41: Case Study- Kanis

Question 1

knee reflex tests…

Answer 1

L4

Question 2

** ankle reflex tests…

Answer 2

S1 (gastrocnemius/soleus)

reflex: of Gastrocnemius/soleus ( ankle.
- sensory: plantar surface of foot and lateral aspect of foot
- Motor: foot plantarflexion, toe flexors and hip extension.
- Pain distribution: bottom of foot, posterior calf, posterior thigh, buttocks.

Question 3

4 indications for intervertebral disk surgery ***

Answer 3

• progressive motor weakness form nerve root injury demonstrated on clinical exam or EMG
• bowel or bladder disturbance or other signs of spinal cord compression
• incapacitating n. root pain despite conservative tx for at least 4 wk
• recurrent incapacitating pain despite conservative tx

NOT complaints of severe pain not responding to chiropractic manipulation

Question 4

differential for radicular back pain

Answer 4

herniated disk or disk disease
spinal stenosis
herpes zoster
facet hypertrophy