Mod 1: Lumbar Exam Screening

Question 1

A pt who presents with a backache and/or a history of a malignanacy during the previous two years, must be assumed to have and screened for ___ depositis in the spine until proven otherwise

Answer 1

secondary malignant

Question 2

An elderly individual without any previous history of back symptoms is more likely to have osteoporosis or a mechanical fault?

Answer 2

osteoporosis

Question 3

continuous pain unrelated to posture is unlikely or likely ro be mechanical in origin

Answer 3

unlikely

Question 4

loss of strength too widespread to be accountable by a single nerve root lesion

Answer 4

often suggests a neurological disease

Question 5

loss of sphincter control is never due to

Answer 5

simple mechanical causes

Question 6

T/F: very intense pain, which requires morphine for more than 48hrs may indiciate the presence of a serious systemic disease

Answer 6

True

Question 7

T/F: severe pain, deformity, and muscle spasm in areas od the spine other than lower cervical and lower lumbar should also arouse suspicion of systemic disease

Answer 7

True

Question 8

T/F: constitutional signs which accompany back pain like pyrexia, loss of weight, malaise, and excessive weakness do not suggest disease

Answer 8

false

Question 9

Which one is a red flag for body temp:
A. 92 F
B. 98.8 F
C. 95 F
D. 102 F

Answer 9

D. 102, anything > 100 F

Question 10

Which one is a red flag for blood pressure
a. 120/80
b. 170/100
c. 140/80
d. 110/40

Answer 10

b. 170/100, anything >160/95mmHg

Question 11

which one is a red flag for pulse
a. 120
b. 60
c. 77
d. 40

Answer 11

A. 120, anything >100 BPM

Question 12

which of the following is a red flag for respiration rate
A. 17
B. 12
C. 26
D. 15

Answer 12

C. 26, anything >25

Question 13

Ruling out Cancer as a Cause of Low Back Pain: which one is not a characteristic
A. Age less than 50
B. Prior history of cancer
C. No unexplained weight loss
D. Conservative treatment is successful

Answer 13

B, it is NO prior history of cancer

Question 14

Compression of the spinal cord

Answer 14

Myelopathy

Question 15

Compression of an indvidual nerve root or roots

Answer 15

Radiculopathy

Question 16

Myotomal weakness

Answer 16

Positive for both Radiculopathy and Myelopathy

Question 17

Dermatomal change

Answer 17

Positive for both Radiculopathy and myelopathy

Question 18

Deep Tendon reflex dimished

Answer 18

Radiculopathy

Question 19

Deep tendon reflex hyperreflexia

Answer 19

Myelopathy

Question 20

upper motor neuron signs

Answer 20

Positive for Myelopathy

Question 21

ataxia

Answer 21

positive = myelopathy

Question 22

unilateral or bilateral neuro signs: radiculopathy

Answer 22

unilateral

Question 23

unilateral or bilateral neuro signs: myelopathy

Answer 23

bilateral

Question 24

Causes impaired bowl and bladder function and saddle anesthesia

Answer 24

Cauda Equina Syndrome

Question 25

Experienced due to involvement of internal organs, often referred to the spin or other anatomical regions, may be characterized as dull, diffuse, poorly localised, may rhythmically build and recede, commonly constantl and unchanged with posture or position

Answer 25

visceral pain

Question 26

changes with position and activity, associated with mechanical stress on the spine, follows known spinal referral patterns

Answer 26

mechanical pain

Question 27

LBP rare
Spondylolisthesis (vertebra slips out of place onto the vertebra below it)
Ankylosing Spondylitis (arthritis that causes inflammation in the joints and ligaments of the spine)
Disc Pathology (disc associated pain, disc herniation, histology findings)

Answer 27

Younger (<20 y.o)

Question 28

Disc pathology
Facet pathology (synoval joints that can have infection, inflammation, trauma, tumor)
Instability
Muscle strain

Answer 28

20-50 y.o

Question 29

Degenerative disc disease
Stenosis (narrowing, cause pressure on spinal cord or the nerves that go from your spinal cord to muscles)
Degenerative spondylolisthesis (slip of one vertebral body over the one below causing degenerative changes in spine)

Answer 29

Older (>50 y.o)