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| Pregunta | Respuesta |
| How many foramena on the sacral bone? | 4 on each side. |
| How many bands does the iliolumbar ligament have? | 2. |
| The superior band of the iliolumbar ligament runs from the transverse process of _____ to the iliac crest. | L4. |
| The inferior band of the iliolumbar ligament runs from the TP of _____ to the ______, the ______ and the _______. | L5. To the iliac crest, the anterior surface of the SIJ, the lateral sacral ala. |
| Actions of the QL. | 1) unilaterally: elevates the ilium. 2) bilaterally: forced exhalation and back extension. |
| The primary function of the iliopsoas muscle includes hip flexion and ______. | External rotation. |
| Is the iliopsoas muscle active during sitting? | Yes. |
| In NWB, the piriformis muscle acts as a ____ rotator when the hip is (flexed/ extended) | Lateral rotator. When hip is extended. |
| In NWB, the piriformis acts as a ______ when the hip is 90 deg flexed. | abductor |
| What does the piriformis do in WB? | To resist hip internal rotation. |
| Which muscle and movement do we check for L2 integrity? | Iliopsoas (hip flexion) |
| Which muscle and movement do we check for L3 integrity? | Iliopsoas (hip flexion) quads (hip flex and knee ext) femoris (knee extension) |
| Which muscle and movement do we check for L4 integrity? | Tibialis anterior (ankle DF) |
| Which muscle and movement do we check for L5 integrity? | Extensor hallucis longus (1st toe extension) |
| Which muscle and movement do we check for S1 integrity? | Gastroc, soleus, ankle everters (PF and eversion) |
| Which muscle and movement do we check for S2 integrity? | Gastroc, soleus, ankle everters (PF) |
| DTR for L4 | Patellar tendon |
| DTR for L5 | Medial hamstring |
| DTR for S1 | Achilles tendon |
| Sensory distribution of L2 | Anterolateral thigh |
| Sensory distribution of L3 | Anteromedial and distal thigh |
| Sensory distribution of L4 | Medial leg/ankle/foot |
| Sensory distribution of L5 | Dorsum of the foot |
| Sensory distribution of S1 | Lateral ankle/foot |
| Sensory distribution of S2 | Posterior medial thigh/calf |
| Name possible screening exams for the lower quadrant. | 1. standing flexion 2. Gillet's test 3. Long-sitting test 4. Sitting flexion test 5. SLR 5. Prone knee bend 6. slump test 7. centralization/peripheralization |
| How to determine the 'blocked' side during the standing flexion test? | Put both thumbs on PSIS while patient bends forward. The PSIS that MOVES CRANIALLY THE FIRST is the blocked side. |
| During the long-sitting test, the longer limb during supine becomes shorter in sitting, the affected innominate is rotated (anteriorly/ posteriorly) | Anteriorly. |
| During the long-sitting test, the affected side is shorter in supine and longer in sitting, the affected innominate is rotated (anteriorly/ posteriorly) | posteriorly |
| What are the positive results of the prone knee bend test? | pain into lateral aspects of the hip, into upper lumbar spine (L1-3), into anterior thigh. |
| List the 5 tests for the Laslett cluster of the SIJ. | 1. distraction test 2. thigh thrust 3. Gaenslen's test 4. sacral thrust 5. compression test |
| How many tests in the Laslett's cluster must be positive to indicate SIJ dysfunction? | 3 out of 5. |
| The patient stands with left PSIS higher, left ASIS lower, left leg longer in supine and L leg shorter in long sitting. What is the most likely pelvic girdle dysfunction? | Anterior L innominate rotation. |
| The patient stands with left PSIS lower, left ASIS higher, left leg shorter in supine and left leg longer in long sitting. What is the most likely pelvic girdle dysfunction? | Posterior L innominate rotation. |
| The patient stands with L PSIS and ASIS both higher, left leg shorter both in supine and long sitting. What is the most likely pelvic girdle dysfunction? | Upslip of L innominate. |
| The patient has a deeper sacral sulcus on R, sacral ILA is posterior and down on the left. What is the most likely pelvic girdle dysfunciton? | L rotation of the sacrum. |
| A patient with increased back stiffness and pain reports no MOI, joint mobility revealed very little mobility throughout the entire spine. Which imaging should you refer to rule out which inflammatory diagnosis? | Radiograph for Ankylosing Spondylitis. |
| Pain pattern for Ankylosing Spondylitis is (cranial/caudal) to (caudal/cranial) | Caudal to cranial. |
| A patient comes with a referral for 'sciatica', he reports unilateral flank pain, some limb weakness and numbness. He stands with a lateral shift and his pain increases with flexion and Valsava's. What spine-related disorder do you suspect and how can you rule it in/out? | Disc protrusion. Can perform SLR, lumbar segmental mobility test to differentiate from piriformis syndrome. |
