What are some examples of LBP acute injuries?
Chronic?
fracture, strain, disc herniation, infection, or referred pain
–> chronic are more common.
What is discongenic pain?
thought to be from degeneration or wearing out
Psoas syndrom will cause a _________ contracture and can be caused by any position __________.
flexion ; shortened psoas
The test for nerve root compression where the dr. squeezes bilateral jugular, the patient feels inflammation in the back.
Naffziger test
Soto Hall is what?
Where pain is elicited at the site of the spinal disorder. Where the dr. lays the pt down and the dr lifts the head up to elicit pxn
When you move the ASIS-test?
Pelvic rock Test
Where the dr lays the pt down and slides the leg off- what is the test
Gaenslen test
The patrick test is ?
where you FABERE- flexion, abduction, external rotation, extension
-tests for sacroilitis
The 3 prone position
-nachalas?
-palpation
strength testing
nachalas: leg is flexed at the knee,+ pain will radiate down the anterior thigh implies femoral nerve entrapment or disease.
Spinal Stenosis: def, effects? worsened?what kind of pain
degenerative changes in the L-Spine
- hypertrophy of facets joints, Ca2+ deposits in liga flavum/ post long log, loss of intervertebral disc height.
- shooting pain
- worsened by extension
These occur L4-L5 or L5-S1 95% as ?
HNP
HNP have this type of pain? best scan for this? this is what type of _______contraindication for? What is another contraindication
numbness ( radicular pxn), MRI, relative contraindication for HVLA—- spondylolisthesis
