Lumbar Thoracic Mechanics Flashcards
L4-L5 herniation
- what nerve
- weakness
- difficulty walking on what
- affected reflexes
L5 nerve
weak dorsiflexion
heel
internal hamstring reflex
L5-S1 herniation
- what nerve
- weakness
- difficulty walking on what
- affected reflexes
S1 nerve
weak plantarflexion
toes
calcaneal reflex
viscerosomatic reflexes controlled by the pelvic splanchnic n.
- lower GU
- bladder
- lower GI
- uterus/cervix
- LE, urethra, erectile tissue
- prostate
viscerosomatic reflexes controlled by the vagus n.
- head/neck
- heart
- lungs
- esophagus/UE
- upper GU
- upper GI
- middle GI
what spinal level controls the adrenal medulla
T10
what spinal level controls the appendix
T12
cervical superior facet orientation
backwards, upward, medial (BUM)
thoracic superior facet orientation
backwards, upward, lateral (BUL)
lumbar superior facet orientation
backwards, medial (BM)
iliolumbar ligament
connects 4th and 5th lumbar vertebrae to the iliac crest
rotatores origin and insertion
T1-T12 –> between transverse and spinous processes
brevis: adjacent vertebrae
longus: skipping one vertebra
rotatores action
extension
unilateral rotation to opposite side
multifidus origin and insertion
O:
L1-L5 (sacrum, ilium, mamillary processes)
T1-T4, C4-C7 (transverse and articular processes)
I:
skipping 2 to 4 vertebrae
multifidus action
extension
unilateral flexion to same side
unilateral rotation to opposite side
semispinalis capitis origin and insertion
O: C4-C7
I: occipital bone
semispinalis cervicis origin and insertion
O: T1-T6
I: C2-C5
semispinalis thoracis origin and insertion
O: T6-T12
I: C6-C4
semispinalis ms. action
extension
unilateral bend of head to same side
unilateral rotation to opposite side
lumbar flexion
40-90
lumbar extension
20-45
lumbar sidebending
15-30
coupled motion vs linkage
coupled: one action cannot be done without other action along a second axis
linkage: increasing ROM by linking multiple structures; one can move without other
cobb angle
- <25
- 24-45
- > 45
- > 50
- > 70
angle used to measure scoliosis <25: conservative, frequent radiographs 24-45: bracing, non-operative >45: surgical fusion >50: respiratory compromise >75: cardiac compromise
straight leg raise
+pain 15-30 degrees
workup for radiculopathy
- pain in dermatome distribution
- LE weak
- diminished reflexes
- +straight leg
MRI
workup for spinal stenosis
- bilateral LE pain
- neurogenic claudication
- LE weak
- diminished reflexes
- +straight leg
MRI
workup for cauda equina
- saddle anesthesia
- LE weakness
- diminished reflexes
- urinary retention
MRI
head and neck viscerosomatic reflex spinal levels
T1-T4
heart viscerosomatic reflex spinal levels
T1-T5
lungs viscerosomatic reflex spinal levels
T2-T7
esophagus/UE viscerosomatic reflex spinal levels
T2-T8
upper GI viscerosomatic reflex spinal levels
T5-T9
middle GI viscerosomatic reflex spinal levels
T10-T11
lower GI viscerosomatic reflex spinal levels
T12-L2
upper GU viscerosomatic reflex spinal levels
T10-T11
lower GU viscerosomatic reflex spinal levels
T12-L2
bladder viscerosomatic reflex spinal levels
T11-L2
uterus and cervix viscerosomatic reflex spinal levels
T10-L2
LE, urethra, erectile tissue viscerosomatic reflex spinal levels
T11-L2
prostate viscerosomatic reflex spinal levels
T12-L2
