Lumbar Examination for Symptom Modulation & Movement Control Flashcards
1
Q
What are the 9 must not miss serious diagnoses
A
- Major depression
- Suicide risk
- Femoral head & neck fracture
- Cauda Equina Syndrome
- Cervical myelopathy
- AAA
- DVT
- PE
- Atypical MI
2
Q
What does CASSS stand for
A
- Control: smoothness, coordination, & timing of movement
- Amount: amplitude of movement at each joint
- Symmetry: observed in bilateral tasks or comparing unilateral performance b/w limbs
- Speed: length of time
- Symptoms: pain but also can include mechanical symptoms, reports of instability, or fatigue
3
Q
Lumbar normal ROM
A
- Flexion = 70-90º
- Extension = 10-30º
- Lateral flexion = 25-35º
- Axial rotation = 20-40º
4
Q
Dermatomes of L1-S1
A
- L1: just inferior-medial to ASIS
- L2: medial mid thigh
- L3: medial to patella
- L4: medial malleolus
- L5: dorm of foot proximal to 1-2 toes
- S1: lateral calcaneus
5
Q
Myotomes of L2-S1
A
- L2 Hip Flexors
- L3 Knee Extensors
- L4 Ankle Dorsiflexors
- L5 Long Toe Extensors
- S1 Ankle Plantar Flexors
6
Q
Slump test procedure
A
- Sitting, Hands Behind the Back
- Slouch T-L Spine (keep CS neutral)
- Overpressure at shoulders (CS Neutral)
- Cervical Flexion
- Cervical Overpressure
- Extend Patient’s Knee (Keep CS Flexion)
- Passive Ankle Dorsiflexion (Keep CS Flexion & Knee Extended)
- Patient Extends Head (Keep Knee/Ankle)
7
Q
Straight leg raise (AKA Lasegue’s Test) position and test
A
- Position: supine, passive, knee extended, hip slightly IR & adducted
- Test; flex hip until p!, then back down (extend hip) until S/S disappear, then DF ankle OR chin to chest (flex c-spine) with ankle DF (more provocative)
8
Q
Nerve differentiation in the straight leg test
A
- Sciatic: normal straight leg raise
- Tibial: eversion + DF (TED)
- Peroneal: inversion + PF (PIP)
- Sural: inversion + DF (SID)
9
Q
Well (contralateral) SLR when positive indicates
A
- Sign of large disc prolapse
10
Q
slide 17
A
