Ortho Final Review Lumbopelvic

Question 1

What is the basic pelvic anatomy?

Answer 1

SI Joints
Pubic Symphysis

Question 2

What is the basic SI Joint Anatomy?

Answer 2

Articulation between Sacrum and Coxal Bones that are supported by thick ligaments anteriorly and posteriorly

Question 3

What plane of motion are pelvic facet joints?

Answer 3

Primarily in the sagittal plane, facilitating flexion and extension

Question 4

How many planes of motion does pelvis move in?

Answer 4

All 3 planes of motion

Question 5

Lumbar contribution Flexion/Extension

Answer 5

Flexion= 50
Extension= 20

Question 6

Lumbar contribution in sidebending

Answer 6

Sidebending= 30

Question 7

Lumbar Contribution in rotation

Answer 7

Rotation= 32 each side

Question 8

Rotation and Sidebending occur _________

Answer 8

TOGETHER

Question 9

In lumbar flexion, the sacrum _________________

Answer 9

counter nutates, PPT

Question 10

In lumbar extension, the sacrum _______________

Answer 10

nutates, APT

Question 11

The pelvis can:

Answer 11

1. Anteriorly or Posteriorly Tilt
2. Hike or Drop
3. Rotate on top of the Femur

Question 12

What happens in a PPT?

Answer 12

Abs are pulled up and hip extensors pulled down
Hip flexors and back extensors are stretched

Question 13

What happens in a APT?

Answer 13

Back extensors pull up, and hip flexors pull down
Hip extensors and abs stretch

Question 14

What are the special tests used for the lumbar spine?

Answer 14

SLR
Slump Test
Prone Knee Flexion
Gower’s Sign

Question 15

What happens when the psoas is shortened?

Answer 15

The lumbar spine is pulled into further extension

Question 16

What is the SLR test?

Answer 16

Pt in supine, leg passively flexed by PT
Test is positive if there is pain in back/leg between 30-70 degrees
*Neural tension on the sciatic nerve

Question 17

What is the slump test?

Answer 17

Patient in sitting, flexes in trunk first, then cervical, then extension, then knee one at a time
* abnormal dural tension

Question 18

What is prone knee flexion test?

Answer 18

Patient prone, with knee passively bent by PT, pain in front of thigh = tightness in quads or femoral nerve
Pain in back can mean L2/L3 disc injury
*test abnormal tension of femoral nerve

Question 19

What is Gower’s sign test?

Answer 19

Patient in standing, flexes trunk and does 1/2 squat, if they need to use UE to stand back up, test is positive
*used often for Duchennes
*tests inhibited LE/Spinal extensor muscles

Question 20

What tests are performed to test SI mobility?

Answer 20

Standing/Seated Flexion
Gillet (Stork) test
Squish Test

Question 21

What test is performed for sacral torsion?

Answer 21

Sphinx Test

Question 22

What is the Long Sit test used for?

Answer 22

inominate rotation

Question 23

What exercises should a patient do for spinal stabilization or movement awareness/control?

Answer 23

Pelvic Clocks
TA contractions
Neutral Spine Education

Question 24

What exercises should a patient do for gentle ROM?

Answer 24

SKTC
DKTC
LTR

Question 25

What are the 3 fundamental goals for lumbopelvic stabilization?

Answer 25

1.Education on neutral spine 2. Facilitate activation of core stabilizers (Multifidi/TA/pelvic floor) 3. Progress to dynamic activities, maintaining a neutral spine and contraction of spinal stabilizers

Question 26

What is the primary goal for Lumbar disc herniation when there are neurological signs?

Answer 26

reduce/eliminate compression of neural tissue If patient is acute: reduce inflammation and spasm with goals to initiate interventions to improve neuro symptoms

Question 27

What is the focus for treating lumbar spondylosis?

Answer 27

decreasing stress on discs or joints to prevent further damage to the spine and LE

Question 28

What is lumbar stenosis?

Answer 28

narrowing of spinal canal or IV Foramen *Can affect any area of the spine

Question 29

What are the symptoms for lumbar stenosis?

Answer 29

Pain Radiculopathy Myelopathy in standing or extension of the spine (bc it closes the facets)

Question 30

Should you use williams or mckenzie exercises for lumbar stenosis?

Answer 30

Williams FLEXION

Question 31

What is lumbar spondylolysis?

Answer 31

small fracture in the pars articularis (scotty dog) due to trauma or over stress Can be unilateral or bilateral *Bilateral can create instability causing vertebra to slip forward

Question 32

What sort of treatment should be performed for a patient with lumbar spondylolysis?

Answer 32

Treat pain or spasm Stabilization of the spine Patient Education *Avoid high-impact or excessive extension

Question 33

How long does it primarily take spondylolysis to heal?

Answer 33

3-6 Months

Question 34

What is lumbar spondylolisthesis?

Answer 34

forward slippage of vertebral body after bilateral pars fracture

Question 35

What is the most common lumbar spondylolisthesis?

Answer 35

L5-S1

Question 36

What is retrolisthesis- Complete?

Answer 36

vertebra slips back between the spinal segment

Question 37

What is retrolisthesis- Partial?

Answer 37

Vertebra slips backward to either spinal segment above or below

Question 38

What is retrolisthesis- Stair Step?

Answer 38

Vertebra slips backward TO THE spinal segment above it an ahead of one below it.

Question 39

What are possible causes for sciatica?

Answer 39

HNP Stenosis Spondylolisthesis Spinal Tumor Muscle tightness

Question 40

What are common symptoms for Sciatica?

Answer 40

LBP Pain in the buttocks Pain/Tingling in posterior thigh to leg or foot

Question 41

What is the early tx for SI joint sprains or strains?

Answer 41

Reduce Pain Inflammation Education

Question 42

How do you restore balance to muscles that affect the joint?

Answer 42

Stretch Strengthen Stabilization Proprioception

Question 43

What muscles need to be re-educated in SI Joint instability?

Answer 43

Glute Max Erector Spinae Biceps Femoris Lats Piriformis Multifidi

Question 44

What muscles need to be re-educated in lumbar instability?

Answer 44

Multifidi Erector Spinae TA (Pelvic Floor)