1. Lower Back Pain (LBP)
SAAO
Dustin Bui

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

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

4. 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

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

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

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

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

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

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

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

12. 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

13. 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

14. 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

15. 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

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

17. 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.

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

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

20. 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

21. 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

22. 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