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Flashcards in Lumbar Lecture Deck (32)
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1

Spinous processes are located where, relative to the vertebral body?

Same level

2

Why are the vertebral bodies higher anteriorly?

Maintains lordosis

3

What is the first ligament to become tender with lumbar postural changes and where is it located (relative to the PSIS)?

Iliolumbar ligament 1 inch superior and lateral to PSIS

4

Thomas tests examines what muscle dysfunction:

psoas/iliopsoas

5

Describe the hoover test.

Testing for malingerers
When patient raises one leg, the contralateral side should create pressure on the physician's hand
No pressure: malingering

6

If the trendelenburg test is positive on the right (right leg is up), what muscle is weak?

Right gluteus medius

7

The valsalva maneuver exacerbates pain/symptoms when the patient has what condition?

Disc herniaton

8

First thing done in diagnosis of lumbar spine

Active range of motion (PROM if AROM limited)

9

How do you test the piriformis?

Internal rotation of lower extremity

10

Most common locations (#1 and #2) and direction of herniated discs

Posterolaterally
L5-S1 (#1)
L4-L5 (#2)

11

Describe some symptoms of a herniated disc.

Sharp low back pain with LE radiculopathy exacerbated by valsalva maneuver
Sensory deficits
Decreased reflexes associated iwth affected nerve root

12

Discs are named for the vertebrae above or below?

Above

13

Muscles/sensory of a Disc herniation of L3 and what root affected:

L4 root
Patellar reflex
Anterior tibialis (inversion, dorsiflexion)
Quads (extension)
Sensation to medial leg/foot

14

Muscles/sensory of disc herniation at L4 and what root affected

L5 root
EHL (dorsiflex great toe)
Laterla leg/dorsum of foot sensation

15

Muscles/sensory of disc herniation at L5 and what root affected

S1 root
Achilles reflex
Peroneus longus, brevis (eversion; plantarflexion)
Lateral foot sensation

16

Nerve roots exit foramina superior or inferior to correspondering IV disc?

Superior

17

Iliopsoas innervation

T12-L3

18

Quadriceps innervation

Femoral nerve L2-L4 ==> extend leg at knee

19

Adductors innervation

Obturater nerve (L2-L4)
Adduct hip

20

Tibialis anterior innervation

Deep peroneal nerve (L4)
Foot dorsiflexion with inversion

21

Sx of spinal stenosis

Aching low back pain to lower legs
Worsened by lumbar extension
Relieved by sitting

22

Sx of psoas syndrome and findings on PE

Aching back pain with possible radiation to groin
Positive thomas test
Flexed/extended L1 or L2
Positive pelvic shift test on the contralateral side
Sacral dysfunction on oblique axis
Contralateral piriformis spasm

23

Warning signs:
Severe LBP
Sudden onset
No hx of trauma

Dissecting AA

24

Warning signs:
Claudication sx with LBP

Spinal stenosis

25

Warning signs:
Pain that wakens pt from sleep

Malignancy

26

Warning signs:
Rapidly progressing neurological deficits

Epidural abscess/infection

27

Define spondylosis.

Degenerative changes within IV disc with ankylosing of adjacent vertebral bodies

28

Defne spondylolysis

Defect/fx of pars interarticularis W/O anterior displacement of vertebral body
Dx: oblique x-ray (fx of collar on scotty dog)

29

Define spondylolisthesis and where it is usually located on the lumbar spine.

Anterior displacement of one vertebral body in relationship to the one below -- primarily the lumbar spine L5 on S1

30

Difference between spondylolisthesis and spinal stenosis.

Pain aggravated by activity and relieved by rest
(stenosis is relieved by SITTING!)