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545 > spinal conditions > Flashcards

spinal conditions Flashcards

1
Q

what happens to spinal diameter during flexion and extension

A

Ext - IVF narrows (inferior glide)

Flex - IVF opens (superior glide)

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2
Q

nerve compression from

A

ext
osteophyte
disc herniation
swelling

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3
Q

Signs and symptoms of nerve compression

A

pain, tingles, numb
loss of nerve condition
loss of neural mobility

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4
Q

how do we test nerve conduction

A

reflexes
myotomes
dermatomes

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5
Q

T/F need intact annulus for normal biomechanics

A

tre

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6
Q

nucleus pulpous migrates __ to the direction of the movement

A

opposite

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7
Q

during flexion where does nucleus pulpous migrate

A

posteriorly

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8
Q

whats worst thing that can happen after traetemtn

A

leg pain

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9
Q

clinical presentation of disc lesion

A

age
central low back pain referred to butt/leg

loss off normal lordosis

aggravated by flexion, coughing, sneezing

eased by ext

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10
Q

lateral shift named based on

A

what the shoulder are doing in relation to pelvis

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11
Q

where do you stand when naming the shift

A

behind the patient

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12
Q

positions that inc intradiscal pressure

A

sitting, leaning fowd

standing, leaning fwd

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13
Q

activities that increase intradiscal presure

A

cough / sneeze
valsalva
breath holding
bearing down

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14
Q

positions that decrease intradiscal pressure

A 
lying down, knees supported
side lying
lying prone
standing with one leg on step
sitting lumbar supported
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15
Q

what to do for disc lesions

A 
centralise pain
correct shift
support lordosis 
educate patient on posture
avoid flexion

ergonomics, exercise, prevention

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16
Q

when to refer to physician disc lesion

A

neurological sign is present

worsening (loss of reflex, mytome, sensation)

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17
Q

should you peripheralize symptoms

A

no centralize

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18
Q

do you want to increase or decrease intradiscal pressure

A

dec

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19
Q

t/F x ray helpful in investigating for disc lesion

A

no but you can see the disc space narrowing

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20
Q

t/f MRI / CT scan helpful disc lesion

A

yes you can see nerve compression

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21
Q

stenosis means

A

narrowing

22
Q

spinal stenosis

A

bone spurs creating narrowing

23
Q

who gets spinal stenosis

A

older hx of low back pain

24
Q

where is pain in spinal stenosis s

A

can be central

can radiate bilaterally

25
Q

what aggrevates spinal stenosis

A

positons that dec IVF (standing , walking)

26
Q

pain relieved by what in spinal stenosis

A

positions that inc IVF, sitting, standing, lean fwd

27
Q

treatment of spinal stenosis

A

avoid positions of ext
education on positions
pace back to activities
address mm imbalance (ab strength, hamstring flexibility)

28
Q

what can x ray show in spinal stenosis

A

spurs / narrows

29
Q

what can MRI/ CT scan show for spinal stenosis

A

where there is neurological compromise if SIGNS worsening

30
Q

whats an objective measure that shows worsening in patient with spinal stensos

A

clonus, babinksi

31
Q

spondyloliothesis

A

the gymnast
fwd slippage of one vert
decreases IVF

32
Q

hows spondylolthesis graded

A

grade 1-4

33
Q

clinical presentation fo spondylolisthese

A 
gymnast, dancer
hyperextension activiteis 
central low back pain, referred
weak abs
tight hamstrings
aggravated by ex
eased by flexion
34
Q

treatment of spondlolisthesisi

A 
address low quadrant mm imbalance
focus on ab strengthening (TA)
education
miomechs
avoid hyperexntion
35
Q

X-rays in sponolishtsis

A

useful in standing to visualize slippage
can confirm clinical suspicions

get if its a career decidier

36
Q

MRi for spondolisthesis

A

not needed unless worsening neurological signs

37
Q

do spondolisthesis need specalist

A

not unless worsening neurological signs of significant slippage

38
Q

optimum lumber spine posture _____

A

supports the normal lumbar lords

39
Q

why do we need to know optimal posture

clinical relevance?

A

understand pathology of abnormal posture
understand effect on spinal diameter
understand condition specific limitations

40
Q

postrural back pain clinical presentaiton

A 
any age group
pain increases with prolonged postures
poor posture/ ergonomics 
not caused by flex/ext
better in AM, worse in PM

associated with decreased fitness
no neuro signs

41
Q

treating postural back pain

A 
address posture / ergonomics 
address mm imbalance
address fitness
add spinal suport
educate on rest postures
42
Q

guidelines for treatment of impairments with flexion bias

A

avoid ext if it increases neurological /pain
rest /support in positions of flexes when it reduces neurological /pain
reducate on posture
return to activity

43
Q

why flexion bias

A

widens IVF, decreases pressure on roots

reduces effects of derangement in joint

44
Q

why extension bias

A

reduces disc derangement
facilities centralization of pain
if flexion is contraindicated

45
Q

how does extension facial centralization

A

by encouraging anterior migration of nuclear material

decreases stress on posterior annulus

46
Q

guidelines for management of impairments with an extension bias

A

rest / support in extension if it helps
re educate on posture
return to activities

47
Q

some components of patient education

A 
lifting
standing 
avoid prolonged sitting
flexiblity / strength
pillows, chairs
48
Q

likely treatment for postural back pain

A

they can do flex and ext

49
Q

likely treatment for disc pathology

A

do ext first progress to flex after they can sit n reach fwd

50
Q

spondyloslisthesis likely treatment

A

give them flexion, avoid ext because an instabilty in anterior direction

51
Q

spinal stenosis likely treatment

A

flexion , avoid ext

545 (34 decks)

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