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PHTH 545 > Spinal Conditions > Flashcards

Spinal Conditions Flashcards

1
Q

Because of ___ we don’t see a lot of anterior disc herniations

A

ALL

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2
Q

The IVF is mechanically maintained by the ____ of the disc

A

height

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3
Q

Any thickening of the ____ joint = comprised IVF space

A

facet

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4
Q

________ corner of vertebrae = most common area of disc lesions

A

posterolateral

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5
Q

Extension = IVF is made _____, ____ glide of the facet joint

A

smaller; inferior

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6
Q

Flexion = IVF made _____, _____ glide of the facet joint

A

larger, superior

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7
Q

S/S of nerve compression depend upon degree of ______

A

compression

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8
Q

3 S/S of nerve compression?

A
  1. pain
  2. tingling
  3. numbness
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9
Q

Clinical presentation of LOSS of nerve conduction?

A

Changes in …

  1. reflexes
  2. myotomes
  3. dermatomes
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10
Q

Clinical presentation of LOSS of neural mobility?

A
    • femoral nerve stretch test

2. + SLR

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11
Q

The nucleus pulposis moves in the (same/opposite) direction that the disc moves.

A

OPPOSITE

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12
Q

We need an intact _____ for normal biomechanics

A

annulus

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13
Q

With a disc herniation, pt’s may present with a ______ shift away from the painful side

A

lateral

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14
Q

How to treat disc injury?

A

fix lateral shift WITHOUT causing any leg pain!!!

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15
Q

With a disc lesion, there will be ____ LBP +/- referred pain to _____ or down ____

A

central; buttock; leg

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16
Q

Pt’s with a disc lesion may present with loss of normal _____

A

lordosis

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17
Q

Why do pts with disc lesions present with loss of normal lordosis?

A

because they are trying to increase the IVF space by flexing

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18
Q

Disc lesions are often aggravated by _____ postures such as sitting and bending forward

A

flexion

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19
Q

Disc lesions are often aggravated by ____ or _____.

A

coughing; sneezing

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20
Q

The lateral shift seen in pts with disc lesions is always named for what the _____ are doing relative to the _____.

A

shoulders; pelvis

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21
Q

What are 4 positions that increase intradiscal pressure?

A
  1. sitting, leaning forward
  2. sitting
  3. standing, leaning forward
  4. standing
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22
Q

Once you restore a pt’s extension, they cannot go into a _____ posture for a set period of time!

A

flexed

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23
Q

3 exercises to restore extension?

A
  1. standing back extensions with hands on low back
  2. cobra
  3. cat cow (progression)
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24
Q

4 activities that increase intradiscal pressure?

A
  1. cough/sneeze
  2. valsalva
  3. breath holding
  4. bearing down
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25
Q

5 positions that decrease intradiscal pressure?

A
  1. lying down. knees supported
  2. sidelying
  3. lying prone
  4. standing, one leg on step
  5. sitting, lumbar support maintaining lordosis
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26
Q

5 steps for treating disc lesions?

A
  1. centralise pain
  2. correct shift
  3. support lordosis
  4. educate pt re specific postures
  5. avoid flexed postures
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27
Q

Always monitor ______ signs in pts with disc lesions, and refer if they worsen

A

neurological

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28
Q

Refer pt’s with disc lesions immediately if any ____ or ___ involvement

A

bowel; bladder

29
Q

In pt’s with disc lesions, avoid any positions that ______ the symptoms

A

peripheralize

30
Q

In pt’s with disc lesions, avoid any exercise or activity that increase ______ ______

A

intradiscal pressure

31
Q

2 investigations that may be used for disc lesions?

A
  1. X-Rays

2. MRI/CT scan

32
Q

How long should you avoid flexed postures for a pt with a disc lesion?

A

dependent on the pt!!!!

33
Q

For a pt with a disc lesion, when should you introduce flexion type positions and exercises?

