Musculoskeletal - Back

Question 1

What area’s of the spine are screened if the patient has upper extremity or lower extremity complains?

Answer 1

If UE - cervical and thoracic spine

If LE - lumbar and pelvis

Question 2

Toe raises are testing what?

Answer 2

S1, tibial nerve

Question 3

Heel walks are testing what?

Answer 3

L4, L5, deep fibular nerve

Question 4

What motions are tested and what myotomes/nerves are being screened during the lower quarter screen?

Answer 4

hip flexion (L1, L2, femoral nerve)
knee extension (L3, L4, femoral nerve)
ankle DF (L4, L5, deep fibular nerve)
big toe extension (L5, deep fibular nerve)
ankle eversion (L5, S1, superficial fibular nerve)

Question 5

What deep tendon reflexes are tested?

Answer 5

patellar tendon (L3, L4)
achilles tendon (S1, S2)

Question 6

What sensory dermatomes are tested during the lower motor screen and where are they tested?

Answer 6

L2 (anterolateral thigh)
L3 (anteromedial thigh and distal leg)
L4 (medial calf and ankle)
L5 (lateral leg, anterior shin, and foot)
S1 (lateral ankle and foot)
S2 (medial posterior thigh)

Question 7

When testing each myotome during the lower quarter screen, name the muscle that each segment is testing.

Answer 7

L2 - iliopsoas
L3 - iliopsoas, quadriceps
L4 - tibialis anterior
L5 - extensor hallucis longus
S1 - fibularis longus/brevis
S1 - hamsting

Question 8

Each vertebral segment (two adjacent vertebrae with the disc between) for what type of lever?

Answer 8

first-class lever (designed for balance - the axis is located between the force and the resistance)

• facets = fulcrum
• paraspinal muscles = the force
• weight of UB and head = resistance

Question 9

What part of the vertebra protects the spinal cord and nerve roots?

Answer 9

the vertebral arch (made of pedicles and laminae)

Question 10

Most spinal chord injuries result from what?

Answer 10

1. direct or indirect trauma to the vertebral column. Most from violent motions of head or trunk.
2. stress fractures to the body and arch from repetitive trauma, direct trauma or disease process.

Question 11

What is the inner and outer portion of a intervertebral disc?

Answer 11

inner gelatinous center = nucleus pulposus.

outer layer of concentric fibers = annulus fibrosis

Question 12

Excessive compression of the spine can cause what type of fracture?

Answer 12

burst fracture

Question 13

Forced flexion of the thoracic or lumbar spine can result in what type of fracture?

Answer 13

wedge fracture

Question 14

Compression of the anterior aspect of the vertebral body can result in what type of fracture?

Answer 14

teardrop fracture

Question 15

How are disc injured?

Answer 15

trunk rotation increases intradiscal pressure and annular fibers that are oriented in the direction of rotation become taut.
so, rotation while under a load (from lifting objects) increases the risk of injury.

Question 16

What are facet or zygapophyseal joints?

Answer 16

• plane synovial joints between inferior and superior articular processes of adjacent vertebra.
• flat surfaces covered in hyaline cartilage.
• each facet joint is covered in loose articular capsule

Question 17

What movements will facet or zygapophyseal joints help control?

Answer 17

flexion
extension
rotation

Question 18

Typical ways facet or zygapophyseal joints are injured?

Answer 18

quick flexion and rotation movements
disease (osteoarthritis)
related nerves are often affected causing pain and spasm