Lumbar Subjective Exam

Question 1

What will the analysis of subjective history lead you do?

Answer 1

A hypothesis

Question 2

True or False

Objective examination will not comfirm or change your hypothesis

Answer 2

False

Question 3

List 3 things you would do before beginning the evaluation (subjective/objective examination) process

Answer 3

• read the medial referral/script
• look up relevant info in EMR
• look at pt intake forms
• past medical history
• view body chart
• patient recorded outcome measure

Question 4

What is the following a definition of?

to identify confusion, memory loss, denial, attitude toward PT, abusive language, response to previous treatment

Answer 4

Quote/Verbs

Question 5

What is the following a definition of?

Including MOI, when, how long, current status, red/yellow flags questions , etc.

MOI: mechanism of injury

Answer 5

Chief complaint

Question 6

What is the following a definition of?

severity, quantifier (NPRS), SINSS, location, description, onset, quality (burning, sore, throbbing, etc.)

NPRS: numeric pain rating scale

Answer 6

Pain Description

Question 7

What is the following a definition of?

What makes the pain increase

Answer 7

Aggravating factors

Question 8

What is the following a definition of?

What makes the pain decrease?

Answer 8

Relieving factors

Question 9

What is the following a definition of?

(relevant); red/yellow signs

Answer 9

Past medical history

Question 10

What is the following a definition of?

who is this pt? job? whom do they live with? etc.

Answer 10

Psychosocial

Question 11

What is the following a definition of?

patient driven, use Patient Reporting Outcome Measure

Answer 11

Patient goals

Question 12

Are the following Red or Yellow flags?

• night pain (pain at night waking pt up)
• changes in bowel/bladder
• fever or chills
• nauesea/vomiting
• weight changes - unaccounted; unusual weight loss or gain
• chest pain
• headaches
• unusual weakness

Answer 12

Red Flags

Question 13

Are the following Red or Yellow flags?

Signs of Fracture
- major trauma
- minor trauma or strain in elderly or osteoporotic

Signs of infection/osteomyelitis
- recent fever, chills, unexplained weight loss
- recent bacterial infection, IV drug abuse, immune suppression

Screening questions for cancer

Answer 13

Red Flags

Question 14

What is this a definiton of?

absence of sensation in the 2nd through 5th sacral nerve roots, the perianal region

Cauda Equina Syndrome (CES)

Answer 14

Saddle Anesthesia

Question 15

What is the following a defintion of?

urinary retention changes in frequency of urination, incontinecne, dsyura, hematuria

CES or infection

Answer 15

Bladder Dsyfunction

Question 16

What part of SINSS is this?

• intensity of the pt’s pain
• impact of pain on ADL
• amount of pain meds needed to control pain
• presence or absence of night pain

Answer 16

Severity

Question 17

What part of SINSS is this?

• ratio of the magnitude of aggravating factors to easing factors
• amount and type of activity to aggravate symptoms
• amount and type of activity to ease symptoms

Answer 17

Irritability

Question 18

What are the Four Habits Model?

Answer 18

• invest in beginning
• elicit the pt’s perspective
• demonstrate empathy
• invest in the end