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Low Back Supine Exam

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1. Exam Series: Guide to the Back Exam

. Wikipedia. . Accessed 2018. 2. Corwell B. Back Pain. In: Rosen’s Emergency Medicine . 9th ed. Elsevier; 2018:275-284. 3. Sudhir A, Perina D. Musculoskeletal Back Pain. In: Rosen’s Emergency Medicine . 9th ed. Elsevier; 2018:569-576. 4. Moore D. Lower Extremity Spine and Neuro Exam. Orthobullets. . . Accessed 2018. [ ] 5. Chou R, Fu R, Carrino J, Deyo R. Imaging strategies for low-back pain: systematic review and meta-analysis. Lancet . 2009;373(9662):463-472. [ ] 6. Jarvik J, Gold L, Comstock B, et al (...) Exam Series: Guide to the Back Exam Exam Series: Guide to the Back Exam - CanadiEM Exam Series: Guide to the Back Exam In , by Kathryn Chan July 23, 2018 A 67-year-old male presents to your emergency room with back pain. He has a history of intermittent back pain that typically responds to NSAIDs, however this particular episode has been much more severe. He now feels sharp pain that radiates into this left foot with certain movements, which causes weakness when walking. His past medical

2018 CandiEM

2. Low Back Supine Exam

Low Back Supine Exam Low Back Supine Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Low Back Supine Exam Low Back Supine Exam (...) Aka: Low Back Supine Exam , Supine Low Back Exam II. Exam: Miscellaneous Assess for primary hip disorder Assess Leg lengths Supine Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Low Back Supine Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Examination About FPnotebook.com is a rapid access, point-of-care medical reference

2018 FP Notebook

3. Exam Series: Guide to the Knee Exam

, Move” Throughout the physical examination compare the asymptomatic to the symptomatic knee. The knee exam should be conducted with the patient supine, examining a knee in a chair or wheelchair can significantly compromise your exam! Every patient will have a different laxity to their joints at baseline, use the asymptomatic knee to get a sense of the patients baseline laxity. Pain with provocative movements without associated laxity suggests a ligament strain rather than a tear. Remember to assess (...) to examine the joint above and below; a hip injury can masquerade as knee pain and a proximal fibular fracture can be a Maisonneuve fracture that is associated with an ankle eversion injury. It is also important to examine the patient supine, examining a knee in a chair or wheelchair (which is tempting in a busy ED with a shortage of beds!) can significantly compromise your exam. Soft tissue injuries (ligamentous and meniscal) should not be immobilized in a Zimmer splint as this can contribute

2018 CandiEM

4. Exam Series: Guide to the Shoulder Exam

suggests a supraspinatus tear, subacromial impingement, or subacromial bursitis : Instruct the patient to internally rotate their shoulder such that the back of their hand rests on their low back. Ask the patient to lift-off from their back against resistance. Pain suggests a subscapularis tear. : Place the seated patient in 90° of abduction and 90° elbow flexion. A positive test is failure to externally rotate against resistance, and indicates a tear to teres minor. Impingement: : Assist the patient (...) and mechanical symptoms with resistance that then resolves with supination is a positive test. A positive test indicates a SLAP tear (superior labral tear from anterior to posterior), which is often comorbid with bicep tendinopathy. Neurovascular exam : The neurovascular exam must be conducted before and after every reduction. Sensory function should be tested with both light touch and pinpoint. Nerve Origin Motor function Sensory function Reflexes Axillary C5,6 Deltoid: arm abduction Deltoid muscle

2018 CandiEM

5. Low Back Sitting Exam

. Exam: Measure thighs and calves (signs of muscle atrophy) Significant Discrepancy difference: >1/2 inch Calf difference: >1/4 inch IV. Exam: Sitting root test (Sitting Straight Leg Raise) Observe discrepancy between supine and sitting SLR Discrepancy suggests Not as sensitive as standard supine SLR Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Low Back Sitting Exam." Click on the image (or right click) to open the source (...) Low Back Sitting Exam Low Back Sitting Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Low Back Sitting Exam Low Back Sitting

2018 FP Notebook

6. Low Back Supine Exam

Low Back Supine Exam Low Back Supine Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Low Back Supine Exam Low Back Supine Exam (...) Aka: Low Back Supine Exam , Supine Low Back Exam II. Exam: Miscellaneous Assess for primary hip disorder Assess Leg lengths Supine Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Low Back Supine Exam." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Examination About FPnotebook.com is a rapid access, point-of-care medical reference

