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OPP II > Winter Midterm Written > Flashcards

Winter Midterm Written Flashcards

1
Q

Define somatic dysfunction

A

Impaired or altered function of related components of the somatic system; skeletal, arthrodial and myofascial structures, and related vascular, lymphatic and neural elements.

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2
Q

What does TART stand for?

A

T- tenderness
A- asymmetry
R- restricted ROM
T- tissue texture abnormalities

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3
Q

What is THE RULE OF THREES in relation to the spine

A

FOR Transvers Processes:
T1-T3: same plane as SP
T4-T6: 1/2 segment higher than corresponding SP
T7-T9: 1 full segment higher than corresponding SP
T10: 1 full segment higher
T11: 1/2 segment higher
T12: same plane

**Note: reverse is true for spinous process locations (same plane or below)

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4
Q

What is Fryettes 1st Principle? What type of dysfunction is this?

A

In NEUTRAL position rotation and sidebending OPPOSITE sides. Type 1 (or neutral) DYSFUNCTION. Usually GROUP CURVE, postural causes maintained by long restrictor muscles (ILS)

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5
Q

What is Fryettes 2nd Principle? What type of dysfunction is this?

A

in HYPERFLEXION or HYPEREXTENSION, rotation and sidebending on SAME side. Type 2 (non-neutral) dysfunction. Most likely single (or 2) vertebrae on one below usually caused by trauma and maintained by short restrictor muscles (rotatores, interspinalis, intertransversalis).

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6
Q

What is Fryettes 3rd Principle?

A

Initiating motion of a vertebral segment in one plane of motion will modify the movement of the segment in the other two planes of motion.

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7
Q

What type of dysfunction gets better in both flexion and extension or shows no change?

A

Neutral Dysfunction

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8
Q

What type of dysfunction gets worse in forward bending? (or say better in extension)

A

Extension dysfunction

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9
Q

What type of dysfunction gets worse in backward bending? (or say better in flexion)

A

Flexion dysfunction

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10
Q

How are somatic dysfunctions named?

A

For the position where you find them living (their freedom of motion)

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11
Q

Whats the action of the erector spinae (iliocostalis, logissimus, spinalis)

A

Extend and ipsilaterally sidebend the spine

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12
Q

Whats the action of the quadratus lumborum?

A

Fixes the 12th rib during respiration and lateral flexes the trunk

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13
Q

Whats the action of iliopsoas?

A

Strong hip flexor

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14
Q

Whats the action of the diaphragm? Which 3 apertures pass through it?

A

Primary muscle of inspiration and assists in raising intra-abdominal pressure. The 1) inferior vena cava 2) esophagus 3) aorta pass through it.

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15
Q

What is the motion of the internal and the external obliques? When I rotate my trunk to the right which internal and external obliques am I using?

A

Internal- Ipsilateral trunk rotator
External-Contralateral trunk rotator

Right rotation is from right internal oblique and left external oblique

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16
Q

Orientation of ___________ facets determines preferred spinal motion.

A

SUPERIOR facets

17
Q

What are the facet joint orientations for: Cervical, Thoracic, and Lumbar spine?

A

Cervical: BUM (backward, upward, medial)
Thoracic: BUL (backward, upward, lateral)
Lumbar: BM (backward, medial)

Think BUM, BUL, BM

18
Q

List the primary motions for the thoracic and lumbar spine…also include facet orientations, plane of motion and axis.

A

Thoracic: Rotation (would be sidebending but ribs restrict that motion) transverse plane w/superior inferior axis
Lumbar: Flexion and Extension; sagittal plane with right left axis

19
Q

What is antalgic posture

A

Posture compensation away from side of pain

20
Q

What symptoms with low back pain could indicate a MEDICAL EMERGENCY?

A

Saddle anesthia and/or fecal or urinary incontinence

21
Q

What are a couple tests you can do to test for disc herniation?

A

Straight leg test (pt supine lift one leg at time 30-60 degrees) OR Valsalva maneuver (bear down like straining to defecate)- if pain with either they may have disc herniation impinging on spinal cord/ meninges

22
Q

Define Radiculopathy and is lumbar or thoracic spine more prone to radiculopathies?

A

A disease of spinal nerve roots. Pain will follow distribution of one or more roots and is due to pressure, inflammation or other inrritations of said nerve root. Lumbar spine common site for radiculopathy.

