Test 1 Flashcards
Indications of an os odontoidium
Convex tubercle
Tendinosis
Intra-tendon degeneration
Pain below the knee indicative of what?
Disc lesion with NR irritation
Patients with disc lesions often haev what history
History of recurrent back pain without leg pain
Young patient vs old patient difficulties and disc lesion
Young: hard time sitting and easier to stand or walk
Older: hard time walking or standing because compressive
MC disc lesions
L4 and L5
Weakness of dorsiflexion of great toe-NR/disc?
L5 NR
L4 disc
Achilles reflex
S1 NR
Weak plantar flexion-NR/disc?
S1 NR
L5 disc
SLR positive for NR/disc when reproduction below?
45 degrees
L5 disc lesion affects ____ NR. + _____ pathological reflex
S1
Achilles
Sensory deficit in posterior lateral leg and lateral foot
S1 NR
L5 disc
Weak plantar flexion
L5 disc
S1 NR
Difficult toe walking
L5 disc
S1NR
L4 disc lesion affects what
L5 NR
Sensory deficit in anterior lateral lower leg and top of foot
L4 disc
L5 NR
Weak dorsiflexion
L4 disc
L5 NR
Patellar reflex
L4 NR
Facet syndrome pain area
LBP with hip/butt pain above knee
Pain is localized with kemps
And not below the knee with SLR
What is the Hadley S curve used for?
Facet syndrome lumbar
Canal stenosis complaint
Onset of leg pain with walking and better with rest. Flexed position better
Multilevel findings
Diffuse arm symptoms including numbness and tingling
TOS
Tests for TOS
Adsons (toward)
Halstead (look away)
Wrights (pec minor)
Functional test: Roos
MC area for facet referred pain
Down outer arm to the hand
C5-7 joints
Reasons for large ADI
Atlantodental instability Inflammatory arthropathy Ed (sero-/+) Downs So odontoidium A genesis of posterior arch Occipitalization Normal variant
Radiographic features of a severe sprain
Widening of interspinous distance
Loss of parallelism between facet joints
Horizontal displacement more than 3.5mm
Angular displacement more than 11 degrees
Hoffman sign
“Finger flick” patients middle finger
+ flexion of fingers and adduction of thumb
UMNL
Sharp pain on motion
Joint
Deep burning and dull pain
Bone/ligament
Amoss sign
IVD
AS
Thoracic subluxation
A sense of superficial abdominal reflexes in patients with scoliosis has been suggested as an indicator of what
Syringomyelia
Unilateral absence of superficial abdonimal reflexes may be in an indicator of what
Corticospinal tract lesion
Epigastric reflect
T5-7
Upper abdominal reflex
T7-9
Middle abdominal reflex
T9-11
Lower abdominal reflex
T11-12
Missing pedicle DDX?
Congential
Destructive
1. Bone tumor (lytic mets/primary)
2. ST tumor
3. Infection
SurgicalRed flags for LBP
Trauma Infection Saddle anesthesia Immunosuppression Pain worse at night Progressive neurological complaints Bladder dysfunction CA Weight loss
What tests traction L2-L4 (femoral)
Nachla
Ely
Femoral Nerve traction test
What orthopedic exams would cause nerve traction that you would perform in cases of radiating posterior buttock pain
Slumps (SOL) SLR/WLF Bechterew’s (seated SLR) (disc/NR) Lindner’s (chin to chest-pain in LB/sciatic=NR) Laseque’s (NR)
Orthopedic exams that cause nerve traction that would be utilized in cases of radiating anterior buttock pain
Femoral nerve traction test
Nachlas
Elys
Canal stenosis patient presentation
Bilateral buttock pain
Forward flexed position
LBP
Limited extension
Kemps test
Patient lateral flexed away
Flexed forward and laterally toward doctor
Extension with compression of the shoulder on the side being tested
Local pain convex: capsulitis
Local pain concave: facet
Radiating leg pain: disc
When do lumbar facet syndromes present with nerve traction signs
With extensive DDD only
What are 3 common sites for compression relating to TOS
Scalene triangle
Costoclavicular
Pec minor hypertrophy
Brachial plexus stinger
Multi dermatomal radiating pain
Mechanism: cervical lateral flexion opposite direction of shoulder
What tests would you to for brachial plexus injuries
brachial plexus TT
Bakody
Bikele
Signs of cervical stinger
Cervical spine pain with bilateral radiating arm pain
What tests would you to for meningitis
Brudinski
Kernig
foraminal compression test
IVF encroachment
If also radiculopathy pain—indicates causing pressure on NR
Pressure down with head rotated
Jackson compression test
Pressure on head when laterally flexed
IVF encroachment confirmation (after foraminal compression)
Max. Foraminal compression
Laterally flex, rotate and extend adn then doc puts pressure
Pain on side being tested: radiating: IVF encroachment. Local: facet
Opposite: muscle stretch
Cervical canal stenosis
Less than 13 mm
Lumbar canal stenosis
12 mm relative
10 absolute
Modic type two
Fatty infiltrate
Bright and bright
Cause of isthmic/spondylolytic spondylolisthesis and where MC
L5
Stress fracture of the pars
Where is degenerative spondylolisthesis MC
L4
If AA is larger than ___ send out for ultrasound
3.5cm
