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PT 515 Musculo > Lumbosacral Examination and Intervention > Flashcards

Lumbosacral Examination and Intervention Flashcards

1
Q

Herniated Disk pattern

A
  • Insidious onset
  • Unilateral to symmetrical
  • Worse with flexion activities
  • Variable symptoms
  • Periods of no pain
  • Mornings and evenings worse
  • Low back and buttock symptoms
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2
Q

Lumbar Radiculopathy pattern

A
  • Back pain initially before leg pain
  • Pain/parasthesia presents suddenly
  • Symptoms intermmittent or constant
  • Varies dependent on activity and position
  • Pt reports weakness or difficulty with gait
  • Pain in low back and radicular pattern down LE
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3
Q

Adherent Nerve Root pattern

A
  • Episode of back pain months ago or surgury
  • Leg symptoms never completely went away
  • Sitting not and issue and walking makes it feel better
  • Reports episodes of burning and aching or parasthesias
  • Unable to bend forward due to sharp pain in LE
  • Pain in low back and leg
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4
Q

Stenosis pattern

A
  • Chronic back pain
  • Intermittent sx in back “Stiffness”
  • complains of one or both legs cramping with walking
  • Sitting always relieves symptoms
  • Standing tall or extending spine aggravates leg pain
  • low back and bilateral leg pain
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5
Q

Spondylosis Pattern

A

Symmetrical or asymmetrical back pain
Localized pain
Episodic; usually time b/w episodes decreases
May not c/o functional limitations until tissue is engaged

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6
Q

Spondylolysis Pattern

A

Localized back pain; usually asymmetrical
May have been due to trauma or excessive repetitive force
Most cases insidious
OK with stationary tasks like sitting and standing
Extending or side-bending towards painful side an issue
Pain localized in low back

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7
Q

Spondylolesthesis Pattern

A

General back ache to intense stabbing pain or catching
Flexion activities ok compared to extension
Transitioning in and out of positions painful
May c/o feeling weak, difficult to stand up

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8
Q

SI subjective exam

A

More likely to be traumatic
Fortin sign = pt points toward PSIS
Pt may report difference in fit of pants or that they feel uneven when they sit

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9
Q

Red Flags

A 
Failure to improve with conservative care >30 days
Cancer
Cauda Equina syndrome
Infection
Spinal Compression fx
Abdominal Aortic Aneurysm
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10
Q

Shift named for…

A

Position of the shoulders relative to the pelvis

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11
Q

Stenotic posture

A

Flexed at the hip and reduced lordosis

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12
Q

Derangements will deviate…

A

Away from the painful side

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13
Q

Adherent nerve roots will deviate…

A

Towards the painful side

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14
Q

Stenosis marked limitation in…

A

Extension

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15
Q

Spondylolysthesis will always be better….

A

Towards endrange

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16
Q

Flexion ROM

A

80°

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17
Q

Extension ROM

18
Q

Side-bending ROM

19
Q

Rotation (Thoracolumbar)

20
Q

Acute Kyphotic deformity

A

Testing starts prone over pillows to accomodate deformity

21
Q

Flexion PROM End feel

22
Q

Extension PROM End feel

A

Firm or hard

23
Q

Side-bending/rotation PROM end feel

A

Firm or hard

24
Q

Grading of PROM

A

Hypo/Hyper/Normal

25
Q

Hicks CPR on stabilization

A

3 of 4 variable present:

  • Younger than 40 y/o
  • Greater general flexibility (SLR >91°)
  • Instability catch or aberrant movement during flex/ext
  • Positive findings on the prone instability test
26
Q

Symptoms below the buttock?

A

Do a neuro screen

27
Q

Neuro Exam

A

LLNT (SLR, slump)
Myotomes
Dermatomes
MSRs/DTRs

28
Q

SLR/Slump 3 criteria for being positive

A

Reproduce comparable sign
Asymmetrical findings
Sensitizing movements change symptoms

29
Q

Tests for intermmittent claudication of nerve

A 
Bicycle test (Patients with PVD will get ischemic pain)
Stoop test
30
Q

Test cluster for SIJ provocation

A 
Iliac compression
Iliac Gapping
Thigh Thrust
Pelvic Torsion Left
Pelvic Torsion Right
31
Q

Clinical Reasoning in patients with Lumbopelvic pain

A

Use repeated movements in conjunction with the 5 pain provocation tests

32
Q

Diagnosis vs classification

A

Try to classify, diagnosis isnt necessarily possible

33
Q

Low back pain classifications

A

1) Manipulation
2) Specific Exercises
3) Stabilization
4) Traction

34
Q

CPR for success with manipulation

A

4 or more present:

  • Recent onset
  • Low FABQ (35)
35
Q

Stabilization training

A

Specific exercise approach more effective in patients with chronic spondylolysis or spondylolysthesis

36
Q

Directional Preference return to function phase

A

Once pt centralized, after 72 hours w/o symptoms you start repeated FIL
After FIL, flip over and do prone ext w/ a sag
Continue if no pain

37
Q

Anterior rotated SI

A

Needs posterior rotation

38
Q

Posterior rotated SI

A

Needs anterior rotation

39
Q

Sliders used

A

In acute conditions
5-6 active repetitions
or 1-2 sets 30-60 seconds passively

40
Q

Tensions used

A

Sub-acute to chronic

41
Q

Femoral nerve testing

A

Prone or side-lying

42
Q

Sciatic nerve testing

A

Supine

Bias nerve for sural, tibial, and fibular

PT 515 Musculo (18 decks)

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