Lumbar Examination Flashcards

1
Q

What technique helps verify the patient’s statements?

A

Restate what the patient says to you.

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2
Q

What question gathers additional relevant information?

A

Are there other details you think I should know?

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3
Q

What question explores the patient’s beliefs about their condition?

A

What do you think your back needs?

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4
Q

What question investigates the patient’s pain perception?

A

What do you think is happening inside your body when you are in pain?

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5
Q

What question assesses the impact of life factors on back pain?

A

How is your job, social life, family life, stress affecting your low back pain?

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6
Q

What interviewing technique uses the patient’s own motivation?

A

Motivational Interviewing

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7
Q

What should you resist during patient interviews?

A

Resist urge to interrupt patient.

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8
Q

What should be the focus during motivational interviewing?

A

Be empathetic and focus on the patient, not your knowledge.

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9
Q

What is a red flag for malignancy related to age?

A

Age > 50

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10
Q

What is a red flag for malignancy related to medical history?

A

Prior history of cancer

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11
Q

What is a red flag for malignancy related to weight?

A

Unexplained weight loss

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12
Q

What is a red flag for malignancy related to pain?

A

Night pain not relieved by positional changes

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13
Q

What is a key symptom for detecting cauda equina?

A

Urinary retention

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14
Q

What is the first step in measuring lumbar ROM?

A

Palpate and mark S1 and T12

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15
Q

How do you measure true lumbar flexion?

A

Difference between readings at S1 and T12

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16
Q

What should you teach patients with a history of low back pain?

A

Better hip mobility

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17
Q

What correlates with hamstring tightness in low back pain patients?

A

Motion during forward bending

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18
Q

What is a key feature to observe in spinal rotation?

A

Symmetry between sides

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19
Q

How do you measure sidebending ROM?

A

Measure from the fingertips to the floor

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20
Q

What indicates a possible discogenic origin of pain?

A

Pain during sagittal repeated motions

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21
Q

What does pain during rotation suggest?

A

Facet joint pathology

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22
Q

What does SFMA stand for?

A

Selective Functional Movement Assessment

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23
Q

What is the significance of overpressure during ROM scan?

A

Improves ability to implicate specific structures

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24
Q

What should you look for in flexion/extension strength evaluation?

A

Core endurance and strength

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25
Q

What is the take-home message for teaching hip mobility?

A

Hamstring tightness is often caused by low back pain

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26
Q

What indicates the need for better hip mobility training?

A

Low lumbar-to-hip flexion ratio during bending

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27
Q

What should be noted during functional overhead squat analysis?

A

Look for hinging segments/skin creases

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28
Q

What is the purpose of the arms down deep squat?

A

Functional movement assessment; helps with patients with limited thoracic extension

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29
Q

What is tested at L1 in MRS evaluation?

A

Hip flexion

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30
Q

What reflex is associated with L3/L4?

A

Patellar reflex

31
Q

What is a key indicator in functional myopathy evaluation?

A

Ability to walk on toes (S1) and heels (L5)

32
Q

What is tested at L5 in MRS evaluation?

A

Foot/toes dorsiflexion

33
Q

What does the Babinski test indicate?

A

Upper motor neuron lesion if positive bilaterally

34
Q

What is tested at S1 in MRS evaluation?

A

Plantar flexion of foot/toes

35
Q

What is the clinical significance of the Achilles reflex?

A

S1/S2 nerve function

36
Q

What is tested at L4 in MRS evaluation?

A

Ankle dorsiflexion

37
Q

What does a positive clonus test suggest?

A

Upper motor neuron lesion

38
Q

What is tested at S2 in MRS evaluation?

A

Plantar flexion

39
Q

What does the extension rotation test assess?

A

Lumbar facet joint dysfunction/Facet syndrome

40
Q

What does the quadrant test assess?

A

Lumbar foraminal stenosis

41
Q

What condition does the bike test help evaluate?

A

Neurogenic claudication/Stenosis

42
Q

What does the slump test assess?

A
  • Lumbar Radiculopathy (Leg pain with LBP) would be the dx associated with this test.
  • Deficits in neural mobility and irritability
43
Q

What does a positive straight leg raise test suggest?

A

Herniated nucleus pulposus (HNP)

44
Q

What does the active straight leg raise test assess?

A
  • Instability
  • SIJD
  • Pelvic floor dysfunction
45
Q

What indicates a positive hip abduction test?

A

Substitution patterns indicating gluteus medius weakness

46
Q

What will the patient report feeling with a (+) femoral nerve bias test?

A

Burning or painful sensation down the anterior thigh

47
Q

What does the prone instability test assess?

A

Lumbar segmental stability

48
Q

What does the one-legged stork standing test assess?

A
  • Lumbar spondylolisthesis
  • Facet syndrome
49
Q

What does a positive spinal torsion test suggest?

A

Lumbar instability/hypermobility

50
Q

What is indicated by painful arc during flexion?

A

Aberrant motion indicating movement faults

51
Q

What does Gower’s sign indicate?

A

Aberrant motion indicating movement faults

52
Q

What is assessed by the standing stork test?

A
  • Lumbar spondylolisthesis
  • Facet syndrome
53
Q

What does a positive slump test suggest?

A

Lumbar radiculopathy

54
Q

What does a positive active SLR test with pelvic compression suggest?

A

Core stability deficits

55
Q

What is indicated by an inability to perform the active SLR test?

A

Hypermobility or instability

56
Q

What condition is suggested by difficulty in the hip abduction test?

A
  • LBP
  • SI joint pain
57
Q

What is evaluated by the femoral nerve bias test?

A

Anterior hip/pelvic/leg pain

58
Q

What does a positive prone instability test suggest?

A

Lumbar instability including spondylolisthesis

59
Q

What is the significance of toe walking in functional myopathy evaluation?

A

Detects subtle alterations in nerve function
S1 ISSUE

60
Q

What does a positive Babinski test on one side suggest?

A

Lower motor neuron lesion

61
Q

What is a gross evaluation of lower extremity nerve function?

A

Ability to walk on toes and heels

62
Q

What is indicated by a positive clonus test?

A

Upper motor neuron lesion

63
Q

What does the Babinski test assess?

A

Upper and lower motor neuron lesions

64
Q

What is the purpose of static palpation?

A

Detect stiffness in the lumbar spine

65
Q

What does motion palpation evaluate?

A

Mobility of lumbar segments

66
Q

What is a common issue with palpation?

A

Inconsistent detection of stiffness across practitioners

67
Q

What can be as effective as palpation for judging stiffness?

A

Visual assessment of movement

68
Q

What is assessed during lumbar spine lateral flexion analysis?

A

Ipsilateral and contralateral rotation mobility

69
Q

What does a positive extension rotation test indicate?

A

Facet joint dysfunction

70
Q

What does a positive quadrant test indicate?

A

Lumbar foraminal stenosis

71
Q

What condition does the bike test evaluate when in flexion they feel better?

A

Neurogenic claudication

72
Q

What does a positive slump test indicate?

A

Lumbar radiculopathy

73
Q

What is indicated by a positive active SLR test?

A

Hypermobility or instability

74
Q

What degree does the straight leg raise test need to be less than to indicate Herniated Nucleus Pulposis (HNP)?

A

< 40 Degree