Lumbar

Question 1

Examples of yellow flags

Answer 1

Emotional distress
Hypervigilance
Pain catastrophizing
Elevated fear-avoidance beliefs
Low self efficacy
Misunderstanding about the nature and likely impact of pain
Misunderstanding about the best strategies for long term success

Question 2

Blue flag

Answer 2

Pt perception of work and work conditions that impair return to work

Question 3

Black flags

Answer 3

Social and financial issues

Question 4

Self efficacy

Answer 4

Belief one can achieve future goals

Question 5

Red flags for metastatic cancer

Answer 5

• hx of cancer
• night pain at rest
• unexplained at loss
• age > 50 or less than 17

Question 6

Red flags infection within disk or vertebrae

Answer 6

• immunosuppressed
• prolonged fever >100.4 deg F
• hx of intravenous drug use
• hx of UTI, cellulitis, or pneumonia

Question 7

Red flags suggesting undiagnosed vertebral fx

Answer 7

• prolonged corticosteroids
• mild trauma age >50 yo
• age > 70 yo
• a known hx of osteoporosis
• recent major trauma at any age (MVA or fall from height >5 ft)

Question 8

Red flags that may indicate a dangerous abdominal aneurysm

Answer 8

• pulsating mass in the abdomen
• hx of atherosclerotic vascular disease
• a throbbing, pulsating back pain at rest or with recumbency
• age >60 yo

Question 9

Yellow flags

Answer 9

Person’s beliefs about pain and injury

Question 10

MRI T2 image of disc annulus

Answer 10

High intensity zone is an area of bright signal in annular region of IVD

Question 11

MRI T2 end plate

Answer 11

Modic sign. Increased signal at end plate.

Question 12

Motor control exercises by Costas et al stage 1

Answer 12

Train coordinated activity of trunk muscles.
• independent activation of deeper muscles: transversus abdominis and multifidus
• reduce overactivity of superficial muscles in an individualized manner

Question 13

Motor control exercises by Costas et al stage 2

Answer 13

Implement precision of the desired coordination
• train skills in static tasks
• incorporate the skills into dynamic tasks and functional positions

Question 14

Clinical prediction rule lumbar spine

Answer 14

Less than 16 days
FABQ less than 19
One hypomobile lumbar segment 
No symptoms below the knee
One hip > 35 Deg IR

Question 15

Stabilization lumbar spine criteria

Answer 15

•Younger age •Greater general flexibility •Instability “catch” •Positive prone instability test

Question 16

Intervention procedures lumbar stabilization group

Answer 16

•Promoting isolated contraction and co-contraction of deep stabilizing muscles •Strengthening of large spinal stabilizing muscles

Question 17

Lumbar extension directional preference criteria

Answer 17

•Symptoms distal to buttock that peripheralize with lumbar f lexion and centralize with extension •Directional preference for extension

Question 18

Lumbar ext intervention procedures

Answer 18

•End-range extension exercises •Mobilization to promote extension •Avoidance of flexion

Question 19

Flexion criteria for lumbar spine

Answer 19

•Older age •Directional preference for flexion •Imaging evidence of lumbar stenosis

Question 20

Flex ion intervention procedures lumbar spine

Answer 20

•Mobilization or manipulation of the spine and/or lower extremities •Exercises to address impairment of strength and flexibility •Body-weight supported treadmill ambulation

Question 21

TBC systems: lateral shift criteria

Answer 21

•Visible frontal plane deviation of shoulders relative to pelvis •Directional preference for lateral translation movements of the pelvis

Question 22

TBC: lateral shift intervention procedures

Answer 22

•Exercise to correct lateral shift •Mechanical or autotraction

Question 23

TBC: traction criteria

Answer 23

•Signs and symptoms of nerve root compression •No movements centralize symptoms

Question 24

TBC: traction intervention procedures

Answer 24

•Mechanical or autotraction