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Clinical Medicine > Lumbar (Last Clin Med lecture) > Flashcards

Lumbar (Last Clin Med lecture) Flashcards

1
Q

What can happen if the hip has congenital hip dyplasia?

A

The ball part of the joint can come out of the socket

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2
Q

What are the 2 special test done as soon as the baby is born to test for congenital hip dysplasia?

A

Barlows & Ortolani

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3
Q

What does Barlow test do to the hip if it is positive?

A

Dislocate posteriorly

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4
Q

What does the Ortolani do?

A

If Barlow test is positive

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5
Q

What interventions are need for congenital hip dislocation?

A

Surgical Correction or Splinting/Harnessing
Gait training
ROM/Strengthening Exercise
Developmental Transitioning

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6
Q

What is the pain referral for SI dysfunction?

A

Deep in butt and refer down the leg

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7
Q

What are some key indicators for SI involvement?

A
  • Mechanical low back pain
  • Trauma
  • Pt may or may not report LE sxm
  • General hyper mobility
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8
Q

If a patient with SI involvement reports LE pain how will it present?

A
  • Unilateral
  • Above the knee
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9
Q

What are some things that will cause SI problems?

A

Trauma
Pregnancy
Systemic arthritis
Traumatic/ microtrauma arthritis

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10
Q

What would a patient present as in an exam with SIJ pathology?

A
  • Complaints increase w/ walking
  • Lumbar AROM painfree w/ no TTP in lumbar spine
  • Hip extension w/ OP painful
  • TTP over posterior aspect if SI joint
  • ## Normal neuro exam
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11
Q

What are the 6 special test done to know whether or not SIJ is involved?

A

Distraction/Gapping
Compression
Post Shear/Thigh Thrust
Pelvic Torsion
Sacral thrust

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12
Q

If you can only do one test to rule out SI joint what is the best test?

A

Thigh thrust

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13
Q

If you have + test for 3 or more of the 6 special test for SIJ involvement what is the specificity & sensitivity?

A

Sensitivity: .94
Specificity: .78

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14
Q

If all 6 of of the SIJ ligamentous provocation stress exam is negative what can you rule out?

A

SIJ as a source of LBP

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15
Q

Manual therapy: If the innominate is anteriorly rotated what do you need to perform?

A

Posterior rotation- activation of hip extensors

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16
Q

Manual Therapy: if the innominate is posteriorly rotated what do you need to perform?

A

Anterior rotation - activation of hip flexors

17
Q

Therapeutic Exercise: If the innominate is anterior rotated what do you need to perform?

A

Posterior rotation –> Ie pulling involved leg toward chest

18
Q

Therapeutic exercise: If innominate is posterior rotated what do you need to perform?

A

anterior rotation –> half-kneeling lunge

19
Q

What are the most common causes of piriformis syndrome?

A
  • Inflammation (swelling) in piriformis or tissues around it
  • Muscle spasms
  • Scarring in muscle
20
Q

What are the common patterns of symptoms for piriformis syndrome?

A
  • Worse with sitting for long periods of time, walking or running & climbing stairs
  • SXM described as pain, aching, & burning in piriformis region & N/T down the leg
21
Q

What is the presentation of exam for someone with pirifromis syndrome?

A
  • Normal lumbar ROM & no TTP
    (may have pain w/ hip flexion & IR/ER
  • TTP in piriformis region
  • Positive neruor sign may be present
  • Positive FAIR test
22
Q

What is the treatment for piriformis?

A
  • Education
  • Modalites PRN
  • Address neural tension
  • Stretch piriformis
  • Eventually prescribe strengthening exercises for piriformis & lumbar spine
  • General fitness activity
23
Q

What is a femoral neck stress fracture caused by?

A

Repetitive loading of femoral neck that leads to either compression side or tension side

24
Q

What is the best imagining for femoral neck stress fracture?

A

MRI

25
Q

Why might radiographs not be the best thing for diagnosing femoral neck stress fracture?

A

Findings often lag behind therefore results in false negative early on

26
Q

Which type of stress fracture is nonoperative treatment for?

A

compression fracture

27
Q

Which type of stress fracture is surgery indicated?

A

tension sided stress fractures

28
Q

What are the demographics of a femoral neck stress fracture?

A

Females> Males
Female athlete triad

29
Q

What activity are related to femoral neck stress fracture?

A

Military personnel
Track & field or cross country athlete
High training volume & intensity

30
Q

What medical things may make someone more susceptible to femoral stress fracture?

A

Lower BMI
Decreased bone mineral density
Energy deficiency
Tobacco use

31
Q

What anatomical conditions may make someone more susceptible to femoral stress fracture?

A

Femoracetabular Impingement
Coxa Vara

Clinical Medicine (12 decks)

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