Thoracolumbar Spine IV- Acute IDDs

Question 1

______ IDD is less common than persistent IDD

Answer 1

Acute

Question 2

Acute IDD is rare in the ______ region

Answer 2

thoracic

Question 3

With acute IDD it is MOST common in the _______ region

Answer 3

lumbar

Question 4

Only ___-___% of IDDs are symptomatic

Answer 4

1; 3

Question 5

Persistent IDD is the source of pain in < ___% of LBP

Answer 5

5

Question 6

Acute IDD is MOSTLY involved with ___-____ year olds

Answer 6

30; 50

Question 7

95% of acute IDD’s occur at ___-_____ region

Answer 7

L4; S1

Question 8

With acute IDD, the _______ portion of the disc is the MOST common area

Answer 8

posterolateral

Question 9

The posterolateral portion of an acute IDD is ______, thinner, and with MORE _______ and LESS ______ annular fibers

Answer 9

weaker

vertical

oblique

Question 10

The posterolateral portion of the an acute IDD is just lateral to the _____ ______ ligament

Answer 10

posterior longitudinal

Question 11

`What is the main etiology for acute IDD?

Answer 11

trauma

Question 12

With acute IDD there is ______ compression

Answer 12

axial

Question 13

With acute IDD, forward bending or stooping without or with twisting/lifting leads to…

LESS _________ disc compression

Unevenly distributed ______ tension

Increased and asymmetrical stress on weaker and thinner __________ annular and end plate fibers

Less fixated _____ _____

Answer 13

circumferential

annular

posterolateral

end plates

Question 14

With acute IDD, forward bending or stooping without or with twisting/lifting leads to…

MORE ______ _______ shearing force due to the above plus pull of gravity, except less at ____, _____

Answer 14

anterior segmental

L5, S1

Question 15

With acute IDDs

It is MORE commonly OUTER ______ ______ and ______ ______ avulsion

LESS commonly INNER ______ ______ and ______ ________ herniation

Answer 15

annular tearing; end plate
annular tearing; nucleus pulposus

Question 16

With acute IDD, the disc structures are ____________ once damaged and a large _______ immune inflammatory response occurs

Answer 16

immunoreactive; AUTO

Question 17

With an acute IDD, a Large AUTO immune inflammatory response occurs:

There is excessive _______ pressure OR increased ______ fluid pressure in and around disc and spinal n.

Answer 17

osmotic; static

Question 18

With an acute IDD, a Large AUTO immune inflammatory response occurs:

Static fluid consists of increased _______ chemicals that sensitizes n. and structures to ______/_______

Answer 18

inflammatory

pressure; tension

Question 19

With an acute IDD, a large AUTO immune inflammatory response occurs:

__________/________ S&S could occur

NO ________ vv. in PNS or CNS; results in poor drainage on its own

there is an ________ inflammatory phase

Answer 19

radiculpathy/radicular

lymphatic

EXTENDED

Question 20

With acute IDD, the typical postlat IDD symptoms:

____/_____ spinal pain

*The annulus is highly _____ so very P!ful

There is significantly MORE swelling than cervical disc due to higher number of ______

Answer 20

dull; achy

innervated

GAGs

Question 21

With acute IDD, the typical postlat IDD symptoms:

Radiculopathy has possible ________ paresthesia’s within 24 hrs. into the _______ extremity

Answer 21

segmental; distal

Question 22

A possible worse situation with acute IDD:

Presence of _______
Presence of coldness indicating greater _________ compromise

Answer 22

radiculopathy; circulatory

Question 23

With acute IDD, there is reffered pain into the _______ and _______

Answer 23

glutes; groin

Question 24

A patient with acute IDD will have _________ pain with lying and standing/walking

A. decreased
B. increased

Answer 24

A.

Question 25

A patient with acute IDD will have _________ LBP and paresthesia's with FB/sitting/lifting; also coughing and sneezing A. decreased B. increased

Answer 25

B.

Question 26

With acute IDD, the 24 hr. behavior- ______ pain in the AM due to the pooling of _______ from sleeping in a static position

Answer 26

increased; swelling

Question 27

With acute IDD, you may observe that your patient has a lateral shift of _______ on ________ They typically ___ away from the P! Counter contralateral _____ to level eyes

Answer 27

shoulders; pelvis SB SB

Question 28

With acute IDD and observation you rarely see a smaller _____ girth Wasting likely at 4-6 weeks and indicative of severe _____ ______ ( MORE of a sign for persistent _________)

Answer 28

calf; spinal n. compression radiculopathy

Question 29

The Scan findings for Acute IDD: ROM all may increase pain _____ and possibly _____ away from injured area of disc is likely MOST limited and increases ______ and _______ A. ROT; FLX; extremity; LBP B. EXT; FLX; extremity; LBP C. FLX; SB; extremity; LBP

Answer 29

C.

