Lumbar Flashcards
Red flags accompanying lumbar pain for cancer
Unexplained weight changes
Hematochezia (bright blood in stool)
Breast changes
Night sweats
Red flags accompanying lumbar pain for nerve root damage
Muscle weakness
Loss of DTR
Red flags accompanying lumbar pain for herniated disc
Positive straight leg test
Red flags accompanying lumbar pain for AAA
Pulsatile abdominal mass
Red flags accompanying lumbar pain for fractures
Pinpoint tenderness over SP’s
Red flags accompanying lumbar pain for cauda equina damage
Saddle anesthesia
Loss of bowel/bladder control
What does the “stork test” with increased pain indicate
Spondylolysis
Spondylolisthesis
Facet atrophy
Symptoms of cauda equina syndrome
Low back pain
Saddle anesthesia
Loss of bladder/bowel control
Decreased/absent deep tendon reflex (L3 - L4, S1)
Loss of anal sphincter tone
If you encounter someone with cauda equina syndrome
Refer to ER immediately for neurosurgery
Normal range for Ferguson’s angle
25-35 degrees between lumbar and sacrum
Postural/tonic muscles become what with dysfunction
Short
Hypertonic
Spastic
Dynamic/phasic muscles become what with dysfunction
Inhibited
Hypotonic
Weak
Function of the iliolumbar ligament
Runs from L4/L5 TP to iliac crest
Restricts movement of LS junction
Action of quadratus lumborum
Side bending
Action of psoas major
Hip flexion
Action of psoas minor
Flex T/L junction
Extend L/S junction
Unilaterally side bend lumbar
Action of erector spinae group (spinalis, longissimus, iliocostalis)
Extend (bilateral contraction)
Side bend (unilateral contraction)
Muscle target for AL1
Internal abdominal oblique
Muscle target for AL2
External abdominal oblique
Other areas corresponding to AL1
Transversus abdominis
Iliopsoas
Ilioinguinal nerve
L1 nerve root
Physician position for AL1
FSTRT - same side
Physician position for AL2
FSARA - opposite
Physician position for AL3
FSART - opposite
Physician position for AL4
FSART - opposite
Physician position for AL5
FSART - same
Other areas corresponding to AL2
Internal abdominal oblique
Iliopsoas muscle
Genitofemoral nerve
Muscle target for AL3
Iliacus
Muscle target for AL4
Iliacus
Other areas corresponding to AL3
Psoas (both)
Femoral cutaneous nerve
Femoral nerve
Obturator nerve
Other areas corresponding to AL4
Psoas (both)
Femoral cutaneous nerve
Femoral nerve
Obturator nerve
Other areas corresponding to AL5
Adductor longus
Pubic shear
Obturator entrapment
Muscle target for AL5
Rectus abdominus
