Module #7: Thoracic & Lumbar Flashcards

1
Q

The lumbar plexus runs from which vertebrae?

A

L1-L4

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2
Q

Which nerve roots does the lumbar plexus divide into?

A

Iliohypogastric, Ilioinguinal, Geniofemoral, Lateral Cutaneous, Femoral, Obturator

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3
Q

What does the femoral nerve innervate?

A

L2-L3: Illiacus, pectineus, Sartorius, Rectus Femoris, Quadriceps

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4
Q

What is the pathway of the femoral nerve?

A

L2-L4: Motor for hip flexors and knee extensors. Sensory: skin over the anterior and medial thigh and medial side of leg and foot. Runs more medial

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5
Q

What muscles does the sciatic nerve innervate?

A

biceps femoris
adductor magnus
semimbranosus
semitendonisus

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6
Q

What is the pathway for the sciatic nerve?

A

L4-S3:Runs through the greater sciatic notch or foreman,, over piriformis muscle in between greater trochanter and ischial tuberosity through posterior thigh. splits at bath of knee or above knee into the peroneal and tibial nerves.

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7
Q

What are your true ribs?

A

Ribs 1-7

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8
Q

What are your false ribs?

A

8-10

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9
Q

What are your floating ribs?

A

11-12

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10
Q

Which part of the spine is ROM limited?

A

Thoracic

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11
Q

Where does mild Kyphosis (Posterior Curvature) happen?

A

Thoracis Spine

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12
Q

Where does Mild Lordosis (Anterior Curvature) happen?

A

Lumbar Spine

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13
Q

How many facet joints are on each vertebrae?

A

Four-Allows for movement

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14
Q

True or False- Facet joints are richly innervated:

A

True

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15
Q

what are costal Facets?

A

the site where rib forms a joint with the inferior aspect of the thoracic vertebrae.

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16
Q

What are the four ligaments of the spine?

A

Posterior Longitudinal Ligament
Anterior Longitudinal Ligament
Ligamentum Flavum
iliolumbar Ligament

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17
Q

What is COPD?

A

Increased mucus production in bronchioles, characterized by smooth muscle spasm. Can cause congestion compromise air passage diameters.

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18
Q

What condition commonly cause COPD?

A

Asthma

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19
Q

How do you treat COPD?

A

MFR, diaphragm stripping, increase rib capacity with joint play and rib springing. TRP decrease

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20
Q

What should you avoid with COPD?

A

essential oils, aromatherapy, deep pressure

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21
Q

What ROM do we not test and why?

A

Passive because it is too hard on the therapist’s body

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22
Q

When is bronchitis usually diagnosed?

A

When the cough is present for at least three months of the year over two consecutive years

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23
Q

What is bronchitis also know as?

A

Blue Bloater

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24
Q

what is the pathway of the Lumbar Plexus?

A

Travels Obliquely between superficial and deep heads of psoas major and anterior to QL, then roots split into anterior and posterior divisions.

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25
Q

Origin of Multifidi and Rotators

A

Multifidi: Sacram and TVP’S of lumbar to cervical vertebrae
Rotators: TVP’S of lumbar to cervical vertebrae

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26
Q

Insertion of Multifidi and Rotators

A

Multifidi: Spinous Processes of Lumbar through 2nd Cervical Vertebrae (2-4 Vertebrae span
Rotatores: Same but 1-2 Vertebrae span

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27
Q

Innervation of Multifidi and Rotatores

A

Spinal

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28
Q

Actions of Multifidi and Rotatores

A

Uni-Laterally rotate vertebral column to opposite side
Bilaterally extend vertebral column.

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29
Q

What is the deepest abdominal Muscle?

A

Transverse Abdominis

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30
Q

The action(s) of the transverse abdominis

A

Compress the Abdominal contents

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31
Q

Origin of the transverse abdominis

A

Lateral Inguinal ligament, iliac crest, thoracolumbar fascia, internal surfaces of lower six ribs

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32
Q

Insertion of Transverse Abdominis

A

Rectus Sheath to linea alba

33
Q

Innervation of Transverse Abdominis

A

Iliohypogastric, ilioinguinal, ventral divisions.

34
Q

what is the diaphragm pierced by?

A

Quadratus Lumborum and psoas major

35
Q

Diaphragm-What side do you palpate on and why?

A

Left side- Liver is on right, under rib 7.

36
Q

Origin of Serratus Posterior Superior

A

Spinous processes of C7-T3

37
Q

Insertion of Serratus Posterior Superior

A

Posterior surfaces of 2nd through 5th ribs

38
Q

Actions and innervation for Serratus Posterior Superior

A

Elevate rib during inhalation
T1-T4

39
Q

Origin of Serratus Posterior Inferior

A

Spinous processes of T12-L3

40
Q

Insertion of Serratus Posterior Inferior

A

Posterior surfaces of the 9th through 12th ribs

41
Q

Actions and innervation for Serratus Posterior Inferior

A

Depress the ribs during exhalation
T9-T12

42
Q

What is the purpose of the thoracic spine?

