Question 1

Clinical prediction rules (CPR) for predicting success with spinal hypermobility treatment

Accepted Answer

Age < 41 (most important factor)
Positive prone instability test
SLR > 91
Aberrant(shaking) movement patterns

Question 2

Hypermobility Clinical Features RE: Pain

Accepted Answer

pain increased with extension, worse at the end of the day, hypertonicity of lumbar PVM, poor strength & coordination

Question 3

Clinical prediction rules (CPR) for predicting failure with spinal hypermobility treatment

Accepted Answer

Lack of hypomobility with PIVM, negative prone instability test, lack of aberrant movements, FABQ <9

Question 4

Demographics of Spondylolithesis

Accepted Answer

Males > Females (although female slippage is 4 x as likely to continue to progress)

Question 5

Signs of Spondylolsis

Accepted Answer

Muscle banding w/ standing, "Step" prescence in standing (both disappear in prone position), bilateral sciatica, increased lordosis, hamstring tightness

Question 6

Grades of Spondylolithesis

Accepted Answer

1-25% slip (anterior)
2-50% slip
3-75% slip
4- 100% slip

Question 7

Symptoms of spondylolsis

Accepted Answer

Unable to sit extended period of time, relief w/flexion & rest, radiation into leg, episodic or recurrent LBP

Question 8

7 clinical signs of instability

Accepted Answer

1- Inability to sit for a prolonged period
2- increased muscle tone with standing
3- "step" (spondylolithesis) on standing
4- decreased muscle tone in prone
5- shaking while bending forward
6- Grade 5-6 on PIVM (unstable)
7- Radiological findings

Question 9

CPR for acute LBP manipulation

Accepted Answer

<16 days sxs,                            >35 degrees hip IR,                    PAIVM reveals hypomobility,              FABQ <19,                                 No sxs distal to the knee

Question 10

Lumbar Spine Coupled movement with flexion

Accepted Answer

Sidebending & Rotation to SAME side

Question 11

Lumbar spine Coupled movement with extension

Accepted Answer

Sidebending & rotation OPPOSITE side

Question 12

Non-coupled movement of Lumbar spine with flexion

Accepted Answer

Sidebend to right with active rotation to the left (OPPOSITE)

Question 13

Non-coupled movement of Lumbar spine with extension

Accepted Answer

Sidebend to right with active rotation to right (SAME)

Question 14

3 models for treating back pain

Accepted Answer

Pathanatomical, Biopsychosocial, and Segmental Dysfunction

Question 15

2 categories of Segmental dysfunction model

Accepted Answer

1- Altered segment stiffness 
2- Altered Motor control

Question 16

CPR for cervical HVT

Accepted Answer

1-NDI < 23%, 2-Bilateral involvement, 3- Don't perform sedentary work > 5 hrs/day, 4- Feel better w/neck movement, 5- Don't feel worse with cervical extension, 6- Dx of spondylosis without radiculopathy

Question 17

5 contraindications for upper cervical manipulation

Accepted Answer

downs syndrome, MVA, RA, Long term steroid use, hypermobility

Question 18

6 special test for cervical radiculopathy

Accepted Answer

Vertebral artery, spurling's test, neck distraction, ULNT1 (median), Cervical ROM, Bakody's sign (shoulder abduction test)C4-C5

Question 19

CranioCervical vertebral ligaments of the spine: Cruciate ligament , alar ligament, posterior longitudinal ligament, ligamentum flava, ligamentum nuchae, anterior longitudinal ligament

Accepted Answer

limit extension of vertebral column

Question 20

Purpose of the alar ligament

Accepted Answer

limit rotation

Question 21

What type of joint is the Atlantoaxial (AA) joint?

Accepted Answer

Uniaxial synovial (diarthodial)

Question 22

What level of the Lumbar spine is at the same height as the Iliac Crest?

Accepted Answer

L4-L5 interspace

Question 23

What sacral level is the PSIS of the pelvis used to locate?

Accepted Answer

S2 level

Question 24

How do you locate the SI Joint?

Accepted Answer

Inferior and medial to the PSIS

Question 25

What area can be located once the SI Joints are located bilaterally?

Accepted Answer

Coccyx

Question 26

Location of the Ala on the Sacrum?

Accepted Answer

Lateral superior portion ("wings")

Question	Answer
Clinical prediction rules (CPR) for predicting success with spinal hypermobility treatment	Age < 41 (most important factor) Positive prone instability test SLR > 91 Aberrant(shaking) movement patterns
Hypermobility Clinical Features RE: Pain	pain increased with extension, worse at the end of the day, hypertonicity of lumbar PVM, poor strength & coordination
Clinical prediction rules (CPR) for predicting failure with spinal hypermobility treatment	Lack of hypomobility with PIVM, negative prone instability test, lack of aberrant movements, FABQ <9
Demographics of Spondylolithesis	Males > Females (although female slippage is 4 x as likely to continue to progress)
Signs of Spondylolsis	Muscle banding w/ standing, "Step" prescence in standing (both disappear in prone position), bilateral sciatica, increased lordosis, hamstring tightness
Grades of Spondylolithesis	1-25% slip (anterior) 2-50% slip 3-75% slip 4- 100% slip
Symptoms of spondylolsis	Unable to sit extended period of time, relief w/flexion & rest, radiation into leg, episodic or recurrent LBP
7 clinical signs of instability	1- Inability to sit for a prolonged period 2- increased muscle tone with standing 3- "step" (spondylolithesis) on standing 4- decreased muscle tone in prone 5- shaking while bending forward 6- Grade 5-6 on PIVM (unstable) 7- Radiological findings
CPR for acute LBP manipulation	<16 days sxs, >35 degrees hip IR, PAIVM reveals hypomobility, FABQ <19, No sxs distal to the knee
Lumbar Spine Coupled movement with flexion	Sidebending & Rotation to SAME side
Lumbar spine Coupled movement with extension	Sidebending & rotation OPPOSITE side
Non-coupled movement of Lumbar spine with flexion	Sidebend to right with active rotation to the left (OPPOSITE)
Non-coupled movement of Lumbar spine with extension	Sidebend to right with active rotation to right (SAME)
3 models for treating back pain	Pathanatomical, Biopsychosocial, and Segmental Dysfunction
2 categories of Segmental dysfunction model	1- Altered segment stiffness 2- Altered Motor control
CPR for cervical HVT	1-NDI < 23%, 2-Bilateral involvement, 3- Don't perform sedentary work > 5 hrs/day, 4- Feel better w/neck movement, 5- Don't feel worse with cervical extension, 6- Dx of spondylosis without radiculopathy
5 contraindications for upper cervical manipulation	downs syndrome, MVA, RA, Long term steroid use, hypermobility
6 special test for cervical radiculopathy	Vertebral artery, spurling's test, neck distraction, ULNT1 (median), Cervical ROM, Bakody's sign (shoulder abduction test)C4-C5
CranioCervical vertebral ligaments of the spine: Cruciate ligament , alar ligament, posterior longitudinal ligament, ligamentum flava, ligamentum nuchae, anterior longitudinal ligament	limit extension of vertebral column
Purpose of the alar ligament	limit rotation
What type of joint is the Atlantoaxial (AA) joint?	Uniaxial synovial (diarthodial)
What level of the Lumbar spine is at the same height as the Iliac Crest?	L4-L5 interspace
What sacral level is the PSIS of the pelvis used to locate?	S2 level
How do you locate the SI Joint?	Inferior and medial to the PSIS
What area can be located once the SI Joints are located bilaterally?	Coccyx
Location of the Ala on the Sacrum?	Lateral superior portion ("wings")

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