2015 FP Notebook

7. Trunk Muscle Strength, Strength Endurance and Activity in Persons With Low Back Pain

Trunk Muscle Strength, Strength Endurance and Activity in Persons With Low Back Pain Trunk Muscle Strength, Strength Endurance and Activity in Persons With Low Back Pain - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before (...) adding more. Trunk Muscle Strength, Strength Endurance and Activity in Persons With Low Back Pain (TRUSC) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03494452 Recruitment Status : Recruiting First Posted : April 11

2018 Clinical Trials

8. Acute Low Back Pain

, or of increasing pain and weakness, imaging studies are usually not helpful during the first 3-4 weeks of back symptoms. If low back symptoms persist for more than 4 weeks, further evaluation may be indicated. If radicular symptoms (leg pain and weakness) persist undiminished for more than 4 weeks, further evaluation is strongly indicated. Reevaluation begins with a review and update of the history and physical exam to assess again for red flags or evidence of nonspinal conditions causing back symptoms. Plain (...) if the diagnosis of radiculopathy is obvious on the clinical exam. EMG results may be unreliable in detecting subtle nerve damage until a patient has had significant radiculopathy for over 3 weeks. EMG may be used to help delineate abnormal neurological exams in patients with risk factors for neuropathy (e.g. alcohol or diabetes). Following imaging studies, EMG of the lower limb and paraspinal muscles may be helpful in the following circumstances: 1) in patients limited by radiating low back pain for more than

2011 University of Michigan Health System

9. Low Back Sitting Exam

. Exam: Measure thighs and calves (signs of muscle atrophy) Significant Discrepancy difference: >1/2 inch Calf difference: >1/4 inch IV. Exam: Sitting root test (Sitting Straight Leg Raise) Observe discrepancy between supine and sitting SLR Discrepancy suggests Not as sensitive as standard supine SLR Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Low Back Sitting Exam." Click on the image (or right click) to open the source (...) Low Back Sitting Exam Low Back Sitting Exam Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Low Back Sitting Exam Low Back Sitting

2015 FP Notebook

10. Mechanisms of Specific Trunk Exercises in Low Back Pain

exercises. The exercise protocol progresses to include trunk flexion and extension strengthening exercises as well as abdominal bracing exercises in supine and quadruped positions, and finally to exercises in more functional positions. Other Names: Trunk stabilization exercises Segmental stabilization exercises Active Comparator: 'Eligible' Subject Group - MSI Subjects between the ages of 21-55 years with low back pain >12 months who are eligible for Treatment-Based Classification (TBC) stabilization (...) stress accumulation because the strategies are used repetitively. Thirdly, there is exercise prescription that includes practice in performing modified versions of the direction-specific impairment tests from the physical exam, with an emphasis on impairments that can be modified to eliminate LBP symptoms. Other Names: Specific exercise Sarhmann exercise approach MSI exercises Active Comparator: 'Ineligible' Subject Group -MSI Subjects between the ages of 21-55 years with low back pain >12 months who

2011 Clinical Trials

11. AIM Clinical Appropriateness Guidelines for Sleep Disorder Management

(persistent hypertension in a patient taking three or more antihypertensive medications). Because of daytime sleepiness, deaths related to motor vehicle accidents are also more common in patients with OSA. Diagnosis of OSA: Although OSA may be suspected based on the symptoms described above, physical exam findings (e.g., obesity, increased neck circumference, retrognathia etc.), or presence of comorbidities, the diagnosis must be confirmed by a sleep test. During sleep testing, various physiological (...) candidates. In the management of patients with OSA, long-term compliance with positive airway pressure devices remains problematic. Adherence to therapy is defined by the Centers for Medicare & Medicaid Services (CMS) as use of P AP for greater than or equal to 4 hours per night on 70% of nights during a consecutive thirty (30) day period. Compliance may be as low as 50% at one year and for this reason compliance monitoring is an important component of the management of patients with OSA. Every effort

2019 AIM Specialty Health

12. The SNMMI and EANM Practice Guideline for Renal Scintigraphy in Adults

clinically.. 204 f. Patient Positioning: supine position; be careful to reduce motion. In patients who cannot lie 205 flat it is possible to perform the exam seated with the back on gamma-camera detector. 206 g. Technical Parameters: Dynamic image acquisition 207 h. Collimator: Low Energy – High resolution or General purpose, according to availability 208 i. Minimum Matrix: 64x64 or 128 x128 pixel 209 j. Views: Posterior. Anterior views must be acquired in the presence of horseshoe or ectopic 210 kidney (...) , yields very low-quality images with a high radiation dose and is 153 no longer used. 154 99m-Tc-MAG3 (Fritzberg AR, et al, 1986), is similar to OIH (Russell, 1999), although it has very 155 little glomerular filtration due to its high plasma protein binding, resulting in a lower extraction 156 fraction. (Muller-Suur, 1989). 99m-Tc-MAG3 is currently the most frequently used renal tubular 157 agent in nuclear medicine practice. Since its excretion is directly related to proximal tubular 158 function