A

to protect organs by allowing ribs to attach

43
Q

what is the purpose of the lumbar spine?

A

to bear the weight of the body- carries 20-25% of axial load, may reach 70 % with disc degeneration

44
Q

What is the smallest muscle in the ESG that sits in the lamina groove?

A

Spinalis

45
Q

Thickest most visible muscle part of the ESG

A

Longissimus

46
Q

What three muscles composes the ESG?

A

Spinalis, Longissimus, iliocostalis

47
Q

What are the actions of the ESG?

A

Extends the vertebral column and laterally flexes the vertebral column to the same side.

48
Q

Origin of the Semispinalis

A

Transverse processes of C4-T5

49
Q

Insertion of the semispinalis

A

Between the superior and inferior nuchal lines of the occiput

50
Q

Actions and innervation of the semispinalis

A

Extends head and vertebral column– Cervical

51
Q

Difference between Mechanical back pain and radiating pain

A

Mechanical: Pain in back due to sprain, strain, SI joint dysfunction, facet joint injury
Radiating: Pain in back due to facet joint irritation disc bulge or nerve compression by soft tissue.

52
Q

Four Scoliosis terms:

A

Span
Apex
Major Curve
Minor Curve

53
Q

Two types of scoliosis

A

Structural and Functional

54
Q

What does COPD stand for?

A

Chronic Obstructive Pulmonary Disease

55
Q

what is Emphysema?

A

Degenerative condition by the developement of large empty spaces in place of the alveolar clusters, destruction of the alveolar Capillary Beds. Shortness of breath

56
Q

What is emphysema also known as?

A

Pink Puffer

57
Q

What is the focus of a massage treatment for disc herniation?

A

Reduce Muscle tightness

58
Q

Term for when a client with scoliosis has a convex side of the curve on their right lower side, how would you label this in your notes?

A

Dextroscoliosis

59
Q

What postural dysfunction in the spine will increase the load on vertebral facet joints?

A

Exaggerated Lumbar Lordosis

60
Q

What clues might tell you someone has lumbar facet syndrome?

A

Deep aching pain at spine, sleeping prone, more pain in morning, stiffness, joint compression

61
Q

Name five respiratory muscles

A
  1. Scalene
    2.Diaphragm
  2. Sternocleidomastoid
  3. Quadratus Lumborum
  4. Intercostals
62
Q

What is the focus of a massage treatment for Osteoporosis?

A

Position for comfort, relaxation techniques, passive joint play to promote health and nutrition, light exercises like swimming, lifting a book.

63
Q

What is the focus of a massage treatment for Osteoarthritis?

A

Stretching, reduce pain, deep moist heat to soften tissues, MRF to affected joint, reduce stiffness

64
Q

What is the focus of a massage treatment for Rheumatoid arthritis (bone attacking own joints)?

A

Relaxation, Diaphragmatic breathing, reduce stress, decrease pain, heat, reduce postural deviations, trps. During flare up: Cold, relaxation techniques to unaffected structures.

65
Q

What three muscles make up the transversospinalis group?

A

Multifidi, Rotatores, Semispinalis Capitis.

66
Q

What three conditions are classified as COPD?

A

Asthma, chronic bronchitis, Emphysema

67
Q

What is an AROM that would compress the lumbar facet joints?

A

Later flexion, or extension

68
Q

Describe the difference where symptoms would be felt for disc protrusions

A

Upper lumbar region-Femoral nerve down anterior medial thigh.
Lower Lumbar Region: Sciatic, down posterior leg possibly down to the foot.

69
Q

Define the terms for scoliosis

A

Span: The distance the curve expands (C2-T1)
Apex: Vertebrae of curve, furtherst from midline
Major Curve: Forms ‘S’ with the greatest angulation
Minor Curve: happens in major curve and is the smallest angulation

70
Q

Define functional and structural scoliosis

A

Functional: the soft tissues have adapted by shortening and lengthening, posture can be altered.
Structural: bones altered shape due to pathology so the posture cannot be altered but soft tissues can be treated.

71
Q

What is spondyloysis?

A

Vertebral stress fracture, usually pars interarticularis. Precursor to spondylolisthesis.

72
Q

What is spondylolisthesis?

A

Forward slippage of vertebra (L5-S1)

73
Q

what is Ankylosing Spondylitis?

A

Chronic, systematic inflammation of joint (spine).

74
Q

What are we looking for when we do the prone knee bend test?

A

Nerve root compression in the lumbar nerve roots, femoral nerve. looking for neurological pain in upper quadricep area

75
Q

True or false: Only the thoracic vertebrae articulates with ribs

A

True. Costo= Ribs

76
Q

What is the purpose of our ribs?

A

Protects organs: Kidney, heart, lungs and limits movement in the thoracic spine

77
Q

What are the effects of diaphragmatic breathing?

A

Relaxation, increased lymph flow, increased efficiency in gas exchange, helps stretching techniques, decrease pain and stress.

78
Q
A