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OMM II > Low Back Exam > Flashcards

Low Back Exam Flashcards

1
Q

What are the goals of a PE?

A
  1. Determine the symptoms do not represent life or function threatening
  2. Where pain is coming from
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2
Q

What are the four causes of LBP?

A
  1. Referred pain
  2. Activity related pain
  3. Non-activity related
  4. Psych
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3
Q

What is lumbago?

A

LBP

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4
Q

What is sciatica?

A

Pain in the lower back and hip, radiating down the thigh and into the leg. Is a descriptive term for a distribution of pain, not a diagnosis.

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5
Q

What is the cause of sciatic nerve neuropathy?

A

Piriformis tightness

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6
Q

Foot and ankle paresthesias = ?

A

Peroneal neuropathy

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7
Q

What causes a leg radiculopathy?

A

L5/S1 nerve compression by herniated disc

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8
Q

SI joint ligament pattern can cause what?

A

Sciatica

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9
Q

Steadily increasing back pain, especially in the elderly, could suggest what?

A

Malignancy

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10
Q

Continuous pain, not altered by posture or movement is suspicious for what?

A

Renal stones

Psychogenic causes

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11
Q

True or false: isolated pain in the upper lumbar region is generally not concerning

A

false–could be AAA

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12
Q

What is spondylolysis?

A

Breakage of a vertebral segment

scottie dog

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13
Q

Scottie dog appearance on x-ray = ?

A

spondylolysis

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14
Q

Why is coughing or sneezing that worsens back pain concerning?

A

Increased abdominal pressure leads to pressure on the spine

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15
Q

Back pain with lying down or wakes up at night (not relieved by turning over) is concerning for what?

A

Bone CA

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16
Q

Why is asking about function important with LBP?

A

See how bad it really is

Assess what needs to be done

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17
Q

Pt failing to improve is suspicious for what?

A

Psychosocial issues

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18
Q

Heel and toe walking assess what?

A

L5/S1 nerves

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19
Q

What does the Adam’s forward bending test check for?

A

Scoliosis

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20
Q

Flexion of the spine loads the anterior or posterior parts of the spine?

21
Q

Extension of the spine loads the anterior or posterior parts of the spine?

22
Q

Flexion of the spine stretches the anterior or posterior parts of the spine?

23
Q

Extension of the spine stretches the anterior or posterior parts of the spine?

24
Q

What does side-bending spine load?

A

The facets of either sides, closing the neural foramen

25
Q

What does ROM of the spine check for?

A

Non specific muscles

26
Q

What is the capsular pattern for the lumbar spine?

A

limited ROM in all directions

27
Q

What does capsular pain indicate?

A

Capsule inflammation/irritation

28
Q

Toe walking = which nerve root?

29
Q

Heel walking = which nerve root?

30
Q

Single leg calf raises checks for what nerve levels?

31
Q

Weakness or inability to perform heel/toe walking without an explanable condition =?

A

Acute plantar fasciitis

32
Q

Why is fixation of the back in lordosis with flexion of the lumbar spine concerning?

A

may indicate fusion of the spine, like ankylosing spondylitis

33
Q

What does the slump test check for?

A

Dural tension for the sciatic nerve root

34
Q

True or false: when looking at reflexes we need to look for only the maximal response

A

False–one that is most reproducible (and maximal)

35
Q

What if LE MSR are brisk?

A

Look at UE reflexes to localize the issue

36
Q

True or false: symmetric absence of Achilles is increasingly common with age

37
Q

When are reflexes/sensory signs particularly concerning?

38
Q

What does the FABER test check for?

A

SI joint pain

39
Q

What are the positive signs for the FABER test?

A

Anterolateral hip region (hip path)

Posterior (sacroiliac) pain

40
Q

SLR tests for what?

A

L4, L5, or S1 nerve root irritation vs hamstring pain

41
Q

Positive SLR is what?

A

Pain that goes down the back of the leg and into the foot/ankle

42
Q

What is Bragard’s test?

A

Dorsiflex the foot in SLR. Confirms positive or ambiguous SLR

43
Q

SLR is a sign of what?

A

Dural tension/pulling on sciatic nerve roots

44
Q

How can you quickly assess for claudication?

A

check peripheral pulses

45
Q

What is the buttock sign?

A

hip flexion more painful than SLR

46
Q

Femoral nerve stress test is what?

Positive is what?

A

Checks for femoral nerve irritation (L2, L3, or L4)

Positive = pain or paresthesias along anterior/medial leg

47
Q

False positives with femoral nerve stress test is what?

A

Axial spine pain d/t facet joints

OA of the hip

48
Q

Step-off signs along the spine indicates what?

A

Spondylolisthesis

49
Q

What are the 4 causes of activity related pain?

A
  • Discogenic pain
  • Facet joint pain
  • Stenotic pain
  • Arthritic pain

OMM II (43 decks)

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