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(2) Evaluation & Intervention of MSK Conditions 💪 > S3_L1: Thoracolumbar Spine > Flashcards

S3_L1: Thoracolumbar Spine Flashcards

1
Q

Determine the actions of the muscles below:

  1. Rectus Abdominis
  2. Erector Spinae
  3. Internal Oblique
  4. External Oblique
  5. Quadratus Lumborum
  6. Multifidus

A. Flexion
B. Extension

A
  1. A
  2. B
  3. A
  4. A
  5. B
  6. B
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2
Q

How many degrees does a normal thoracic kyphosis have?

A

40 degrees

Source: Thoracolumbar Spine (Quizlet)

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3
Q

How many degrees does a normal lumbar lordosis have?

A

45 degrees

Source: Thoracolumbar Spine (Quizlet)

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4
Q

In scoliosis, curves are named by the side of their ____.

A

convexity

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5
Q

Define lateral stenosis.

A

Narrowing of the intervertebral foramen affecting a nerve root

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6
Q

Case: A.B. a 16 y/o (-)Htn/DM, ® handed female was referred for PT eval and mx secondary to intermittent aching pain graded 2/10 pain on (B) upper and mid- back regions elicited by long hours of sitting and is relieved c rest and lying down. Condition started when the px was 10 years old and her mom noticed that px’s shoulders were not level. This prompted MD consultation, where Pt underwent an x-ray 2018. Results revealed a 50° thoracodextroscoliosis, with apex at T6 and a 15° lumbar levoscoliosis apex at L3. Pt is a high school student, sleeps on a firm mattress, and uses 3 1- inch pillows, two under her head and the other on her side when sleeping. Pt usually carries he bag using her ® shoulder.

Based on the case above, what is the convexity of the thoracic and lumbar segment?

A

Thoracic: Right
Lumbar: Left

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7
Q

Case: A.B. a 16 y/o (-)Htn/DM, ® handed female was referred for PT eval and mx secondary to intermittent aching pain graded 8/10 pain on (B) upper and mid- back regions elicited by long hours of sitting and is relieved c rest and lying down. Condition started when the px was 12 years old and her mom noticed that px’s shoulders were not level. This prompted MD consultation, where Pt underwent an x-ray that revealed a 50° thoracodextroscoliosis, with apex at T6 and a 15° lumbar levoscoliosis apex at L3. Pt is a high school student, sleeps on a firm mattress, and uses 3 1- inch pillows, two under her head and the other on her side when sleeping. Pt usually carries he bag using her ® shoulder.

Based on the case above, what kind of curve is expected to be seen at the X-Ray result?

A

S-Curve

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8
Q

Case: A.B. a 16 y/o (-)Htn/DM, ® handed female was referred for PT eval and mx secondary to intermittent aching pain graded 8/10 pain on (B) upper and mid- back regions elicited by long hours of sitting and is relieved c rest and lying down. Condition started when the px was 12 years old and her mom noticed that px’s shoulders were not level. This prompted MD consultation, where Pt underwent an x-ray that revealed a 50° thoracodextroscoliosis, with apex at T6 and a 15° lumbar levoscoliosis apex at L3. Pt is a high school student, sleeps on a firm mattress, and uses 3 1- inch pillows, two under her head and the other on her side when sleeping. Pt usually carries he bag using her ® shoulder.

Based on the case, what is the major curve?

A

thoracodextroscoliosis

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9
Q

Case: A.B. a 16 y/o (-)Htn/DM, ® handed female was referred for PT eval and mx secondary to intermittent aching pain graded 8/10 pain on (B) upper and mid- back regions elicited by long hours of sitting and is relieved c rest and lying down. Condition started when the px was 12 years old and her mom noticed that px’s shoulders were not level. This prompted MD consultation, where Pt underwent an x-ray that revealed a 50° thoracodextroscoliosis, with apex at T6 and a 15° lumbar levoscoliosis apex at L3. Pt is a high school student, sleeps on a firm mattress, and uses 3 1- inch pillows, two under her head and the other on her side when sleeping. Pt usually carries he bag using her ® shoulder.

Based on the case, in what severity is the thoracic and lumbar segment classified as?

A

Thoracic: Severe
Lumbar: Mild

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10
Q

TRUE OR FALSE: Mild scoliosis produces no symptoms.

A

True

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11
Q

Identify 4 modalities that may be used for patients with scoliosis.

A
  1. HMP
  2. US
  3. Traction
  4. NMES
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12
Q

TRUE OR FALSE: Idiopathic Structural Scoliosis has a male bias on infants.

A

True

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13
Q

Enumerate 2 causes for LBP

A
  1. Inflammation
  2. Mechanical
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14
Q

The _____ muscle is quick to atrophy in pts with LBP.

A

multifidus

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15
Q

This is also known as Strumpell-Marie Arthritis or Marie-Strumpell Arthritis

A

Ankylosing Spondylitis

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16
Q

This muscle is attached to the thoracolumbar fascia and acts as a corset that provides intersegmental stability

A

Transversus Abdominis

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17
Q

_____ is also known as neutral spine, and has no or minimum stress on inert structures

A

Neutral Zone

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18
Q

Most common spinal bracing

A

Milwaukee Brace

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19
Q

Enumerate the 2 measurement techniques for scoliosis. Which one of those is more commonly used?

