DSA: Thoracic and Lumbar Vertebral Mechanics

Question 1

For T1-T3, spinous processes are located at the ______?

Answer 1

Corresponding Transverse Processes

Question 2

For T4-T6, spinous processes are located at ______?

Answer 2

Half a segment BELOW corresponding transverse process

Question 3

For T7-T9, spinous processes are located at ______?

Answer 3

Full segment BELOW corresponding transverse process

Question 4

For T10, spinous process is located at ______?

Answer 4

Full segment BELOW corresponding transverse process

Question 5

For T11, spinous process is located at ______?

Answer 5

Half a segment BELOW corresponding transverse process

Question 6

For T12, spinous process is located at ______?

Answer 6

Corresponding Transverse Processes

Question 7

What is the superior facet orientation for cervical vertebrae?

Answer 7

Backwards, Upwards, Medial

Question 8

What is the superior facet orientation for thoracic vertebrae?

Answer 8

Backwards, Upwards, Lateral

Question 9

What is the superior facet orientation for lumbar vertebrae?

Answer 9

Backwards, Medial

Question 10

What is the role of the anterior longitudinal ligament?

Answer 10

Limits extension

Question 11

What is the role of the posterior longitudinal ligament?

Answer 11

Resists hyperflexion and prevents posterior herniation of nucleus pulposus

Question 12

What is the role of the ligamentum flava?

Answer 12

Connect laminae of adjacent vertebra

Question 13

What is the role of the interspinous ligament?

Answer 13

Connect adjoining spinous process

Question 14

What is the role of the intertransverse ligament?

Answer 14

Connects adjoining transverse processes

Question 15

What is the role of the tranversospinalis muscles?

Answer 15

Extends spine

Question 16

What is excessive motion?

Give an example.

Answer 16

Excessive restriction to vertebrate above functional vertebral unit.
Ex: Excess motion of L2 is motion of L2 on L3.

Question 17

Who described the physiologic motion of the spine?

Answer 17

Harrison Fryette

Question 18

Describe Type 1 spinal mechanics.

Answer 18

TONGO:
Type 
One
Neutral range
Group of vertebra
Opposite direction for rotation and sidebending

Question 19

Describe Type 2 spinal mechanics.

Answer 19

Flexion or Extension
Single Vertebra
Same direction

Question 20

Describe Fryette’s third principle.

Answer 20

Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion.

*If motion is restricted/improved in one direction, it will also be restricted/improved in other directions.

Question 21

If you push anteriorly on the right transverse process, what direction will the vertebra rotate?

Answer 21

Rotated Left

Question 22

If you can easily translate the transverse process to the right, what direction is the vertebra sidebent?

Answer 22

Sidebent Left

Question 23

For scoliosis, when would you use conservative treatment?

Answer 23

<25 deg

Question 24

For scoliosis, when would you use bracing as a treatment?

Answer 24

25-45 deg

Question 25

For scoliosis, when would you use surgical treatment?

Answer 25

> 50 deg

Question 26

If a patient has scoliosis with a Cobb angle of greater than 50 degrees, what complications can the patient expect?

Answer 26

Respiratory compromise

Question 27

If a patient has scoliosis with a Cobb angle of greater than 75 degrees, what complications can the patient expect?

Answer 27

Cardiac compromise

Question 28

What is radiculopathy?

Answer 28

Pain with dermatomal distribution that can impair neurological function

Question 29

What test will be for radiculopathy?

Answer 29

Straight Leg Raise Test

Question 30

What is spinal stenosis?

Answer 30

Narrowing of spinal cord in cervical or lumbar portion of spine

Question 31

What are some key symptoms of cauda equina syndrome that require immediate work-up?

Answer 31

Saddle anesthesia
Lower extremity weakness
Diminished reflexes
Urinary retention