Lumbar - Lecture

Question 1

It is important to inspect for what type of skin markings when dealing with the lumbar spine?

Answer 1

Lipomatas
Hairy Patches
Café-Au-Lait spots
Birth Marks

Question 2

What is the name of the genetic autosomal dominant trait disorder that produces pigmented spots, and pedunculated soft tissue nodules clustered along nerve sheaths?

Answer 2

Neurofibromatosis

Question 3

Name some bone changes that may result in skeletal deformities that are associated with Neurofibromatosis

Answer 3

Vertebral body scalloping
Fibrous Dysplasia
Tibial Pseudoarthrosis
Sphenoid bone deformity

Question 4

What is a gibbous deformity?

Answer 4

A sharp kyphosis in the lower thoracic, affecting the normal lordosis of the lumbar spine

Question 5

T or F

The top of the iliac crest is around the level of L3-L4

Answer 5

False

L4/L5

Question 6

If there is a pars interarticularis defect in the lumbar spine we typically refer to it as what?

Answer 6

Spondyloslisthesis Spondylolysis

Question 7

T or F

A spondylolisthesis is ONLY a unilateral defect in the pars

Answer 7

False

Can be bilateral as well

Question 8

What measurement technique is used to grade a Spondy?

Answer 8

Meyerding’s Scale

Question 9

The articulations between two consecutive lumbar vertebrae form how many joints?

Answer 9

3
1 between the 2 bodies and the IVD
The other 2 are formed by the articulation of the Superior articular process of one vertebra and the inferior of the vertebra above.

Question 10

The umbilicus lies at what lumbar disc levels

Answer 10

L3-L4

Question 11

What is the primary function of the zjoint in the lumbar spine

Answer 11

To protect the motion segment from anterior shear forces, excessive rotation, and flexion

Question 12

T or F

The ALL becomes thicker as it ascends

Answer 12

False

Question 13

What ligament connects two consecutive laminae?

Answer 13

Ligamentum Flavum

Question 14

T or F

Interspinous ligaments connect the tips of two adjacent spinous process.

Answer 14

False

Supraspinous ligaments
- the question was describing the interspinous ligament

Question 15

What ligament functions to restrain flexion, extension, and axial rotation as well as side bending of L5 on S1

Answer 15

Iliolumbar Ligament

Question 16

T or F

The Quadratus Lumborum is an important muscle for the lumbar segmental stability through its ability to provide segmental stiffness and control motion

Answer 16

False

This is the function of the Lumbar Multifidus

Question 17

Describe the importance of the Thoracolumbar fascia.

Answer 17

Assists in the transmission of extension forces during lifting activities and stabilizes the spine against anterior shear and flexion moments.

Question 18

What muscle takes origin from the anterior portion of T12-L5 vbodies & discs? What is its main function?

Answer 18

Psoas

The main hip flexor

Question 19

T or F

in the lumbar spine a disc pathology affects the nerve root below

Answer 19

True

Question 20

T or F

A disc is named after the vertebrae below

Answer 20

False

Above

Question 21

T or F

Prolapse aka Protrusion

Answer 21

False

aka Bulge

Question 22

Describe a disc protrusion

Answer 22

A little piece of the nucleus pulposus protrudes into the annular fibres

Question 23

T or F

With a bulging disc the nucleus pops out of the annular fibres but there has not yet been torn fibres

Answer 23

True

Question 24

What is an aka for Extrusion of a disc?

Answer 24

Herniation

Question 25

Describe an extruded disc

Answer 25

Annular fibres are torn and the nucleus bursts into the PLL and the PLL is torn. Patient often describes a shredding noise.

Question 26

When multiple pieces of the nucleus are in the spinal canal this is called?

Answer 26

Sequestered Disc

Question 27

L4 reflex = ?

Answer 27

Patellar Reflex

Question 28

Foot dorsiflexion and inversion is testing what muscle and what nerve root?

Answer 28

L4 | Tibialis Anterior - deep peroneal nerve

Question 29

T or F L4 dermatome is the lateral leg, behind the lateral malleoli and along the 2-4th toes

Answer 29

False Medial leg, behind the medial malleoli and along the medial side of the food and great toe.

Question 30

T or F L5 muscle testing is evaluating primarily foot, big toe, and toes 2,3,4 plantar flexion

Answer 30

False Dorsiflexion

Question 31

What nerve root is evaluation Hip and Pelvis abduction

Answer 31

L5

Question 32

Hip and pelvis abduction muscle testing tests what muscles?

Answer 32

Gluteus medius and minimus - superior gluteal nerve

Question 33

Foot plantar flexion muscle test is stressing what muscles?

Answer 33

Gastrocnemius and Soleus innervated by Tibial Nerve

Question 34

T or F Foot plantar flexion and eversion is testing the peroneus longs and braves innervated by the deep peroneal nerve

Answer 34

False Superficial peroneal nerve

Question 35

What is the reflex for S1

Answer 35

Achilles

Question 36

What nerves innervate the outer half of the IVD

Answer 36

Sinuvertebral nerve and the grey rami communicans

Question 37

What part of the IVD receives only sympathetic innervation

Answer 37

The lateral aspect

Question 38

The Z joints are innervated by what nerve?

Answer 38

The medial branches of the dorsal rami

Question 39

Motion in the lumbar spine can occur in what cardinal planes

Answer 39

Sagittal - flexion and extension Coronal - Side bending Transverse - rotation

Question 40

T or F | Most of the flexion and extension of the lumbar spine occurs in the upper segmental levels

Answer 40

FALSE bitches | Lower segmental levels

Question 41

Where does most of the side bending occur?

Answer 41

Mid-lumbar region

Question 42

Where does most of the rotation occur?

Answer 42

It is coupled with side bending however most of the rotation occurs at the lumbosacral junction

Question 43

Does flexion or extension of the lumbar spine cause a minimal reversal of the lordosis

Answer 43

Flexion

Question 44

What motion of the lumbar spine is associated with an anterior roll and an anterior glide of the vertebral body

Answer 44

Flexion

Question 45

Axial rotation of the lumbar spine amounts to approx how many degrees?

Answer 45

13 to both sides

Question 46

Where does the greatest amount of segmental rotation occur and how much is it?

Answer 46

L5-S1 | 5 degrees

Question 47

Name some of the Acute Phase Goals mentioned in the powerpoint

Answer 47

Decrease pn, inflammation and muscle spasm Promote healing of tissues Increase pn free ROM Regain soft tissue extensibility Regian neuromuscular control Allow progression to the functional stage