A

for a soft tissue injury, give at least 6 weeks, but again dependent on pt presentation

34
Q

Stenosis = _____

A

narrowing

35
Q

Spinal stenosis = usually ______ pt, with previous Hx of ____

A

older; LBP

36
Q

With spinal stenosis, pain can be both _____ and radiate ______ into both legs and feet

A

central; bilaterally

37
Q

Will X-rays show any signs of spinal stenosis?

A

YES bc of bony changes (think bone spurs, facet degeneration, DDD, etc.)

38
Q

What positions aggravate pain in pt’s with spinal stenosis? Relieve?

A 
Aggravate = positions that decease the IVF (standing, walking)
Relieving = positions that increase the IVF (sitting, standing, leaning forward)
39
Q

3 Rx’s for spinal stenosis?

A
  1. avoid positions of extension (decrease IVF)
  2. Educate re positions that increase the IVF and pacing of activities
  3. address muscle imbalances esp abdominal strength and hamstring flexibility
40
Q

4 further investigations for someone with spinal stenosis?

A
  1. X-ray
  2. MRI/CT scan
  3. specialist referral
  4. list an objective measure of worsening that could warrant specialist referral
41
Q

________= forward slippage of one vertebra on the other

A

spondyloslisthesis

42
Q

Spondylolisthesis ______ IVF

A

DECREASES

43
Q

Grade I spondy?

A

0-25%

44
Q

Grade II spondy?

A

25-50%

45
Q

Grade III spondy?

A

50-75%

46
Q

Grade IV spondy?

A

75-100%

47
Q

Spondy = ______ pars

A

elongated

48
Q

Spondylolisthesis can be diagnoses at any age (T/F).

A

TRUE

49
Q

_______ activities are a common cause of spondy

A

hyperextension

50
Q

Where is the pain in pt’s with a spondy?

A

central LBP + - referred pain

51
Q

_________ is associated with weak abdominal muscles +/- tight hamstrings

A

spondy

52
Q

Spondy = aggravated by ______ postures, relieved by ______

A

extension; flexion

53
Q

There (is/is not) radiological evidence of spondy

A

IS

54
Q

5 steps in Rx of spondy?

A
  1. address lower quadrant imbalance
  2. focus on abdominal strengthening
  3. education
  4. biomechanical counselling
  5. avoid hyperextension activities
55
Q

With spondy, specialist usually not warranted unless worsening neurological signs or significant increase in slippage (T/F).

A

TRUE

56
Q

Optimum L spine posture supports the normal lumbar ______

A

lordosis

57
Q

Postural back pain = not specifically caused by flexed or extended postures (T/.F).

A

TRUE

58
Q

Postural back pain = worse in am, better at night (T/F).

A

FALSE; the way around

59
Q

Postural back pain = often associated with decreased _______

A

fitness

60
Q

There may be neurological S/S with postural back pain (T/F).

A

FALSE; NO NO NO

61
Q

Postural back pain = due to increased strain on ______ and reduced endurance of postural muscles because they’re not in an ______ position

A

tisses; advantageous

62
Q

There is no need to do further investigations for postural back pain (T/F).

A

TRUE

63
Q

5 Rx steps for postural back pain?

A
  1. address posture / ergonomics for work / studying
  2. address muscle imbalance. specific muscle weakness and tightness
  3. address fitness issue
  4. add spinal supports as indicated
  5. educate includes rest postures / breaks
64
Q

Flexion or extension Treatment: postural back pain?

A

can do either

65
Q

Flexion or extension Treatment: disc pathology

A

extension when acute; progress to to flexion

66
Q

Flexion or extension Treatment: spondy

A

flexion + core stability

67
Q

Flexion or extension Treatment: spinal stenosis

A

flexion; will never progress to extension activities

68
Q

X-Ray required only where the need to know status of ____ ____ exceeds the radiation risk

A

bone health

69
Q

MRI/CT scan indicated where worsening ________ signs and where ______ is likely an option, failure to respond to treatment

A

signs; Sx

PHTH 545 (23 decks)

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