Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OMM > Low Back Pain Eval > Flashcards

Low Back Pain Eval Flashcards

1
Q

Percentage of American adults who will experience at least one serious episode of LBP

A
  • 84%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

LBP economic cost

A
  • $100 billion/year
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Patients who have best recovery from LBP

A
  • Pts who have high expectations for recovery *psychosocial variables are stronger predictors of long-term disability than anatomic findings found on imaging studies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

LBP Red Flags

A
  • Fracture - Tumor - Infection - Cauda Equina Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Suspicion for fracture

A
  • >70 years, female, premature menopause/lack of hormone replacement - Recent trauma - Hx of hyperthyroidism, Cushing’s, Addison’s, Osteoporosis - Sedentary lifestyle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Suspicion for Cancer

A
  • Night pain (unrelieved by change of position) - Unexplained weight loss - Prior or family history of cancer - Changes in bowel &/or bladder function/control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Suspicion for Cauda Equina Syndrome

A
  • Sciatica (pain stops at knee) - B/L leg weakness/numbness - Difficulty walking - Urinary retention or overflow incontinence - New onset of unexplained constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Signs of Surgical Emergency

A
  • Cauda Equina syndrome - Saddle anethesis - Decreased anal sphincter tone - Bowel or bladder symptoms - Sciatica w/ rapidly progressing motor weakness/neurologic deficit(s) *usually assoc. w/ massive central disc herniation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Transitional vertebra

A
  • Congenital anomaly in which there is a naturally occurring articulation or bony infusion b/w the transverse processes of L5 and sacrum, but there is still a small remnant disc space b/w - Type II means one or both transverse processes appear to form a diarthrodial joint w/ sacrum but no bony fusion - Type IV means that there is a type II on one side and a complete bony fusion on the opposite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Spondylosis

A
  • Arthritis of the spine. Seen radiographically as disc space narrowing and arthritic changes of the facet joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Spondylolisthesis

A
  • Anterior displacement of a vertebra on the one beneath it. A radiologist determines degree of slippage upon reviewing spinal x-ray. Slippage graded I-IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Spondylolisthesis Grading

A
  • Grade I: 1-25% slip (does not require surgery) - Grade II: 26-50% slip (“) - Grade III: 51-75% slip (surgery if persistent and disabling symptoms) - Grade IV: 76-100% slip (“)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Spondylolysis

A
  • A fracture in the in the Pars interarticularis where the vertebral body and the posterior elements, protecting the nerves are joined, In a small percent of the adult pop., there is a developmental crack in one of the vertebrae (usually at L5)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Spinal stenosis

A
  • Local, segmental, or generalized narrowing of the central spinal canal by bone or soft tissue elements, usually bony hypertrophic changes in the facet joints and by thickening of the ligamentum flavum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Radiculopathy

A
  • Impairment of a nerve root, usually causing radiating pain, numbness, tingling or muscle weakness that corresponds to a specific nerve root
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sciatica

A
  • Pain, numbness, tingling in the distribution of the sciatic nerve, radiating down the posterior or lateral aspect of the leg, usually to the foot or ankle
17
Q

Cauda Equina Syndrome

A
  • Loss of bowel and bladder control and numbness in the groin and saddle area of the perineum, assoc. w/ weakness of the lower extremities - Can be caused by abnormal pressure on the bottom-most portion of the spinal canal and spinal nerve roots, related to either bony stenosis or a large herniated disc
18
Q

Schmorl’s Nodes

A
  • Herniation of the nucleus pulposus into the adjacent end plate - Seen in approx 20% of MRI studies in pts w/o back pain - Assoc. w/ degenerative changes in the lower back - Not an independent risk factor for back pain
19
Q

Uncomfortable back extension causes

A
  • Think deg disc disease
  • Spondylosis
  • Hypertrophy of lumbar zygopophyseal (facet) joints
  • Hypertrophy of ligamentum flavum
20
Q

Neurogenic vs. Vascular pain chart

A
21
Q

Lumbar Synovial Cyst

A
  • Mimics a herniated disc in that it will cause pain to shoot down the nerve root from its origin
22
Q

Tarlov cyst

A
  • Sacral perineural cysts
  • Nerve root cyists found most commonly in the sacral roots, arising b/w the covering layer othe perineurium and the endoneurium near the dorsal root ganglion
  • Mayi complain of low back pain w/ neurological claudication (pain)
23
Q

L1 lumbosacral myotome

A
  • Femoral nerve

*Iliopsoas (hip flexion)

24
Q

L2 lumbosacral myotome

A
  • Femoral nerve

*Iliopsoas (hip flexion)

