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29 Cards in this Set
- Front
- Back
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List 4 Common Mechanical Causes of LBP (lower back pain)
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-Arthritis
-Spondylosis/Spondylolisthesis -Degen. Disc Dx -Somatic Dysfxn |
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List 2 common NON-mechanical causes of LBP
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-Viscerogenic: renal colic, endometriosis
-Vasculogenic: abdominal aortic aneurysm --rule these out before moving to mech. causes |
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What is primary motion of Lumbar Spine?
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Lumbar has fair amount of Flexion/Extension.
--Less Sidebending & Rotation (due to sagittal orient of facets) |
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Posterolateral Complex of spine is what?
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-Facets/Facet Joints/Lig.Capsule
-Neural Foramina -Lamina -Ligamentum Flavum |
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If pain radiates from Facets, what distribution does it follow?
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NOT necessary dermatome.
Pain is referred elsewhere, -ie, back down side of leg pain may NOT be sciatic N, rather referred pain |
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When L-Spine Extends, what happens to:
-IntVert Foramen: - Disc -Facets |
-Foramen narrows
-Ant. Disc becomes taut -Facets Slide Down/Are Loaded |
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When L-Spine Flexes, what happens to:
-IntVert Foramen: -Ant. Disc -Facets |
-Foramen enlargens
-Nucleus of Disc deforms Posteriorly -Facets Slide UP |
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The Lumbars, like Thoracics, follow what type of mechanics in Neutral?
In NON-neutral |
-Type 1 in neutral
-Type 2 in Non-neutral |
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Flexion of Lumbar induces what in Sacrum
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Lumbar Flexion --> Sacral Extension
---vice versa too |
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Which Spinal Mechanical motion occurs FIRST in Type I, and therefore is written first?
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Sidebending occurs first, then rotation....makes sense
--ie, L4-L6, N, Sr Rleft |
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Which muscles maintain rotation in Type II.
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Short restrictors
---long restrictors maintain type one/neutral |
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Which Spinal mechanical motion occurs first in Lumbar Type II
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Predominantly in Flexion or Extension.
--Rotation occurs first ----ie. L4, F, Rr, Sr then sidebending, which is too the same side |
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Note on Type I vs II in Lumbar Examination:
--Pt prone/seated in neutral--rotate L & R. Repeat in Flexion & Extension. Compare to Neutral. ---1. if motion is SAME in BOTH flexion & extension then? --2. If Motion is MORE RESTRICTED in Flexion, (or ext), then |
1. Neutral Dysfunction--will follow Type I
2. Flexion/Ext Dysfxn--Type II |
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If it's determined that the Lumbar Dysfxn is Type II Flex/Ext Dyfxn, whereby motion is MORE restricted in either as compared to neutral, then you name it for?
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Named for position in which the restriction LESSENED--ie, moved more freely in--thus, it lives there.
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If Lumbar Restriction is noticed more in Flex/Ext than in Neutral, while be less restricted in Flexion, how is it named (use L4 and Right Rotation)
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Less Restricted motion=easier to push into Flexion =where it likes to live=
Flexion Dysfunction, restricted to Extension -----L4, F, Rr, Sr ----note Rotation is first and sidebending is to same side |
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LIst 4 Red Flags for LBP
--ie, causes other than typical strains/referred pains |
1. Major Trauma
2. Age >50 (osteoporsis), Less than 20 3. History of Cancer 4. Cauda Equina Sx |
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LBE with
Saddle Anathesia New Onset bladder/bowel dysfx -severe/rapid progressive Neuro Sx ------indicates? |
Cauda Equina
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Anterior Points, like the Periumbilical Chapmans refer to what 3 viscera?
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Adrenal,
Kidney, Bladder |
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Anterior Points, like the 7th ICS left Chapmans refers to what viscera?
--7th on Right? |
-7th ICS Chapmans
Spleen on Left Pancreas on Righ |
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Which Anterior Chapmans Reflexes refer to Stomach?
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5th ICS Left
6th ICS Left |
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Which Anterior Chapmans Reflexes refer to Liver?
Gallbladder? |
Liver: 5th & 6th ICS Righ
-6ht ICS Right also for Gallbladder |
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NOTE:
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Go back to Ricci Lecture to make cards for Chapmans that are on Chart given starting at RED Bars
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List 4 medicinal managment drugs for LBP
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-NSAIDs
-Muscle Relaxants -Tricyclic Antidepressants -Narcotics |
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Which Nerve does Hip ADductors?
Roots? |
Obturator N.
L2-4 |
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Which Nerve does Hip Quads?
Roots? |
Femoral N. does Quads
Roots L2-4 |
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Which Nerve does Iliopsoas?
Roots? |
T12, L1-3
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What is nerve root for Patellar Tendon?
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L4
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Test for Hip Flexion Contracture: bringing one knee to chest in supine and attempt to keep other extended
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Thomas Test
--pos if can't keep straight |
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Name for Lumbosacral Angle
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Ferguson's Angles
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