Question 30

Flx and possibly SB away from injured area of disc likely MOST limited and ↑s extremity and LBP due to… Swelling being pushed toward ______ There is tension on torn ______, _______, and ______

Answer 30

spinal n. annulus; endplate; dura

Question 31

The Scan findings for Acute IDD: ______ and _______ toward injured area of disc possibly less limited May ↑ LBP due to increased _______ pressure on end plate fx and high ________ pressure of disc A. ROT; EXT; hydrostatic; osmotic B. EXT; SB; hydrostatic; osmotic

Answer 31

B.

Question 32

The Scan findings for Acute IDD: Ext and possibly SB toward injured area of disc possibly LESS limited and it may.... ________ extremity P! especially with repetition by squeezing _______ away from the spinal n.

Answer 32

Centralize; swelling

Question 33

With acute IDD, which motion is NOT consistent with affecting symptoms?

Answer 33

ROT

Question 34

___________ is the abolition of distal and/or spinal P! in a distal to proximal direction in response to repetitive motion(s) or sustained position

Answer 34

Centralization

Question 35

With acute IDD, the typical postlat IDD signs: Resistance and MMT- _______ Possible + stress tests with ________/_______/________/_______ Neuro tests possibly + depending on severity and timing - diminished _______ - DTR- __________ - ________ FATIGUE - + ________ mobility tests

Answer 35

variable compression; distraction; PA pressures; torsion dermatomes hyporeflexive Myotomal neurodynamic

Question 35

Rare central and posterior IDD S&S Cord or _____ _____ S&S Typically ___-____ level _________ and emergency referral

Answer 35

cauda equina L1; L2 Immobilization

Question 36

_________ ______ and ______ developed by Robin McKenzie, PT is based on the belief that MOST spinal pain comes from injuries to the disc which is not supported in the research Classification system depending primarily on symptoms: - _______ of symptoms - ________ that decrease symptoms

Answer 36

Mechanical Diagnosis; Therapy Location; Positions

Question 37

The McKenzie method (Mechanical Diagnosis and Therapy) determines a __________ ________

Answer 37

directional preference

Question 38

The McKenzie method (Mechanical Diagnosis and Therapy) may be associated with _________, decreasing severity, and improving ________ You should match up with _____ and ______ positions

Answer 38

centralization; function exercise; ADL

Question 39

The MOST common directional preference with the McKenzie method is ______/________

Answer 39

EXT/Hyperext

Question 40

3 classification syndromes with Mechanical Diagnosis and Therapy: _______- focuses on correcting poor posture _______- focus on stretches to improve end range motion _______- focus on using end range motion to improve the theoretical nucleus deformation in disc herniations

Answer 40

Postural Dysfunction Derangement

Question 41

Mechanical Diagnosis and Therapy 1. Dynamic disc theory - ________ NOT migration in a normal disc

Answer 41

Deformation

Question 42

Remember this!

Question 43

The dynamic disc theory is ONLY predictable in ________ lumbar spines when the annulus is intact and with normal hydration A.symptomatic B. asymptomatic

Answer 43

B.

Question 44

The dynamic disc theory is limited and has a contradictory finding in the symptomatic disc AND _____-_____ ____ disease with annular changes

Answer 44

Age-related disc

Question 45

With Mechanical Diagnosis and Therapy: there could be increasing hydrostatic pressure through repetitive motions; MOST often_______

Answer 45

Extension

Question 46

PT Rx with Mechanical Diagnosis and Therapy is NOT _____ to other treatments for acute LBP/disability

Answer 46

superior

Question 47

Acute IDD PT Rx: MET- focuses on tissue _____ and _____ with local muscles ________ walking

Answer 47

proliferation; stabilization unweighted

Question 48

How should we squat and pick up items to minimize excessive stresses and maximize stability for the disc? Equalize ______ body and _____ pressure MORE circumferential disc ________ and evenly distributed annular _______ with greater ______ flexion and ______ pelvic tilt LESS anterior segmental _______ with less _______

Answer 48

vertebral; disc compression; tension; lumbar; posterior shearing; stooping

Question 49

Prognosis for acute IDD: _____% start improve by ____ weeks resolve by _____ weeks _____ will NOT require sx It is a _______ process but the same overall outcomes without sx

Answer 49

90 6 12 MOST slower