Exam #2

Question 0

What are the two main joint types of the lumbar spine?

Answer 0

1.) Zygapophoseal joints (facet joints): Synovial 2.) Intervertebral joints: Fibrocartilagenous joints Lecture 11 video

Question 1

For the lumbar spine, give the following ROMs: 1.) Flexion 2.) Extension 3.) Side-bending

Answer 1

1.) 40-50˚ 2.) 20-30˚ 3.) 30˚ Lecture 11 video

Question 2

The lumbar spine vertebrae become (larger or smaller?) as you descend? Which lumbar vertebrae is the largest?

Answer 2

Becomes larger, L5 being the largest (largest in height and circumference) Lecture 11 video

Question 3

The developing lumbar lordosis in children is resisted by the ______ muscle.

Answer 3

iliopsoas muscle Lecture 11 video

Question 4

The superior articular facets of the lumbar spine are rotated ______˚ from the sagittal plane.

Answer 4

45˚

Question 5

The superior articular facets of the lumbar spine are _____ and face primarily _____ and ______.

Answer 5

They are CONCAVE and face primarily MEDIALLY and BACKWARD. Lecture 11 video

Question 6

The inferior articular facets of the lumbar spine are _____ and face _____ and _____.

Answer 6

They are CONVEX and face LATERALLY and FORWARD.

Question 7

In terms of vertebral levels, define the: 1.) Anatomical lumbar spine 2.) Functional lumbar spine

Answer 7

1.) L1-L5 2.) T11-L5 Lecture 11 video

Question 8

What is the Fergusun Angle? What is the normal value?

Answer 8

A line paralleling the top of the sacrum and a line drawn horizontally. Normal value is 35˚ *Video Lecture #11, 6:30*

Question 9

What increases the Fergusun Angle?

Answer 9

Forward tipping of the sacrum

Question 10

Lumbar lordosis is dependent upon the ________ ________.

Answer 10

Sacral base

Question 11

Lumbosacral angle is influenced by __________.

Answer 11

Capsular tissue of the hip

Question 12

An increase in lumbar lordosis correlates to what change in: 1.) Fergusun Angle? 2.) Cervical lordosis, thoracic kyphosis?

Answer 12

1.) Increased Fergusun Angle. 2.) Increased cervical lordosis and thoracic kyphosis

Question 13

1.) What muscle(s) is/are likely the cause of a posterior rotation of the ilium with subsequent loss of lordosis? 2.) Which other muscles would be affected and how?

Answer 13

1.) Shortening of the HAMSTRING MUSCLES 2.) Quads and IT band (stretching)

Question 14

What muscle(s) could be responsible for low back pain AND pain in the posterior aspect of the shoulder?

Answer 14

Latissimus dorsi (hypertonia and tenderness)

Question 15

What is the origin, insertion, and action of the iliopsoas muscle?

Answer 15

-Origin: Transverse processes of lumbar vertebrae and lateral aspect of lumbar vertebral bodies. -Insertion: Less trochanter of the femur -Action: Powerful hip flexor, weak lateral rotator of hip, *EXTENDS LUMBAR VERTEBRAL COLUMN (deepening the lumbar curve) to maintain posture*

Question 16

What is the most important evaluation test for the iliopsoas? What does this test tell you?

Answer 16

Thomas Test: It indicates whether or not the iliopsoas is shortened.

Question 17

What affect will a shortened iliopsoas have on the lumbar spine and hip?

Answer 17

A shortened iliopsoas will cause an INCREASED LORDOSIS and FLEXED HIP

Question 18

1.) What affect will a shortened/hypertonic gluteus maximus have on the pelvis and lumbar spine? 2.) Hamstrings?

Answer 18

1.) Pull pelvis posteriorly, reduced lumbar lordosis (HYPOlordosis). 2.) Same

Question 19

What affect will shortened/hypertonic quadriceps muscles have on the pelvis and lumbar spine?

Answer 19

Anteriorly rotated ileum/pelvis, increased lordosis

Question 20

What type of somatic dysfunctions do erector spinae muscles bring about?

Answer 20

Type-I somatic dysfunctions

Question 21

What muscle(s) bring about Type-II somatic dysfunctions?

Answer 21

Multifidus and rotatores

Question 22

What are the contents of the multifidus triangle?

Answer 22

Multifidus muscles, L4-L5, intertransverse ligament, iliolumbar ligaments, and SI joint.

Question 23

What are the most commonly ruptured discs?

Answer 23

Lumbar discs L4-L5.

Question 24

What are the borders/boundaries of the Multifidus Triangle?

Answer 24

Spine of L4 to iliac crest and tip of sacrum

Question 25

Which ligament(s) of the lumbar spine limit: 1.) Extension 2.) Flexion

Answer 25

1.) Anterior longitudinal ligament 2.) Posterior longitudinal ligament

Question 26

Why are disc ruptures more likely in the lower lumbar segments?

Answer 26

Because the posterior longitudinal ligament NARROWS as it descends

Question 27

1.) What is the pain referral pattern of the iliolumbar ligaments? 2.) What other anatomical structures/regions can refer pain to this area (4)?

Answer 27

1.) Anterior groin area 2.) Iliopsoas muscle, SI joint, hip pain, kidney

Question 28

What dermatomal level refers pain to the anterior groin?

Answer 28

L1

Question 29

At which lumbar spine levels does the greatest amount of flexion occur? How much occurs there (in a percentage)?

Answer 29

L4-L5 (20-25%), L5-S1 (60-75%) –> L4-S1 = 80-90% of flexion

Question 30

What happens to intervertebral foramen (IVF) size during: 1.) Flexion 2.) Extension

Answer 30

1.) Larger 2.) Smaller

Question 31

What is the normal value for lumbar side-bending?

Answer 31

20-25˚

Question 32

What is the indication for a positive hip drop test (2)?

Answer 32

1.) <20-25˚ drop in iliac crest on ipsilateral side of knee drop 2.) Sharp angulation or absence of curve on contralateral side (non-weight bearing side)

Question 33

In which direction is the spinous process rotating if the TP rotates left?

Answer 33

SP rotates right (counter-clockwise)

Question 34

Regarding spinal mechanics, rotation occurs around which AXIS? and within which PLANE?

Answer 34

Rotation occurs around a VERTICAL AXIS, and within a HORIZONTAL PLANE.

Question 35

Regarding spinal mechanics, sidebending occurs around which AXIS? and within which PLANE?

Answer 35

Sidebending occurs around an AP AXIS, and within a CORONAL PLANE.

Question 36

The annulus fibrosis is thicker _____, and thinner _______.

Answer 36

Thicker ANTERIORLY, thinner POSTERIORLY

Question 37

During flexion, the nucleus pulposus moves _______

Answer 37

Posteriorly

Question 38

During sidebending to the right, the nucleus pulposus moves _____, i.e. TOWARDS or AWAY from the concavity?

Answer 38

Left (i.e. towards the CONCAVITY)

Question 39

Decreased disc thickness causes an increased weight load on the ______ joint.

Answer 39

FACET joint

Question 40

What is the most common direction of a disc herniation?

Answer 40

Posterolateral

Question 41

In what bodily position is the most force directed on to an IV disc? Minimal amount of force?

Answer 41

Sitting = maximal force Lying down = minimal force

Question 42

What activity puts the maximal load on L3?

Answer 42

Laughing

Question 43

What motion of the lumbar spine results in decreased lordosis?

Answer 43

Forward flexion