| Your patient comes in reporting 'blocked' when twisting to his R side . She has very poor body mechanics and moves in an unguarded manner. What spine-related disorder do you suspect the most? | Acute facet block. |
| Place the steps in the correct order for the Slump test. 1. passively DF ankle 2. passively flex head and neck 3. passively extend knee | 1. Passively flex the neck and ankle 2. Passively extend the knee 3. Passively DF the ankle |
| You are performing the quadrant test and your goal is to maximally close the intervertebral foramen on the L side. What should you cue the patient to do? | 1. L side bend 2. L rotation 3. maximal extension |
| You are performing the quadrant test and your goal is to stress the facet joint of the L lumbar articular pillar, what should you cue the patient to do? | 1. L side bend 2. R rotation 3. maximal extension |
| Which aberrant movements are you looking for in patients with LBP? | 1. instability catch 2. painful arc in flexion 3. painful arc returning from flexion 4. Gower's sign 5. reversal of lumbopelvic rhythm |
| Which test has very high specificity for herniated nucleus pulposis or neural tension and radiculopathy in the lower back? | Crossed SLR. (SP is 97%). |
| How to bias the tibial nerve during SLR? | Add eversion of the ankle and extension of the toes. |
| How to bias the sural nerve during SLR? | Add inversion to the ankle. |
| How to bias the common fibular nerve during SLR? | Lock the ankle in PF and inversion. Add internal rotation while flexing the hip. |
| How to only test for spinal nerve root involvement by minimally stressing the peripheral nerves? | Keep hip in neutral (no adduction, abduction, rotation) and only perform flexion. Do not add any ankle/foot bias. |
| The unilateral posterior rotation of the lilium is couple with ipsilateral hip _______. | ER. |
| The ER of the femur is paired with ____ of the tibia. | ER. |
| The ER of the tibia is paired with _____ of the foot. | supination |
| Supination of the foor is coupled with ______ and _____ glide of the fibula head. | cranial and anterior |
| Is spinal manipulation recommended for internal disc derrangements? | No. |
| Patient comes in with back pain that is not physically provocable, and had a previous history of lung cancer. What should you rule out? | Primary tumors (Sarcoma, Myeloma) |
| Patient has back pain and pain with swallowing, dysphagia, as well as weight loss. What do you suspect? | Esophageal cancer |
| Patient has back pain that is deep and gnawing, radiating from the chest to back. What do you suspect? | Pancreatic cancer. |
| T/F: Acute pancreatitis may manifest itself as mid-epigastric pain radiating through the back. | T. |
| Where is the usual referral pattern of cholecystitis? | Abrupt, severe abdominal pain and right upper quadrant tenderness, nausea, vomiting, and fever. |
| What are some common referral patterns of heart and lung disorders? | 1. chest 2. back 3. neck 4. jaw 5. upper extremity |
| T/F: AAA can manifest as nonspecific back pain. | T. (especially lumbar pain) |
| Where does UI and gyencological conditions refer pain to? | trunk, pelvis, and thighs |
| What is an outcome measure that has established validity for LBP? | Oswestry Disability Index |
| What are the three diagnostic categories of LBP? | 1. LBP with mobility deficits 2. LBP with radiating pain 3. generalized LBP |
| Which 4 treatment options have level I evidence to be beneficial for LBP patients? | 1. Manual therapy 2. Trunk coordination, endurance and strengthening exercises 3. Centralization procedure 4. Progressive endurance and fitness |
| What should be the intensity of exercise for chronic LBP a) without generalized pain b) with generalized pain | a) Moderate to high intensity b) progressive, low intensity with submaximal fitness and endurance activities |
| T/F: The CPG emphasizes the importance of patient education. Therefore in-depth explanation for pathology should be carried out. | F! Should NOT go in depth. |
| Patient with LBP has positive crossed SLR sign. Which traction position is best recommended by the CPG? | Prone. |
| Which group of LBP patient should we avoid using traction on? | 1. acute or subacute nonradicular pain. 2. chronic LBP |
| What type of exercise was weakly recommended for elderly patients with chronic LBP with radiation? Should it be used alone? | Flexion exercise. Use with other highly recommended treatments. |
| T/F: As a PT, you should not provide nerve mobility for patient with LBP if they are in the subacute or chronic stage and has radiating pain. | F. Nerve mobilization is recommended. |
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