Reflex testing
3 main types of reflexes that you will be testing on patients with spinal pain
what is stretch,pathological, & superficial
extension of toes or spreading of the toes
what is a positive babinski sign
bulging disc,facet joint enlargement. & ligament flavum thickening
what is 3 degenerative changes that occur in the lumbar spine
increases IVF by 12%
what does flexion do to the central canal
disc derangement,disc degeneration, and disc herniation
what is 3 conditions that affect intervertebral discs
metabolic disease that cause hyporeflexia
what is diabetes and hypothyroidism
forced wrist flexion, pausing at end range
older patient > 60 years with leg pain and worse when walking
what is a snapshot of when to suspect lumbar stenosis in a patient
Radiograph, MRI, and electromyographic paraspinal mapping
what is 3 ancillary studies for suspected lumbar spinal stenosis
a generalized extension over greater than 50% of the circumference of the disc
what is a disc bulge
C5
what is dominant nerve root for biceps reflex
stroke anteromedial tibia
what is oppenheims
IVF, lateral recess, and central canal
what is radiographically the different sites of stenosis
competing diagnosis for a 70 year old with neurological deficits,leg pain & paresthesia
CES,Stenosis, & radiculopathy
balloons out. just a part of the disc balloons into the canal. it narrow base
what is disc extrusion
medial hamstring
what is L5
positive romberg test hyperreflexia, + babinski,+ clonus, loss of cremasteric reflex
what is suggestions of a UMNL
neurogenic claudication & radicular/sciatica
what is two neurological presentations of spinal stenosis
pulses in feet decreased, cold touch in the foot, hurts more often in calf
what is PAD
broader base than the depth
what is disc protrusion
clench teeth or squeeze one thigh with the opposite hand
rapid foot tapping
positive clonus for lower extremity
leg symptoms made worse by walking, extension of the spine increases leg symptoms, flexion often improves symptoms,balance and leg proprioception can be affected, rarely CES can be present. basci neurology deficits presnt in 50% of cases, SLR rarely +
leg pain is changed by spine position, stenosis hurts more in thigh
what is stenosis
most often herniated disc
L4-L5 or L5-S1