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82 Cards in this Set

  • Front
  • Back
what is sciatica?
pain originating in the back and radiating down the posterior or lateral thigh?
what is radiculopathy?
impairment of the nerve root
what is spondylosis?
arthritis of the spine
what is spondylolisthesis?
anterior dislocation of the pars
what is spondylolysis?
degeneration of the spine
what is a sprain of the spine?
involves the ligaments
what is a strain of the spine?
involves the muscle
what are 4 critical differential diagnoses for lower back pain?
cauda equina syndrome
fracture
osteomyeltitis
infection cancer
what does age over 50 put patients at risk for when presenting with lower back pain? (2)
cancer
fracture
what could unrelenting lower back pain at night be a sign of? (2)
cancer
fracture
what could progressive motor or sensory deficit be due to with lower back pain? (2)
cauda equina syndrome
cancer
what could saddle anesthesia be due to?
cauda equina syndrome
what could difficulty urinating/incontinence be due to when presenting with lower back pain?
cauda equina syndrome
what could a history of osteoporosis lead to?
compression fx
what could chronic use of oral steroids lead to in the back? (2)
infection
fracture
where can you test L1 in a neuro exam? (3)
groin
iliopsoas
hip flexion
what 2 things should you note when looking at a patient with lower back pain?
gait
posture
where can you test L2 in a neuro exam? (5)
anterior thigh
iliopsoas
sartoious
hip adductors
hip flexion
where can you test L3 in a neuro exam? (7)
medial aspect of the knee
iliopsoas
quads
sartorius
hip adductors
hip flexion
extension
where can you test L4 in a neuro exam? (2)
tibialis anterior
medial lower leg
where can you test L5 in a neuro exam? (1)
big toe (extensor hallicus longus)
where can you test S1 in a neuro exam? (1)
achilles tendon
what type of paralysis is seen with LMN injury?
flaccid
what will happen to DTR in LMN injury?
decreased or absent
will babinski be present or absent with LMN inj?
absent
will muscles atrophy with LMN inj?
yes
will fasciculations be present with LMN inj?
maybe
what type of paralysis is seen with UMN inj?
spastic
what will happen to DTR in UMN inj?
increased
will babinski be present or absent with a UMN inj?
present
will muscles atrophy with UMN inj?
no unless due to dissuse
will fasiculations be present with UMN inj?
no
when will the straight leg test be +?
if the patient wants to lean back
what are 4 special tests you can do for LBP?
straight leg test
faber
trendelenberg
hoovers
what does the faber test look for?
hip/sacroiliac dysfunction
what does the trandelenberg test look for?
gluteus medius dysfunction
what 3 things will be observed on a LBP x-ray? (3)
boney achitecture
fracture
osseus lesions
what 2 things can a LB CT scan show?
fracture
prior lumbar surgery
what 2 things can a LB bone scan show?
cancer osteomyelitis
stress fracture
when is myelography used?
absolute contraindications for MRI
what is cauda equina syndrome due to?
reduction of volume of the spinal canal
what does cauda equina syndrome cause? (3)
compression of spinal canal
muscle paralysis
urinary or bowel dysfunction
what are 4 symptoms of cauda equina syndrome?
radicular pain of both legs
saddle anesthesia
difficulty voiding or loss of sphincter control
leg weakness
what are 3 physical findings of cauda equina syndrome?
sensory changes
difficulty standing
difficulty with heel to toe walking
what is an emergent surgical referral for LBP?
cauda equina syndrome
what type of compression fracture affects the anterior half of the vertebral body?
simple
what type of compression fracture extends into the posterior third of the vertebral body?
burst
which type of compression fractures are unstable? (2)
posterior ligament disruption
flexion-distraction injuries
what are 3 physical findings of compression fractures?
tenderness to palpation over the vertebrae
step off
hematoma
what are 5 causes of acute LBP?
strain
sprain
twisting
repeated lifting
vibrating equipment
will acute LBP have any neuro deficits?
no
how long must you have LBP for it to be considered chronic?
3 months
will there be neuro dysfunction with chronic LBP?
no
what life style change makes a difference in chronic back pain?
smoking cessation
what are the 2 most common sites for disk herniation?
L4-5
L5-S1
where will disc herniation pain be worse?
leg
when is disc herniation pain worse? (2)
valsalva
motion
will there be neuro deficits in disc herniation patients?
yes
what should you do if there are no red flags present with disc herniation?
wait until 4-6 weeks of conservative care before radiography
what drug would be good for disc herniation and why?
gabapentin because it is good for nerve pain
what are 3 physical therapy treatments for disc herniation?
ultrasound
transcutaneous electrical nerve stim
traction
what is contraindicated with disc herniation?
no HVLA
what is spinal stenosis?
narrowing of the central spinal canal by bone or soft tissue with compression of nerve root
what 3 sites are most common for spinal stenosis?
L2-3
L3-4
L4-5
when will spinal stenosis pain be better?
flexing forward (bending over a shopping cart)
how do you differentiate spinal stenosis from PVD?
pulses will be normal
what test may be + in spinal stenosis?
rhomberg
what side is scoliosis named for?
convexity
what are 2 causes of scoliosis in adults?
degenerative spondylosis or spondylolisthesis
what do these symptoms indicate:
pain at region of deformity
radicular symptoms at L4 or L5 nerve root
scoliosis
how do you treat scoliosis? (2)
NSAIDS
exercise program
what is spondylolisthesis?
anterior slippage of one vertebral body over the next
what do these symptoms suggest?
loss of lordosis
step off of spinal processes
decreased reflexes
weakness in toe or heel walking
spondylolithesis
what 2 xrays do you want for spondylolisthesis?
AP and lateral
what is one unique treatment for spondyloisthesis?
abdominal binder
what is spondylolysis?
disruption of the pars interarticularis
what is spondylolysis due to?
repeated hyperextension
what may spondylolysis become?
spondylolisthesis
where will you have spasms in spondylolysis?
hamstrings
when will spondylolysis pain be worse?
with standing
what do these symptoms suggest:
decreased lordosis
step off
decreased flexion secondary to hamstring spasm
spondylolysis
what is HIPLSIT?
hip long restrictors
innominate shears
pubic dysfunction
lumbars
sacroiliac dysfunctions
innominate rotations and flares
thoracic dysfunctions