chapter 4: lumbar spine

Question 1

lumbar spine nerve roots exit where

Answer 1

below the vertebral foraen

Question 2

iliolumbar ligament connects what and can refer pain where

Answer 2

connects L4-L5 TP with iliac crest

can refer pain to the groin area

Question 3

major movement for lumbar spine

Answer 3

flexion and extension

Question 4

lateral to medial back muscles

Answer 4

iliocostalis longisisumus spinalis

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Question 5

L5 sidebending to the right will create what axis

Answer 5

right oblique axis

L5 N SrRl will change sacrum to Right on right forward sacral torsion

Question 6

sacralization of L5

Answer 6

TP of L5 fuses with sacrum
loss of mobility of L5 jiont
early disc degen

Question 7

lumbarization of sacrum

Answer 7

S1 separated from scarum no looks like 6th lumbar vert

Question 8

psoas syndrome symptoms

Answer 8

spasm shortens psoas
sacral torsion toward side of sidebending
contralateral pelvic shift
contralateral piriformis muscle spasm (pseudosciatica)
hypertonic psoas
type 2 dysfunction of L1 or L2 (usually flexed and rotated to side of dysfunctional psoas)
contralateral pelvic shift
sacral torsion towards side
positive thomas test

Question 9

treat psoas syndrome

Answer 9

take care of L1 or L2 first

Question 10

spinal stenosis gets better with what

Answer 10

forward flexed positiotn

Question 11

mri change spinal stenosisis

Answer 11

degen change

calcifications

Question 12

where does spinal cord usualy terminate

Answer 12

L1 and L2

Question 13

most common anomaly in lumbar spine

Answer 13

facet (zygopophyseal) trophism

lumbar spine facet jionts are more closely aligned to coronal plane vs sagittal (back medial plane)

Question 14

motion of L5 and sacrum

sidebending of L5 will casuse sacral oblique axis to be engaged on ___ side

rotation of L5 wil cause sacrum to rotate toward ___ side

Answer 14

same

opposite

Question 15

ferguson’s angle

Answer 15

lumbosacral angle

formed from intersection of horizontal line and the line of inclination of sacrum

normal is 25-35

increased lordosis = increased angle = low back pain
decrased lordosis = decreased ferggy angle

Question 16

herniated nucleus pulposus cause

pain worsens with what

Answer 16

due to narrowing of the posteior longit ligament and a psoeteriolateral herniation of the intervertebral disc

98% btwn L4-L5 or L5-S1

flexion of lumbar spine = worse pain, bumbness or tingling and sharp pain

Question 17

organic causes psoas syndrome

Answer 17

SAMS UU

salpingitis
appendicitis
metastatic carcinoma of prostate
sigmoid colon dysfunction

ureteral calculi
ureter dysfunction

Question 18

tender point where for psoas syndrome

Answer 18

medial to ASIS

Question 19

treatment for psoas

Answer 19

ice

stretch if chronic

Question 20

spinal stenosis is worsened by what

Answer 20

extension

Question 21

spondylolisthesis grading

1
2
3
4

Answer 21

1 = 0-25%
2 = 25-50%
3 = 50-75%
4 = >75%

Question 22

spondylolysis defintinon

and how view it

Answer 22

defect of pars interarticularis without anterior displacement of verterbral body

oblique view will ID the fracture of pars interartricularis
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Question 23

spondylosis

Answer 23

degenerative change within intervertebral disc and ankylosing of adjacent vertebral bodies

Question 24

sondylolisthesis with what x rays

spondylolysis with what x rays

Answer 24

lateral

oblique

Question 25

cauda equina syndrome compression of which nerve roots

Answer 25

below L2

Question 26

signs and symptoms of cauda equina syndrome

Answer 26

saddle anesthesia, decrased DTR, decreased rectal sphincter tone, loss of bowel and bladder control