MSK 731 Exam 1

Question 1

What plane is the thoracic spine facet joints in

Answer 1

frontal plane

Question 2

Why is greater SB in the thoracic spine limited

Answer 2

due to the ribs

Question 3

list the Thoracic region greatest to least motion

Answer 3

Rotation, SB, FLX, EXT

Question 4

At what level does the thoracic spine have the most movement

Answer 4

T5 and T10

Question 5

Why does T11 and T12 have the least amount of motion out of the thoracic spine

Answer 5

transition to shape of lumbar facets

Question 6

What motions does the lumbar spine have

Answer 6

most: FLX, EXT
least: rotation

Question 7

What are the 4 variables for stabilization

Answer 7

1. joint integrity
2. passive stiffness
3. neural input
4. muscle function

Question 8

Name some characteristics of local muscles

Answer 8

-closer to axis of motion
-often deeper
-greater stabilization
-postural
-aerobic
-more often type 1 fibers

Question 9

Name the main local muscles of thoracolumbosacral

Answer 9

-psoas
-quadratus lumborum
-pelvic floor
-transversus abdominus
-multifidi/rotatores

Question 10

Does muscle function normalize automatically once symptoms are improved?

Answer 10

no

Question 11

How much (%) does it take to activate muscles

Answer 11

30%

Question 12

What are the 4 main reasons for stabilization issues

Answer 12

1. pain
2. swelling
3. joint laxity
4. disuse

Question 13

What plane is the lumbar spine anterior facet joints in

Answer 13

coronal/frontal plane

Question 14

What plane is the lumbar spine posterior facet joints in

Answer 14

sagittal plane

Question 15

What are the main frontal stabilizer (local muscles) of the thoracolumbosacral

Answer 15

-Posas
-quadratus lumborum

Question 16

How does the pelvic floor and transversus abdominus help stabilize the thoracolumbosacral

Answer 16

increases contraction of multifidus

Question 17

If the multifidi/rotatores are smaller, what is more likely to happen

Answer 17

-higher injury rates
-LBP

Question 18

How long do you hold for myotome testing

Answer 18

10 seconds

Question 19

How long do you hold & range for mmt & or resisted testing to assess for a grade 1 strain

Answer 19

shorten & 10 seconds

Question 20

What is the best MET parameters for achieving a combo of strength & coordination

Answer 20

3 set of 20 reps w/ moderate load

Question 21

When a person rotates their trunk describe what the upper thoracic is doing

Answer 21

ipsiaterally coupling w/ SB (i.e. R rotation & R SB)

Question 22

When a person rotates their trunk describe what the lower thoracic is doing

Answer 22

opposite rotation & SB (i.e. R rotation & L SB)

Question 23

What type of scoliosis does a person have if they FLX forward and the abnormality in the spine does NOT go away

Answer 23

structural scoliosis

Question 24

describe scoliosis/rotoscoliosis

Answer 24

• greater /equal to 10 degrees SB curvature
• SB & Contralateral rotation

Question 25

What is the normal curvature of the spine

Answer 25

-cervical = lordosis -thoracic = kyphosis -lumbar = lordosis -sacral = kyphosis

Question 26

What is indicated if a pt has limited SB & FLX

Answer 26

indicates contralateral Z joint

Question 27

What is indicated if a pt has limited SB & EXT

Answer 27

indicates ipsilateral Z joint

Question 28

If a pt spine is a 'C' curve in trunk rotation, what vertebrae should a PT first assess

Answer 28

T10

Question 29

What position does SB occur in

Answer 29

neutral

Question 30

When does thoracolumbar fascia & posterior passive restraints have more tension

Answer 30

in neutral

Question 31

When does thoracolumbar fascia & posterior passive restraints slacken

Answer 31

EXT/hyper EXT

Question 32

Why does EXT/hyper EXT lead to LESS stability of the lower trunk

Answer 32

thoracolumbar & posterior restraints are slacken in that position

Question 33

Anterior shearing forces are more greater in EXT/hyper EXT. True or false

Answer 33

true

Question 34

What can a PT observe when a pt EXT/Hyper in the trunk for instability/anterior shearing