2019 Society of Nuclear Medicine and Molecular Imaging

13. Paediatric Urology

therapy with LHRH and HCG in cryptorchid infants. Eur J Pediatr, 1993. 152 Suppl 2: S31. 66. Forest, M.G., et al. Effects of human chorionic gonadotropin, androgens, adrenocorticotropin hormone, dexamethasone and hyperprolactinemia on plasma sex steroid-binding protein. Ann N Y Acad Sci, 1988. 538: 214. 67. Aycan, Z., et al. Evaluation of low-dose hCG treatment for cryptorchidism. Turk J Pediatr, 2006. 48: 228. 68. Hesse, V., et al. Three injections of human chorionic gonadotropin are as effective (...) , 1960. 83: 686. 79. Kozminski, D.J., et al. Orchiopexy without Transparenchymal Fixation Suturing: A 29-Year Experience. J Urol, 2015. 194: 1743. 80. Martin, J.M., et al. Is radiotherapy a good adjuvant strategy for men with a history of cryptorchism and stage I seminoma? Int J Radiat Oncol Biol Phys, 2010. 76: 65. 81. Na, S.W., et al. Single scrotal incision orchiopexy for children with palpable low-lying undescended testis: early outcome of a prospective randomized controlled study. Korean J Urol

2019 European Association of Urology

14. ACR–ASNR–SPR Practice Parameter for the Performance of Computed Tomography (CT) Perfusion in Neuroradiologic Imaging Revised

of patients undergoing neuroradiologic exams, including airway management, the use of sedative agents and contrast media, the recognition and management of adverse effects, and cardiopulmonary resuscitation. He or she should be certified by the appropriate registry and have an unrestricted state license. IV. SPECIFICATIONS OF THE EXAMINATION A. Written Request for the Examination The written or electronic request for CT perfusion should provide sufficient information to demonstrate the medical necessity (...) can also be injected through an existing IV access provided it has the required caliber and specifications. In select patients without peripheral IV access, contrast may be administered through an existing central venous line (CVL) catheter under the supervision of a physician following a strict protocol [62]. In children, depending on their age and size, a smaller cannula may be necessary. The patient should lie on the scanner table in supine position with his or her head in a head holder

2019 American Society of Neuroradiology

15. Surveillance of healthcare-associated infections and prevention indicators in European intensive care units: HAI-Net ICU protocol, version 2.2

controlled and/or corrected at least twice a day ? oral decontamination using oral antiseptics at least twice a day. The percentage of correct cuff pressure and oral decontamination records is collected by 30 consecutive reviews of the files of intubated patients (each patient is observed once per day, the same patient is observed for several consecutive days) during the evaluation period ? position of the patient not supine (direct observation). ? Prevention of central line associated bloodstream (...) include registered nurses involved in bedside patient care. Students are not included. A ‘registered nurse’ is a nurse who has graduated from a college’s nursing program or from a school of nursing and has passed a national licensing exam to obtain a nursing license. Also include ‘agency nurses’, ‘bank nurses’, ‘interim nurses’ or other registered nurses who are not permanently employed for that position in the hospital. Total number of nursing assistant hours in ICU over seven day period: total

2017 European Centre for Disease Prevention and Control - Technical Guidance

16. CRACKCast E171 – Pediatric Cardiac Disorders

the amount of blood returning to the right side of the heart The systemic blood shunts across the VSD leading to further hypoxia Management: Increase the SVR, To abolish the hyperpnea, To correct the metabolic acidosis Increase the SVR to push blood back towards the right ventricle Knee to chest position Ketamine Phenylephrine Decrease the PVR to promote forward flow to the lungs Supplemental O2 Calm the child Relax the structures around the pulmonary outflow tract Morphine/Fentanyl BB (esmolol (...) ) ● HR < 180 (children) ● Variable beat-to-beat ● HR changes with activity Mgmt ● See next question! Treat the underlying cause Trial of analgesia, fluids and antiemetics [10] Describe the management of SVT in the infant/child. Unstable (poor perfusion, AMS, long cap refill, pallor, cyanosis, hypotension) CARDIOVERSION! 5 – 1 J/kg; if no success then increase to 2 J/kg Stable Vagal attempts Vagal maneuvers (eg, a bag containing a slurry of crushed ice and water to the face, digital rectal exam

