Ch.40 LBP

Question 1

Lumbar vertebra get larger as you travel __.

Answer 1

Caudally

Question 2

The lower 3 vertebra are more ___ shaped anteriorly allowing __.

Answer 2

Wedge; normal lumbar lordosis

Question 3

What are pedicles designed to do?

Answer 3

Resist bending & transmit forces back & forth to posterior elements

Question 4

What structures create the zygapophyseal joints?

Answer 4

Superior & inferior articular processes

Question 5

What is the pars interarticularis?

Answer 5

Part of lamina b/w superior & inferior articular processes subject to fx from bending forces

Question 6

What is the primary shock absorber in the intervertebral disc?

Answer 6

Annulus fibrosus

Question 7

At what joints do the majority of spinal flex/ext occur?

Answer 7

L4-5 & L5-S1 contributing to high incidence of disc problems

Question 8

What is the MC direction of disc herniation?

Answer 8

posterior lateral d/t thing lateral fibers of posterior longitudinal ligament

Question 9

What does the anterior longitudinal ligament resist?

Answer 9

Ext, translation & rotation

Question 10

What does the posterior longitudinal ligament resist?

Answer 10

Flexion

Question 11

Which direction causes disruption of longitudinal ligaments?

Answer 11

Rotation

Question 12

Which ligament is pierced when performing lumbar punctures?

Answer 12

Ligamentum flavum

Question 13

What are the erector spinae muscles?

Answer 13

Iliocostalis, longissiumus, spinalis

Question 14

What do multifidi do?

Answer 14

Segmental stabilizers, control lumbar flexion & provide spine proprioception

Question 15

What does the quadratus lumborum do?

Answer 15

Side bending & flexion of lumbar spine

Question 16

How can the psoas cause back pain?

Answer 16

increase lorodosis & force on posterior elemens causing zygapophyseal pain

Question 17

What is an important abdominal muscle in tx LBP?

Answer 17

Transversus abdominis

Question 18

How does glut weakness cause LBP?

Answer 18

Pelvic instability causes lumbar SB & rotation inc torsional forces on discs

Question 19

What can a tight piriformis cause in the spine?

Answer 19

Inc shear forces at lumbosacral junction

Question 20

What dec the pressure on lumbar discs when lifting?

Answer 20

Keeping the load close to your body

Question 21

Where does the conus medullaris end?

Answer 21

L2

Question 22

What do the ventral primary rami innervate?

Answer 22

Limbs

Question 23

What do the dorsal primary rami intervate?

Answer 23

Posterior 1/2 of vertebra, paraspinal muscles & zygapophyseal joints

Question 24

What does the medial branch innervate?

Answer 24

zygapophyseal joints & lumbar multifidi

Question 25

What is substance P?

Answer 25

Neuropeptide known to modulate sensory nociceptive feedback

Question 26

What is the venous engorgment theory in spinal stenosis?

Answer 26

Spinal veins dilate, causing congestion & dec BF causing inc epidural/intrathecal pressures & neuroischemic insult l/t neuritis

Question 27

What is the aterial insufficiency theory of spinal stenosis pain?

Answer 27

Defective reflex spinal artery dilation during to lower limb exercise