Lumbar

Question 1

Lumbar manipulation prediction rule

Answer 1

4/5: 
Pain <16 days
No symptoms distal to knee
FABQ score <19
IR >35 deg at least one hip
Hypomobility at least one level of lumbar spine

Question 2

How much mechanical traction needed to overcome body friction?

Answer 2

25-50% body weight

Question 3

What motion is performed with McKenzie method?

Answer 3

Repeated lumbar extension
Typically centralizes pain for disc hernia causing radiculopathy
Start prone lying, progress to low puppy, high puppy, standing extension

Question 4

lumbar rom

Answer 4

flexion 80deg
rotation 45deg
lateral flexion 35deg
extension 25deg

Question 5

lumbar open and closed pack

Answer 5

facet open: midway flexion/extension

facets closed: extension

Question 6

lumbar capsular patern

Answer 6

lateral flexion and rotation equally limited

extension

Question 7

pathology?
Constant pain without any relation to position
Pain worsening over several months and is constant and unremitting
what next?

Answer 7

refer to physician, stop treatment

spinal cancer

Question 8

pt has severe spondylolisthesis

what movement/position avoid?

Answer 8

Avoid extension activities, especially in standing

Question 9

does exercise exacerbate or reduce pain and stiffness in ankylosing spondylitis?

Answer 9

Exercise typically reduces complaints of pain and stiffness

• Exercise especially beneficial before significant ossification begins to occur (can help maintain normal posture, which maintains space within the thoracic cavity allowing for optimal lung expansion.)
• A warm therapeutic pool is often recommended as an ideal exercise environment for patients with ankylosing spondylitis.

Question 10

why do a lumbar puncture?

where?

Answer 10

sample of cerebrospinal fluid is collected for diagnostic analysis - confirm serious medical conditions including viral or bacterial meningitis.
L3-L4 or L4-L5 level, below spinal cord (conus medullaris L1, L2)

Question 11

Compression fractures secondary to osteoporosis are commonly associated with what movement?
intervention should stretch what muscles?

Answer 11

• associated with and symptoms provoked with trunk flexion
• Stretching antagonist muscles: shoulder horizontal adductors and medial (internal) rotators, hip flexors and medial (internal) rotators is recommended

Question 12

lumbar manipulation CPR

Answer 12

Pain lasting less than 16 days
No symptoms distal to the knee
FABQ score less than 19
Internal rotation of greater than 35 degrees for at least one hip Hypomobility of a least one level of the lumbar spine

Question 13

Lumbar herniation affecting L4-5 intervertebral disc affects which nerve? weakness?

Answer 13

L5, extensor hallucis weakness