2018 CandiEM

17. Shoulder Conditions Diagnosis and Treatment Guideline

14 A. History and clinical exam 14 B. Diagnostic imaging 15 V. Treatment 15 A. Conservative treatment 15 B. Surgical treatment 16 VI. Specific Conditions 16 A. Rotator cuff tears 16 As industrial injury: 17 As occupational disease: 17 Diagnosis and treatment 17 Revision rotator cuff repairs 18 Irreparable Rotator Cuff Tears 18 B. Subacromial impingement syndrome without a rotator cuff tear 19 Diagnosis and treatment 19 C. Calcific tendonitis 20 Diagnosis and Treatment 20 Washington State (...) Subjective Objective Imaging Non-operative care Tenodesis or tenotomy of long head of biceps Partial biceps tear, biceps instability from the biceps groove, proximal biceps enlargement that inhibits gliding in the biceps groove, complete tear of the proximal biceps tendon Anterior shoulder pain, weakness and deformity Tenderness over the biceps groove, pain in the anterior shoulder during resisted supination of the forearm Partial thickness tears do not have the classical appearance of ruptured muscle

2018 Washington State Department of Labor and Industries

18. CRACKCast E176 – Pediatric Musculoskeletal Disorders

fracture? See the orthobullets notes here – [29] List seven red flags for pediatric back pain. You need to think broadly From Uptodate: MSK Nonspecific – idiopathic low back pain spondylolysis and spondylolisthesis; scoliosis; Scheuermann’s (juvenile) kyphosis; and intervertebral disc degeneration, herniation, or calcification Infectious discitis, vertebral osteomyelitis (including tuberculous), epidural abscess, and bacterial infection of the sacroiliac joint. Non Spinal infections that can present (...) ulna fractures are rare in children; therefore, with all such fractures, a dislocation of the radial head should be excluded “Ulna bow sign” – make sure that the radial head transects the capitellum on all views! Require ortho – ORIF or CRIF Toddler’s fracture oblique nondisplaced fractures of the distal tibia caused by low-energy torsional forces applied to the porous bone of infants and young children. The peak incidence is between 1 to 3 years of age but it can occur in children as old as 6

2018 CandiEM

19. Standards for obstetrical ultrasound assessments

sex? Repeat exams for the sole purpose of determining fetal sex should not be scheduled? Appendix 10 ? ? Umbilical Artery Doppler: ? Is not a minimum assessment requirement and is only done when clinically indicated? ? As per SOGC guidelines (Fetal Health Surveillance: antepartum and intrapartum Consensus Guideline #197 – Sept 2007 – Appendix 12), umbilical artery Doppler: ? ? should not be done in low risk pregnancies as it has not been shown to be of value in this group of women. ? ? can (...) British Columbia, which included cohorts at risk for growth restriction and macrosomia as well as a low risk “normal” cohort? The analysis showed that adopting the Intergrowth standard would lead to a significant decrease in the frequency of small-for-gestational age diagnoses and a substantial increase in large-for-gestational age diagnoses? The Working Group found this concerning, especially since the under identification of small fetuses has the potential for increasing mortality and serious

2016 CPG Infobase

20. CRACKCast E093 – Appendicitis

(<8 mg/L) in patients deemed to be low risk for appendicitis, based on the provider’s clinical assessment, to exclude appendicitis. Alternatively, we do not believe that there are sufficient data to establish the diagnosis of appendicitis conclusively based on the combination of elevated WBC and CRP levels; rather, these should only assist in the decision making process regarding the need for imaging.” Only useful for those low-risk patients who can have serial exams, and watchful waiting. 6 (...) appendicitis is always found! “In fact, only 40% of patients have the base of their appendix within 3m of McBurney’s point, with 36% of patients having the base more than 5m away.” – These patients can present with pain in the LLQ or the Right flank or in the back (if retrocecal!). Causes: Fecaliths (hard stools) (65%), Appendicoliths (calcified deposits) lymphoid hyperplasia (primary or secondary to an enteric infection). foreign bodies (eg, vegetable matter, inspissated barium), tumors, intestinal

2017 CandiEM

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