Thoracic Lumbar Spine OSCE

Question 1

What is the medical term for increased concavity of the thoracic spine?

Answer 1

kyphosis

Question 2

What is the medical term for increased convexity of the lumbar spine?

Answer 2

lordosis

Question 3

ROM lumbar spine

Answer 3

flexion, extension, rotation, lateral bending

values?

Question 4

Palpation lumbar spine

Answer 4

1. spinous processes
2. transverse processes
3. paraspinal muscles
4. TART
5. SI joint

Question 5

What are step-offs associated with?

Answer 5

spondylolisthesis, usually lower lumbar spine

Question 6

Tenderness over SI joint is usually associated with?

Answer 6

sacroilitis, ankylosing spondylitis

Question 7

When does pain w percussion over spine occur?

Answer 7

osteoporotic fx, malignancy, infection

Question 8

Dermatomes LE

Answer 8

L1-L3 anteromedial thigh
L4 patella, big toe
L5 anterior leg and ankle and big toe
S1 lateral leg and 5th digit
S1-S4 posterior thigh

Question 9

Straight Leg Raise Test

Answer 9

Def: passively flex pt IPSILAT leg

+ test: presence and/or worsening pain in IPSILAT leg especially form 30-60 degrees

Indication: lumbosacral radiculopathy (usually disc herniation)

Other: >70 degrees pain most likely MSK, >15 laterally could be IT band

Low specificity, high sensitivity

Question 10

Contralateral Straight Leg Raise Test

Answer 10

Def: passively flex pt CONTRALAT leg

+ test: pain radiating into contralat. leg especially btw 30-60 deg

Indication: lumbosacral radiculopathy (disc herniation, sciatic neuropathy)

Other: high specificity, low sensitivity

Question 11

Name 2 diseases where decreased spinal mobility is common

Answer 11

OS, ankylosing spondylitis

Question 12

Persistence of lumbar lordosis suggests what? name 2

Answer 12

muscle spams, ankylosing spondylitis

Question 13

When does “listing” of the trunk occur?

Answer 13

herniated lumbar disc

Question 14

When are iliac crests unequal or pelvic tilt present?

Answer 14

unequal leg lengths, scoliosis, hip ad/abduction, herniated lumbar discs

Question 15

When do unequal shoulder heights occur?

Answer 15

1. scoliosis
2. sprengel deformity (attachment of extra bone or band from upper scapula to C7)
3. winged scapula LONG THORACIC N!!!!
4. weak trap

Question 16

Cauda Equina Syndrome

Answer 16

Def: spinal n. root compression
Causes: fx, trauma, disc protrusion, tumor
Sign/Sx:
1. LBP
2. bowel/bladder incontinence
3. saddle anesthesia
4. loss of anal sphincter tone
5. b/l sciatic
6. leg weakness

Question 17

Spina Bifida

Answer 17

• congenital

- spina bifida oculta, meningocele, myelomeningocele

Question 18

Ferguson’s Angle

Answer 18

normally 30-40, angle made to evaluate stability of lumbosacral region