Low Back Pains, Sprains, and Strains Flashcards
Acute onset
associated w/ one specific mechanism of injury
Chronic onset
overuse injuries, degenerative, and/or postural abnormalities/deficiencies (typing)
Which is worse acute or chronic?
acute
What persists despite changes in spine position
pain from inflammation
What varies depending upon spine positioning and can be relieved or exacerbated
pain of mechanical nature
What 5 things should a physical exam have?
Inspection Palpation ROM Neurologic Evaluation Reflexes Special tests
What 4 things compromise Inspection?
Spine curvature
Position of shoulders and pelvis should be level
Soft tissue symmetry
Skin markings
What 5 things should be palpated
Spinous processes Pelvic iliac crest Sacroiliac joints Ischial tuberosity Greater trochanters
What 4 things should ROM test?
Forward flexion
Extension
Lateral bending
Rotation
Where does the sciatic nerve run?
through greater sciatic foramen under piriformis muscle. Between the greater trochanter and ischial tuberosity
What causes increased back pain, but has relief w/ flexion?
spinal stenosis
L4 dermatome
medial side of lower leg
L5 dermatome
lateral leg and dorsum of foot
S1 dermatome
lateral malleolus, lateral and plantar surface of foot
S2 dermatome
outer anal ring
S3 dermatome
middle anal ring
S4/5 dermatome
inner anal ring
What is a positive Babinski test?
great toe extends while other toes flex and splay
What is a positive Clonus test?
on releasing the foot, if “beats” over 3-5x before settling into rest
What test is used to test for problems in sciatic nerve or hamstring tightness?
straight leg raise
Who has an increase incidence of low back pain?
35-55 yo
What is the second most common reason for office visits?
low back pain
What is the #1 reason for missed work?
low back pain
What is the most common site of bony metastasis?
spine
What is the biggest differential ddx for low back pain?
mechanical (97%)
lumbar sprain/strain-70%
T/F is imaging needed?
NO!!
A normal cervical spine has what type of curve?
lordotic curve
Hyperextension- hyperflexion of the neck?
whiplash
What is the first line of imagining for low back pain?
Plain film xray
What can lessened the lordotic curve?
muscular spasm or nerve root impingement
What can increase lordotic curve?
poor posture and muscle weakness
C7 dermatome
middle and extension
C8 dermatome
ring and small finger
What ligament is torn in whiplash?
torn nucal ligament
What is spinal cord damage frequently associated with?
lower cervical spine fractures
T/F a Rectal exam should be done with cervical injuries?
True
When can you only see a clear C-spine?
on a sober/coherent patient
What is the most common cervical root compression?
6
What is the most common cervical root compression?
6
What is Hoffman’s sign?
“Babinski of the upper extremity” -flick nail of middle finger
What is wrist clonus?
series of quick alternating movements of flexion and extension at the wrist
How is thoracic outlet syndrome diagnosed?
Adson’s test
What is a positive test for Adson’s test?
diminished radial pulse, numbness and tingling
What most commonly cause Torticollis?
drugs
What is the txt for Torticollis?
physical therapy
stretching exercises/ massage
