Low back pain quiz 3

Question 1

Most episodes of low back pain include all the following except

1. older age
2. carpal tunnel syndrome
3. scoliosis
4. spinal stenosis

Answer 1

carpal tunnel syndrome

Question 2

With the straight leg raising test the NP is evaluating tension on which nerve

1. L1L2
2. L3L4
3. L5S1
4. S2S3

Answer 2

L5 S1

Question 3

Sciatica is

Answer 3

Sciatica:“associatedpain*syndrome”

Question 4

Sciatic produces paresthesias where

Answer 4

paresthesias extending down the leg in a 
dermatomal pattern (nerve roots L4, L5, S1, S2, S3

Question 5

Spondylolisthesis

Answer 5

forward displacement of vertebrae

Question 6

Spondylosis

Answer 6

stress fracture forward onto next vertebral body

-seen in hyperextension sports (diving, gymnastics, wt. lifting, +FH)

Question 7

Scotty Dog sign:

Answer 7

break in the “dog collar” corresponds to a fx in the region of the pars interarticularis – specific sign for spondylosis

Question 8

Risk Factors for LBP

Answer 8

Overweight
Mechanical disorders (scoliosis, kyphosis)
Non-mechanical disorders (prostate CA, pelvis & renal disease)
Occupational strain
Leg length differences (measure)
Poor posture – don’t slouch
Poor body mechanics

Question 9

what is the most comfortable position for someone with LBP

Answer 9

lying down

Question 10

Cauda Equina syndrome

Answer 10

anal laxity, bladder dysfunction , lower extremity weakness
perianal and perineal weakness
Knee extension with weaknesses and foot drop

Question 11

Herniated Disc

Answer 11

Radicular pain – shooting, electric to below the knee. Goes down the center of the butt/thigh
and around the leg.

Question 12

Herniated Disc pain is worsen with

Answer 12

Valsalva maneuvers

Question 13

Herniated disc can not

Answer 13

walk on heels and tiptoes

Question 14

Unable to walk on toes is

Answer 14

S1

Question 15

Unable to walk on heels

Answer 15

L4 and L5

Question 16

L4-5 nerve root dysfunction

Answer 16

weakness in dorsiflexion of ankle or great toe

Question 17

Perform straight leg raise sitting & lying is

Answer 17

Gold standard

Question 18

L3 – L4 Disc prolapse will produce

Answer 18

Pain in front of thigh
Wasting of quadriceps muscles may be present
Diminished sensation on the front of the thigh and medial lower lag
Reduced knee jerk (mostly L4)

Question 19

L4 – L5 Disc prolapse

Answer 19

Pain along posterior or posteriolateral thigh w/ radiation to the top of foot
Weakness on dorsiflexion of the great toe and foot
Paresthesia and numbness of foot and great toe
No reflex changes noted

Question 20

L5 – S1 Disc prolapse

Answer 20

pain along posterior thigh w/ radiation to the heel
Weakness on plantar flexion – may be absent
Sensory loss in the lateral foot
Absent ankle jerk reflex (mostly S1)

Question 21

positive waddell sign

Answer 21

3out of 5 present Distraction:inconsistentpainresponseafterdistraction
• Overreaction to slight touch
• Regionalization: pain that radiates to an anatomically incorrect region
• Simulation:axial loading and rotation
•Tenderness:superficial and diffuse tenderness and/or non anatomictenderness

Question 22

Low back pain red flags

Answer 22

Possible fracture with MVA , trauma, fall
>50 <20
H/o cancer
pain worsens when supine 
severe night time pain 
fever chills wt. loss
infection, IVDA, immunosuppression

Question 23

DTR @ S1

Answer 23

ankle

Question 24

DTR @ S4

Answer 24

Knee

Question 25

Diagnostic test for LBP

Answer 25

Nojustificafionforimagingstudiesw/infirst30daysof complaintwhenallotherthingsareexcluded*

Question 26

Backpainpersists>4weeks what diagnostic test should be performed?

Answer 26

cbc,ESR,X-ray,bonescan*

Question 27

Suspected stenosis diagnostic test

Answer 27

MRI, CT

Question 28

suspected sciatica

Answer 28

Surgeon, MRI, CT, EMG

Question 29

absent or decreased ankle jerk suggest

Answer 29

S1

Question 30

diminished knee jerk is suggestive of

Answer 30

L34 herniation

Question 31

Pain below the knee at less than 70 degrees of elevation that is aggravated by dorsiflexion of the ankle or hip rotation is a sign of

Answer 31

L5-S1 nerve root tension

Question 32

sprain is

Answer 32

injury to a ligament

Question 33

Strain is

Answer 33

trama to muscle or muscular skeletal unit

Question 34

fracture

Answer 34

loss of continuity of the bone

Question 35

s/s of a lumbar sacral strain

Answer 35

minimal pain at event but increases w/stiffness 12-36 hours later as soft tissue swells

Question 36

pain with a Lumbar sacral strain is located where

Answer 36

back can radiate to the buttocks

Question 37

Pain is increased w/movement or standing and relieved with rest is consistent with a

Answer 37

Lumbar scacral strain

Question 38

Herniated disk pain is

Answer 38

radicular pain shooting electric pain to below the knee

Question 39

worsened with valsalva maneuver

Answer 39

Herniated disc

Question 40

Herniated disk creates numbness where

Answer 40

along the nerve root

Question 41

L5S1 pain is located

Answer 41

posterior or posteriolateral thigh w/ radiation to the top of foot

Question 42

L5 S1 Weakness

Answer 42

on plantar flexion

Question 43

L5 S1 can see sensory loss

Answer 43

in the lateral foot

Question 44

L5 S1 absent

Answer 44

ankle jerk

Question 45

Most common complaint for runners

Answer 45

Patellofemerolpainsyndrome(PFPS)

Question 46

ACl you will see

Answer 46

Pop =joint effusion, w+ anterior drawer test

Question 47

Knee X-ray indications after acute knee injury:
aged 55 years or over
tenderness at the head of the fibula
isolated tenderness of the patella
inability to flex knee to 90 degrees
inability to bear weight (defined as an inability to take four steps, ie. two steps on each leg, regardless of limping) immediately and at presentation

Answer 47

is the Ottawa Knee rule