Lumbar Examination

What questions should you ask to help rule out cervical spine?

Do your symptoms change with any movements of the neck or upper back?

What questions should you ask to rule in spinal stenosis?

Do you have no pain with sitting?

Are your symptoms improved while sitting?

Over 65?

What index is used for lower back issues? Is higher or lower bettwe?

Oswestry Disability Index, lower

What questionnaire should be filed out to help rule in the nociceptive pain category?

Fear avoidance belief questionnaire

Dermatomes for LQ neuro screen

L1- inguinal area

L2- mid anterior thigh

L3- distal anterior thigh

L4- medial lower leg/foot

L5- between 1st and 2nd toes

S1- lateral foot

S2- popliteal fossa

Myotomes for LQ neuro screen

L2-L3 hip flexion

L3-L4 knee extension

L4 ankle dorsiflexion

L5 great toe extension

L5-S1 ankle plantar flexion

S1-S2 ankle eversion

Reflexes for LQ neuro screen

L4- quads

S1- achilles

Neural related clearing for lumbar spine and what they are testing for

Passive SLR- space occupying lesion

Crossed SLR- space occupying lesion

SLUMP test- neural tension

What is the BIGGEST red flag when treating people with LBP

inability to reproduce pain during examination

What are other red flags for patients with LBP

uncontrolled with meds, worsens at night/rest, exacerbates with general activity, BILATERAL, several dermatomes

What are some yellow flags for patients with LBP

its uncontrollable, it will never get better, delayed return to work, avoidance of activities, catastrophizing, low social support, anxiety, or depression

How useful is imaging for the general population

Not useful UNLESS there are serious underlying conditions

How useful is imaging for the athletic population

More important

What three movements are you looking at for the regional exam

Multi-segmental flexion

Multi-segmental extension

Multi-segmental rotation

What is done to test multi-segmental flexion in the regional assessment

Active SLR

Passive SLR

Double knee to chest

Prone rock test

What is done to test multi-segmental extension in the regional assessment

Active lumbar lock thorax EXT/ROT

Passive lumbar lock thorax EXT/ROT

Prone on elbow lumbar EXT/ROT

FABER Test

Modified Thomas Test

How do you break apart the modified thomas test

Straight leg- rectus femoris

ABD thigh, flex knee- TFL/ITB

ABD thigh, ext knee- TFL and RF

Nothing Fixes- iliopsaoas

What is done to test multi-segmental rotation in the regional assessment

Seated hip ER

Prone hip ER

Seated hip IR

Prone hip IR