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Flashcards in Review of year 1 material Deck (79)
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1

Manipulation is a _______ velocity technique.

High

2

Mobilization is a _______ velocity technique

Low

3

Distraction is a form of ?

traction

4

Mobilization principles

- hands close to the joint line
- patient comfortable?
- therapist comfortable? (table height, joints in neutral)
- position joint (open packed, end range)
- keep arms in line with the direction of force
- stabilize (proximal bone usually)
- continually assess patient's tolerance/response
- if the patient isn't relaxing, ask yourself what you can do to make them relax more

5

Lumbar tests

- passive supine SLR
- crossed supine SLR
- slump (seated SLR)
- femoral nerve tension test
- spring test
- prone instability test

6

SIJ tests (4)

- SI distraction
- SI compression
- thigh thrust (posterior shear test)
- sacral thrust (spring test)

7

Screening: tests of function (4)

- chair stand
- squat
- single leg stance
- back bending

8

Screening: active motion testing (5)

- flexion/extension
- lateral flexion
- rotation
- repeated movements

9

Things to watch for when testing active motion

- symptoms
- deviations
- limitations of movement
- curve reversal
- rhythm
- compensatory movement

10

Contraction of what muscle facilitates pelvic floor contraction?

TR

11

What two muscles might atrophy post lumbar surgery?

Multifidi
TRA

12

When would you perform dynamic lumbar stabilization with a patient?

- hypermobile people who are symptomatic
- people with a fracture to promote stabilization

13

What is lumbar spinal stenosis?

Narrowing of the skeletal canal

14

Symptoms of lumbar spinal stenosis

- loss of sensation
- weakness
- reflex changes
- balance deficit from decreased nerve function
- pain with extension like reaching overhead
*- relief with flexion, sitting, recumbence*

15

Clinical picture of spinal stenosis patient

- 30's 40's: long history of low back pain
- 50's: generally asymptomatic
- 60's: slow onset, feels like leg pain but is actually compression. can't walk or stand long due to upright posture. numbness, paresthesia, weakness. LE symptoms predominate back pain, if any.

16

Symptoms of neurogenic claudication

- absent peripheral pulse (nerve compression affects blood circulation)
- ischemic signs in calves (pain, paresthesia, cramping)
- cauda equina symptoms (incontinence, saddle paresthesia, gait imbalance due to inability to coordinate muscle activity)

17

Spine diameter

C: 17-18mm
T: 12-14mm
L: 15-17mm

18

Interventions for stenosis

- flexion: knees to chest, drape over a swiss ball
- Neurontin: decreases nerve excitability
- laminectomy: cutting away bone and cleaning out

19

Spondylosis is...

spinal arthritis

20

Spondilolysis...

defect or fracture of vertebrae (typically pars, located between facets)

21

Spondylolysthesis...

vertebrae shifted out of normal position

Grades: fraction of body slipped
I: up to 1/4
II: 1/4 to 1/2
III: 1/2 to 3/4
IV: 3/4 to full
V: complete

22

Symptoms of spondylolisthesis

pain with palpation
flexion (midrange) feels good

23

Symptoms of clinical lumbar instability

- "catch in the back"
- Gower's sign
- reversal of LP rhythm
- pain moving into flexion
- pain returning from flexion
- clunking feeling or giving way

24

Treatment for clinical lumbar instability

core exercise in neutral spine
- NSAIDS
- lumbar fusion

25

Lateral shift is named for...

the direction the shoulders move

26

The upper body shifts _______ from pain in lateral shift.

away from the pain

27

Correction of lateral shift _______ intensity and causes _________.

increases intensity
centralization of symptoms

28

After correction of lateral shift, one should avoid...

flexion

29

Classifications of instability (5)

stabilization
manipulation
specific exercise (flexion or extension biased)
traction
lateral shift

30

Factors for stabilization

younger
+ prone instability test
aberrant motions
greater SLR ROM
Spring test hypermobility
increasing episode frequency
3+ episodes