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OMM M1T2 test 1 > Lower Back Pain 2 > Flashcards

Lower Back Pain 2 Flashcards

1
Q

What nerves contribute to iliopsoas strength?

A

L1 to L3

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2
Q

What nerves contribute to quadriceps strength?

A

L2 to L4

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3
Q

What nerves contribute to the hip adductor muscle strength?

A

L2 to L4

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4
Q

What nerve contributes to tibialis anterior strength?

A

L4

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5
Q

What nerve contributes to extensor hallucis longus strength?

A

L5

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6
Q

What never contributes to extensor digitorum longus and brevis strength?

A

L5

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7
Q

What nerve contributes to gluteus medius strength?

A

L5

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8
Q

What nerve contributes to fibularis longis and brevis strength?

A

S1

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9
Q

What nerve contributes to gluteus maximus strength?

A

S1

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10
Q

What nerves contribute to gastrocnemius and soleus strength?

A

S1 and S2

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11
Q

During the iliopsoas testing, if there is low back pain excerbaton what could that indicate?

A

Discogenic pain

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12
Q

What is psoas syndrome and what are some etiologies?

A

Flexion-contracture of the iliopsoas due to prolonged positioned with a shortened psoas

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13
Q

What is the quality of iliopsoas pain and where is it located?

A

Achy muscle spasm

In the lower back, radiating to the groin

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14
Q

What are the signs and symptoms of ilipsoas syndrome?

A 
Increase pain standing or walking
Positive thomas test
Positive tp medical to ASIS
Positive pelvic shift test
Nerve weakness in L1 and L2
Contralateral periformis spasm
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15
Q

How would you treat ilipsoas syndrome?

A

Acute - ice and no use of heat initially
Indirect followed by direct OMM
Chronic - stretch

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16
Q

What is tested for L1, L2 and L3 for sensation?

A

Anterior thigh

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17
Q

What is tested for L4 for sensation?

A

Medial side of the foot

18
Q

What is tested for L5 for sensation?

A

Web space between great toe and second toe

19
Q

What is tested for S1 for sensation?

A

Lateral side of the foot

20
Q

What is tested for S2, S3, S4 and S5 for sensation?

A

Perianal skin

21
Q

What kind of tests can you do for sensation

A

Pin prick for pain
Light touch with a wisp
Vibration with a tuning fork

22
Q

If there is an abdominal source of lower back pain where is a likely location?

A

Retroperitoneal viscera

23
Q

When palpating the abdomen what should you been palpating and testing?

A

Palpate for guarding response, masses and presence of abdominal aneurysm

24
Q

What does the Valsalva exam test for?

A

It will exacerbate the symptoms of any space occupying lesion in the spinal canal
Positive test for pain reproduction

25
Q

How is the Valsalva test performed?

A

Patient is supine
Place hand or fist on mid-abdominal area
Gently inc pressure and have patient press back with abdominal wall

26
Q

How would the Soto Hall test be performed?

A

Patient is supine
Restrain the sternum
Passively flex the neck

27
Q

What does it mean when pain is elicited in the Soto Hall test?

A

Spinal disorder

28
Q

What tests can be done for scaroiliac joint pain?

A 
Pelvic Rock test (grabs AIIS and wiggle)
Gaenslen test (grab one knee, drop the other)
Patrick test (scottish dancing)
29
Q

What does the Patrick test look for?

A

Tests for sacroiliitis

Also tests for joint disease

30
Q

What type of test is a Patrick test and what are the motions?

A

Pain reproduction test
FABERE
Flexion, Abduction, External Rotation and Extension

31
Q

What will a positive Nachalas test produce?

A

Pain radiation down the anterior though which implies femoral nerve entrapment/disease

32
Q

How is the Nachalas test performed?

A

Patient is prone

Leg flexed at the knee

33
Q

What are the two ways to test trunk strength?

A

Raise shoulders prone and hold 10 seconds

Raise legs prone and hold 10 seconds

34
Q

What is the pathogenesis for spinal stenosis?

A

Degenerative changes in the L-spine:
Hypertrophy of facet joints
Ca++ deposits in lig lavum/post long lig
Loss of intervertebral disc height

35
Q

What is the quality and location of pain in spinal stenosis?

A

Lower back to lower legs

Achy, shooting pain with paresthesias

36
Q

What are the signs and symptoms of spinal stenosis?

A

Worsened by extension (standing, walking, lying supine)

Osteophytes and decreased intervertebral space on imaging

37
Q

What is the treatment for spinal stenosis?

A

OMT : decrease restriction, inc ROM
PT, NSAIDs, low dose steroids
Epidural steroid injection
Surgical laminectomy with decompression

38
Q

What is the pathogensis of a herniated nucleus propulsus

A

Narrowing of posterior long lig
95% at L4-L5 or L5-S1
Exterts pressure on nerve root of vertebra below

39
Q

Where is the location and quality of pain in a herniated nucleus propulsus?

A

Low back and lower leg

Numbness, tingling, sharp burning, shooting pain worsens with flexion

40
Q

What are the signs and symptoms of a herniated nucleus propulsus?

A

Weakness and decreased reflexes
Sensory deficit in corresponding dermatome
Positive straight leg test

41
Q

What test is a the gold standard for herniated nucleus propulsus?

A

MRI

42
Q

What is the treatment for a herniated nucleus propulsus?

A

Less than 5% are surgical candidates
Bed rest for max 2 days
Indirect OMM follow by gentle direct

OMM M1T2 test 1 (14 decks)

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