Thoracic/Lumbar DSA

Question 1

Qualities of a Thoracic Vertebra

Answer 1

Heart-shaped body, costal facets present, spinous process is long and sloped posteroinferiorly

Question 2

Qualities of a Lumbar Vertebra

Answer 2

Kidney-shaped body, large, shorter, broad spinous processes

Question 3

For T1-3 the spinous process is located…

Answer 3

at the level of the corresponding transverse process

Question 4

For T4-6 the spinous process is located…

Answer 4

a half segment below the corresponding transverse process

Question 5

For T7-9 the spinous process is located…

Answer 5

a whole segment below the corresponding transverse process

Question 6

For T10 the spinous process is located…

Answer 6

a whole segment below the corresponding transverse process

Question 7

For T11 the spinous process is located…

Answer 7

a half segment below the corresponding transverse process

Question 8

For T12 the spinous process is located…

Answer 8

at the same level as the corresponding transverse process

Question 9

Which have a lordosis or a kyphosis?

a) cervical
b) sacral
c) lumbar
d) thorcacic

Answer 9

a) lordosis
b) kyphosis
c) lordosis
d) kyphosis

Question 10

On cervical vertebrae, where is the superior facet located?

Answer 10

Backwards, upwards and medial

Question 11

On thoracic vertebrae, where is the superior facet located?

Answer 11

Backwards, upwards, lateral

Question 12

On the lumbar vertebrae, where is the superior facet located?

Answer 12

Backwards and medial

Question 13

What do the following ligaments connect?

a) Anterior Spinal Ligament
b) Posterior Pinal Ligament
c) Ligamentum Flava
d) Interspinous ligaments
e) Intertransverse ligaments

Answer 13

a) Anterior aspect of vertebral bodies, prevents hyperextension
b) Posterior aspect of the vertebral bodies, resists hyperflexion and posterior herniation of nucleus pulposus
c) Laminae of adjacent vertebrae
d) Adjoining spinous processes
e) Adjoining transverse processes

Question 14

ROM degrees for flexion, extension, rotation, and sidebending of thoracic and lumbar spine

Answer 14

Flexion: 40-90, Extension: 20-45, Rotation: 3-18, Sidebending: 15-30

Question 15

What are the transversospinalis muscles of the spine?

Answer 15

Rotatores brevis- from spinous process to transverse process of adjacent vertebra
Rotatores longi- from transverse process to spinous process one vertebrae away
Multifidus- same setup that skips 2-4 vertebrae
Sepispinalis (capitus, thoracis, cervicalis)- skips 5 or more vertebrae

Question 16

Example of coupled motion?

Answer 16

Sidebending and rotation of spine

Question 17

What part of the vertebrae do we always reference when referring to motion?

Answer 17

The anterior superior surface of the vertebrae

Question 18

Fryette’s Principles- History

Who developed the accompanying third principle?

Answer 18

Harrison Fryette described physiologic motion of the thoracic and lumbar spine and published in 1918 Two principles of spinal motion
C.R. Nelson developed the third principle in 1948

Question 19

Fryette Type One Spinal Mechanics

Answer 19

In a neutral position, sidebending and rotation are coupled in OPPOSITE directions. Most commonly a group of affected vertebrae, but can be a single vertebra
Ex. T1-3 S(r)R(l)

Question 20

Fryette Type Two Spinal Mechanics

Answer 20

In a flexed or extended position, sidebending and rotation are coupled in the SAME direction, tend to be singly affected vertebrae
Ex. T9 S(r)R(r)

Question 21

Third Principle

Answer 21

Initiating movement of a vertebral segment in any plane of motion with modify the movement of that segments in other planes of motion, so if it is restricted in one direction, it will also be restricted in other directions. Same for improvement

Question 22

Translating a vertebrae to the right means…

Answer 22

Sidebending to the left

Question 23

Dextro vs. Levoscoliosis

Answer 23

Left sidebent vs Right sidebent

Question 24

Complication in scoliosis Cobb angle >50 degrees

Complication in angle >75

Answer 24

Respiratory compromise

Cardiac compromise

Question 25

Sacralization

Lumbarization

Answer 25

Fusion of a transverse process of L5 with the sacrum

Failure of S1 to fuse with the sacrum