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VanPimping's Ortho lecture > Test 2 lumbar > Flashcards

Test 2 lumbar Flashcards

1
Q

What percentage of the population experiences LBP at some point in their lives?

A

80%

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2
Q

What inspection element can clue the doctor in on possible underlying neurological or boney pathologies?

A

Lipomatas, hairy patches, cafe-au-lait, or birth marks; basically any congenital skin marking

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3
Q

Lipomata

A

aka lipoma; benign tumor of fatty tissue

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4
Q

Neurofibromatosis

A

hereditary disorder that produces pigmented spots and pedunclated soft tissue nodules clustered along nerve sheathes

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5
Q

Gibbus deformity

A

sharp kyphosis in the thoracic spine affecting the normal lordosis of the lumbar spine

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6
Q

Spondylolytic spondylolisthesis

A

a unilateral or bilateral defect in the pars with anterior or posterior displacement of the vertebra on the vertebra below it

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7
Q

What scale is used to measure spondylos?

A

Myerding’s Grading Scale

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8
Q

What level is the umbilicus and why is this significant?

A

L3/4 - where the abdominal aorta bifurcates into common iliac arteries

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9
Q

Ligamentum flavum

A

connects two consecutive vertebrae

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10
Q

Interspinous ligament

A

connects two consecutive spinous processes

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11
Q

supraspinous ligament

A

connects the tip of two adjacent SP’s

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12
Q

Psoas

A

originates from anterior portions of T12-L5; main hip flexor

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13
Q

Sciatic nerve divides into

A

tibial and peroneal divisions

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14
Q

What could cause the sciatic nerve to be tender upon palpation?

A

disc pathology such as a space-occupying lesion

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15
Q

A disc pathology effects the nerve root _____

A

below (L4 disc pathology affects L5 nerve root)

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16
Q

Aka for disc herniation

A

extrusion - nucleus pulposa extrudes into the spinal canal and fibers have been torn

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17
Q

What innervates Z joints in the lumbar spine?

A

Dorsal rami

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18
Q

In what three planes can lumbar motion occur?

A

frontal, sagittal, transverse

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19
Q

How many degrees of freedom are available in the lumbar spine?

A

six

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20
Q

Where does most of the lumbar flexion and extension occur? side-bending? rotation?

A

Lower segmental levels
Mid lumbar levels
Minimal, occurs with lat flexion at lumbosacral junction

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21
Q

Which lumbar motion requires a change in the degree of lordosis?

A

Flexion - lordosis reverses

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22
Q

Palpation of the lumbar spine should be accompanied by palpation of what other areas?

A

Hip and pelvic

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23
Q 
A heredity (autosomal
dominant trait) disorder
that produces pigmented
spots, and pedunculated
soft-tissue nodules
clustered along nerve
sheaths
A

Neurofibromatosis

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24
Q

Nodules develop from Neurofibromatosis
during childhood, growing
to more than ___ cm in
size and can reach up to ____ cm in size

A

0.5, 1.5+

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25
Q

Cafe-au-lait patches are usually

seen over the (3)

A
  1. trunk
  2. pelvis
  3. flexor creases of the elbows and knees
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26
Q

Bone changes in Neurofibromatosis
may result in
skeletal deformities

A 
Scoliosis,
Vertebral body scalloping,
Fibrous dysplasia, Tibial
Pseudoarthrosis, Sphenoid bone
deformity, Mental impairment,
seizures, hearing loss,
exopht
halmosis, decreased visual
acuity, and GI bleeding eventually
occur
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27
Q 
When a patient is
standing an
inclination or listing
to one side or the
other may be a sign
of a possible \_\_\_\_ \_\_\_\_, secondary
to a\_\_\_\_\_ \_\_\_\_
A

sciatic scoliosis, herniated disc

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28
Q

sharp kyphosis in the lower thoracics, affecting the normal lordosis of the lumbar spine

A

gibbus deformity

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29
Q

palpable or visible step-off from onenprocess to another maybe indicative of a

A

spondyloslisthesis

30
Q

anterior or posterior displacement

of a vertebrae with pars defect indicates

A

spondylolysis (oblique views)

31
Q

A unilateral or bilateral defect in the pars interarticularis with
anterior or posterior displacement of a vertebrae on the adjacent lower vertebra

A

Spondylolytic Spondyloslisthesis

32
Q

_____ lies at the L3-L4 disc

space at the point where the _____ divides into the common iliacs.

