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PTRS 845 Midterm > Lumbar Spine Conditions > Flashcards

Lumbar Spine Conditions Flashcards

1
Q

3 Categories of LBP

A
  1. Serious Spinal Pathologies (tumors, infection, fx, cauda equina syndrome)
  2. Sciatica
  3. Nonspecific LBP (dysfunctions of msk tissues
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2
Q

Term: Back-related LE symptoms caused by back (nerve/nerve root) conditions

A

Sciatica

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3
Q

Distributions of LBP

  1. Serious Spinal Pathologies
  2. Sciatica
  3. Nonspecific LBP
A
  1. ~10%
  2. ~40%
  3. ~50(+)%
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4
Q

Term: narrowing of the central canal or lateral intervertebral foramina

A

Spinal Stenosis

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5
Q

Condition

  • Male > Female
  • 60+ yo
  • Congenital or age related degeneration
A

Spinal Stenosis

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6
Q

Term: Type of spinal stenosis most often due to degeneration

A

Lateral Spinal Stenosis

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7
Q

Boundaries of the lateral foramen

  • Anterior
  • Posterior
  • Superior
A

A: Vertebral body and disc

P: Ligamentum flavum

S: Facet joints

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8
Q

Term: Neural compromise due to obstruction of blood flow to the nerve, nerve root, or dural sleeve

A

Neurogenic Claudication

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9
Q

Condition: Symptoms

  • Localized vauge pain
  • Back and leg pain (can be bilateral)
  • Presence of N/T and weakness in LEs
  • Cramping
A

Spinal Stenosis

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10
Q

Conditon: Aggravating Factors

  • Extension
  • Prolonged standing or walking
  • Walking downhill
  • Lying flat

** Anything that loads the posterior column **

A

Spinal Stenosis

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11
Q

Condition: Easing Factors

  • Flexion
  • Sitting or squatting
  • Walking uphill
  • Bike riding
A

Spinal Stenosis

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12
Q

Condition: Objective Exam

  • Flat lumbar posture
  • Painful/limited extension
  • Pain with SB on involved side
A

Spinal Stenosis

Flat back posture unload the posterior column

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13
Q

Term: Compromised ciculatory system due to PVD

A

Vascular Cluadication

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14
Q

Condition: Pain worse with incline walking but improved with decline walking

A

Vascular Claudication

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15
Q

Condition: Symptoms

  • Flexion does not ease symtpoms
  • Rarely have back sx
A

Vascular Claudication

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16
Q

Condition: Objective Exam

  • Skin color or temperature changes
  • Hair loss
  • Peripheral pulses absent
  • LE cramping/tightness
A

Vascular Claudication

17
Q

Describe how the lumbar facet joints project the discs

A

Because they are oriented to prevent rotation

18
Q

Describe what motions cause facet compression

A

Lateral flexion and rotation

19
Q

Nerve: Innervates the lumbar facet joints

A

Medial branch of the dorsal primary ramus

20
Q

Describe the connection between LBP and mutlifidus atrophy

A

The medial branch of the dorsal primary ramus innervates the facet joints as well as multifidus.

The facet joint capsules are highly innervate and are a large source of LBP

When the facet joints are aggravated the body avoids activities that would worsen the pain, less firing of those nerves means less activity in multifidus leading to atrophy

21
Q

Structure: Synovial fold within facet joints

A

Meniscoid

22
Q

2 Functions of the Meniscoid

A
  1. Provide smooth gliding motion
  2. Prevent excess motion
23
Q

Cause of Acute Facet Joint

A

Mechanical block from meniscoid

24
Q

Condition: Symptoms

  • Unilateral pain, sharp over facet
  • Increased pain with stretch/compression of joint
  • Limitation in SB and extension
A

Acute Facet Joint

25
Q

Condition: MOI of sudden unguarded movement (i.e. flexion or rotation)

A

Acute Facet Joint

26
Q

5 Causes of Chronic Facet Joint

A
  1. Degerenation
  2. Hypertrophy
  3. Osteophytes
  4. Inflammation
  5. Microfracture
27
Q

Condition: Symptoms

  • Unilateral pain
  • Less sharpt over the joint
  • Rarely radiates down leg
A

Chronic Facet Joint

28
Q

Condition: Symptoms

  • Stiffness and pain in AM
  • Increased pain with stretch of joint
A

Chronic Facet Joint

29
Q

Condition: History

  • Past Acute Facet Joint
  • Never entirely symptom free
  • Trauma
  • Degeneration
A

Chronic Facet Joint

30
Q

Condition: Objective

  • Localized pain but can refer to larger area
  • Local tenderness with palpation, stiff, thick
  • Initially hypomoble
A

Chronic Facet Joints

31
Q

3 Things to Know about Facet Joints and Referred Pain

A
  1. Facet joint have a referral pattern
  2. The referral pattern becomes broad with facet joint pathology
  3. The referral pattern is similar to many other LBP referrals
32
Q

Condition: Irritation/Inflammation, compression, or tension to the nerve root

A

Acute Nerve Root (ANR)

33
Q

3 Possible Causes of ANR

A
  1. Disc pathologies
  2. Degenerative changes
  3. Other medical conditions
34
Q

Describe the progression of pain with ANR

A

Can begin as a proximal ache and them move distally

35
Q

Condition: Symptoms

  • More distal than proximal signs i.e. radiating
  • Limited ROM and activity
  • Muscloskeletal involement is central/local
A

ANR

36
Q

Condition: Chronic irritation of nerve root/adhesion

A

Chornic Nerve Root (CNR)

37
Q

4 Possible Causes of CNR

A
  1. Hx of disc pathology
  2. NR injury
  3. Degenerative changes
  4. Spinal surgery/scaring
38
Q

Condition: Symptoms

  • More proximal than distal
  • Minimal limitation of activity
A

CNR

39
Q

Condition: Objective

  • Localized thickness in tissues
  • Stiff segmentally
  • May report pain with OP
A

CNR

PTRS 845 Midterm (13 decks)

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