lumbars

Question 1

a. When a patient is standing an inclination or listing to one side or the other may be a sign for what?

Answer 1

a. Possible sciatic scoliosis

b. Secondary to herniated disc

Question 2

a. What is a gibbus deformity?

Answer 2

a. Sharp kyphosis in the lower thoracics

b. Affecting the normal lordosis of the lumbar spine

Question 3

a. In bony palpation of lumbars, how inferior is palpated?

Answer 3

a. Inferiorly and medially to the S2 spinous process

Question 4

a. What may indicate spondyloslisthesis?

Answer 4

a. Palpable or visible step-off from one process to another
b. Unilateral or bilateral problem with a pars interarticularis defect is an indicator
i. Seen on oblique view

Question 5

a. What scale is used to measure spondylos?

Answer 5

a. Meyerdings scale

Question 6

a. What disc level does umbilicus lie?

Answer 6

a. L3-L4 disc space at the point where aorta divide into commons iliacs
b. Anterior portion of L4 L5 and S1 bodies and discs are palpable below the arterys division
c. Anterior portions of the bodies are covered by the ALL

Question 7

a. What is the primary fucntion of Z joints in the lumbar?

Answer 7

a. To protect the motion segment from anterior shear forces

b. Excessive rotation and flexion

Question 8

a. ALL extends from?

Answer 8

a. Sacrum along anteior aspect of entire spinal column

Question 9

b. Where is PLL extend from?

Answer 9

a. PLL found throughout the spinal column where it covers the posterior aspect and IVD

Question 10

a. Name the three ligaments of lumbar

Answer 10

a. Ligamentum flavum
i. Connects two consecutive laminae
b. Interspinous ligament
i. Connects two consecuitve spinal processes
c. Supraspinous ligament
i. Connects the tips of two adjacent spious processes
d. Iliolumbar ligament
i. Functions to restrain flexion, extension, axial rotation and side bending of L5-S1
e. Pseudo ligaments
i. Intertransverse, transformainal and mamillo-accessory
ii. Resemble membranous part of fascial system separating paravertebral compartments
iii. No mechanical function

Question 11

a. What is the importance of quadratus lumborum?

Answer 11

a. Rehabilitation viewpoint is it contributions as lumbar spine stabilizer

Question 12

b. What is the importance of lumbar multifidus?

Answer 12

a. Lumbar segmental stability through its ability to provide segmental stiffness and control motion

Question 13

a. What is the importance of erector spinae?

Answer 13

a. Consist of iliocostalis lumborum and the thoracic longissimus
b. Both are subdivided into the lumbar and thoracic longissimi and iliocostalli

Question 14

a. What is the importance of the thoracolumbar fascia?

Answer 14

a. Assists the transmission of extension forces during lifting activites
b. Stabilizes the spine against anterior shear and flexion moment

Question 15

a. What is the importance of Psoas muscle?

Answer 15

a. Take origin from anterior portion of T12-L5 VB and discs
b. The main hip flexor
c. Pain from posaos absecess increases when the hip is actively flexed.

Question 16

a. What is the largest nerve in the body?

Answer 16

a. Sciatic nerve
i. Gives branches to the hamstings and 2 into terminal branches
1) Tibial and peroneal

Question 17

1. Where is the sciatic nerve palpated?

Answer 17

a. Midpoint between ischial tuberosity and the greater trochanter

Question 18

2. What can cause sciatic nerve to be tender to palpat?

Answer 18

a. Disc pathology or a space occupying lesion

Question 19

a. Disc is names for the vertabrae _

Answer 19

a. Above

Question 20

b. Disc pathology affect the never root _

Answer 20

a. Below

Question 21

a. A L4 disc pathology affects __ nerve root

Answer 21

a. L5

Question 22

a. What are the 4 disc pathologies?

Answer 22

a. Protrusion
i. Fragments of nucleus pulposus protrude into the annular fibers (weaken annular fibers)
b. Prolapse aka bulge
i. Nucleus pops out of annular fibers NOT yet torn fibers
ii. Just stretched
c. Extrusion aka herniation
i. Fibers torn
ii. Nucleus bursts into the PLL
iii. PLL is torn
iv. Shredding noise description by patient
d. Sequestration
i. Multiple particles of the nucleus are in spinal canal

Question 23

a. What is the general pattern of nerve supply to the lumbar spine?

Answer 23

a. Outer half of IVD
i. Innervated by sinuvertebral nerve
ii. Grey rami coommunicants
b. Posteiror-lateral aspect
i. being innervated by both sinuvertiberal nerve
ii. Grey rami communicants
c. Lateral aspect
i. Sympathetic innervation
d. Z joints
i. Innervated by medial branches of dorsal rami

Question 24

a. What cardinal planes do lumbar motion spine joints?

Answer 24

a. Saggitall (flexion extension
b. Coronal (side bending)
c. Transverse (rotation)

Question 25

a. Where on lumbar Is most flexion extension, side bending and rotation done?

Answer 25

a. Flexion extension
i. Lower segmental levels
b. Side bending
i. Mid lumbar area
c. Rotation
i. Side bending coupled motion
ii. Lumbosacral junction

Question 26

a. During lumbar flexion what motions may be produced?

Answer 26

a. Produces combo of anterior roll and anterior glide of the VB
b. Straightening or minmal reversal of lordosis
c. L4-L5 reversal may occur
i. at L5-S1
1) Joint will straighten but no reverese

Question 27

a. Axial rotation to both sides is how much in lumbar spine?

Answer 27

a. 13 degrees

b. L5-S1 5 degrees