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Sports Medicine > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

1
Q

the last rib articulates with what rib?

A

t12

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2
Q

what XR view of the spine evaluates the pars interarticularis?

A

oblique

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3
Q

loss of disc space height on XR evaluates for what etiology?

A

DDD

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4
Q

stiffness after inactivity indicates what general type of lumbar spine pathology?

A

spondylosis

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5
Q

pain with spinal extension / rotation indicates what etiology of pain?

A

spondylosis

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6
Q

synovitis around the facet joint can compress what structure?

A

neuroforamina

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7
Q

narrowing of joint space and sclerosis is indicative of what type of spine pathology?

A

spondylosis

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8
Q

what are the grades of spondylolisthesis?

A

Grades 1-IV

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9
Q

what XR views should you get to evaluate for lumbar spondylolisthesis?

A

flex/extend views

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10
Q

how much segmental motion is considered significant displacement in spondylolisthesis?

A

3mm or greater

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11
Q

what nerve roots make up the sciatic nerve?

A

L4-S2

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12
Q

what nerve root provides motor innervation to the iliopsoas?

A

L3

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13
Q

what nerve root level provides motor innervation to the tibialis anterior?

A

L4

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14
Q

what nerve root provides sensory innervation to the dorsolateral thigh?

A

L5

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15
Q

medial branches of the spinal nerves innervate what two structures?

A

facet joint and multifidus muscles

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16
Q

what is the only true lateral flexor of the L-spine?

A

quadratus lumborum

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17
Q

what is the primary type of collagen in the nucleus pulposus?

A

type II collagen

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18
Q

what is the type of collagen that predominantly comprises the annulus fibrosus?

A

type I collagen

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19
Q

t/f the pain from a foraminal disc herniation can be worse with lumbar spine extension

A

true

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20
Q

what is the Kirkaldy-Willis Degenerative cascade of the lumbar spine?

A

the natural course of the interrelationship between disc and facet joint degeneration/instability/stenosis

21
Q

generally, what are the two types of intervertebral disc herniations?

A

protrusion and extrusion

22
Q

what is the difference between protrusion and extrusion?

A

protrusion - base is larger than amount of disc material
extrusion - base is smaller than amount of disc material

23
Q

what is the most common zone for disc herniation?

A

subarticular zone, just off midline anterior to the facet joint

24
Q

in a paramedian disc herniation, what nerve root is most likely to be affected?

A

the nerve root beneath the level of the herniation

25
Q

what is the typical MOI of annular fissure?

A

flexion combined with rotation

26
Q

what is the most common etiology of facet syndrome?

A

OA

27
Q

in a foraminal disc herniation, what nerve root is most likely to be affected?

A

exiting nerve root at the level of the disc

28
Q

t/f there is no consensus on the correct imaging for spondylolysis and oblique views have fallen out of favor

A

true

29
Q

how does spondylolysis start?

A

stress reaction

30
Q

other than bracing and physical therapy, what other modality has the potential to improve radiographic healing in spondylolysis?

A

bone stimulator

31
Q

what is the primary issue that generates pain at the SIJ?

A

hypermobility of the joint

32
Q

t/f there is no definitive diagnostic test for piriformis syndrome and it is actually very rare

A

true

33
Q

instead of piriformis syndrome, what is the preferred term for this pain pattern?

A

deep gluteal syndrome

34
Q

what is the rehab protocol with the most evidence for addressing lumbar spine pathologies with a directional preference?

A

mechanical diagnosis and therapy (MDT)

35
Q

what type of intervention injection for facet mediated pain has the most evidence?

A

medial branch block

36
Q

what is the difference between radiculitis and radiculopathy?

A

radiculitis - pain down a dermatome
radiculopathy - pain with weakness or abnormal reflex(es)

37
Q

t/f facet joint pain can cause pain down a portion of the leg

A

true

38
Q

a paramedian disc herniation occurring at the L4-L5 level is most likely to cause nerve root involvement at what level?

A

L5

39
Q

what is the incidence of piriformis syndrome in a patient with buttocks pain with intermittent radicular symptoms?

A

6-8%

40
Q

T1 weighted images emphasize what type of tissue?

A

fat / adipose

41
Q

T2 weighted immages highlight what material?

A

water

42
Q

what ligament of the spine is located at the inner margins of the lamina?

A

ligamentum flavum

43
Q

what is the name for the degenerative end plate changes resulting from disc height loss and osseous changes?

A

Modic changes

44
Q

which portion of the annulus is most prone to tearing?

A

posterolateral

45
Q

what type of annulus tear is typically more likely to be symptomatic?

A

radial tear

46
Q

t/f circumferential or transverse annular tears are often not associated with clinical symptoms

A

true

47
Q

what are the three zones of nerve impingement?

A
  1. lateral recess (medial to the pedicle)
  2. foraminal
  3. extraforaminal
48
Q
A

Sports Medicine (18 decks)

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