Spinal Flashcards
At what level does the spinal cord terminate
L1/2
List (in order of severity) the disc injury types
- Annular tear
- Bulge
- Protrusion
- Extrusion
- Sequestration
What is the myotome for elbow flexion
C5
What is the myotome for wrist extension
C6
What is the myotome for wrist flexion or finger extension
C7
What is the myotome for finger flexion
C8
What is the myotome for finger abduction
T1
What is the myotome for hip abduction
L1,2
What is the myotome for knee extension
L3,4
What is the myotome for knee flexion
L5, S1
What is the myotome for great toe extension?
L5
What is the myotome for great toe flexion?
S1
What is the tendon reflex for biceps ?
C5
What is the tendon reflex for brachioradialis?
C6
What is the tendon reflex for triceps ?
C7
What is the tendon reflex for quads?
L3,4
What is the tendon reflex for achilles tendon?
L5, S1
Referred pain down the anterior thigh may involve which dermatomes?
L2-4
Referred pain down the lateral shin may involve which dermatomes?
L5
Referred pain down the lateral border of the foot may involve which dermatomes?
S1
Referred pain/sensory changes in the big toe may involve which dermatomes?
L4, maybe L5
What myotome is implicated when people with back pain cannot easily walk on their toes
S1
What myotome is implicated when someone cannot walk on the heels of their feet ?
L4
What myotome is implicated with glute max
L3
List four features of a Z-joint pattern
- Back pain greater on one side
- Lumbar extension is painful
- Ipsilateral lateral flexion painful
- Unilateral PA painful
The paper by Schafer describes 4 Hierarchical classifications for back pain. What are they (in order)?
- Neuropathic sensitisation
- Denervation
- Peripheral nerve sensitisation
- Musculoskeletal
What type of back and leg pain benefits from opening gliders and neural mobilisation
- PNS
The LANSS assess for NS. List some of the signs and symptoms
Distal pain
Paraesthesia
Autonomic changes
Burning
Allodynia
Hyperalgesia
Paroxysmal pain
What paper demonstrates increased odds of pain in those with disc and vertebral changes on MRI
Brinkki, 2015 systematic review
Why is important to know the level of bulge relevant to the conus medullaris ?
If UMN signs are present, then the problem is higher than L1/2 (conus medullaris)
Most disc bulges are where?
Central or paracentral
What type of disc bulge may be painful in flexion
Paracentral
What type of disc bulge may be painful in extension ?
Foraminal
How many of the Laslett cluster need to be positive for a positive cluster
3/5
How do you test the L4 nerve root?
Dorsiflexion and inversion
How do you test the L5 nerve root?
Big toe extension
How do you test the S1 nerve root?
Calf raise in standing
What nerve root does the bicep reflex test?
C6
The triceps reflex tests what nerve root?
C7
How do we test C5 nerve root?
Shoulder abduction
How do we test C6 nerve root?
Elbow flexion
How do we test C7 nerve root?
Elbow extension
How do we test C8 nerve root?
Extension of thumb
How do we test T1 nerve root?
Finger intrinsics - must have MCP flexed to 90, IP’s extended and resisted adduction of fingers
List in order from C5 down, how you would conduct a sensation exam?
- Radial sided forearm
- Tip of thumb
- Tip of middle finger
- Tip of little finger
- Ulnar sided forearm
What two factors need to be present for a neuro dynamic test to be considered positive ?
- Reproduces familiar symptoms
- Structural differentiation
What tests are involved in the sij clusters (4)
- Pelvic torsion or Gaenslens
- Posterior shear
- Compression
- Distraction
