Lordosis

Question 1

When in the physical exam would you discover abnormal lumbar lordosis?

Answer 1

part of screening exam; symmetry/asymmetry
mid-gravity line
spinal curve assessment

Question 2

What somatic dysfunction can increase lordosis?

Answer 2

cervical extended segments
thoracic flexed segments
lumbar extended segments
anterior innominate rotation
sacral flexed dysfunctions

Question 3

How would you measure the lateral mid-gravity line?

Answer 3

extend from mid-body of L3 and should fall at front of sacral promontory

Question 4

What is a normal Fergusen Angle?

Answer 4

30-40 degrees

Question 5

What is a normal Mitchell angle?

Answer 5

125 to 145 degrees

Question 6

How do you measure a Mitchell angle?

Answer 6

line through mid-body l4/L5 and line through mid-body of S1/S2

Question 7

How do you measure a Fergusen angle?

Answer 7

horizontal line and line on top of sacral promontory

Question 8

What is Baastrup?

Answer 8

kissing spines

Question 9

How could you measure a Cobb angle for a lumbosacral lordotic angle?

Answer 9

line at superior endplate of L2 and line at superior endplate of S1

Question 10

What is a normal Cobb angle when L2 and S1 endplates are used?

Answer 10

40 to 60 degrees

Question 11

What is the normal Cobb angle when L2 and L5 endplates are used?

Answer 11

35 to 55 degrees

Question 12

How is the Jungman’s pelvic index computed?

Answer 12

PI = x/y
x= front of pubic bone to y
y= front of sacral promontory to line x

Question 13

What is the normal ratio at 20? 50?

Answer 13

20 = 0.55
50 = 0.65

Question 14

At what Junman’s PI does chronic LBP occur?

Answer 14

0.65-0.75

Question 15

Increased lumbar lordosis can increase weight bearing on ?

Answer 15

facets causing facet joint pain

Question 16

Increased lumbar lordosis causes narrowing of?

Answer 16

intervertebral formina with neural entrapment

Question 17

Approximation of spinous processes

Answer 17

Baastrup

Question 18

Define visceroptosis.

Answer 18

descent of the viscera from the normal position

Question 19

What can result from visceroptosis?

Answer 19

visceral ischemia syndrome

Question 20

What are symptoms of visceral ischemia syndrome?

Answer 20

postprandial pain
anorexia
weight loss
diarrhea

Question 21

What physical findings are present in visceral ischemia syndrome?

Answer 21

occasionally occult fecal blood

short systolic bruit in epigastrium

Question 22

Poor posture is the result of which weak muscles?

Answer 22

rectus abdominus
abdominal oblique
shortening of psoas

Question 23

What is spondylolisthesis?

Answer 23

slipping of vertebra on vertebra below; can result in lordosis

Question 24

In coxa vera, the femoral shaft neck angle is below what degree?

Answer 24

< 120 degrees

Question 25

Etiologies that cause fibrosis of a muscle producing permanent shortening.

Answer 25

``` Etiologies of Muscle contracture: congenital muscle disease prolonged ischemia inflammatory myositis ```

Question 26

What does a Thomas test show?

Answer 26

shortened psoas, iliacus, rectus femoris

Question 27

What can cause exostoses?

Answer 27

larger erector spinae, gluteal and thigh muscles, yoga participants

Question 28

What causes Rickets?

Answer 28

Vit D deficiency; wedged vertebrae

Question 29

What causes cretinism?

Answer 29

neonatal hypothyroidism

Question 30

What causes Stiffman syndrome?

Answer 30

onset caused by sudden movement, jarring, noise or emotional upset

Question 31

How does Stiffman syndrome present?

Answer 31

hypertonicity and rigidity of paravertebral muscles

Question 32

What testing would identify Stiffman syndrome?

Answer 32

Abnormal EMG; normal motor and sensory exam

Question 33

How would you treat Stiffman Syndrome?

Answer 33

Diasepam (valium) 20 - 300 mg per day; lumbar flexion exercises; rom exercises. OMT: soft tissue, ME/HVLA

Question 34

What's a consequence of decreased lordosis?

Answer 34

- increased weight bearing load on discs | - increased risk of disc herniation

Question 35

What are the etiologies of decreased lordosis?

Answer 35

``` lumbar strain and sprain acute lumbar disc herniation lumbar spondylosis ankylosing spondylitis psoas contracture ```

Question 36

How would you treat flat back syndrome?

Answer 36

heel lifts bilaterally | lumbar extension exercises

Question 37

What is a common association with flat back syndrome?

Answer 37

mitral valve prolapse | mycobacterium avium complex

Question 38

What are kissing spines called in the cervical region?

Answer 38

Michotte syndrome

Question 39

What are common etiologies of cervical lordosis?

Answer 39

increased thoracic kyphosis osteoporosis poor posture ill fitting glasses

Question 40

What are the etiologies of decreased cervical lordosis?

Answer 40

cervical sprain & strain cervical disc herniation cervical spondylosis flat back syndrome

Question 41

Which abnormal lordosis are irreversible?

Answer 41

ankylosing spondylitis | osteoporosis