Mechanical back pain Flashcards
What test assesses the extent of the spinal flexion? What finding is normal?
Schober’s test
>20cm
What myotome is responsible for hip flexion?
How is it tested?
L1/2
Flex thigh - push against doc’s hand
What myotome is involved in knee extension?
How is it tested?
L3/4
straighten flexed knee agast doc’s hand
What myotome innervates foot dorosiflexion and extensor halluics longus?
How is it tested?
L5
Extend great toe and dorsiflex foot (against pressure)
__/_ innervates ankle plantarflexion muscles.
How is it tested?
S1/2
Plantarflexion against pressure
Nerve irritation in lower limb is tested by the _____ _____ test and the _____ stretch.
Straight leg test
-lift up leg, extend the foot
Femoral stretch
-lie on side, flex knee back
What is the first line investigation for back abnormalities?
MRI scan
Sciatica is defined as _____ and/or _____ pain in a specific ______ distribution, accompanied by ________ disturbance
buttock and/or leg pain
dermatomal distribution
neurological disturbance
Disc prolapse is an emergency requiring surgery. (T/F)
False
surgery seldom recommended
An important feature of a disc prolapse is _______. If present, surgery may be advised.
Sciatica (leg pain)
Steroids may be prescribed for back pain (on top of analgesia) (T/F)
False
What are the possible causes of sciatica?
Compression by:
- prolapsed intervertebral disc
- osteophytes at the facet joints (secondary to osteoarthritis)
Patients over 60, with burning leg pain when walking (less pain UPHILL than downhill) describes….
What are the causes?
Spinal claudication
-Bulging discs, osteophytes and bulging ligamentum flavum result in compression of nerve roots.
What two conditions are associated with automatic cervical spine instability?
Down syndrome
Rheumatoid arthritis
In rheumatoid arthritis, the destruction of the synovial joint between the ____ and the dens of ____ results in _____-______ ______.
atlas and the dense of axis
antlanto-axial subluxation
