Lumbar - Lecture Flashcards
It is important to inspect for what type of skin markings when dealing with the lumbar spine?
Lipomatas
Hairy Patches
Café-Au-Lait spots
Birth Marks
What is the name of the genetic autosomal dominant trait disorder that produces pigmented spots, and pedunculated soft tissue nodules clustered along nerve sheaths?
Neurofibromatosis
Name some bone changes that may result in skeletal deformities that are associated with Neurofibromatosis
Vertebral body scalloping
Fibrous Dysplasia
Tibial Pseudoarthrosis
Sphenoid bone deformity
What is a gibbous deformity?
A sharp kyphosis in the lower thoracic, affecting the normal lordosis of the lumbar spine
T or F
The top of the iliac crest is around the level of L3-L4
False
L4/L5
If there is a pars interarticularis defect in the lumbar spine we typically refer to it as what?
Spondyloslisthesis Spondylolysis
T or F
A spondylolisthesis is ONLY a unilateral defect in the pars
False
Can be bilateral as well
What measurement technique is used to grade a Spondy?
Meyerding’s Scale
The articulations between two consecutive lumbar vertebrae form how many joints?
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.
The umbilicus lies at what lumbar disc levels
L3-L4
What is the primary function of the zjoint in the lumbar spine
To protect the motion segment from anterior shear forces, excessive rotation, and flexion
T or F
The ALL becomes thicker as it ascends
False
What ligament connects two consecutive laminae?
Ligamentum Flavum
T or F
Interspinous ligaments connect the tips of two adjacent spinous process.
False
Supraspinous ligaments
- the question was describing the interspinous ligament
What ligament functions to restrain flexion, extension, and axial rotation as well as side bending of L5 on S1
Iliolumbar Ligament
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
False
This is the function of the Lumbar Multifidus
Describe the importance of the Thoracolumbar fascia.
Assists in the transmission of extension forces during lifting activities and stabilizes the spine against anterior shear and flexion moments.
What muscle takes origin from the anterior portion of T12-L5 vbodies & discs? What is its main function?
Psoas
The main hip flexor
T or F
in the lumbar spine a disc pathology affects the nerve root below
True
T or F
A disc is named after the vertebrae below
False
Above
T or F
Prolapse aka Protrusion
False
aka Bulge
Describe a disc protrusion
A little piece of the nucleus pulposus protrudes into the annular fibres
T or F
With a bulging disc the nucleus pops out of the annular fibres but there has not yet been torn fibres
True
What is an aka for Extrusion of a disc?
Herniation
Describe an extruded disc
Annular fibres are torn and the nucleus bursts into the PLL and the PLL is torn. Patient often describes a shredding noise.
When multiple pieces of the nucleus are in the spinal canal this is called?
Sequestered Disc
L4 reflex = ?
Patellar Reflex
Foot dorsiflexion and inversion is testing what muscle and what nerve root?
L4
Tibialis Anterior - deep peroneal nerve
T or F
L4 dermatome is the lateral leg, behind the lateral malleoli and along the 2-4th toes
False
Medial leg, behind the medial malleoli and along the medial side of the food and great toe.
T or F
L5 muscle testing is evaluating primarily foot, big toe, and toes 2,3,4 plantar flexion
False
Dorsiflexion
What nerve root is evaluation Hip and Pelvis abduction
L5
Hip and pelvis abduction muscle testing tests what muscles?
Gluteus medius and minimus - superior gluteal nerve
Foot plantar flexion muscle test is stressing what muscles?
Gastrocnemius and Soleus innervated by Tibial Nerve
T or F
Foot plantar flexion and eversion is testing the peroneus longs and braves innervated by the deep peroneal nerve
False
Superficial peroneal nerve
What is the reflex for S1
Achilles
What nerves innervate the outer half of the IVD
Sinuvertebral nerve and the grey rami communicans
What part of the IVD receives only sympathetic innervation
The lateral aspect
The Z joints are innervated by what nerve?
The medial branches of the dorsal rami
Motion in the lumbar spine can occur in what cardinal planes
Sagittal - flexion and extension
Coronal - Side bending
Transverse - rotation
T or F
Most of the flexion and extension of the lumbar spine occurs in the upper segmental levels
FALSE bitches
Lower segmental levels
Where does most of the side bending occur?
Mid-lumbar region
Where does most of the rotation occur?
It is coupled with side bending however most of the rotation occurs at the lumbosacral junction
Does flexion or extension of the lumbar spine cause a minimal reversal of the lordosis
Flexion
What motion of the lumbar spine is associated with an anterior roll and an anterior glide of the vertebral body
Flexion
Axial rotation of the lumbar spine amounts to approx how many degrees?
13 to both sides
Where does the greatest amount of segmental rotation occur and how much is it?
L5-S1
5 degrees
Name some of the Acute Phase Goals mentioned in the powerpoint
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