A

umbilicus, aorta

33
Q

the primary function of the _______ _____ is to protect the motion segment from anterior shear forces, excessive rotation, and flexion

A

zygapophyseal joint

34
Q

Connects two consecutive laminae

A

Ligamentum flavum

35
Q

Connects two consecutive spinal processes

A

Interspinous ligament

36
Q

Connects the tips of two adjacent spinous processes

A

Supraspinous Ligament

37
Q

Functions to restrain flexion, extension, axial rotation, and side bending of L-5 on S-1

A

Iliolumbar Ligament

38
Q

separates paravertebral
compartments, and do not have any
mechanical function

A

intertransverse, transforaminal, and mamillo-accessory (resemble the membranous part of the fascial system)

39
Q

lumbar spine stabilizer for breathing

A

Quadratus Lumborum

40
Q

provide segmental stiffness and control motion

A

Lumbar multifidus (LM)

41
Q

Assists the in transmission of extension forces during lifting activities

A

Thoracolumbar

fascia

42
Q 
Stabilizes the
spine against
anterior shear
and flexion
moments
A

Thoracolumbar

fascia (TLF)

43
Q 
takes origin
from the anterior
portion of the T12-
L5 vertebral bodies
and discs- the main
hip flexor
A

Psoas

44
Q

Pain from a ____
abscess increases
when the hip is
actively flexed

A

psoas

45
Q 
gives off
branches to the
hamstrings and then
divides into 2
terminal branches –
the tibial and the
peroneal divisions
A

sciatic

46
Q 
A disc pathology or a
space- occupying
lesion can cause the \_\_\_\_
nerve to be tender to
palpate
A

sciatic

47
Q

To palpate the sciatic nerve –
locate midpoint
between the ____ ____ and the
_____ ____

A

ischial tuberosity, greater trochanter

48
Q

A disc is named
after the vertebrae
_____

A

above

49
Q

A disc pathology
affects the nerve
root ____

A

below

50
Q

little pieces of the
nucleus pulposus protrude into the annular
fibers (weaken annular fibers)

A

Protrusion

51
Q

nucleus pops out of the annular fibers NOT yet torn fibers , just stretched

A

Prolapse aka Bulge

52
Q

fibers torn,
nucleus bursts into the PLL –
PLL is torn, patient
often describes a shredding noise

A

Extrusion aka Herniation

53
Q

multiple pieces of the

nucleus (particles) are in the spinal canal

A

Sequestration –

54
Q

_______ joints are innervated by the medial branches of the dorsal rami

A

zygapophyseal

55
Q

lateral aspect of IVDs are innervated by

A

sympathetic innervation

56
Q

posterior-lateral aspect, outer half of the IVD

A

sinuvertebral nerve and the grey rami communicants

57
Q

____ degrees of freedom are available at

the lumbar spine

A 
Six
right and left 
Sagittal (flexion and extension)
• Coronal (side bending)
• Transverse (rotation)
58
Q

_____ and ____ of the lumbar

spine occurs in the lower segmental levels

A

flexion and extension

59
Q

most of the side bending of the lumbar

spine occurs in the ____ _____ area

A

mid-lumbar

60
Q

occurs most at

the lumbosacral junction

A

rotation

61
Q

extension involves a _____ roll and
glide of the vertebra, and a posterior and inferior motion of the_____ ____, but not necessarily a change in the degree of lordosis

A

posterior, zygapophyseal joints

62
Q

Axial rotation of the lumbar spine amounts to approximately ___ to both sides most occures at L5/S1 at __ degrees

A

13°, 5 degrees

63
Q

•Although ____ alignment provides some
valuable information, a positive correlation
has not been made between _____
alignment and pain

A

spinal, abnormal

64
Q

It is the _____ of motion and the
symptoms provoked, rather than the
_____ of motion that is more important

A

quality, quantity

65
Q

The key muscle tests examine the integrity of the
_____ and the contractile and
inert components of the various muscles

A

NMJ

66
Q

isometric tests, the contraction should be
held for at least ___ seconds to demonstrate any
weakness

A

5

67
Q

If the clinician suspects weakness, the test is
repeated ______ to assess for fatiguability, which could indicate spinal nerve root
compression.

A

2-3 times

68
Q

______ vary considerably between

individuals

A

Dermatomes

69
Q

Acute phase goals

A

• Decrease pain, inflammation, and muscle
spasm
• Promote healing of tissues
• Increase pain-free range of segmental motion
• Regain soft tissue extensibility
• Regain neuromuscular control
• Allow progression to the functional stage

70
Q

functional phase goals

A

• Correction of imbalances of strength and
flexibility
• Incorporate neuromuscular re-education
• Strengthening of entire kinetic chain
• Postural correction and retraining
• To initiate and execute functional activities
without pain and while dynamically stabilizing
the spine in an automatic manner

VanPimping's Ortho lecture (11 decks)

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