Lordosis Flashcards
When in the physical exam would you discover abnormal lumbar lordosis?
part of screening exam; symmetry/asymmetry
mid-gravity line
spinal curve assessment
What somatic dysfunction can increase lordosis?
cervical extended segments thoracic flexed segments lumbar extended segments anterior innominate rotation sacral flexed dysfunctions
How would you measure the lateral mid-gravity line?
extend from mid-body of L3 and should fall at front of sacral promontory
What is a normal Fergusen Angle?
30-40 degrees
What is a normal Mitchell angle?
125 to 145 degrees
How do you measure a Mitchell angle?
line through mid-body l4/L5 and line through mid-body of S1/S2
How do you measure a Fergusen angle?
horizontal line and line on top of sacral promontory
What is Baastrup?
kissing spines
How could you measure a Cobb angle for a lumbosacral lordotic angle?
line at superior endplate of L2 and line at superior endplate of S1
What is a normal Cobb angle when L2 and S1 endplates are used?
40 to 60 degrees
What is the normal Cobb angle when L2 and L5 endplates are used?
35 to 55 degrees
How is the Jungman’s pelvic index computed?
PI = x/y x= front of pubic bone to y y= front of sacral promontory to line x
What is the normal ratio at 20? 50?
20 = 0.55 50 = 0.65
At what Junman’s PI does chronic LBP occur?
0.65-0.75
Increased lumbar lordosis can increase weight bearing on ?
facets causing facet joint pain
Increased lumbar lordosis causes narrowing of?
intervertebral formina with neural entrapment
Approximation of spinous processes
Baastrup
Define visceroptosis.
descent of the viscera from the normal position
What can result from visceroptosis?
visceral ischemia syndrome
What are symptoms of visceral ischemia syndrome?
postprandial pain
anorexia
weight loss
diarrhea
What physical findings are present in visceral ischemia syndrome?
occasionally occult fecal blood
short systolic bruit in epigastrium
Poor posture is the result of which weak muscles?
rectus abdominus
abdominal oblique
shortening of psoas
What is spondylolisthesis?
slipping of vertebra on vertebra below; can result in lordosis
In coxa vera, the femoral shaft neck angle is below what degree?
< 120 degrees
Etiologies that cause fibrosis of a muscle producing permanent shortening.
Etiologies of Muscle contracture: congenital muscle disease prolonged ischemia inflammatory myositis
What does a Thomas test show?
shortened psoas, iliacus, rectus femoris
What can cause exostoses?
larger erector spinae, gluteal and thigh muscles, yoga participants
What causes Rickets?
Vit D deficiency; wedged vertebrae
What causes cretinism?
neonatal hypothyroidism
What causes Stiffman syndrome?
onset caused by sudden movement, jarring, noise or emotional upset
How does Stiffman syndrome present?
hypertonicity and rigidity of paravertebral muscles
What testing would identify Stiffman syndrome?
Abnormal EMG; normal motor and sensory exam
How would you treat Stiffman Syndrome?
Diasepam (valium) 20 - 300 mg per day; lumbar flexion exercises; rom exercises. OMT: soft tissue, ME/HVLA
What’s a consequence of decreased lordosis?
- increased weight bearing load on discs
- increased risk of disc herniation
What are the etiologies of decreased lordosis?
lumbar strain and sprain acute lumbar disc herniation lumbar spondylosis ankylosing spondylitis psoas contracture
How would you treat flat back syndrome?
heel lifts bilaterally
lumbar extension exercises
What is a common association with flat back syndrome?
mitral valve prolapse
mycobacterium avium complex
What are kissing spines called in the cervical region?
Michotte syndrome
What are common etiologies of cervical lordosis?
increased thoracic kyphosis
osteoporosis
poor posture
ill fitting glasses
What are the etiologies of decreased cervical lordosis?
cervical sprain & strain
cervical disc herniation
cervical spondylosis
flat back syndrome
Which abnormal lordosis are irreversible?
ankylosing spondylitis
osteoporosis
