Lumbar Spine

Question 1

lumbar spine joints

Answer 1

diarthrodial
superior and inferior facets w capsule
10 or 5 pairs of facet joints in lumbar spine
facets located on vertebral arches
facets carry 20-25% of axial load can increase to 70% w degeneration

Question 2

degeneration of vertebral disc =

Answer 2

spondyLOSIS

Question 3

defect in pars interarticularis arch of vertebrae

Answer 3

spindyLOLysis

Question 4

forward displacement of one vertebrae over another

Answer 4

spondylolisthesis

Question 5

backward displacement of one vertebrae on another

Answer 5

retrolisthesis

Question 6

which way do superior facets or articular processes face

Answer 6

medially and backward

generally concave

Question 7

which way do inferior facets face

Answer 7

laterally and forward
convex

opposite for superior facets
medially and backward
concave

Question 8

in the lumbar spine the TVPS are at the _______ as SPs

Answer 8

same level

Question 9

if S1 segment is mobile, it results in 6th lumbar vertebra

Answer 9

lumbarization

(hypermobility tx)

Question 10

the 5th lumbar segment is fused to the sacrum and ilium, resulting in 4 lumbar vertebra

Answer 10

sacralization

(treated for hypomobility)

Question 11

which ligament connects the transverse process of L5 to the posterior ilium and prevents anterior displacement of L5

Answer 11

iliolumbar

(prevents spondylolisthesis)

Question 12

purpose of intervertebral discs

Answer 12

• shock absorbers
• hold vertebrae together, allow movement between bones
• separate vertebrae as part of funtional segmental unit
• separate vertebrae and allow the passage of nerve roots from the spinal cord through intervertebral foramina

Question 13

which annulus fibrosis zone: fibrocartilage that attaches to outer aspect of vertebral body, contains lots of cartilage cells

Answer 13

outer zone

Question 14

which annulus fibrosis zone contains the largest number of cartilage cells

Answer 14

inner zone

Question 15

which part of intervertebral disc receives blood supply

Answer 15

periphery

the other parts receive nutrition by diffusion through the cartilaginous end plate

Question 16

if the pressure is great enough on discs, defects can occur in cartilaginous end plate resulting in

Answer 16

Schmorl’s nodules that are herniation’s of the nucleus pulposus into the vertebral body

Question 17

disc bulges posteriorly without rupture of annulus fibrosis

Answer 17

protrusion

Question 18

only the outermost fibres of annulus fibrosis contain the nucleus

Answer 18

prolapse

Question 19

the annulus fibrosis is perforated and the discal matter moves into epidural space

Answer 19

extrusion

Question 20

formation of discal fragments from the annulus fibrosus and nucleus pulposus outside the disc proper

Answer 20

sequestrated

Question 21

injury to disc, list 4 problems from least to worst

Answer 21

1. protrusion
2. prolapse
3. extrusion
4. sequestration

Question 22

each nerve root in lumbar spine is named for the vertebra ______

Answer 22

above it

L4 n. root exits between L4 and L5

Question 23

where is the most common site of problems in L spine

Answer 23

L5-S1

b/c it bears most weight

centre of gravity passes directly through this vertebra

Question 24

resting position of lumbar spine

Answer 24

midway between flexion and extension

Question 25

close packed position of lumbar spine

Answer 25

full extension

Question 26

capsular pattern of lumbar spine

Answer 26

side flexion and rotation equally limited, extension

Question 27

pain is more likely to be bilateral if it is a

Answer 27

central protrusion spondylolisthesis spinal stenosis metastases

Question 28

_______implies that pain is moving toward or is centered in lumbar spine

Answer 28

centralization

Question 29

________- implies that pain is being referred or is moving into the limb

Answer 29

peripheralization

Question 30

in pelvic cross syndrome what mms are weak, long and inhibited

Answer 30

abdominals glutes

Question 31

in pelvic cross syndrome what mms are strong, tight, short

Answer 31

hip flexors back extensors

Question 32

a tuft of hair that can indicate a spina bifida occulta or diastematomyelia

Answer 32

Faun's beard

Question 33

in the lumbar spine why does a "step deformity" occur

Answer 33

b/c the spinous process of one vertebrae becomes prominent when either the vertebra above or the affected vertebra slips forward on the one below

Question 34

S1 myotome= lift a tonne

Answer 34

ankle plantar flexion & eversion, hip extension

Question 35

this nerve, which lies within the transverse abdominus mm, may be compressed by spasm of the mm

Answer 35

ilioinguinal

Question 36

in the extended position, patient complains of strong pain, heavy feeling in lumbar area or low back is ‘coming off’ - what test is this

Answer 36

passive lumbar extension test

Question 37

what variation of the straight leg raise increases the dural stretch through cervical flexion?

Answer 37

Brudzinski's sign (flexing neck to chest) Bragards (dorsiflex foot)

Question 38

what is the best special test to assess for stress fracture of the pars interarticularis?

Answer 38

one leg (stork) standing lumbar extension test

Question 39

when the lumbar spine is laterally flexed to the left, the vertebrae translate and rotate to the _____

Answer 39

right following the coupled motion of the spine

Question 40

Tx of sacralization is equal to treatment for ____ while Tx of lumbarization is equal to treatment for ____

Answer 40

sacralization = hypomobility lumbarization = hypermobility

Question 41

when suggesting home-care for a patient with an acute disc herniation, you should…

Answer 41

suggest pain free ROM reduce herniation by maintaining lumbar lordosis extension strenghening for posterolateral herniaiton

Question 42

which ligament prevents spondylolisthesis

Answer 42

iliolumbar