Assessment and treatment of the Lumbar spine Flashcards
(38 cards)
Name three things that can go wrong with a vertebra.
- Fracture
- It can weaken (e.g. osteoperosis)
- Bone can grow excessively (e.g. bony spurs, fusion)
Name two functions of the annulus fibrosus.
Stabilizer
Spacer
Shock absorber
How many layers does the annulus fibrosus have?
12 layers:
- 6 going in one direction and 6 going in the other.
If a joint/ disc becomes sloppy in the lumbar spine, what are two ways the body will compensate?
- Muscles will tighten around the area.
2. Bony spurs or fusion of the discs
Name three things that can go wrong with the nerve root.
- impingement
- Compression of the nerve supply to the nerve root
- Tension
Name three things that can go wrong with the ligaments/joints.
Dislocation Sprain fixated joint Laxity Hypomobility
What is the name of the fascia that is important for stabilizing the lumbar spine?
thoracolumbar fascia
True or false.
The psoas major stabilizes the lumbar spine.
True
Name three things that can go wrong with the muscles in the lumbar region.
Strain Spasms Atrophy Soreness Tightens - Can increase compressive load.
Will pain be felt if their is damage to the inner 2/3rds of the annular fibrosis? Why?
No, because the inner 2/3rds of the annular fibrosis are not innervated.
When do radial fissures become painful?
When they creep out into the outer 1/3rd of the annular fibrosis.
What complications does a herniation cause?
Compression of the nerve root or compression of the blood supply to the nerve root.
Patient comes to you with unrelenting pain down their leg and no pain in their lower back. What are these signs of?
Extruded disk fragement
Patient comes in with LBP. Their job involves a lot of repetitive flexion with some rotary movement. At MOI, felt something, but not overly painful. LB became stiff and uncomfortable over an hour or two. Pain in the morning and at the end of the day. Made worse with sitting, coughing, sneezing, bearing down for a BM. Made better with short walks, extension activities and changing positions. What is the most likely cause of their S&S?
Disc bulge or herniated disc.
What is spondylosis? What joint may have increased weight bearing in extension or compression due to it?
It is a degenerative disc disease and the facet joint may have increased weight bearing.
Which physiological movement of the discs will unload the disc in the lumbar spine?
Extension will unload it.
Which movements produce pain in a person with an acute sprain of the facet joint? How is pain usually reduced?
All ROMs may be affected.
Pain is reduced by decreased weight bearing and movement in midrange
True or False
Compressed discs leads to stiff joints.
False.
Compressed discs leads to lax joints.
Patient comes in with intermittent LBP with posterolateral leg pain. Pain is brought on by activities involving extension. Pain is relieved by resting in flexed position such as sitting or crook lying. What is the most probable cause? Describe the impairment.
Spinal stenosis.
Narrowing of the spinal canal by bony protrusions. Can irritate nerve roots.
What is spondylolisthesis?
A specific instability whereby one vertebra slips anteriorly on the vertebra below. Usually due spending prolonged periods of time in extension or flexion, which allows for creep and slippage due to gravity.
What is the cause of the LBP in spondylolisthesis?
Vertebra begin to slip or creep posteriorly or anteriorly and muscles will tighten to prevent it and cause LBP.
What usually decreases LBP for patients with spondylolisthesis?
Activities that keep optimum muscle tone
What is commonly associated with spondylolisthesis, but not always.
Fractured pars interarticularis
AKA Scotty dog fracture
Name a common muscle imbalance affecting the lumbar spine.
Pelvic Cross Syndrome:
- Tigh erector spinae and hip flexors
- Weak abdominals and gluteal muscles
