Anatomy

Question 1

Normal ROM in the spine

Answer 1

O/A - f/e 10-15, Lat flex 8, minimal rotation
A/A - f/e 10, rot 45, no Lat flex
C3-C7 - flex 64, ext 24, Lat flex 40, rot 40
T1-S1 - flex 80, ext 25, Lat flex 35, rot 45

Question 2

What innervated the disk?

Answer 2

Recurrent Sinu-vertebral nerve
Gray ramus communicans from the sympathetic chain.

It is innervated to the 2nd or 3rd annular lamella

Question 3

Fryette’s law of spine biomechanics

Answer 3

C-spine : SB and Rot occur to same side

T/L spine neutral - SB / rot occur to the opposite side

T/L spine in flex - SB / Rot occur to the same side

Question 4

Articular Receptors in the spine

Answer 4

Type I - postural
Type II - dynamic receptors
Type III - inhibitory (facet capsules)
Type IV - nociceptive

Question 5

What innervated the facet?

Answer 5

Triple innervation (level above and below and same)

Posterior primary ramus (skin and muscles too)

Recurrent nerve sinu-vertebral - innervated the anterior portion along with the ligamentum flava a which is the anterior facet joint capsule

Question 6

Describe the articulate cartilage of the SIJ

Answer 6

Sacral- hyaline

Iliac - fibrocartilage

Question 7

What is the innervation of the SIJ?

Answer 7

Posterior- posterior primary rami of L4-S3

Anterior - L2-S2

Question 8

Tibial nerve

Answer 8

L4-S3

Medial HS, adductor Magnus, posterior company of leg, intrinsics of foot

Question 9

Fibular nerve

Answer 9

L4-S2

Lateral HS, lateral compartment of leg, EDB of foot

Question 10

Pudendal

Answer 10

S2-S4

External urethral and anal sphincters, levator and, skin of the perineum, penis, clitoris

Question 11

Superior gluteal

Answer 11

L4 - S1

Glute Med, glute min, TFL

Question 12

Inferior gluteal nerve

Answer 12

L5-S2

Gluteus maximums

Question 13

Nerve to overrate internus and superior gemellus

Answer 13

L5-S2

Obturator internus, superior gemellus

Question 14

Nerve to quadratus femoris and inf gemellus

Answer 14

L4-S1

Quadratus femoris and inferior gemellus

Question 15

Posterior femoral cutaneous nerve

Answer 15

S1-S3

Skin on posterior thigh

Question 16

Nerve to piriformis

Answer 16

S1-S3

Piriformis

Question 17

Nerves to levator ani, coccygeus, external anal sphincter

Answer 17

S4

Skin between anus and coccyx

Question 18

Anococcygeal nerves

Answer 18

S4-CO?

Perianal skin

Question 19

What major vessels bifurcate anterior to the SIJ and what is it significance in diff dx?

Answer 19

Common iliac artery - internal/external iliac arteries

Gluteals receive blood from the internal and if occlusion is present it will cause ischemic pain in the glutes- mimicking SI pain