Lumbar radiculopathy/ Cauda Equina

Question 1

mobility rule of 3: lumbar radiculopathy

Answer 1

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

Question 2

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

Answer 2

• 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

Question 3

What is the goal of williams flexion exercises

Answer 3

-To reduce lumbar lordosis or flatten the back

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

Question 4

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

Answer 4

L5

Question 5

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

Answer 5

l4

Question 6

Repeated flexion distraction motion helps do what (cox)

Answer 6

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

Question 7

What is the 50% rule in Cox

Answer 7

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

Question 8

What is the 3 syndromes in mckenzie

Answer 8

Postural syndrome
Dysfunctional syndrome
Derangement syndrome

Question 9

What is postural syndrome

Answer 9

Poor posture
flexed habits
stretching and minor pain

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

Question 10

tx of postural syndrome

Answer 10

Ergonomics
postural training
stabilization exercises
etc

Question 11

What is dysfunctional syndrome

Answer 11

-Adaptive shortening (end range stress of shortened structures)

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

Question 12

Tx of dysfunction syndrome

Answer 12

mobilize in the direction that recreates pain of soft tissue restrictions

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

Question 13

What is derrangement syndrome and when can it be reducable

Answer 13

progressive internal disc disruption

usually younger can be reversed

Question 14

what are the theraputic goals to centralize pain in mckenie

Answer 14

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

Question 15

red flags for lumbar disc

Answer 15

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

Question 16

What are two good tests for lumbar instabiluty

Answer 16

Single limb stance
sitting on a gimbal with one leg lifted

Mod reliability (unilateral pelvic lift test)

Question 17

symptoms of vascular claudication

Answer 17

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

Question 18

neurogenic claudication aggrevating/relieving factors

Answer 18

agg- erect posture, ambulation, exttemsion of the spine

relieving- squatting, bending forward, sitting

Question 19

Hwo to grade aorta calcification score

Answer 19

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

Question 20

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

Answer 20

> 2

Question 21

What are some claudication tests

Answer 21

Calf raise
walking in place

-time from start to cramping= claudication time

Question 22

primary source of vertebral metastisis

Answer 22

Lung (31%)