MSD III MIDTERM

Majority of LBP patients you will see are non-musculoskeletal

the spinal cord terminates at __

True or false: degenerative discs can herniate

The outer 1/2 of the annulus is innervated, explain the clinical significance

Kuslich states that a vetebral end plate is ____ painful

the superior articular process faces anterior lateral while the inferior articular process faces posterior medial

jim bob at clinic c/o LBP for 4 weeks, he is corporate monkey w 5 kids under 5, worse in flexion better in ext, no N P!

What would you NOT typically see in a swayback deformity?

What ligament resists disc posteriorly bulging and is taut in flexion?

With flexion the facets disengage, this puts more pressure on the ___?

What does Alrwaily state about TBCS?

What causes radicular pain?

You should see a _____ tilt with back extension

which conditions can have bilateral pain

Why do some disc herniations demonstrate centralization and some don’t?

Which back pain is characterized by ERP specifically?

Kuslich states that a facet capsule is ____ painful

what else would you perform with William to rule in derangement and what would you look for?

What structures can cause pain from nerve impingement/irritation?

pressure is reduced at night on spine allow disc to swell w water, volume reduces by 20% in the first few hours of wake

surgery is helpful for LBP in 1% of cases

In Delitto’s TBC system, what factors favor manipulation subgroup

"The body may break, but you, the healer, shall rise. Every challenge shapes you into a force of restoration."

What structures can cause referred pain in the leg besides the disc?

65 yo erica has sharp/localized pain in standing, P! Relieved with walking+sittin, P! Also referred-> what LBP?

stretch break!!

55 year old pt comes in w onset paraspinal pain. Pt reports they feel better when walking or sitting, (+) ext-rot test

List three key findings for neurogenic claudication that would differ from vascular claudication MOST CORRECT

"Doubt will whisper, but your knowledge will roar. You are not just a student—you are a force of healing."

patient does not have pain with coughing, doesnt centralize, P! not relieved by rest are sensitive for facet dysfunction

Where does directional preference occur without centralization?

Kuslich states that a outer annulus is ____ painful

Which of the following states the most specific to least specific clinical findings for ruling in discongenic pain?

During normal extension the lumbar spine has __ deg ROM and the thoracic spine has ___ ROM?

what are mechanical benefits of traction? (freebie)

spondylolisthesis, whats NOT true?

how did kuslich describe annular pain?

How does neurogenic and vascular claudication differ?

For musculoskeletal LBP, ____ is the most common

 Orientation of the facets in the sagittal plane

normal lumbar flexion?

Which treatments are included in the symptom modulation phase?

Early intervention for discogenic back pain: pair and share(or to urself)-> how would you educate your patient with LBP

Why do we assess movements in lying during our exam?

 if patient does not present with sciatica pain and is negative for ipsilateral SLR you can rule out nerve involvement

patient is NOT > 65 yo, is better when walking not better in flexion, these are specific to facet dysfunction

What is degenerative disc disease also known as?

The apex of motion during normal side bending should be where?

facets can cause radicular pain

During normal disc mechanics w spinal flexion, the ant. annular fibers ___, the post. annular fiber ___ the NP moves __

List in order from greatest to least the restrictions to flexion

Spondylolisthesis can be caused by ___ which leads to the ligaments becoming lax and the vertebral body slipping forward

William c/o LBP goes to R. thigh. This is his 3rd flare up. His P! is constant, feels better w walking. PDM in RFIS/RFIL

madeline diane sweatman comes into ur clinic showing hyper mobility and shes 6 months prego but extreme LBP, manipulate?

Which of the following is correct regarding quality of spinal motion

T-dawg comes in c/o LBP. Worse sitting than walking, P! forward flexion & worsened when rising from flexion. What is it?

which is NOT a exam finding for mckenzie classification OTHER

is LBP commonly self limiting, resolves within 3-4 weeks (or 6-8 weeks according to sexton), 30-55yo mechanical LBP

normal thoracic kyphosis

which of the following is NOT a subgroup of delittos updated 2007 TBCS

Kuslich states that a compressed nerve root is ____ painful

almost done...2 lectures left

during traction meredith west has decreased ischemic P! & muscle spasm, improved circulation & reduced chemical response

What causes referred pain?

"With every joint and tendon you mend, you are stitching lives together. You’re mastering the art of rebirth."

Internal disc disruption caused by ?

RECALL!! What is responsible for transmitting sensory information from the nerve to the spinal cord?

What would you suspect is causing excessive extension in the lumbar spine?

pt supine, instruct patient to perform partial sit up, if pain increases/symptoms increase (most likely peripheralize)=+

3 of 5 findings: age>50, best when walking, best when sitting, onset of pain is paraspinal, + ext rotation test

Annular wall breached by intra-discal mass that has separated from disc (mass can lodge/float around-symptoms come & go)

 Orientation of the facets in the frontal plane

Looking at the amount of ROM a person has in plane of motion versus at how they achieve that motion

Due to the sagittal facing facets in the lumbar, it has restricted ___ (1-2deg)

Prolapse disc is due to ?

potty break!!

