Back and Pelvis Flashcards
increased anterior convexity in the curvature of the spine
lordosis
exaggeration of posterior convexity of the thoracic vertebral column found commonly with OA and osteoporosis.
kyphosis
lateral curve of the spine usually right convex thoracic, most of, which are idiopathic
scoliosis
Anterior slip, bilateral pars defect, congenital usually L5 on S1, degenerative L4 on L5 - palpable step off with or without neurological symptoms
spondlolisthesis
narrowing of the spinal canal or neural foramen producing root ischemia or neurogenic claudication.
spinal stenosis
stress fracture of pars interarticularis. indicated by prominence of L4/L5
spondylolysis
Indicates hip joint pathology
decreased IR/ER or reproduction of pain
Largest and strongest vertebra
lumbar
Where do the muscles of the spine attach?
spinous and transverse processes
What part of the disk does the herniated disk fragment come from?
nucleus pulposus
Most common area of disk herniation that causes lateral and posterior thigh and leg pain (sciatica)
L5-S1
Special test that is almost always positive when a patient has a herniated disk in lower levels of spine
straight-leg raise
When do you consider surgery for herniated disks?
cauda equina syndrome or profound motor/neuro deficits
exacerbated by standing erect and downhill ambulation and is alleviated with lying supine and forward flexion
neural claudication
exacerbated with biking, uphill ambulation, and lumbar flexion and is not alleviated with standing
vascular claudication
Physcial exam finding of spinal stenosis
pain with extension that is relieved with flexion
What is the surgical procedure for spinal stenosis?
laminectomy
Mechanism is usually trauma, spinal cord injury, compression of sacral nerve roots. *Urinary retention with neurogenic bladder. Is an emergency
cauda equina syndrome
Joints affected by ankylosing spondylitis
sacroiliac and spinal facet joints
Formation of bony bridges between adjacent vertebrae, and progressive ossification of extraspinal joint capsules and ligaments. This tissue replaces the disk fibers with new bone.
ankylosing spondylitis
Most common presenting symptom of ankylosing spondylitis
low back pain
Mainstay of treatment for ankylosing spondylitis
lifelong exercise program
Complication of severe compression fracture
burst fracture
Hallmark symptom of lumbar compression fractures
midline back pain
What causes the kyphosis associated with vertebral compression fractures?
wedge shape of fracture
At what degree of curvation should you consider bracing a scoliotic patient?
20-40 degrees
A measure of the resulting scoliosis angle based on radiographs
Cobb’s angle
What muscle test assesses muscle strength of L1-L3 and depends on iliopsoas?
hip flexion
Describe the location to check for sensory nerve distribution of L1-L3
between inguinal ligament and above patellae
What muscle test assesses L4 neurogenic level and is accomplished through the anterior tibialis muscle?
dorsiflexion of ankle
What muscle test assesses L5 neurogenic level and is accomplished through the extensor hallucus longus?
great toe extension
What neurogenic sensory area does L5 cover?
lateral leg and dorsum of foot
What neurogenic sensory area does L4 cover?
medial foot and leg
What neurogenic sensory area does S1 cover?
lateral foot
What muscle test assesses S1 neurogenic level and is accomplished by the peroneus longus and brevis?
ankle eversion
