Practical 2

Question 1

Disc Lesion w/ radiculopathy presentation

Answer 1

Prefer to be in extension
LBP and leg pain below knee
Numbness/tingling in specific dermatome
Sway back posture can be a presentation

Question 2

Disc lesion with radiculopathy tests

Answer 2

Crossed SLR: stretches sciatic nerve

Bowstring: puts pressure on nerve

Question 3

Disc lesion with radiculopathy mobilization

Answer 3

extension bias PA

Question 4

Disc lesion with radiculopathy exercise

Answer 4

prone press up

Question 5

Facet syndrome presentation

Answer 5

Prefer to be in flexion
Well localized LBP with hip/buttock pain above the knee
Absence of neurological deficits and nerve root tension signs/tests
AROM provokes pain (flexion/extension)
Hypomobility with spring testing
Referrals to lumbar spine region, gluteal region, trochanteric region, posterior thigh pain, lateral thigh region, groin region
kyphosis-Lordosis posture is can be presentation

Question 6

Facet syndrome tests

Answer 6

○ Stork would be acceptable: extension, stress on capsule, increases weight bearing load on joints and causes pain
repeated or prolonged ext: stress/weight on joints

Question 7

Facet syndrome mobilization

Answer 7

Flexion bias PA

Question 8

Facet syndrome exercise

Answer 8

Bilateral knee to chest

Question 9

Spinal Stenosis presentation

Answer 9

Prefer to be in flexion
More commonly in elderly >65
Onset of pain with walking and relief after resting 20 minutes or maintaining a flexed position
Normal peripheral pulses
Decreased lumbar extension and difficulty standing or lying in erect position
Neurological deficits may be cross dermatomal

Question 10

Spinal Stenosis tests

Answer 10

Rhomberg Prolonged Extension

Flexion preference – repeated or prolonged flex/ext (10 reps/30 sec

Question 11

Spinal Stenosis mobilization:

Answer 11

flexion bias PA

Question 12

Spinal Stenosis exercise:

Answer 12

Bilateral knee to chest

Question 13

Spondylolisthesis presentation:

Answer 13

○ Prefer to be in flexion
Mechanical pain worsened with activity and alleviated with rest
May be asymptomatic or made worse with extension
Prominent spinous process or indented spinous process
Grade 3 or greater have transverse skin furrow and hyperlordosis

Question 14

Spondylolisthesis tests:

Answer 14

stork

Step defect

Question 15

Spondylolisthesis mobilization:

Answer 15

Flexion bias PA above and below segment

Question 16

Spondylolisthesis exercise

Answer 16

Birddog

Question 17

Piriformis syndrome presentation

Answer 17

○ Unilateral buttock and posterior leg pain and paresthesia
Neurological MSR normal
Palpation of muscle causes referred pain down back of leg

Question 18

Piriformis syndrome tests

Answer 18

Resisted ER

SLR

Question 19

Piriformis syndrome mobilization:

Answer 19

contract relax ER

Question 20

Piriformis syndrome exercise:

Answer 20

piriformis stretch

Question 21

Ankylosing Spondylitis presentation

Answer 21

Young males
Stiff low back with pain that may radiate into the buttock, anterior or posterior thighs
Stiffness when rising with relief with movement
Loss of lumbar lordosis with increasing kyphosis in the thoracic spine and decrease in chest expansion

Question 22

Ankylosing Spondylitis tests:

Answer 22

Chest expansion test

○ Structural vs Non-Structural kyphosis

Question 23

Ankylosing Spondylitis mobilization:

Answer 23

Gentle PA mobilizations to get movement

Question 24

Ankylosing Spondylitis exercise:

Answer 24

○ Prone lying and press ups- start lying, ½, and then full

Question 25

Abdominal Aneurysm

Presentation

Answer 25

Usually asymptomatic until rupture
Mild to sever middle abdominal or LBP
May be associated with complaint of leg pain with exertion (claudication)
Pulsatile mid or upper abdominal mass
Auscultation may reveal bruit
Peripheral pulses may be prominent

Question 26

Abdominal Aneurysm tests

Answer 26

Auscultation for bruits

Observation – look for palpable mass (Do first)

Question 27

SIJ Dysfunction presentation:

Answer 27

Primarily pain over the SI joints, butt and lateral side of the thigh
Improves with walking, standing

Question 28

SIJ Dysfunction tests:

Answer 28

Distraction

Compression

Question 29

SIJ Dysfunction mobilization:

Answer 29

Gaenslen’s contract/relax

Question 30

SIJ Dysfunction exercise:

Answer 30

birddog

Question 31

Instability presentation:

Answer 31

Painful arc in flexion
Painful arc on return from flexion
Instability catch
Reversal lumbopelvic rhythm
Gower’s sign

Question 32

Instability special test

Answer 32

Prone instability test

Aberrant motion/gowers sign

Question 33

Instability mobilization

Answer 33

soft tissue of paraspinals

Question 34

Instability exercise:

Answer 34

birddog