Term
| When are routine spinal imaging tests indicated |
|
Definition
- they are generally not indicated
- red flags for imaging: cancer, spinal stenosis, compression fx, AS, cauda equina syndrome
- 1mo of severe problems |
|
|
Term
| What is the most important therapeutic instrument for low back problems |
|
Definition
|
|
Term
| What are the flags for cancer in low back pain? |
|
Definition
- age 50+
- hx of cancer
- unexplained weight loss**
- failure to improve (1+mo sx) |
|
|
Term
| What are the flags for spinal stenosis in low back pain |
|
Definition
- age greater than 50
- pseudoclaudication**
- leg pain on walking/standing
- relief by sitting or spinal flexion** |
|
|
Term
| What are the flags for compression fx in low back pain |
|
Definition
- age greater than 50
- corticosteroid use**
- trauma** |
|
|
Term
| What are the flags for ankylosing spondylitis |
|
Definition
- onset less than 40yso and gradual**
- pain duration 3+mo
- morning stiffness
- improved by exercise** |
|
|
Term
| What are the flags for cauda equina syndrome |
|
Definition
- urinary retention
- bilateral weakness
- saddle anesthesia
NEURO_SURGICAL EMERGENCY caused bymassive midline disc herniation |
|
|
Term
What is the affected root, reflex, muscles,and sensation of the following disc herniation:
L3-L4 |
|
Definition
1) L4
2) patellar
3) anterior tibialis
4) medial leg and medial foot |
|
|
Term
What is the affected root, reflex, muscles,and sensation of the following disc herniation:
L4-L5 |
|
Definition
1) L5
2) --
3) extensor hallicus longus
4) lateral leg and dorsum of foot |
|
|
Term
What is the affected root, reflex, muscles,and sensation of the following disc herniation:
L5-S1 |
|
Definition
1) S1
2) achilles
3) peroneus longus and brevis
4) lateral foot |
|
|
Term
| What are the red flags for assessment of lower back pain |
|
Definition
- abd pain
- recent trauma
- pain unrelieved by rest
- saddle anesthesia
- acute urinary/fecal incontinence
- age greater than 50
- h/o cancer
- fever
- other infectious sx
- rheumatologic sx
*checks for Ca, infection, AAA, cauda equina, fracture* |
|
|
Term
| What are the motor tests and sensory tests for the back exam |
|
Definition
1) toe walk and heel walk; to extension, foot dorsiflexion, single toe raise, knee extension
2) medial foot/mid foot sensation; medial heel, first webspace, lateral foot |
|
|
Term
| Describe the straight leg raise test |
|
Definition
1) passive elevation of affected leg
2) positive if pain is 30-60deg elevated
3) note of crossover effect |
|
|
Term
|
Definition
1) flexion, abduction, external rotation
2) pain in groin = hip problem
3) pain in SI area = SI joint problem |
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