23
Q

List the 6 causes of lumbar radiculopathy

A
  1. Rupture or herniated disc
  2. Bone or cord tumors
  3. Bone spurs (aka: exostoses or osteophytes)
  4. Spinal stenosis
  5. Infection or inflammation
  6. systemic diseases (like Diabetes Mellitus)
24
Q

List 4 signs and symptoms of lumbar radiculopathy

A
  1. Low back pain
  2. Lower extremity muscle weakness and spasm
  3. Paresthesias (numbness, tingling, pins and needles)
  4. Lumbar scoliosis (typically unilaterally but can be bilaterally)
25
Q

Describe typical radiculopathy pain

A

Unilat to below knee (bilat is read flag), dull/burning/lancing, radiating, located posterolaterally. If acute its aggravated by activity and improves temp at rest and if chronic hurts all the time

26
Q

At what segment(s) are lumbar herniations most common and why

A

L4-L5 b/c reduced width compared to other interspaces and post. longitudinal ligament is narrower at these segments

27
Q

List 7 differential diagnoses of radiculopathy

A
  1. Acute or chronic lumbosacral sprain
  2. Spondylosis and spondylolisthesis
  3. Spinal arthritis
  4. Bursitis
  5. Referred hip pain
  6. Cauda equine syndrome
  7. Abdominal aortic aneurysm (mimics many low back pain symptoms)
28
Q

List symptoms of Cauda Equina Syndrome

A

bilat or unilat sciatica
saddle anesthesia
lower extremity weakness
urinary retention or decreased sphincter tone
decompressive surgery required w/in 12 hrs of initial loss of bladder control to prevent permanent neurological damage

29
Q

List 13 examination/testings for radiculopathy

A
  1. postural and gait analysis
  2. assessment of spinal mobility
  3. assessment of hip motion and SI joint
  4. Electrodiagnostic testing**
  5. Radiologic procedures (xrays or MRI/CT)
  6. Neurologic exam
  7. Motor function testing of lower extremities
  8. Straight leg test
  9. Seated leg raise
  10. distracted straight leg raise (Tripod test)
  11. Valsalva maneuver (bear down)
  12. Hoover’s test
  13. Babinski reflex test
30
Q

What do you test during neurologic exam for lumbar radiculopathy?

A

Deep tendon reflexes: Patellar (L4), Achilles (S1)- diminished reflexes expected

Sensory Testing/dermatomal eval by pin prick and light touch

31
Q

What is being tested during motor function testing of the lower extremities with the following movements (which corresponding spinal cord segment)? Hip flexion, hip extension, knee flexion and extension, dorsiflexion and plantar flexion, great toe extension

A 
Hip flexion L1-L2*
hip extension L4-L5
 knee flexion L5-S1*
 knee extension L3*-L4
dorsiflexion L4*-L5
plantar flexion S1-S2
 great toe extension L5*-S1
32
Q

What are two tests you can use to check for malingering for lower back pain

A
  1. Hoovers Test

2. Seated Knee Extension (Tripod Test)

33
Q

What would you expect to see in a L3/L4 disc herniation?

A

Affects L4 nerve root.
Pain that wraps around lower back above butt to lateral anterior thigh across leg over knee to medial aspect of foot.
Numbness over anterolateral thigh and knee and medial malleolus.
Quadriceps weakness and atrophy, weak dorsiflexion of ankle.
Diminished knee jerk reflex.

34
Q

What would you expect to see in a L4/L5 disc herniation?

A

Affects L5 nerve root.
Pain that wraps from lower back above butt down the lateral thigh and leg
Numbness over lateral leg and web of great toe also middle strip of dorsum of foot
Weak dorsiflexion of foot and great toe, difficulty heel walking, possible foot drop
Usually no change in deep tendon reflexes

35
Q

What would you expect to see in a L5/S1 disc herniation?

A

Affects S1 nerve root
Pain that goes down from low back over mid buttocks and down middle of posterior thigh and leg to lateral malleolus/foot
Numbness on back of calf (over gastroc) and lateral heel, foot and toe
Weak plantar flexion of foot and great toe, difficulty toe walking
Atrophy of gastroc and soleus
Diminished or absent ankle jerk (Achilles) reflex

OPP II (2 decks)

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