Low back stuff/final

Question 1

McKenzie’s 3 main categories of classification

Answer 1

• postural syndrome (pain due to overstretching tissue of normal length)
• dysfunction syndrome (pain due to over-stretching short tissues)
• derangement syndrome (pain due to “internal derangement. possibly disc)

Question 2

Delitto: 4 parts of stage 1 of impairment classification stuff

Answer 2

• manipulation/mobilization
• stabilization
• specific exercises
• traction

Question 3

3 parts of stage 2 of impairment classification stuff. and what is stage 3?

Answer 3

• strengthening
• flexibility
• aerobics

stage 3 = functional (task) training.

Question 4

Herniated nucleus pulposus (HNP)

- 2 S: and O:

Answer 4

S:

   - inc pain upon waking in morning due to fluid 
  - dec pain resting horizontally

O:

 - postural pain avoidance (possible lateral shift)
 - repeated motion common to see dec pain after shift correction

Question 5

Hypo mobility dysfunction (2 S: & O:)

Answer 5

S:

 - pain and stiffness well localized centrally
 - stiff in A.M. -> dec as pt warms up throughout day -> pain inc again in P.M. due to irritation 

O:

 - hinge point
 - decreased ROM with pain at end range

Question 6

Facet joint sprains (1 S: & O:)

Answer 6

S:
- sharp pain when “I move wrong”

O: limited ROM (A=P)

Question 7

Theories: Butler

Answer 7

AMNT

Question 8

Theories: Travell

Answer 8

trigger points

Question 9

Theories: McKenzie

Answer 9

posterior disc migration

jelly donut

Question 10

Theories: Jones

Answer 10

tender point (strain/counterstrain)

Question 11

Theories: John Barnes

Answer 11

Myofascial release

Question 12

Theories: Ida Rolf

Answer 12

Structural integration. pain due to faulty structure

Question 13

Theories: Shirley Sahraman

Answer 13

muscle imbalances

Question 14

Theories: Moshe Feldenkrais

Answer 14

malposture due to misdirected neurological signaling

Question 15

Theories: Barrett Dorko

Answer 15

myofascial unwinding

Question 16

Myogenic/Myofascial (2 Classic S:, O: )

Answer 16

S:

 - chronic cold hands and feet
 - pain inc with prolonged postures especially flexion

O:

 - trigger points
 - AMNT
 - (think of the theory people)

Question 17

Ankylosing Spondylitis (AS)

2 classic S: and O:

Answer 17

S: 
     - pain/stiffness inc with rest, dec with activity
     - night pain
O: 
    - "Bamboo spine"
    - SI tenderness 
     - chest expansion reduced.

Question 18

Schulman’s Disease (Classic S: and O:)

Answer 18

S:
     - generalized back pain
     - fatigue 
O:
     - Severe inc kyphosis
    - x-ray show end plate deformities

Question 19

Spondylolysis/Spondylolisthesis (classic S: and O:)

Answer 19

S:
     - localized pain over L5-S1. L5 distribution
     - "slipping sensation"
O: 
     - palpable "step off" btw L4-L5
     - pain inc with extension A/PROM

Question 20

DJD (classic S and O)

Answer 20

S:
     - symptoms inc with use, reduced with rest. too much rest = stiffness
    - age >60
O:  
     - pain at end ranges
    - reduced trunk rotation

Question 21

SI dysfunction (classic S and O)

Answer 21

S:
      - pain well localized over SI
      - pain radiates down to knee but not further
O: 
      - SI pain provocation tests
      - malalignment

Question 22

Signs of visceral pain

Answer 22

• inc pain at rest, during night
• pain not associated with movement or body position
• insidious pain onset
• pain covering large, non specific areas
• pain migrating from one joint to another
• unexplained wt gain/loss
• fever
• PMH for carcinoma, systemic disease
• pt who do not respond at all to conservative measures

Question 23

Lumbar ROM

Answer 23

Flex = 40-50
Ext = 15-20
Lat. Flex = 20
Rotation = 5-7