Answer 34

crease, especially a unilateral crease

Question 35

Lumbar compression test are primarily testing what structures

Answer 35

vertebral body & disc

Question 36

When should a PT do combined motions

Answer 36

-limited motion -P! in a motion -unilateral motions do NOT provide any information even though the pt is having problems

Question 37

When should a PT do stability test

Answer 37

-hypermobility is indicated

Question 38

A radiograph of the thoracolumbar spine best shows what levels

Answer 38

L4-L5 interspinous space

Question 39

What is a good landmark for the L3-L4 interspinous space

Answer 39

top of iliac crest

Question 40

PSIS is a good landmark for what SP (spinous process)

Answer 40

S2 SP

Question 41

What rib is the best landmark to finding T12

Answer 41

12th rib (follow)

Question 42

What can cause a pt to have 'Sway Back'

Answer 42

-increased lumbar lordosis -anterior pelvic tilt -associated w/ flexible body typeswe32p0o

Question 43

Describe 'Flat Back'

Answer 43

-flattening of normal curves -greater portion of LBP pt due to LESS dissipation of forces

Question 44

What can cause a pt to have 'Flat Back' (straight spine)

Answer 44

-posterior pelvic tilt -associated w/ rigid body type

Question 45

What can cause 'Rounded/Crouched back'

Answer 45

-increased thoracic kyphosis -flattening lumbar curve -posterior pelvic tilt -associated w/ FHP

Question 46

What region of the spine for LBP is the leading cause of worldwide disability & activity limitation/work absence

Answer 46

lumbar spine

Question 47

What percentage of people will experience LBP in their lifetime

Answer 47

80%

Question 48

Risk factors that could contribute to LBP

Answer 48

-previous LBP -co-morbidities -awkward postures -genetics w/ age related disc changes ONLY

Question 49

What populations are more prevalent to have LBP

Answer 49

-biological women -older than 65 yrs -lower du. status -higher physical work demands

Question 50

Who should get imaging with LBP

Answer 50

-greater than 50 yrs -saddle paresthesia -bowel/bladder dysfunction -NO improvement after 6 weeks of conservative Rx

Question 51

describe PT Rx education & advice

Answer 51

-1st line Rx w/ moderate to strong evidence -stay active w/ early resumption of ADLS

Question 52

describe PT Rx overcoming barriers

Answer 52

-increase consultation time & follow up -reward quality

Question 53

What are the 4 main subgroups of LBP Rx classifications

Answer 53

1. mechanical traction 2. directional pref 3. mobilization/manip 4. stabilization

Question 54

describe mechanical traction

Answer 54

-NO benefit w/ static Tx -intermittent tx for LBP w/ LE P! -NOT use w/ persistent LBP w/ LE P! -radiculopathy

Question 55

describe directional preference

Answer 55

helps choose position to avoid/alleviate P! motions

Question 56

describe mobs/manips

Answer 56

-strong preference -short term effectiveness -acute/sub acute -greater/equal to a score of 4

Question 57

describe stabilization for acute LBP

Answer 57

-safe/effective to do early

Question 58

describe stabilization for sub acute & persistent LBP

Answer 58

-strong support -first line Rx -most effective Rx for functions in this order

Question 59

Prognosis of LBP

Answer 59

-rapid improvements within 1 month -most improve substantially 6 weeks

Question 59

Cognitive therapy is best use for what type of LBP

Answer 59

-first line Rx w/ persistent LBP

Question 60

When is medication recommended

Answer 60

-ONLY when inadequate response to exercise & cognitive behavioral therapy

Question 61

Epidural injection are used for what type of pain phenotype

Answer 61

-radicular p! -no benefit by 4 weeks