Lower Back Pain (LBP) SAAO Dustin Bui

Which of the following is correctly associated? L1-2  Quadriceps L3  Extensor Hallucis Longus L4 Psoas Muscle L5  Tibialis Anterior S1  Gastrocnemius

Motor Exam L1-2  Psoas L3  Quadriceps L4  Tibialis Anterior L5  Extensor Hallucis Longus S1  Gastrocnemius Graded between 0/5 to 5/5

Upon DTR examination of the Achilles Tendon you can not illicit a Response no matter how hard you try. How would you grade this response? 0/5 0/4 1/5 1/4 5/5

DTRs L4  Patellar S1  Achilles Graded 0/4 to 4/4

What are the main motions of the Lumbar Spine? Rotation Sidebending Flexion/Extension

Which of the Following is Not a High Risk Occupation for LBP? Nursing Garbage Collector Warehouse Worker Airline Worker Teacher

Which is the following is not a Risk Factor for LBP? Repetitive Lifting Excessive Twisting/Rotational Movements Chronic Coughing Tobacco Use Jumping

Which is not an Alarm Symptom? Prior Cancer Hx Unexplained Weight Loss Increased Serum Calcium Patient Age = 50+ Pain lasting more than one month

Herniated Nucleolus Pulposus commonly occurs in what Direction? Anterior Anteriolateral Posterior Posteriolateral Lateral

Which of the Following are common locations for HNP? L5-S1 A&B C&D

24yo White Male presents to the Family Medicine clinic with a CC of Lower Back Pain. He denies Weight loss & Trauma. He states that he has Urinary issues & Defecations issues this morning. PE reveals Patellar & Achillies Tendon at +0/4 & LE strength at 1/5 & 2/5. What is the appropriate decision for this patient? 800mg Ibuprofen + Home Rest Conservative OMM for LBP (Bowstring, MFR, etc..) Lumbar on Side HVLA Send to ER for MRI Send him to the Bathroom to Poop & Pee

Cauda Equina Syndrome Impingement of the Cauda Equina Unexplained Back Pain Progressive Motor Deficits Bowel Dysfunction Bladder Dysfunction Saddle Anesthesia Emergency Situation  Send to ER for MRI to R/O Tx: Emergent Surgical Decompression

Which of the following is the Definition of Sacralization? Deformity where S1 is not fused with the Sacrum Asymmetry of the Facet joint Impingement of the Cauda Equina Deformity where the L5 fuses to the Sacrum

Which of the following is the Definition of Lumbarization? Deformity where S1 is not fused with the Sacrum Asymmetry of the Facet joint Impingement of the Cauda Equina Deformity where the L5 fuses to the Sacrum

Which variant of Spina Bifida is associated w/ Herniation of the Meninges through the defect? Spina Bifida Oculta Spina Bifida Meningocele Spina Bifida Meningomyelocele

Spina Bifida Variants Spina Bifida Occulta Spina Bifida Meningocele No herniation through the defect. Tuff of hair present over site. Spina Bifida Meningocele Herniation of the Meninges through the defect Spina Bifida Meningomyelocele Herniation of the Meninges & Nerve Roots through the defect.

Which of the Following Tests is associated w/ a Tight Hamstring & Nerve Root Irritation? Patrick’s Test Straight Leg Test Thomas Test

Which of the Following Tests is associated w/ a Tight Hip Flexors (Psoas)? Patrick’s Test Straight Leg Test Thomas Test

How would you set the Patrick’s (FABERE) Test? Flexion, Adduction, External rotation, & Extension of the Hip Flexion, Abduction, External rotation, & Extension of the Hip Flexion, Adduction, Internal rotation, & Extension of the Hip Flexion , Abduction, Internal rotation, & Extension of the Hip

How would you treat the A1L Counterstrain point? Flex to Spinal Level, Rotate Pelvis towards, Sidebend Trunk towards Flex to Spinal Level, Rotate Pelvis away, Sidebend Trunk towards Extend to Spinal Level, Rotate Pelvis away, Sidebend Trunk towards Extend to Spinal Level, Rotate Pelvis towards, Sidebend Trunk towards

Anterior Lumbar Counterstain Tenderpoint Anatomy Counterstrain Position A1L Internal Oblique Flex to Spinal Level Rotate Pelvis towards Sidebend Trunk towards A2L External Oblique Rotate Pelvis away Sidebend Trunk away A3L Iliopsoas A4L A5L Rectus Abdominus