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Ortho Review > Ortho Final Review Lumbopelvic > Flashcards

Ortho Final Review Lumbopelvic Flashcards

1
Q

What is the basic pelvic anatomy?

A

SI Joints
Pubic Symphysis

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2
Q

What is the basic SI Joint Anatomy?

A

Articulation between Sacrum and Coxal Bones that are supported by thick ligaments anteriorly and posteriorly

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3
Q

What plane of motion are pelvic facet joints?

A

Primarily in the sagittal plane, facilitating flexion and extension

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4
Q

How many planes of motion does pelvis move in?

A

All 3 planes of motion

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5
Q

Lumbar contribution Flexion/Extension

A

Flexion= 50
Extension= 20

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6
Q

Lumbar contribution in sidebending

A

Sidebending= 30

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7
Q

Lumbar Contribution in rotation

A

Rotation= 32 each side

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8
Q

Rotation and Sidebending occur _________

A

TOGETHER

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9
Q

In lumbar flexion, the sacrum _________________

A

counter nutates, PPT

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10
Q

In lumbar extension, the sacrum _______________

A

nutates, APT

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11
Q

The pelvis can:

A
  1. Anteriorly or Posteriorly Tilt
  2. Hike or Drop
  3. Rotate on top of the Femur
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12
Q

What happens in a PPT?

A

Abs are pulled up and hip extensors pulled down
Hip flexors and back extensors are stretched

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13
Q

What happens in a APT?

A

Back extensors pull up, and hip flexors pull down
Hip extensors and abs stretch

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14
Q

What are the special tests used for the lumbar spine?

A

SLR
Slump Test
Prone Knee Flexion
Gower’s Sign

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15
Q

What happens when the psoas is shortened?

A

The lumbar spine is pulled into further extension

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16
Q

What is the SLR test?

A

Pt in supine, leg passively flexed by PT
Test is positive if there is pain in back/leg between 30-70 degrees
*Neural tension on the sciatic nerve

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17
Q

What is the slump test?

A

Patient in sitting, flexes in trunk first, then cervical, then extension, then knee one at a time
* abnormal dural tension

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18
Q

What is prone knee flexion test?

A

Patient prone, with knee passively bent by PT, pain in front of thigh = tightness in quads or femoral nerve
Pain in back can mean L2/L3 disc injury
*test abnormal tension of femoral nerve

19
Q

What is Gower’s sign test?

A

Patient in standing, flexes trunk and does 1/2 squat, if they need to use UE to stand back up, test is positive
*used often for Duchennes
*tests inhibited LE/Spinal extensor muscles

20
Q

What tests are performed to test SI mobility?

A

Standing/Seated Flexion
Gillet (Stork) test
Squish Test

21
Q

What test is performed for sacral torsion?

A

Sphinx Test

22
Q

What is the Long Sit test used for?

A

inominate rotation

23
Q

What exercises should a patient do for spinal stabilization or movement awareness/control?

A

Pelvic Clocks
TA contractions
Neutral Spine Education

24
Q

What exercises should a patient do for gentle ROM?

A

SKTC
DKTC
LTR

25
Q

What are the 3 fundamental goals for lumbopelvic stabilization?

A

1.Education on neutral spine
2. Facilitate activation of core stabilizers (Multifidi/TA/pelvic floor)
3. Progress to dynamic activities, maintaining a neutral spine and contraction of spinal stabilizers

26
Q

What is the primary goal for Lumbar disc herniation when there are neurological signs?

A

reduce/eliminate compression of neural tissue
If patient is acute: reduce inflammation and spasm with goals to initiate interventions to improve neuro symptoms

27
Q

What is the focus for treating lumbar spondylosis?

A

decreasing stress on discs or joints to prevent further damage to the spine and LE

28
Q

What is lumbar stenosis?

A

narrowing of spinal canal or IV Foramen
*Can affect any area of the spine

29
Q

What are the symptoms for lumbar stenosis?

A

Pain
Radiculopathy
Myelopathy in standing or extension of the spine (bc it closes the facets)

30
Q

Should you use williams or mckenzie exercises for lumbar stenosis?

A

Williams FLEXION

31
Q

What is lumbar spondylolysis?

A

small fracture in the pars articularis (scotty dog) due to trauma or over stress
Can be unilateral or bilateral
*Bilateral can create instability causing vertebra to slip forward

32
Q

What sort of treatment should be performed for a patient with lumbar spondylolysis?

A

Treat pain or spasm
Stabilization of the spine
Patient Education
*Avoid high-impact or excessive extension

33
Q

How long does it primarily take spondylolysis to heal?

A

3-6 Months

34
Q

What is lumbar spondylolisthesis?

A

forward slippage of vertebral body after bilateral pars fracture

35
Q

What is the most common lumbar spondylolisthesis?

A

L5-S1

36
Q

What is retrolisthesis- Complete?

A

vertebra slips back between the spinal segment

37
Q

What is retrolisthesis- Partial?

A

Vertebra slips backward to either spinal segment above or below

38
Q

What is retrolisthesis- Stair Step?

A

Vertebra slips backward TO THE spinal segment above it an ahead of one below it.

39
Q

What are possible causes for sciatica?

A

HNP
Stenosis
Spondylolisthesis
Spinal Tumor
Muscle tightness

40
Q

What are common symptoms for Sciatica?

A

LBP
Pain in the buttocks
Pain/Tingling in posterior thigh to leg or foot

41
Q

What is the early tx for SI joint sprains or strains?

A

Reduce Pain
Inflammation
Education

42
Q

How do you restore balance to muscles that affect the joint?

A

Stretch
Strengthen
Stabilization
Proprioception

43
Q

What muscles need to be re-educated in SI Joint instability?

A

Glute Max
Erector Spinae
Biceps Femoris
Lats
Piriformis
Multifidi

44
Q

What muscles need to be re-educated in lumbar instability?

A

Multifidi
Erector Spinae
TA
(Pelvic Floor)

Ortho Review (8 decks)

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