Flashcards in Chapter 4 Lumbar Spine Deck (47)
Reason why lumbar spine is more susceptible to disc herniation?
Narrowing of posterior longitudinal ligament
Comparison of posterior longitudinal ligament at L1 and at L4-5?
Is 1/2 the width at L4-5 than at L1
Location of where spinal cord terminates?
Location of where nerve roots exit in lumbar spine?
Below corresponding vertebrae, but above the IV disc
Origin of iliopsoas m?
T12-L5 vertebral bodies
Insertion of iliopsoas m?
Erector spinae mm from lateral to medial?
Iliocostalis, Longissimus, Spinalis (I Love Spine)
Level of iliac crest?
T10 dermatome at umbilicus is anterior to which IV disc?
Most common anomaly in lumbar spine?
Facet trophism--predisposes to early degenerative changes
What is facet trophism?
Lumbar facet joints are aligned in coronal plane (instead of sagittal)
What is sacralization?
TPs of L5 are long and articulate with sacrum--predisposes to early degenerative changes
What is lumbarization?
Failure of fusion of S1 with other sacral segements
What is spina bifida?
Defect in closure of limina of vertebral segment
3 types of spina bifida?
Occulta, meningocele, meningomyelocele
Alignment of lumbar facets?
Backward and medial for superior facets
Major motion of lumbar spine?
Flexion and extension (small degree of SB, limited rotation)
Sidebending of L5 will cause what sacral motion?
Sacral oblique axis will be engaged on same side
Rotation of L5 will cause what sacral motion?
Sacrum will rotate toward opposite side
Lumbosacral angle--formed by intersection of a horizontal line and the line of inclination of the sacrum (25-35 degrees)
98% of disc herniations occur where?
Between L4-5 or L5-S1
A herniation bt L4-5 will exert pressure on which nerve root?
L5 (the nerve root below)
Positive test seen in disc herniation?
Straight leg raising test
What is relatively CI in herniation?
OMT for herniation?
Initially indirect techniques, then gentle direct
Positive test seen in psoas syndrome?
Tender point seen in psoas syndrome?
Medial to ASIS
Dysfunctions seen in psoas syndrome?
Nonneutral dysfunction of L1-2, positive pelvic shift test to contralateral side, sacral dysfunction on an oblique axis, and contralateral piriformis spasm
When do you stretch psoas m in psoas syndrome?