Lumbar radiculopathy/ Cauda Equina Flashcards

1
Q

mobility rule of 3: lumbar radiculopathy

A

1/3 hr mobility
1/3 hr pos of releif
1/3 hr of ADL

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2
Q

Flexion-distraction cox goals (how low does it drop pressure and how wide does it open foramina %)

A
  • Drops intradiscal pressure to as low as -192mmHg in the lumbar spine
  • Widening the spinal canal foramina area by 28%
  • Reducing pressure on the spinal nerves
  • Returning motion to the spinal jts
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3
Q

What is the goal of williams flexion exercises

A

-To reduce lumbar lordosis or flatten the back

  1. strengthening the abdominal mm
  2. Strenthen the gluteal mm
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4
Q

A posterolateral disk bulge at L4/5 affects what nerve root

A

L5

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5
Q

A far lateral disc bulge at L4-5 affects what nerve root

A

l4

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6
Q

Repeated flexion distraction motion helps do what (cox)

A

helps restore jt mechnics
normalize reflex activation of jt receptors
Diminish segmental reflex activation and mm hypertonus

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7
Q

What is the 50% rule in Cox

A

When pt has 50% less symptoms reduce tx by 50%

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8
Q

What is the 3 syndromes in mckenzie

A

Postural syndrome
Dysfunctional syndrome
Derangement syndrome

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9
Q

What is postural syndrome

A

Poor posture
flexed habits
stretching and minor pain

Mechanical stress leads to: soft tissue change, end range pain, postural changes, structural changes

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10
Q

tx of postural syndrome

A

Ergonomics
postural training
stabilization exercises
etc

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11
Q

What is dysfunctional syndrome

A

-Adaptive shortening (end range stress of shortened structures)

  • occures w age
  • cummulative spinal degen
  • persistent poor posture
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12
Q

Tx of dysfunction syndrome

A

mobilize in the direction that recreates pain of soft tissue restrictions

  • goal is to remodel the tissue shortening/adhesions
  • should not peripheralize pain
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13
Q

What is derrangement syndrome and when can it be reducable

A

progressive internal disc disruption

usually younger can be reversed

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14
Q

what are the theraputic goals to centralize pain in mckenie

A
  1. current posture
  2. stretch (short contracted mm)
  3. Apply reductive pressures to relocate nuclear material
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15
Q

red flags for lumbar disc

A
bilateral leg signs
recent sig traua
bowel + bladder symptoms
Older pt 50> w progressive nerve signs
Thoracolumbar pain + groin pain
Abdominal pain
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16
Q

What are two good tests for lumbar instabiluty

A

Single limb stance
sitting on a gimbal with one leg lifted

Mod reliability (unilateral pelvic lift test)

17
Q

symptoms of vascular claudication

A

pain that comes and goes depending on activities

  • feet especially and distal extremities can feel cold to the touch
  • hard to find peripheral pulse
  • Skin discoluration
  • ulceration
18
Q

neurogenic claudication aggrevating/relieving factors

A

agg- erect posture, ambulation, exttemsion of the spine

relieving- squatting, bending forward, sitting

19
Q

Hwo to grade aorta calcification score

A

Number the amount of vertebra affected (sum ant and post walls)

20
Q

An aa calcification socre of more than what is considered mod to sev

A

> 2

21
Q

What are some claudication tests

A

Calf raise
walking in place

-time from start to cramping= claudication time

22
Q

primary source of vertebral metastisis

A

Lung (31%)