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MSK 731 > MSK 731 Exam 1 > Flashcards

MSK 731 Exam 1 Flashcards

1
Q

What plane is the thoracic spine facet joints in

A

frontal plane

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2
Q

Why is greater SB in the thoracic spine limited

A

due to the ribs

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3
Q

list the Thoracic region greatest to least motion

A

Rotation, SB, FLX, EXT

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4
Q

At what level does the thoracic spine have the most movement

A

T5 and T10

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5
Q

Why does T11 and T12 have the least amount of motion out of the thoracic spine

A

transition to shape of lumbar facets

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6
Q

What motions does the lumbar spine have

A

most: FLX, EXT
least: rotation

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7
Q

What are the 4 variables for stabilization

A
  1. joint integrity
  2. passive stiffness
  3. neural input
  4. muscle function
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8
Q

Name some characteristics of local muscles

A

-closer to axis of motion
-often deeper
-greater stabilization
-postural
-aerobic
-more often type 1 fibers

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9
Q

Name the main local muscles of thoracolumbosacral

A

-psoas
-quadratus lumborum
-pelvic floor
-transversus abdominus
-multifidi/rotatores

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10
Q

Does muscle function normalize automatically once symptoms are improved?

A

no

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11
Q

How much (%) does it take to activate muscles

A

30%

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12
Q

What are the 4 main reasons for stabilization issues

A
  1. pain
  2. swelling
  3. joint laxity
  4. disuse
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13
Q

What plane is the lumbar spine anterior facet joints in

A

coronal/frontal plane

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14
Q

What plane is the lumbar spine posterior facet joints in

A

sagittal plane

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15
Q

What are the main frontal stabilizer (local muscles) of the thoracolumbosacral

A

-Posas
-quadratus lumborum

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16
Q

How does the pelvic floor and transversus abdominus help stabilize the thoracolumbosacral

A

increases contraction of multifidus

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17
Q

If the multifidi/rotatores are smaller, what is more likely to happen

A

-higher injury rates
-LBP

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18
Q

How long do you hold for myotome testing

A

10 seconds

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19
Q

How long do you hold & range for mmt & or resisted testing to assess for a grade 1 strain

A

shorten & 10 seconds

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20
Q

What is the best MET parameters for achieving a combo of strength & coordination

A

3 set of 20 reps w/ moderate load

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21
Q

When a person rotates their trunk describe what the upper thoracic is doing

A

ipsiaterally coupling w/ SB (i.e. R rotation & R SB)

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22
Q

When a person rotates their trunk describe what the lower thoracic is doing

A

opposite rotation & SB (i.e. R rotation & L SB)

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23
Q

What type of scoliosis does a person have if they FLX forward and the abnormality in the spine does NOT go away

A

structural scoliosis

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24
Q

describe scoliosis/rotoscoliosis

A
  • greater /equal to 10 degrees SB curvature
  • SB & Contralateral rotation
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25
Q

What is the normal curvature of the spine

A

-cervical = lordosis
-thoracic = kyphosis
-lumbar = lordosis
-sacral = kyphosis

26
Q

What is indicated if a pt has limited SB & FLX

A

indicates contralateral Z joint

27
Q

What is indicated if a pt has limited SB & EXT

A

indicates ipsilateral Z joint

28
Q

If a pt spine is a ‘C’ curve in trunk rotation, what vertebrae should a PT first assess

A

T10

29
Q

What position does SB occur in

A

neutral

30
Q

When does thoracolumbar fascia & posterior passive restraints have more tension

A

in neutral

31
Q

When does thoracolumbar fascia & posterior passive restraints slacken

A

EXT/hyper EXT

32
Q

Why does EXT/hyper EXT lead to LESS stability of the lower trunk

A

thoracolumbar & posterior restraints are slacken in that position

33
Q

Anterior shearing forces are more greater in EXT/hyper EXT. True or false

A

true

34
Q

What can a PT observe when a pt EXT/Hyper in the trunk for instability/anterior shearing

A

crease, especially a unilateral crease

35
Q

Lumbar compression test are primarily testing what structures

A

vertebral body & disc

36
Q

When should a PT do combined motions

A

-limited motion
-P! in a motion
-unilateral motions do NOT provide any information even though the pt is having problems

37
Q

When should a PT do stability test

A

-hypermobility is indicated

38
Q

A radiograph of the thoracolumbar spine best shows what levels

A

L4-L5 interspinous space

39
Q

What is a good landmark for the L3-L4 interspinous space

A

top of iliac crest

40
Q

PSIS is a good landmark for what SP (spinous process)

A

S2 SP

41
Q

What rib is the best landmark to finding T12

A

12th rib (follow)

42
Q

What can cause a pt to have ‘Sway Back’

A

-increased lumbar lordosis
-anterior pelvic tilt
-associated w/ flexible body typeswe32p0o

43
Q

Describe ‘Flat Back’

A

-flattening of normal curves
-greater portion of LBP pt due to LESS dissipation of forces

44
Q

What can cause a pt to have ‘Flat Back’ (straight spine)

A

-posterior pelvic tilt
-associated w/ rigid body type

45
Q

What can cause ‘Rounded/Crouched back’

A

-increased thoracic kyphosis
-flattening lumbar curve
-posterior pelvic tilt
-associated w/ FHP

46
Q

What region of the spine for LBP is the leading cause of worldwide disability & activity limitation/work absence

A

lumbar spine

47
Q

What percentage of people will experience LBP in their lifetime

A

80%

48
Q

Risk factors that could contribute to LBP

A

-previous LBP
-co-morbidities
-awkward postures
-genetics w/ age related disc changes ONLY

49
Q

What populations are more prevalent to have LBP

A

-biological women
-older than 65 yrs
-lower du. status
-higher physical work demands

50
Q

Who should get imaging with LBP

A

-greater than 50 yrs
-saddle paresthesia
-bowel/bladder dysfunction
-NO improvement after 6 weeks of conservative Rx

51
Q

describe PT Rx education & advice

A

-1st line Rx w/ moderate to strong evidence
-stay active w/ early resumption of ADLS

52
Q

describe PT Rx overcoming barriers

A

-increase consultation time & follow up
-reward quality

53
Q

What are the 4 main subgroups of LBP Rx classifications

A
  1. mechanical traction
  2. directional pref
  3. mobilization/manip
  4. stabilization
54
Q

describe mechanical traction

A

-NO benefit w/ static Tx
-intermittent tx for LBP w/ LE P!
-NOT use w/ persistent LBP w/ LE P!
-radiculopathy

55
Q

describe directional preference

A

helps choose position to avoid/alleviate P! motions

56
Q

describe mobs/manips

A

-strong preference
-short term effectiveness
-acute/sub acute
-greater/equal to a score of 4

57
Q

describe stabilization for acute LBP

A

-safe/effective to do early

58
Q

describe stabilization for sub acute & persistent LBP

A

-strong support
-first line Rx
-most effective Rx for functions in this order

59
Q

Prognosis of LBP

A

-rapid improvements within 1 month
-most improve substantially 6 weeks

59
Q

Cognitive therapy is best use for what type of LBP

A

-first line Rx w/ persistent LBP

60
Q

When is medication recommended

A

-ONLY when inadequate response to exercise & cognitive behavioral therapy

61
Q

Epidural injection are used for what type of pain phenotype

A

-radicular p!
-no benefit by 4 weeks

MSK 731 (1 decks)

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