Lecture 2.3

Question 1

High loads are espeically present in the ______ spine

Answer 1

lumbar

Question 2

the movements that are allowed in the psine are guided by _____ orientation

Answer 2

facet orientation

Question 3

movements of the back are influenced by:

Answer 3

1) Thickness of vertebral discs - enhance movement
2) orientation of articular facets - limit movement to ertain directions

Question 4

Thoracic - permit rotation in _____ ___

Answer 4

coronal plane

Question 5

Lumbosacral - LIMIT movement in ______ plane

Answer 5

sagittal plane

Question 6

lumbar - permit flexion/extension in ____ plane

Answer 6

sagittal

Question 7

Flexion of back caues the nucleus of IV disc to project ________

Answer 7

posteriorly

Question 8

what movement places a great deal of stress on the facet joints?

Answer 8

hyperextension

Question 9

There is a small degree of Lateral flexion in the _____ spine, but limited by ribs.

Most LF occurs in ____ spine

Answer 9

There is a small degree of Lateral flexion in the thoracic spine, but limited by ribs.

Most LF occurs in lumbar spine

Question 10

Erector spina muscles are ___ ____

they are responsible for contrentrically returning the ____trunk to the upright (_______) posture

they also work __________in controlling flexion

They are _______ “quiet” in full fleion - this why you lift with ____ knees

Answer 10

Erector spina muscles are prime movers

They are responsible for contrentrically returning the flexed trunk to the upright (extended) posture

they also work eccentrically in controlling flexion

They are electrically “quiet” in full fleion - this why you lift with bend knees

Question 11

Transversospinalis are ___ to erector spinae

they run between the _______process and the _______ process

they are short - hence they are ________

Answer 11

Transversospinalis are deep to erector spinae

they run between the transverse process and the spibous process

they are short - hence they are stabilisers

Question 12

transversospinalis act together with deep abdominal muscles to form a “corset” around truck connecting via ______ _____

Answer 12

transversospinalis act together with deep abdominal muscles to form a “corset” around truck connecting via lumbar fascia

Question 13

Low back pain can be dvided into two main types:

Answer 13

1 ) mechanicl type pain - Muscle strains, disc prolapse

2) compressive type pain - typically a nerve root

Question 14

What are he conditions for inducing a disc prolapse?

Answer 14

1. 15 degree lumbar fleion - forces nucles posteriorly
2. 15 degree rotation - max torsion in annulus
3. light LF forces nucleus postero-laterally
4. Be fat or overweight
5. contract trunk muscles
6. keep lower limbs fully extended
7. pick up heavy object near opposite foot

Question 15

The 3 types of disc prolapse are:

Answer 15

Bulge

herniation - posterolaterally

Extrusion

Question 16

posterior rami innervate:

Answer 16

• facet joints
• deep back muscles
• overlying skin

Question 17

There is a dics prolapse between L4/5, which nerve root will be spared and why?

Answer 17

L4 - Its already emerged and pass, via the intravertebral foramen, to the exterior

Question 18

L5/S1 Disc prolapse - affects ___ nerve root

How is pain, movement & signs expressed?

Answer 18

S1

Pain - over hip, postero-lateral thigh, partial sensory loss in s1 dermatome

movement - restricted and painful - weakened plantar flexion (S1 myotome)

signs - limited straight leg raise, diminsed sensation

Question 19

What nerve roots supply the diaphragm /

Answer 19

3,4,5 - keeps the diaphragm alive

Question 20

What is spondylosis, osteophytes and stenosis?

Answer 20

With aging bones tend to lose water and become less dense

may cause overgrowth of bone producing bony spurs (osteophytes that can extend into the foramina, narrowing then (stenosis) and compressing exiting nerve roots

Question 21

Compression fractures are often associated with ________

Answer 21

Compression fractures are often associated with osteoporosis

Question 22

What is Ankylosing spondylitis?

Answer 22

Affects spine, joints of pelvis ultimately leading to fusion (ankylosis)

Question 23

Non-mechanical low back pain sign?

Injury

type of Pain

Onset

Aggravation

relief from…

Other features

Answer 23

Injury - none

type of pain - deep aching, continuous, unrelenting

Onset - insidious (awaiting a chance to entrap : treacherous.)

Aggravation - lifting, movement

relief from - analgesia

Other features -fatigue, recent weight loss, urinary symptoms

Question 24

What could be some systemic causes to back pain?

Answer 24

aortic aneurism, metastasis of cancer cells to back

Question 25

Fascia layers create spaces, ____, __, ____can spread throughout

Answer 25

Fascia layers create spaces, infection, puss, blood can spread throughout