*Quadriceps (knee extension)

  • Obturator nerve

*Hip adductors

25
Q

L3 lumbosacral myotome

A
  • Femoral nerve

*Iliopsoas (hip flexion)

*Quadriceps (knee extension)

  • Obturator nerve

*Hip adductors

26
Q

L4 lumbosacral myotome

A
  • Femoral nerve

*Iliopsoas (hip flexion)

*Quadriceps (knee extension)

  • Obturator nerve

*Hip adductors

27
Q

L5 lumbosacral myotome

A
  • Peroneal nerve

*Ankle dorsiflexion (tibialis anterior)

*Ankle eversion (peroneus muscles)

  • Tibial nerve

*Ankle inversion (tibialis posterior)

  • Superior gluteal nerve

*Hip abduction (gluteus medius)

*Leg internal rotation (tensor fascia latae)

28
Q

S1 lumbosacral myotome

A
  • Inferior gluteal nerve

*Hip extension (gluteus maximus)

  • Sciatic nerve

*Knee flexion (hamstrings)

  • Tibial nerve

*Ankle plantar flexion

29
Q

S2 lumbosacral myotome

A
  • Inferior gluteal nerve

*Hip extension (gluteus maximus)

  • Sciatic nerve

*knee flexion (hamstrings)

  • Tibial nerve

*Ankle plantar flexion

30
Q

L1 nerve root lesions pain, sensory loss, weakness and assoc. stretch reflex loss

A
  • Pain: inguinal region
  • Sensory loss: inguinal region
  • Weakness: rarely hip flexion
  • Stretch reflex loss: None
31
Q

L2, 3, 4 nerve root lesions pain, sensory loss, weakness and assoc. stretch reflex loss

A
  • Pain: back, radiating into anterior thigh, and at times medial lower leg
  • Sensory loss: anterior thigh, occasionally medial lower leg
  • Weakness: hip flexion, hip adduction, knee extension
  • Stretch reflex loss: patellar tendon
32
Q

L5 nerve root lesions pain, sensory loss, weakness and assoc. stretch reflex loss

A
  • Pain: back, radiating into buttock, lateral thigh, lateral calf and dorsum foot, great toe
  • Sensory loss: lateral calf, dorsum foot, web space b/w first and second toe
  • Weakness: hip abduction, knee flexion, foot dorsiflexion, toe extension and flexion, foot inversion and eversion
  • Stretch reflex loss: semitendinosus/semibranosus (internal hamstrings) tendon
33
Q

S1 nerve root lesions pain, sensory loss, weakness and assoc. stretch reflex loss

A
  • Pain: back, radiating into butt, lateral or posterior thigh, posterior calf, lateral or plantar food
  • Sensory loss: posterior calf, lateral or plantar aspect of foot
  • Weakness: hip extension, knee flexion, plantar flexion of the foot
  • Stretch reflex loss: achilles tendon
34
Q

S2, 3, 4 nerve root lesions pain, sensory loss, weakness and assoc. stretch reflex loss

A
  • Pain: sacral or butt pain radiating into the posterior aspect of the leg or the perineum
  • Sensory loss: medial butt, perineal, and perianal regions
  • Weakness: may be minimal, with urinary and fecal incontinence as well as sexual dysfunction
  • Stretch reflex loss: bulbocavernosus, anal wink
35
Q

L-4 Nerve Root

A
  • Tibialis anterior (deep peroneal nerve)
  • Difficulty walking on heels (also L5 root)
  • Diminished patellar reflex (asymmetric)
  • Sensory loss medial aspect of the lower leg/ankle/foot
36
Q

L-5 Nerve Root

A
  • Motor to extensor hallucis longus, extensor digitorum longus and brevis and gluteus medius
  • Weakness of ankle and great toe dorsiflexion
  • L5 muscle stretch reflex- medial hamstring tendons
  • Sensory loss to lateral leg and dorsum of foot
37
Q

S-1 Nerve Root

A
  • Motor to peroneus longus/brevis; gastrocnemius,soleus and gluteus maximus
  • Difficulty walking on toes
  • Weakness of plantar flexion of the foot
  • Diminished achilles reflex (asymmetric)
  • Sensory loss lateral and plantar aspect of the foot/ankle
38
Q

T10-T11 Autonomics- sympathetics

A
  • Kidneys, gonads, upper ureter, adrenals
39
Q

T12-L2 Autonomics-Sympathetics

A
  • Lower ureters, uterus, vagina, clitoris, vas deferens, prostate, bladder, urethra, fallopian tubes, seminal vesicles, sphincter, trigone

OMM (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions