Cervical/Lumbar (midterm) Flashcards
the ____ ____ refers to the low back and is made up of 5 vertebrae and their intervertebral disc spaces
lumbar spine
T/F L5 - S1 segment is the most common segmentfor problems in the vertebral column
true
the lumbar facet joints sit in the _____ plane
sagittal
______ is degeneration of the IVD
spondylosis
________ is a defect in the pars interarticularis (fracture between laminae and pedicles)
spondylolysis
______ is the forward displacement of one vertebrae over another
spondylolisthesis
T/F discs make up 25% of the total length of the vertebral column
true
______ is the term used to describe any change in the annulus shape causing protrusion beyond normal perimeter
herniation
______ is when the nucleus pulposus is only contained by the outer fibres of the annulus fibrosis and supporting ligaments
protrusion
______ is the rupture of the nuclear material into the vertebral canal
prolapse
_____ is the extension of nuclear material beyond the confines of the posterior longitudinal ligament, above or below the disc space
extrusion
______: the extruded nucleus separates from the disc and moves away from the prolapse area
sequestration
local pain can indicate which of the following impairments?
a) facet joint irritation
b) mm spasm
c) sciatica
d) trigger points
e) a&b
e) a&b
radiating pain can indicate which of the following impairments?
a) ligament sprain
b) nerve root irritation
c) visceral organs
d) systemic conditions
b) nerve root irritation
referred pain can indicate which of the following impairments?
a) facet irritation
b) piriformis syndrome
c) trigger points
c) trigger points
which special test would you conduct if you suspected a posterolateral disc herniation?
straight leg raise
which special test would you conduct if you suspected a posteromedial disc herniation?
well leg raise
which test would you conduct if you suspected lumbo sacral nerve irritation?
bowstring
which test would you conduct if you suspected a lesion/ irritation to the femoral nerve?
femoral/nachlas
if you suspected a disc herniation, space-occupying lesion, or an osteophyte which test would you conduct?
Valsalva
if you suspect a patient has intrathecal/ extrathecal pathology, which test would you run?
Milgrams
to check and see if a patient is “malingering” which test would you conduct?
Hoovers
A patient presents with altered sensation in the spine, particularly the dural sheath which test would you conduct?
slump
when testing for weakness in QL what would be a positive result?
a) inability to side bend
b) compensation in the opposite hip
c) the inability to maintain the position you have placed them into
b) compensation in the opposite hip
when testing for weakness in the lower abs, what would be a positive result?
inability to maintain a pelvic tilt during leg lowering
which of the following tests would be appropriate if you suspected facet joint irritation in the lumbar spine?
a) pheasant
b) milgrams
c) kemps
d) spurlings
c) kemps
which of the following tests would be appropriate if you suspected instability in the lumbar spine?
a) kemps
b) segmental instability test
c) pheasent
d) b&c
d) b&c
which test would you do if you suspect possible radiculopathy in the cervical spine?
a) spurlings
b) hoovers
c) kemps
d) nachlas
a) spurlings
active range of lumbar flexion is usually ______- ____ degrees
a) 30-40 degrees
b) 50-65
c) 40-60
c)40-60
active range of extension in the lumbar spine is usually ___-___ degrees
a) 20-30 degrees
b) 20-40 degrees
c) 20 - 35 degrees
c) 20-35 degrees
T/F extension will be the first thing tested
false
T/F the safest position for lumbar extension is the sphynx position
true
active range of side bending in the lumbar spine is normally _____-____ degrees
a)10-20
b) 15- 20
c) 20-30
b)15-20
T/F the safest position for testing side bending it high seated
true
active trunk rotation is usually _____- _____ degrees
a)10-20
b)0-40
c) 3-18
c) 3-18
rotation is primairly restricted due to ____ ____ orientation
facet joint
T/F when using overpressure in rotation it does not matter if the patient is pain free or not before applying it
false
when a patient experiences pain doing ipsilateral rotation it may indicate which of the following
a) injured/inflamed facet joint surfaces
b) iliosacral ligament or thoracolumbar fascia compression
c) shortened musculature that is irritated/ in spasm
d) all of the above
d) all of the above
resisted testing may be done in a high-seated position after ensuring the patient can hold a ____ ____ which is observed in postural assessment
neutral pelvis
a positive result for a straight leg raise test is
recreation of neuro signs down the back of the leg
the sciatic nerve (L___-S___) supplies nearly all of the skin of the back of the thigh and those of the legs and foot
L4-S3
the two later stages involved in the SLR are which two movements?
a) dorisflexion & forward flexion
b) plantarflexion & forward flexion
c) dorsiflexion & abduction
a) dorsiflexion and forward flexion
T/F if the patient cannot flex their neck at all and are exhibiting symptoms of a posterolateral disc herniation they may be suffering from meningitis
True
a positive result for a slump test is
reproduction of signs and symptoms that are relieved when the head is returned to a neutral posture
a positive result for the bowstring test would be
a reoccurrence of the original symptoms
T/F if the inflammation of the sciatic nerve is severe and chronic you may be able to feel the nerve
true
a positive result for the nachalas test would be
reproduction of pain or paresthesia over the L2, L3 or L4 dermatome , this indicates femoral nerve irritation
the feeling of paraesthesia recreated doing the nachlas test is also known as _______
formication
a positive result for the segmental instability test would be
pain when relaxed
T/F it is impossible to test QL in isolation
true
T/F it is impossible to test the 4 individual abdominal muscles separately but it is clinically important to isolate the upper and lower fibers of the abdominal group
true
________: areas of altered sensation corresponding to a specific nerve level
Dermatomes
Dermatomes can be tested by brushing the referral pattern areas, performing the brushing ______, simultaneously ______-______ times
bilaterally, 7-10
The dermatome associated with the oblique band on the upper anterior thigh, immediately below the inguinal ligament is
a) L2
b) S1
c) L1
d) L4
c) L1
the dermatome associated with the middle anterior thigh is
a) L3
b) S2
c) L5
d) L2
d) L2
the dermatome associated with the anterior thigh immediately proximal to the patella is
a) L4
b)L3
c)L2
d)S1
a) L3
the dermatome associated with the patella, medial thigh and medial aspect of the foot is
a) L4
b)L3
c) S2
d)S1
a) L4
the dermatome associated with the lateral leg and dorsum of the foot is
a) L4
b)L5
c) S1
d)S2
b)L5
the dermatome associated with the lateral malleolus and plantar aspect of the foot is
a) L5
b)S1
c)S2
d) L4
b)S1
the dermatome associated with the back of the leg and thigh is
a) S1
b)L5
c)S2
d)L3
c)S2
there are ____ cervical nerves, ___ thoracic nerves, _____ lumbar nerves and ____ sacral nerves
8, 12, 5, 5
dermatomes are mainly supplied by afferent nerve fibers from a single ______ root of a spinal nerve
dorsal
A ______ refers to a set of muscles innervated by a specific, single, spinal nerve
myotome
there are ____ spinal nerves, each vertebrae has a spinal nerve
31
the _____ cervical quadrant test tests for facet irritation in C0-C2
Upper
there are ____ cervical vertebrae consisting of ____ facet joints
7, 14
there are ____ cervical nerve roots in the C spine
8
the greatest amount of extension in the cervical spine occurs in C___& ____
C5 & C6
T/F C5/6 is the most commonly injured/degenerated level
true
the tvps are made up of 2 parts, _______ & _______
anterior & posterior
T/F cervical spinous process and transverse process present strictly for muscle attachment purposes
true
available movements at the atlanto occipital joint (C0-C1) includes _______,______ & ________
flexion, extension and lateral flexion
available movements at the atlantoaxial joint (C1-C2) include _____ _____ & _________
flexion, extension, and rotation
available movements in the intracervical region (C2-C7) includes _______, ________ , _______ & ______
flexion, extension, lateral flexion and rotation
the resting position of the cervical spine is…
midway between flexion and extension
the close-packed position of the cervical spine is full ______
extension
the cervical spines capsular pattern is ______ and _______ as well as _______
side flexion, rotation and extension
T/F radicular symptoms do not go down the arm for a C4 nerve root injury and above
true
_______ is prevalent amongst persons > 25 years of age where are _____ is prevalent amongst persons < 65 years of age
spondylosis, OA
which structures would you want to rule out if a patient is presenting with a cervical impairment?
a) TMJ
b) shoulder
c) T- spine
d) VBA
e) all of the above
e) all of the above
positive signs for the VBA test include:
a) dizziness
b) diplopia
c) dysphagia
d) dysarthria
e) all of the above
all of the above
T/F during active free ROM the stretch pain will be at the end range of the movement
true
name a compensatory movement the patient could do while testing cervical spine flexion
opening their mouth
while going through AFROM testing for flexion in the cervical spine, watch for _____ bulging of the SP of C2. This is indicative of forward subluxation of C2
posterior
a compensatory movement the patient could do while testing AFROM extension of the cervical spine would be
shoulder elevation
T/F side flexion is done in the sagittal plane
false, it is done in the frontal plane
a compensatory movement the patient could do while testing side flexion AFROM in the cervical spine is
moving the shoulder towards the ear
T/F PROM flexion almost always gets more range than AF/AROM
true
T/F overpressure is applied to every available movement during PROM
false, not extension
weakness without pain during active resisted testing suggests which of the following
a) nerve root problems
b) myotome issues
c) a&b
d) dermatome issues
c) a&b
which of the following will test for foraminal compression?
a) spurlings
b) cervical upper quadrant
c) tinels sign
d) chvostek’s sign
a) spurlings
which of the following will test for hyperexcitability of the facial nerves?
a) cervical upper quadrant
b) cervical lower quadrant
c) tinel’s sign
d) chvostek’s sign
d) chvostek’s
which of the following tests for possible cervical radiculopathy?
a) chvostek’s sign
b) cervical compression test
c) cervical upper quadrant
b) cervical compression test
a positive sign for the cervical compression test would be
a) a facial twitch
b) pain radiating into the arm/arms
c) dizziness
b) pain radiating into the arm/arms
the _________ test is designed to alleviate symptoms of radicular nature
distraction
a positive sign for the distraction test would be the pain being ______ when the head is distracted
relieved
the cervical upper quadrant test is designed to evaluate _____ _____ in C0-C2
facet irritation
the cervical lower quadrant test is designed to evaluate facet irritation C__ - C___
C2-C7
the Valsalva test is deigned to determine the effect of increased _____ on the spinal cord
pressure
a positive sign for the Valsalva test is
a) radicular pain in the arms
b) increased pain due to intrathecal pressure
c) dizziness
d) a&B
d) a&b
_______ sign tests for brachial plexus lesions
Tinel’s
a positive sign for Tinel’s sign is a _____ sensation in the distribution of a nerve on the ipsilateral side
tingling
a positive tinel’s sign means the lesion is anatomically _______ and some recovery is occuring
intact
a positive _______ sign is a twitch of the masseter muscle or the lateral lip
Chvostek’s
if there is severe weakness without pain this suggests a ________ problem
neurological
if there is weakness with pain, this suggests a moderate to severe ________ ________
muscle strain
the C5 dermatome referral pattern is the _____ ______
lateral shoulder
the C6 dermatome referral pattern is the ______ & ________ ______
thumb and index finger
the C7 dermatome referral pattern is the _____ ______
middle finger
the C8 dermatome referral pattern is the ________ and ____ ____
4th and little finger
the T1 dermatome referral pattern is the _____ _____
medial elbow
