quiz #1 - L-spine Flashcards
correct progression of the stages of acute disc herniation
protrusion
prolapse
extrusion
sequestration
facet lock syndrome responds well to what type of manipulation?
joint
one purpose of the facet joints in the lumbar spine is to…
control the direction of spinal movement
where do lumbar facets refer pain?
buttock & posterior leg
closed pack position of the lumbar spine
extension
with pelvic crossed syndrome, the muscles that are weak and taut are…
Rectus abdominus & Gluteus maximus
sleeping position that is best indicated for a patient with Ankylosing Spondylitis is…
supine on firm mattress with no pillow
what can occur with longstanding Ankylosing Spondylitis?
inflammation of the iris
aortic valve incompetence
fused appearance of vertebrae
T/F - once fusion of the spine is complete for a patient with Ankylosing Spondylitis, pain may diminish
TRUE
potential causes or disease process associated with Ankylosing Spondylitis
men more severely
onset is usually in early adulthood
inflammatory stage ends by age 40
development is highly variable
T/F - Ankylosing Spondylitis is the result of prolonged degenerative disc disease
FALSE
vertical bone growths replacing the intervertebral discs are called…
syndesmophytes
special test: in the extended position, patient complains of strong pain, heavy feeling in lumbar area or low back is ‘coming off’
passive lumbar extension test
What variation of the straight leg raise increases the dural stretch through cervical flexion?
Brudinski’s Sign
what is the best special test to assess for stress fracture of the pars interarticularis?
one-leg standing lumbar extension test
T/F - a positive test for the Sign of the Buttock is considered a red flag and requires sending patient to physician
TRUE
between 35 and 70 degrees of hip flexion is where the Sciatic nerve is stretched during the straight leg raise test
TRUE
best special test to assess for facet joint irritation or a space-occupying lesion?
Quadrant test
T/F - during a flare-up, PROM endfeel and hot hydrotherapy are CI’d for a patient with AS
TRUE
T/F - if the Babinski Test is positive, it will be demonstrated by extension of the big toe and abduction of the other toes
TRUE
which ligament connects the TVPs of L5 to the posterior ilium and prevents anterior displacement of L5?
iliolumbar ligament
which ligament is broader and thicker in the lumbar region?
anterior longitudinal ligament
this ligament lies deeply between two consecutive spinal processes
interspinous
this ligament joins the tips of two adjacent spinous processes
supraspinous
this ligament connects two consecutive laminae and is very elastic
ligamentum flavum
when the lumbar spine is laterally flexed to the left, the vertebrae translate and rotate to the…
right
when the 5th lumbar segment is fused to the sacrum, it is referred to as…
sacralization
when the 1st sacral segment is mobile and not fused to the sacrum, it is called…
lumbarization
Tx of sacralization is equal to treatment for ____ while Tx of lumbarization is equal to treatment for ____
hypomobility; hypermobility
what position puts the least amount of pressure on the intervertebral discs?
lying flat on your back
what position puts the most amount of pressure on the intervertebral discs?
sitting while leaning forward & lifting weight
T/F - intervertebral discs are pain sensitive because the anterior & posterior aspects of the annulus fibrosus are innervated
FALSE
degeneration of an intervertebral disc
vascular supply to disc becomes occluded
nucleus changes from gel to fibrous structure
degeneration is an normal process
height of the disc decreases
T/F - degeneration of the lumbar intervertebral discs is pathological when the degeneration process is accelerated
TRUE
which myotome is tested when dorsiflexing the foot?
L4
which myotome is tested when flexing the hip?
L2
which myotome is tested when extending the knee?
L3
which myotome is tested when flexing the knee?
S2
what test is used to confirm that a person is faking an injury?
Hoover test
degeneration of the intervertebral discs, vertebral bodies and facet joints is called…
spondylosis
T/F - symptoms of a disc protrusion vary depending on the vertebral level, direction of protrusion & amount of protrusion
TRUE
contributing factors to Degenerative Disc Disease
mm imbalances leading to asymmetric loading of the spine
poor blood supply to disc
postural dysfunction (head-forward posture)
an injured vertebra shifting or slipping forward on the vertebra directly below is called…
spondylolisthesis
a crack or stress fracture that develops through the pars interarticularis is called…
spondylolysis
T/F - a herniation of the L4 disc will compress the nerve roots of L4 and L5
TRUE
pain that retreats to the origin is called ______ of pain
centralization
pain that moves away from the origin is called ______ of pain
peripheralization
a disc herniation into the vertebral body is called a ______ node
Schmorl’s
when the nucleus pulposus protrudes into the epidural space
sequestration
when the nucleus pulposus emerges through the annulus fibrosus
extrusion
T/F - with a complete annular rupture and sequestered nucleus, movement cannot relieve the symptoms
TRUE
the stages of intervertebral disc degeneration, in order, are…
dysfunction, instability, stabilization
in which directions do the lumbar spine discs usually herniate?
posterior & lateral
T/F - the primary goal in the early stages of a disc herniation is to reduce compressive forces in the lumbar region
TRUE
when suggesting home-care for a patient with an acute disc herniation, you should…
suggest they find postures to help maintain a more natural lumbar lordosis
T/F - gluteus maximus extends the lumbar spine during hip flexion and is hypertonic in lumbar hypolordosis
TRUE
symptom picture for a patient with Hyperlordosis includes…
mm imbalances
ROM at the hip reduced in extension
an increase in lumbar lordotic curve
pain from tight ischemic tissue
T/F - Spondylolisthesis, ITB syndrome and Hyperkyphosis are likely to be found with Hyperlordosis
TRUE
when considering massage treatment for a patient with Hyperlordosis
rule out potential pathological sources
avoid mobilizing hypERmobile vertebral segments
do not randomly stretch fascia
when considering treatment goals for a patient with an Acute Disc Herniation, which of the options is NOT correct?
reduce all fascial restrictions & trigger points
(decrease SNS firing, reduce spasm, pain & edema, reduce compressive forces)
