Lower Back Pain Flashcards
What can you conclude when pain is worse with standing/walking but better with sitting?
Spondylolisthesis (anterior displacement of the vertebral body) more likely
What can you conclude when pain is worse with sitting but better with standing?
The pain is discogenic
The tops of the iliac crests are at what vertebral level?
T3-4
The PSIS is at what vertebral level?
S2
What is the normal range of extension, lateral flexion, and flexion?
Extension - 20-30 degrees
Lateral flexion - 30 degrees
Flexion - 75-90 degrees
What is the best movement to test the L5?
Dorsiflexion of the great toe
What is the best movement to test the S1 myotome?
Plantar flexion
Which myotome do the reflexes of the lower limb test?
Knee: L3/4
Ankle: S1
Babinski: S1
What anatomical sites can be used to test each dermatome in the LL?
L2 - Lateral hip
L3 - Knee
L4 - Medial maleolus
L5 - Great toe
S1 - Lateral aspect of sole
Which movements predominantly test each myotome from L2-S1?
L2 - Hip flexion
L3 - Knee extension
L4 - Dorsiflexion of the foot
L5 - Great toe dorsiflexion
S1 - Plantarflexion of the foot
How might a L4 disc bulge present on LL neuro exam?
Weaken dorsiflexion
Hypoflexia at the knee
Change in sensation around the medial maleolous
How might a L5 disc bulge present on LL neuro exam?
Weaken dorsiflexion of the great toe
Change in sensation at the great toe
(no change in LL reflexes)
How might a S1 disc bulge present on LL neuro exam?
Weakened plantarflexion at the ankle
Hypoflexia of the ankle reflex
Change in sensation around the lateral aspect of the foot
Which nerve roots are examined when testing anal tone?
S2-4
Which cancers commonly met to the back?
Lung
Breast
Prostate
