Term
| What are the characteristics of chronic hypomobile spine joints? (3major) |
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Definition
| Altered spaces btw spinous processes, deep muscle atrophy, and hypermobility (develops in response to a nearby hypomobile joint) |
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Term
| If a segment is chronically hypomobile and stuck in flexion, what will it feel like above and below in terms of amount of space? |
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Definition
| There will be increased space below, and decreased space above. |
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Term
| What muscle groups make up the transversospinalis muscles? |
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Definition
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Term
| What is removed in a discotomy? |
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Definition
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Term
| How can you tell if a pt had a macro or micro discectomy just by looking at the external characteristics? |
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Definition
| Macro will have a 4” scar and a micro will have a 1” scar. |
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Term
| What will happen to the joint play at a segment of degenerative disc disease? |
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Definition
| There will be increased play. |
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Term
| Why is it important to make sure symptoms match the MRI results before a pt goes into surgery? |
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Definition
| There is a high incidence of false positives for disc pathology with MRI, and if the symptoms don’t match what the MRI is reporting the problem as, the patient may have surgery and not end up any better, because the MRI gave back an erroneous report |
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Term
| If a pt. brings you a myelogram, what will you see if something is compressing the spinal cord? |
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Definition
| There will be a little dent in the spinal cord on the picture. (they inject a dye into the dura mater, so that when an x ray is taken it shows a picture of the spinal cord. If there’s a dent in it, that means something is pressing on the cord) |
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Term
| What is the only imaging technique that will increase a patients symptoms when performed? |
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Definition
| A discogram. The injection of dye into the disc will cause increased pain and symptoms if the disc is affected. |
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Term
| Why would a doctor use a slerosant injection (aka: prolotherapy)? |
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Definition
| When a pt has a hypermobile joint. It causes fibrous proliferation at the site of attachment of soft tissue. |
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Term
| What is a spinal stenosis, and what can it lead to? |
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Definition
| It’s a narrowing of the central canal or lateral foramena. It’s usually caused by a bony prominence and can lead to UMN lesion. |
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Term
| What will you see in terms of symptoms when there’s a spinal stenosis affecting the lateral foramen? |
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Definition
| N. root/ segmental symptoms |
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Term
| Why are cervical collars contraindicated in the Tx of spinal disorders? |
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Definition
| Because with overuse, muscles will atrophy. |
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Term
| Why are muscle relaxants contraindicated in the Tx of spinal disorders? |
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Definition
| b/c it makes the pt sleep all the time. If they’re sleeping they’re not working their muscles. |
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Term
| Why are steroid injections contraindicated in the Tx of spinal disorders? |
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Definition
| Because just the injection, without manual therapy, is not helpful to recovery from the problem |
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Term
| Why is surgery contraindicated in the Tx of spinal disorders? |
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Definition
| B/c the pts don’t do better in the long run. |
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Term
| What are the only conservative interventions that have been shown in literature to be effective in pts w/ spinal disorders? (3 major, 1 conditional) |
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Definition
| Education/modification of activity, exercise, early return to work, and in some cases (the conditional one) manipulation. |
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Term
| Why do you need to be careful when prescribing ab exercises for LB pts? |
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Definition
| Because full sit-ups cause lots of flexion and may antagonize the back problem. It requires hip flexion too, and the iliopsoas group attaches to the L spine |
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Term
| What can a LB pt do to strengthen abs instead of full sit ups? |
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Definition
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Term
| What will happen if you overwork the abs in the back pt? Why? |
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Definition
| Overworking the abs will result in erector spinae inhibition, because the rectus abdominis use an antagonist to the back muscles. |
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Term
| Look on pg L49 for lumbar stabilization exercises. |
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Definition
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