Term
| If you’re confused about whether muscle or facet compression is causing pain in a patient, how can you differentiate between the two with resistive tests? |
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Definition
| Bring pt into fwd flexion, and resist extension. If there’s pain, it can’t be caused by facet compression because the facets are gapped. Muscle lesions will create pain with resistance in all ranges of motion of the joint ie: resisted extension while in fwd flexion, in neutral, or in extension. |
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Term
| If passive movement to the side of the symptoms reproduces or increases those symptoms, what structure is most likely responsible? |
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Definition
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Term
| When extending from a fwd flexion position, should a pt extend the back then move the pelvis, or posteriorly rotate the pelvis then extend the back? |
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Definition
| Move the pelvis first to put the spine in good alignment and decrease stress on the joints and muscles. |
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Term
| What 3 tests can you use to rule out the hip joint when doing a low back eval? |
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Definition
| Thomas test, Faber’s, Scouring test. |
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Term
| What can a tight hip joint do to the low back or SI? |
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Definition
| Cause hypermobility, as compensation because the hip joint is restricted – by ITB, iliopsoas or rectus femoris tightness. |
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Term
| What can a tight ITB do to the SI joint? |
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Definition
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Term
| When performing Faber’s test, where should the pain be if it’s a stretching pain? |
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Definition
| In the groin. If it’s SI pain it will be felt posteriorly. |
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Term
| What’s the first thing you should check if a pt is seeing you post hip surgery, and complaining of LBP? |
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Definition
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Term
| If the compression test results in localized pain, is it more likely caused by a disc or a nerve root? |
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Definition
| A disc. Nerve root will cause radiating pain. |
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Term
| If distraction increases a pt’s pain, do you suspect: joint, muscle, or ligament? |
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Definition
| Ligament. Passive distraction should relieve joint pain, should have no effect on muscle pain, but it will increase ligamentous pain. |
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Term
| How can you differentiate between anterior leg pain caused by quads tightness or femoral nerve entrapment? |
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Definition
| Perform the lower limb tension test for the femoral nerve. Have the pt hang their head over the end of the table, and see if moving the nerve at the neck level changes pain. If moving the head increases or decreases pain, it’s a nerve root problem. If it doesn’t, it’s more likely to be muscle-related. |
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Term
| Which will have more joint play, in a non-pathological person: lumbar or thoracic vertebrae? Why? |
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Definition
| Lumbar, because T-spine is attached to ribs. |
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Term
| Can you perform a spring test if the patient says it hurts too much for you to push down on the spinous process? |
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Definition
| Yes. Put fingers on the transverse processes of the vertebra. Just make sure that your fingers are level with each other, and perpendicular to the line of the spine. |
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Term
| What type of patient benefits most from spinal traction? |
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Definition
| Pts w/ radiculopathy secondary to disc problem. |
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Term
| If a pt. presents with saddle anesthesia, what do you think of is most likely causing symptoms? |
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Definition
| Cauda Equina (see pg L23 for complete list of C.E. symptoms) |
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Term
| Unexpected laxity of the anal sphincter (hehe) is a red flag for what condition? |
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Definition
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Term
| What do passive movements test, according to cyriax? |
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Definition
| All inert structures (nerves, ligaments, capsule, bursa, bone, blood vessels, connective tissue) |
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Term
| According to Cyriax, active and passive motion is restricted, and/or there is pain in the same direction, what is indicated? |
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Definition
| In the joint capsule. (arthrogenic) (see pg. L25 for complete list of cyriax) |
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Term
| According to Cyriax, when active and passive motion is restricted and/ or movement is painful in the opposite direction, what is indicated? |
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Definition
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Term
| According to Cyriax, when there is relative restriction of passive motion in various directions, what is indicated? |
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Definition
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Term
| If a resisted movement is painful and strong, what does it indicate? |
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Definition
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Term
| If a resisted movement is painful and weak, what does it indicate? |
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Definition
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Term
| If a resisted movement is painless and weak, what does it indicate? |
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Definition
| Neurological problem or a complete rupture. |
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Term
| If a resisted movement is painless and weak, what does it indicate? |
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Definition
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Term
| How many of the TART symptoms do you need to confirm that there’s a problem at a segment? |
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Definition
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Term
| What 5 symptoms can indicate a possible sympathetic nervous system problems? |
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Definition
| Local tone, altered skin temperature, skin rolling or drag, local edema, and altered histamine response to scratch test. |
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Term
| In what structure does skin drag indicate a problem? |
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Definition
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Term
| Are stiffened joints with no detectable abnormal tissue tension likely to the the source of major symptoms? |
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Definition
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Term
| If a stiff joint is painful on overpressure, what does this indicate about the timeframe of the injury? |
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Definition
| It is acute. A chronically stiff joint will usually have no pain on overpressure, and may even be fibrosed |
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Term
| What are Cyriax’s abnormal end feels? (5) |
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Definition
| Muscle spasm, capsular, bone to bone before end of ROM, empty and springy block. |
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Term
| How does a facet joint sprain differ from facet joint impingment? |
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Definition
| There is usually history of trauma in a sprain, where in impingement there is no Hx of trauma. |
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