Chapter 4 Lumbar Spine Flashcards Preview

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Flashcards in Chapter 4 Lumbar Spine Deck (47):
1

Reason why lumbar spine is more susceptible to disc herniation?

Narrowing of posterior longitudinal ligament

2

Comparison of posterior longitudinal ligament at L1 and at L4-5?

Is 1/2 the width at L4-5 than at L1

3

Location of where spinal cord terminates?

L1-2

4

Location of where nerve roots exit in lumbar spine?

Below corresponding vertebrae, but above the IV disc

5

Origin of iliopsoas m?

T12-L5 vertebral bodies

6

Insertion of iliopsoas m?

Lesser trochanter

7

Erector spinae mm from lateral to medial?

Iliocostalis, Longissimus, Spinalis (I Love Spine)

8

Level of iliac crest?

L4-L5

9

T10 dermatome at umbilicus is anterior to which IV disc?

L3-L4

10

Most common anomaly in lumbar spine?

Facet trophism--predisposes to early degenerative changes

11

What is facet trophism?

Lumbar facet joints are aligned in coronal plane (instead of sagittal)

12

What is sacralization?

TPs of L5 are long and articulate with sacrum--predisposes to early degenerative changes

13

What is lumbarization?

Failure of fusion of S1 with other sacral segements

14

What is spina bifida?

Defect in closure of limina of vertebral segment

15

3 types of spina bifida?

Occulta, meningocele, meningomyelocele

16

Alignment of lumbar facets?

Backward and medial for superior facets

17

Major motion of lumbar spine?

Flexion and extension (small degree of SB, limited rotation)

18

Sidebending of L5 will cause what sacral motion?

Sacral oblique axis will be engaged on same side

19

Rotation of L5 will cause what sacral motion?

Sacrum will rotate toward opposite side

20

Ferguson's angle?

Lumbosacral angle--formed by intersection of a horizontal line and the line of inclination of the sacrum (25-35 degrees)

21

98% of disc herniations occur where?

Between L4-5 or L5-S1

22

A herniation bt L4-5 will exert pressure on which nerve root?

L5 (the nerve root below)

23

Positive test seen in disc herniation?

Straight leg raising test

24

What is relatively CI in herniation?

HVLA

25

OMT for herniation?

Initially indirect techniques, then gentle direct

26

Positive test seen in psoas syndrome?

Thomas test

27

Tender point seen in psoas syndrome?

Medial to ASIS

28

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

29

When do you stretch psoas m in psoas syndrome?

Chronic spasms

30

OMT for psoas syndrome?

Counterstrain to anterior iliopsoas tenderpoint followed by ME/HVLA to high lumbar dysfunction

31

Causes of spinal stenosis?

Hypertrophy of facet joints, Ca deposits within ligamentum flavum and posterior longitudinal l, loss of IV disc height

32

Radiology for spinal stenosis?

Osteophytes and decreased IV disc space, foraminal narrowing on oblique views

33

What is spondylolisthesis?

Anterior displacement of one vertebrae in relation to one below due to fractures in the pars interarticularis

34

Where does spondylolisthesis occur?

L4 or L5

35

What are the neuro deficits in spondylolisthesis?

None

36

What is a positive vertebral step-off sign?

Palpating the spinous process there is an obvious forward displacement at the area of listhesis

37

S/S of spondylolisthesis?

Pain with extension-based activities, tight hams b/l, stiff-legged, short stride, waddling gait

38

Goal of tx for spondylolisthesis?

Reduce lumbar lordosis and somatic dysfunction

39

What is CI in spondylolisthesis?

HVLA

40

Grading for spondylolisthesis?

1 = 0-25%; 2 = 25-50%; 3 = 50-75%; 4 = >75%

41

What is spondylolysis?

Defect of pars interarticularis WITHOUT anterior displacement of vertebral body

42

Radiology for spondylolysis?

Scotty dog on oblique view--fracture of pars interarticularis

43

What is spondylosis?

Radiological term for degenerative changes within IV disc and ankylosing of adjacent vertebral bodies

44

How do you dx spondylolisthesis vs. spondylolysis?

Spondylolisthesis = lateral x-ray; sponylolysis = oblique x-ray

45

Cause of cauda equina syndrome?

Massive central disc herniation

46

S/S of cauda equina syndrome?

Saddle anesthesia, decreased DTRs, decreased rectal sphincter tone, loss of bowel/bladder control

47

Result of delay in surgery for tx cauda equina?

Irreversible paralysis