Sciatica/Lumbar Radiculopathy (lumbar spine) Flashcards
what can happen if a disc tear occurs
gelatinous nucelus pulpous can herniate or prolapse through tear
disc material can impinge on an exiting nerve route causing…
pain, altered sensation in a dermatomal distribution and reduced power in a myotomal distribution, reflexes can also be reduced
what are reflexes a test of
lower motor neurone signs
where is the commonest site in the spine for this to occur
lower lumbar spine
what nerve roots contribute to the sciatic nerve
L4, 5 and S1
-pain radiates to the sensory distribution of the sciatic nerve (“sciatica”)
what is radicular pain felt as
neuralgic burning or severe tingling pain (like severe toothache) radiating down to the back of the thigh to below the knee
where can back pain radiate
buttock and back of thigh but not below knee
patients usually have a positive sciatic stretch test and what else
cross over sign
what is the cross over sign
sciatic stretch testing of the opposite side produces pain on the affected side
in the lumbar spine is the nerve root corresponding to the upper or lower of the two vertebra in the affected segment compressed
lower
in L3/4 prolapse which root is entrapped
L4
what symptoms does L4 entrapment cause
- pain down medial ankle
- loss of quadriceps power
- reduced knee jerk
in L4/5 prolapse which root is entrapped
L5
what symptoms does L5 entrapment cause
- pain down dorsum of foot
- reduced power of extensor hallucis longus and tibias anterior
in L5/S1 prolapse which root is entrapped
S1