A
  1. Cobb Method (more common)
  2. Risser-Ferguson Method
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20
Q

TRUE OR FALSE: In the spine, muscle performance only involves strength, power, and endurance.

A

False.

This also involves stability.

Source: Kisner & Colby 7th ed., page 495

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21
Q

Activation of the (1)_____ muscles as well as the (2)____ muscles of the neck and trunk are fundamental techniques for developing spinal stability.

A
  1. deep segmental
  2. superficial/global multisegmental

Source: Kisner & Colby 7th ed., page 495

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22
Q

Aerobic conditioning exercises are initiated as soon as the patient tolerates repetitive activity without exacerbating symptoms.

TRUE OR FALSE: Aerobic Training may be done in the maximum protection phase/ early training.

A

True.

This may be done as long as the patient can tolerate it in a position of comfort.

Source: Kisner & Colby 7th ed., page 494-495

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23
Q

How do you passively position a patient in supine when active movement and control is not possible. Enumerate 2 ways.

A

Passively position the pelvis in posterior tilt and lumbar flexion by placing the lower extremities in the hook-lying position

OR

Anterior tilt and lumbar spine extension c small pillow or folded towel under the lumbar spine.

Source: Kisner & Colby 7th ed., page 496

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24
Q

In general, movement of the extremities
away from the trunk (shoulder flexion and abduction, hip extension and abduction) causes (1)____; movement of the extremities toward the trunk (shoulder extension and adduction, hip flexion and adduction) causes (2)____.

A
  1. spinal extension
  2. spinal flexion

Source: Kisner & Colby 7th ed., page 496

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25
Q

TRUE OR FALSE: Stretching is contraindication in an acute nerve root irritation from bony spurs or lipping in an arthritic spine.

A

False.

This pain sx may actually be relieved through stretching.

ADDITIONAL NOTE: if there are postures that relieve symptoms but are difficult to assume because of tissue restriction or fluid stasis, stretching or repetitive movement into the restricted range may be appropriate.

Source: Kisner & Colby 7th ed., page 496

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26
Q

The primary functions of the muscles of the trunk are:

  1. to provide (1)____ so (2)____ can be maintained against a variety of forces that disturb balance
  2. to provide a (3)____ so the muscles of the extremities can execute their function efficiently and without undue (4)____ to the spinal structures
  3. to move and control trunk motions during (5)____.
A
  1. stability
  2. upright posture
  3. stable base
  4. stress
  5. functional activities

Source: Kisner & Colby 7th ed., page 513

27
Q

TRUE OR FALSE: Activation of the deep segmental muscles of the trunk, specifically the transversus abdominis (TrA) and multifidus (Mf), is often delayed or absent in patients with back pain.

A

True

Source: Kisner & Colby 7th ed., page 514

28
Q

This maneuver is used prior to all exercises and activities to develop the activation and stabilizing function and eventually automatic feedforward stabilization from the muscles

A

“drawing-in” maneuver

Source: Kisner & Colby 7th ed., page 515

29
Q

What 3 positions may be done when performing drawing-in maneuver?

A
  1. quadruped
  2. prone/ seme-reclined
  3. hook-lying

Source: Kisner & Colby 7th ed., page 517

30
Q

When a bulge is felt during drawing-in maneuver. What muscle is being contracted?

A

internal oblique

Source: Kisner & Colby 7th ed., page 517

31
Q

If a patient has difficulty activating the TrA, what are the two feedback techniques that a PT may use?

A
  1. Pressure biofeedback using a stabilizer inflated to 70 mmHg
  2. Biofeedback using surface electrodes on RA and External Obliques

Source: Kisner & Colby 7th ed., page 518

32
Q

Posterior pelvic tilt exercises principally activates the (1)_____ muscle, which is used primarily for (2)____ trunk flexion activity.

A
  1. Rectus Abdominis
  2. dynamic

Source: Kisner & Colby 7th ed., page 519

33
Q

A PT asks his patient to perform side-planks. Based on your knowledge, what muscles does the PT want to activate in this position?

A
  1. Quadratus Lumborum
  2. External Obliques

Source: Kisner & Colby 7th ed., page 528

34
Q

In performing isometric contractions and rhytmic stabilization to a pt, what the the positional progression?

A

supine - sitting - kneeling - standing

Source: Kisner & Colby 7th ed., page 530

35
Q

TRUE OR FALSE: There is no clinically significant selective difference between the upper and lower RA function

A

True

Source: Kisner & Colby 7th ed., page 531

36
Q

In cases that a pt has knee pain or weakness and unable to squat while lifting, what will the PT opt to teach?

