quiz #1 - L-spine

Question 1

correct progression of the stages of acute disc herniation

Answer 1

protrusion
prolapse
extrusion
sequestration

Question 2

facet lock syndrome responds well to what type of manipulation?

Answer 2

joint

Question 3

one purpose of the facet joints in the lumbar spine is to…

Answer 3

control the direction of spinal movement

Question 4

where do lumbar facets refer pain?

Answer 4

buttock & posterior leg

Question 5

closed pack position of the lumbar spine

Answer 5

extension

Question 6

with pelvic crossed syndrome, the muscles that are weak and taut are…

Answer 6

Rectus abdominus & Gluteus maximus

Question 7

sleeping position that is best indicated for a patient with Ankylosing Spondylitis is…

Answer 7

supine on firm mattress with no pillow

Question 8

what can occur with longstanding Ankylosing Spondylitis?

Answer 8

inflammation of the iris
aortic valve incompetence
fused appearance of vertebrae

Question 9

T/F - once fusion of the spine is complete for a patient with Ankylosing Spondylitis, pain may diminish

Answer 9

TRUE

Question 10

potential causes or disease process associated with Ankylosing Spondylitis

Answer 10

men more severely
onset is usually in early adulthood
inflammatory stage ends by age 40
development is highly variable

Question 11

T/F - Ankylosing Spondylitis is the result of prolonged degenerative disc disease

Answer 11

FALSE

Question 12

vertical bone growths replacing the intervertebral discs are called…

Answer 12

syndesmophytes

Question 13

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

Answer 13

passive lumbar extension test

Question 14

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

Answer 14

Brudinski’s Sign

Question 15

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

Answer 15

one-leg standing lumbar extension test

Question 16

T/F - a positive test for the Sign of the Buttock is considered a red flag and requires sending patient to physician

Answer 16

TRUE

Question 17

between 35 and 70 degrees of hip flexion is where the Sciatic nerve is stretched during the straight leg raise test

Answer 17

TRUE

Question 18

best special test to assess for facet joint irritation or a space-occupying lesion?

Answer 18

Quadrant test

Question 19

T/F - during a flare-up, PROM endfeel and hot hydrotherapy are CI’d for a patient with AS

Answer 19

TRUE

Question 20

T/F - if the Babinski Test is positive, it will be demonstrated by extension of the big toe and abduction of the other toes

Answer 20

TRUE

Question 21

which ligament connects the TVPs of L5 to the posterior ilium and prevents anterior displacement of L5?

Answer 21

iliolumbar ligament

Question 22

which ligament is broader and thicker in the lumbar region?

Answer 22

anterior longitudinal ligament

Question 23

this ligament lies deeply between two consecutive spinal processes

Answer 23

interspinous

Question 24

this ligament joins the tips of two adjacent spinous processes

Answer 24

supraspinous

Question 25

this ligament connects two consecutive laminae and is very elastic

Answer 25

ligamentum flavum

Question 26

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

Answer 26

right

Question 27

when the 5th lumbar segment is fused to the sacrum, it is referred to as...

Answer 27

sacralization

Question 28

when the 1st sacral segment is mobile and not fused to the sacrum, it is called...

Answer 28

lumbarization

Question 29

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

Answer 29

hypomobility; hypermobility

Question 30

what position puts the least amount of pressure on the intervertebral discs?

Answer 30

lying flat on your back

Question 31

what position puts the most amount of pressure on the intervertebral discs?

Answer 31

sitting while leaning forward & lifting weight

Question 32

T/F - intervertebral discs are pain sensitive because the anterior & posterior aspects of the annulus fibrosus are innervated

Answer 32

FALSE

Question 33

degeneration of an intervertebral disc

Answer 33

vascular supply to disc becomes occluded nucleus changes from gel to fibrous structure degeneration is an normal process height of the disc decreases

Question 34

T/F - degeneration of the lumbar intervertebral discs is pathological when the degeneration process is accelerated

Answer 34

TRUE

Question 35

which myotome is tested when dorsiflexing the foot?

Answer 35

L4

Question 36

which myotome is tested when flexing the hip?

Answer 36

L2

Question 37

which myotome is tested when extending the knee?

Answer 37

L3

Question 38

which myotome is tested when flexing the knee?

Answer 38

S2

Question 39

what test is used to confirm that a person is faking an injury?

Answer 39

Hoover test

Question 40

degeneration of the intervertebral discs, vertebral bodies and facet joints is called...

Answer 40

spondylosis

Question 41

T/F - symptoms of a disc protrusion vary depending on the vertebral level, direction of protrusion & amount of protrusion

Answer 41

TRUE

Question 42

contributing factors to Degenerative Disc Disease

Answer 42

mm imbalances leading to asymmetric loading of the spine poor blood supply to disc postural dysfunction (head-forward posture)

Question 43

an injured vertebra shifting or slipping forward on the vertebra directly below is called...

Answer 43

spondylolisthesis

Question 44

a crack or stress fracture that develops through the pars interarticularis is called...

Answer 44

spondylolysis

Question 45

T/F - a herniation of the L4 disc will compress the nerve roots of L4 and L5

Answer 45

TRUE

Question 46

pain that retreats to the origin is called ______ of pain

Answer 46

centralization

Question 47

pain that moves away from the origin is called ______ of pain

Answer 47

peripheralization

Question 48

a disc herniation into the vertebral body is called a ______ node

Answer 48

Schmorl's

Question 49

when the nucleus pulposus protrudes into the epidural space

Answer 49

sequestration

Question 50

when the nucleus pulposus emerges through the annulus fibrosus

Answer 50

extrusion

Question 51

T/F - with a complete annular rupture and sequestered nucleus, movement cannot relieve the symptoms

Answer 51

TRUE

Question 52

the stages of intervertebral disc degeneration, in order, are...

Answer 52

dysfunction, instability, stabilization

Question 53

in which directions do the lumbar spine discs usually herniate?

Answer 53

posterior & lateral

Question 54

T/F - the primary goal in the early stages of a disc herniation is to reduce compressive forces in the lumbar region

Answer 54

TRUE

Question 55

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

Answer 55

suggest they find postures to help maintain a more natural lumbar lordosis

Question 56

T/F - gluteus maximus extends the lumbar spine during hip flexion and is hypertonic in lumbar hypolordosis

Answer 56

TRUE

Question 57

symptom picture for a patient with Hyperlordosis includes...

Answer 57

mm imbalances ROM at the hip reduced in extension an increase in lumbar lordotic curve pain from tight ischemic tissue

Question 58

T/F - Spondylolisthesis, ITB syndrome and Hyperkyphosis are likely to be found with Hyperlordosis

Answer 58

TRUE

Question 59

when considering massage treatment for a patient with Hyperlordosis

Answer 59

rule out potential pathological sources avoid mobilizing hypERmobile vertebral segments do not randomly stretch fascia

Question 60

when considering treatment goals for a patient with an Acute Disc Herniation, which of the options is NOT correct?

Answer 60

reduce all fascial restrictions & trigger points (decrease SNS firing, reduce spasm, pain & edema, reduce compressive forces)