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OMM M1T2 test 1 > Lower Back Pain 1 > Flashcards

Lower Back Pain 1 Flashcards

1
Q

What are some causes of lower back pain?

A 
Fracture
Strain
Disc herniation
Infection
"Referred pain"
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2
Q

How many Americans need health care assistant with low back pain in their lives?

A

4 out of 5

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3
Q

What percent of people will have resolved low back pain/sciatica without intervention?

A

90%

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4
Q

How much lower back pain will resolve in 12 weeks?

A

99%

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5
Q

What is some patient history that would be considered “ominous”?

A 
Bilateral radicular pain
Saddle area anesthesia 
Urinary incontinence 
Urinary retention 
Increased urinary frequency 
Overflow urinary incontinence
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6
Q

If a patient presents with “ominous history” for low back pain, what could some of the causes be?

A 
Acute Cauda Equina Syndrome
Massive multi-nerve compression 
Large central disc herniation
Hemorrhage into spinal canal
Swelling of a rapidly growing tumor
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7
Q

What could be considered an low back pain emergency and must be treated immediately?

A

Cauda equina syndrome

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8
Q

What can you rule out for low back pain in terms of fractures?

A

Major trauma
Fall from a height
Female age over 50 and other risk factors for osteoporosis

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9
Q

What symptoms can be ruled out in terms of infection?

A 
Age Over 50 Years
Age Under 20 Years
Fever or Chills
Pain worse supine
Recent Urinary Tract Infection
IV Drug Abuse
Immune Suppression
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10
Q

When looking on the skin surface of the back, what should you take note of?

A 
Congenital Skin Lesions
Rashes
Skin Infection
Bruising
Erythema
Scars, Lacerations, Abrasions
Abnormal spinal curves
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11
Q

How would you perform the Shober test?

A

Make a mark on the skin midway between the PSISpines and measure down 5 cm
Then measure 10 cm up from the initial point so the total distance is 15 cm
When the trunk is flexed it should stretch to 20 cm

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12
Q

What does a positive trendelenberg test indicate?

A

Weakness of the gluteus medius muscle

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13
Q

What nerve weakness is indicated in a positive trendelenberg exam and what are some possible causes?

A

L5

Disc herniation, spinal tumor, intraspinal abscess

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14
Q

What does the straight leg raising test for?

A

Sciatic nerve

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15
Q

What cause of pain could cause be confused for sciatic pain in the straight leg raising test?

A

Hamstring tightness

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16
Q

If you get find a positive lloyd sign in seated percussion what could that indicate?

A

Possible renal pathology

17
Q

How would you perform spinal percussion and what could cause the need for it?

A

Use a reflex hammer

Fracture, tumor and infection

18
Q

What are the values for reflex grading?

A 
0 – Absent
1 – Decreased
2 – Normal
3 – Increased
4 – Clonus
19
Q

What is clonus?

A

Alternating muscle contraction and relaxation in rapid succession usually indicative of a disconnect between upper and lower motor neurons

20
Q

What reflex is there to test at L1, L2, L3?

A

None

21
Q

What reflex is there to test at L4?

A

The patellar reflex

22
Q

What reflex is there to test at L5?

A

None

23
Q

What reflex is there to test at S1?

A

Achilles reflex

24
Q

What reflex is there to test at S2, S3, and S4?

A

Superficial anal reflex

25
Q

What does a positive babinski sign indicate?

A

A disconnect between the upper and lower motor neurons (muliple sclerosis, amyotrophic lateral sclerosis)
Also could men the destruction of the upper motor neuron (cerebrovascular accident, brain tumor)

26
Q

What are the grades for muscle strength?

A

Grade 0 – Flaccid Paralysis
Grade 1 – Can palpate muscle contraction, but muscle cannot move affected body part
Grade 2 – Can only move body part with gravity eliminated
Grade 3 – Can only move body part against gravity
Grade 4 – In between Grades 3 and 5
Grade 5 – Full strength against full resistance

27
Q

What does does peripheral muscle weakness in lower back pain usually mean?

A

Neural compression especially if the grade is 3 or 4

28
Q

If there is muscle weakness that is grade 0 to 2 usually indicate?

A

A central nervous system problem (CVA, Guillain-Barre Syn., Multiple Sclerosis, etc.)

29
Q

What is the most overlooked somatic dysfunction that causes lower back pain?

A

The quadratus lumborum

30
Q

What is the treatment for somatic dysfunction of the L-spine?

A

Counterstrain for TPs, ME/HVLA restrictions

Decrease restrictions in other areas

31
Q

What area has the most back pain?

A

Multifidus triangle

32
Q

Which is more common, acute or chronic back pain?

A

Chronic

OMM M1T2 test 1 (14 decks)

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