Lumbosacral Spine

Question 1

SLR - SPIN vs SNOUT

high specificity + positive test =

Answer 1

confident in result (positive)
SPIN

good screen test

positive test rules IN lumbar radiculopathy

Question 2

SLR - SPIN vs SNOUT

high sensitivity + negative test =

Answer 2

confident in result (negative)
SNOUT

good screen test

negative test rules OUT lumbar radiculopathy

Question 3

capsular pattern vs hypomoblity

what is expected to be seen in a capsular pattern?
what is expected to be seen in hypomobility?

Answer 3

capsular pattern:
- whole capsule involved (tight)
- expected % loss of motion (capsular pattern)
hypomobility:
- likley includes only part of capsule (or other tissue)
- non capsular pattern of motion loss
- i.e. opening and/or closing restriction

Question 4

what is fryettes first law?

Answer 4

neutral mechanics:
- specific to lumband lower thoracic spine (T9-12)
- when spine is in neutral
- contralateral coupled motions
- this means - side bend to left, rotate to right and vice versa

Question 5

what is fryettes second law?

Answer 5

non neutral mechanics:
- lumbar and lower thoracic spine
- when spine is flexed/extended
- ipsilateral coupled motion
- example: in extension, verterbra will side bend and rotate to the same side (body goes to R side so does vertebra)

Question 6

what is fryettes third law?

Answer 6

whole spine
- motion in one plane reduces available motion in other two planes (joint capsule can only take so much tensile load)

Question 7

sacrum and pelvis

what muscles attach to iliac crest?

Answer 7

• abdominal muscles
• iliacus m.
• internal oblique m.
• QL m.

Question 8

sacrum and plevis

what muscles attach to ASIS?

Answer 8

sartorius
TFL

Question 9

sacrum and pelvis

what muscle attaches to AIIS?

Answer 9

rectus femoris

Question 10

sacrum and pelvis

what muscles attach to greater trochanter?

Answer 10

Hip rotators:
- quadratus femoris
- gemelli mm.
- obturator externus m.
- piriformis m.
- glute med m.
- glute min m.

Question 11

sacrum and pelvis

what muscle attaches to lesser trochanter?

Answer 11

iliopsoas (mainly iliacus)

Question 12

pelvis and sacrum

what muscles attach to ischial tuberosity?

Answer 12

hamstrings:
- semitendinosus
- long head of biceps femoris
- semimembranosus
- quadratus femoris
- inferior gemellus

Question 13

sacrum and pelvis

what muscles attach to body of pubis and inferior pubic ramus?

Answer 13

adductors:
- add long
- add brev
- add magnus

• gracilis

Question 14

effect of pelvic position on lumbar spine

anteriro pelvic tilt causes what in lumbar spine?

Answer 14

extension

*sacrum will also move anteriorly, pulling L5 also into extension

Question 15

effect of pelvic position on lumbarspine

posterior pelvic tilt causes what on lumbar spine?

Answer 15

flexion

• sacrum pulls L5 posteriorly as well

Question 16

what muscles will be shortened with anterior pelvic tilti?

Answer 16

erector spinae muscles
psoas muscle (flexors)
rectus femoris (flexors)

Question 17

what muscles will be lengthened (weak) in anterior pelvic tilt?

• think attachment sites are they getting closer or moving away?

Answer 17

• abdominal muscles
• glute max
• hamstrings?

Question 18

what muscles will be shortened in posterior pelvic tilt?

• think attachement sites moving closer or further away

Answer 18

hamstrings
abdominal m.

Question 19

proximal stability - local muscles of spine
muscles and motions

Answer 19

• diaphragm:diaphragmaticbreating
• pelvic floor: abdominal bracing
• transversus abdominis: drawing in
• multifidus: 1000 lb gorilla

Question 20

lateral sling gives stability to what plane?

Answer 20

frontal plane

Question 21

what muscles are involved in lateral sling?

Answer 21

• gluteus medius
• gluteus minimus
• TFL
• IT band
• fibular longus
• fibularis brevis

Question 22

oblique plane stability

posterior oblique sling is comprised of what muscles/tissues?

Answer 22

• glute maximus
• thoracolumbar fascia
• contralateral latissimus dorsi

Question 23

posterior longitudinal sling provides stability in which plane?

Answer 23

sagittal plane stability

Question 24

what muscles/tissues are apart of posterior longitudinal sling?

Answer 24

• erector spinae
• thoracolumbar fascia
• sacrotuberous ligament
• bicceps femoris

think nutation/non nutation
provide contrasting force at SI joint

Question 25

nutation is the closed packed position for what joint?

Answer 25

sacroiliac (SI) joint

Question 26

anterior longitudinal sling provides stability in what plane?

Answer 26

sagittal plane

Question 27

anterior longitidinal sling is an anatagonist to what?

Answer 27

posterior longitudinal sling

*vise versa

Question 28

what tissues make up the anterior longitudinal sling?

Answer 28

• lower abdominal muscles
• TA
• rectus abdominis
• internal oblique
• external olique

Question 29

oblique plane stability

the anterior oblique sling is an antagonist to?

Answer 29

• posterior oblique spling

*vice versa

Question 31

what tissues make up the anteriro oblique sling?

Answer 31

• ipsilateral internal obliques
• ipsilteral external obliques
• contralateral adductors

• correlation between groin pain and oblique abdominal pain

Question 32

step off deformity
high specificity + positive test =

Answer 32

confident in spondylolithesis

Question 33

single leg drop jump test

what two angle are added together to get the femoral adduction angle?

Answer 33

femur-plevic angle + pelvic dorp angle

look for femoral adduction angle after landing vertical jump.