According to Perolat 2018, referred pain may occur in facet joint origin pain if the joint or its tissues is inflamed

In Delitto’s TBC system, what factors favor the specific exercise subgroup

normal lumbar lordosis

During normal side bending how much ROM should you have

according to fritz CPR for mechanical traction responders at baseline greater improvement when + for these two variables

Which deformity: localized sharp posterior angulation in thoracic spine from collapse of anterior portion of VB

Sarah Smith ℅ LBP w/left buttock and tingling thigh P! And increase P! In sitting, PDM with RFIS & RFIS, centralization

During normal trunk rotation the thoracic spine has ___ deg ROM and the lumbar spine has ___ ROM?

 65 yo Carley paige foster ℅ pain and numbness to her little piggy, P! Worse w extension+ipsi side flex, better w flex

Claire Sheppard comes to you having back pain for 23 days, has pain to her buttocks, and shows thoracic hypo mobility

Dr. J comes in with extreme pain from fracturing his vertebral end plate. Why is this happening? (understand why)

why would the extension rotation test indicate a lumbar facet origin pain? (sensitivity=1.00, if (-) can 100% rule out)

hich is true regarding dowagers hump

 Name that claudication: variable locations, possible numbness, decreased reflexes, normal pulse & skin, relieved w flex

What would you typically see in a patient with flat back deformity?

Addison Rae Harmon has been experiencing pain down her leg with numbness in her big toe, wut is it and wut is it from?

If the L3/4 disc herniates, what nerve would be involved? Explain why!

Jim deans pain has been moving proximally with the REIL exercises you gave him, based on the EBM findings what is true:

Sharkeisha has been experiencing LBP and pain down her leg, what would make you suspect the patient has REFERRED PAIN?

Kuslich states that a anterior dura of PLL is ____ painful

Annular wall breached by intra-discal mass that protrudes through, but remains in contact with disc is ?

Your previous patient sarah is ready for some interventions, choose the best exercises to give her visit 1!!

What imaging test has the highest specificity for identifying a protruding disc?

big booty Judy c/o pain below the knee that is worse with ext, better in flexion what type LBP

highly elastic, resists flexion, may fall victim to aging process cause narrow disc height & possible compress of nerve

what are the two factors most likely to predict dramatic improvement for manipulation in a patient

Your pt suffers with a unilateral fx to the pars interarticularis which causes the vertebral body to rotate, wut it b?

Laurel sexton has presented w LBP with excessive ext. she gymnast has- ant laxity, U suspect vetebrae slipped anteriorly

Pt comes in with sensory loss around the gooch (perineum) and reports cannot hold in bowel movements. Name condition.

Patient comes in c/o LBP. Job requires sitting for long periods of time. On exam you find no tissues at fault.

Only the ____ portion of the disc is capable of producing referred pain according to murphy and kuslich

patient has dermatomal sensory loss, this is not very specific for a conduction deficit 

What would you see if your patient had cord compression?

Dr. J comes into clinic c/o of LBP aggravated by standing only relieved w sitting. He has a hyper-lordotic posture....

What component of the motion segment is the primary tensile load bearing element?

what is true regarding neuro exam?

match the age ranges to their mckenzie classifications

99 year old Amber has strange weakness in her leg, and patchy numbness here and there, + for clonus and babinski

juju does not have pain when sitting, + wide based gait +urinary retention, specific for lumbar central stenosis?

Which of the following clinical findings is SENSITIVE therefore if the test is negative would rule out discongenic pain?

Name that subgroup: ERP, <30 y/o, pain is localized and adjacent to spine, (-) exam

back dominant leg pain is typically from disc pain or spinal stenosis

In a healthy patient, what would you expect to see during full flexion?

45 yr old comes in & points to pain in LB. Obj findings include EIL= ERP, FIL= no change, EIS= ERP, FIS= no change.

reproduction of symptoms during crossover SLR is a specific finding for disc herniation

centralization cannot occur without directional preference

Maci is on your traction table and her pain is moving down her leg, what do you do?

all of the following are contraindications for manipulation EXCEPT

A combination of these 3 things is high specific to rule in a nerve conduction deficit

passive mvm to the jts and/or related soft tissues, including a small amplitude/high velocity therapeutic movement 

describe the stoop test

how did kuslich describe facet capsule pain?

Why is the vertebral end plate considered the “weak link”

state 3 ways that repeated motions impact assessment and treatment (freebie)

f your patient bends down in flexion and their apex is in their thoracic spine, what would you suspect?

What would you NOT see in a patient with excessive lordosis?

List 3 key findings to suspect discongenic pain that differ from other DX..THINK, choose best answer ;) cue dr bohl.....