A

Lifting c lunge technique

Source: Kisner & Colby 7th ed., page 541

37
Q

TRUE OR FALSE: When lifting with a flexed lumbar spine, support for the spine is primarily from inert
structures

A

True

Source: Kisner & Colby 7th ed., page 541

38
Q

A “golfer’s lift” is used for picking up light objects, such as keys, pencils, and small toys. How is this performed?

A

This is done by flexing the trunk forward over one hip while the other hip extends

Source: Kisner & Colby 7th ed., page 541

39
Q

This position involves lifting and carrying objects as close to the center of gravity as possible.

A

Load Position

Source: Kisner & Colby 7th ed., page 541

40
Q

What are the 3 subtypes of spinal stability?

A
  1. passive (inert structures/bones and ligaments)
  2. active (muscles)
  3. neural control

NOTE: Instability of a spinal segment is often a combination of inert tissue damage, insufficient muscular strength or endurance, and poor neuromuscular control. If any one of the legs is not providing support, it affects the stability of the whole structure.

Source: Kisner & Colby 7th ed., page 422

41
Q

TRUE OR FALSE: The thoracic spine is prone to hypomobility impairments

A

True

Source: Kisner & Colby 7th ed., page 479

42
Q

Determine whether the descriptions below refer to a structural or non-structural scoliosis.

  1. curve disappears in supine or prone
  2. seen among patients with cerebral palsy
  3. presence of tumor in the spine
  4. caused by leg length discrepancy
  5. irreversible lateral curvature of the spine
  6. caused by nerve root irritation

A. Structural
B. Non-Structural

A
  1. B
  2. A
  3. A
  4. B
  5. A
  6. B
43
Q

Determine whether the descriptions below refer to a structural or non-structural scoliosis.

  1. idiopathic scoliosis
  2. patient has neurofibromatosis
  3. functional or positional scoliosis
  4. patient has hip contractures
  5. presence of hemivertebra
  6. correction of the lateral curvature with forward bending or side bending

A. Structural
B. Non-Structural

A
  1. A
  2. A
  3. B
  4. B
  5. A
  6. B
44
Q

Determine the kind of intervention for the following type of conditions.

  1. Hypomobility
  2. Spinal instability
  3. Directional Preference
  4. Nerve Root Compression

A. Traction
B. Direction Specific Exercise
C. Manipulation
D. Stabilization

A
  1. C
  2. D
  3. B
  4. A
45
Q

TRUE OR FALSE: Scoliosis may be d/t more contraction on one side of the trunk than the other.

A

True.

This may be possible for non-structural scoliosis

46
Q

TRUE OR FALSE: The diaphragm is considered a core muscle.

A

True

47
Q

Determine if the muscles listed are global or local.

  1. Iliopsoas
  2. Internal Oblique
  3. Multifidus
  4. Medial Fibers of Quadratus Lumborum
  5. Lateral Fibers of Quadratus Lumborum

A. Global/ Superficial
B. Local/ Core

A
  1. A
  2. A
  3. B
  4. B
  5. A
48
Q

The (1)______ exercises is used for patients with extension bias, while the (2)_____ exercises is used for patients with flexion bias.

A
  1. McKenzie Extension
  2. William’s Flexion
49
Q

In treating Scheuermann’s Disease, a PT would promote (1)____ and (2)____ lying programs to prevent further (3)___ contractures.

A
  1. extension
  2. prone
  3. flexion
50
Q

This conditions results from an anterior slippage of a vertebra on the one directly below it

A

Spondylolisthesis

51
Q

Enumerate the 6 exercises in McKenzie Extension Exercise in correct order.

A
  1. prone lying
  2. prone on elbows
  3. prone on hands
  4. double knee to chest
  5. back hyperextension in standing
  6. seated floor reach
52
Q

In the thoracolumbar area, we must first strengthen the (1)_____ muscles, before strengthening the (2)_____ muscles

A
  1. core
  2. global
53
Q

What are the muscles that protect the spine from injuries?

A
  1. Superiorly: Diaphragm
  2. Inferiorly: Pelvic floor muscles
  3. Laterally: Obliques / abdominals
  4. Anteriorly: Transversus abdominis (TrA)
  5. Posteriorly: Multifidus (Mf)
54
Q

In the cobb method, the lowest vertebra has the disk above it wider on the (1)____ side, while the disk below it wider on the (2)___ side.

A
  1. convex
  2. concave
55
Q

This is the vertebra that is in the greatest distance (farthest) from the midline of the spine

A

Apex of the curve / Apical vertebra

56
Q

This is the kind of exercise program that involves an interdisciplinary team which includes psychologists and even guidance counselors to help treat the mental hurdles brought by the condition

A

Integrated Scoliosis Rehabilitation (ISR)

57
Q

This is the kind of exercise program that entails the patient to shift the trunk laterally to concave side and to lift heel on convex side

A

Side-shift Exercise and Hitch Exercise

58
Q

This is the kind of exercise program is an active self correction technique that emphasizes conscious proprioception

A

Scientific Exercises Approach to Scoliosis (SEAS) Program

59
Q

In KLAPP’s Exercise, a PT decides to let her pt do it in a quadruped position, what spine segment did he wanted to target?

A

thoracolumbar spine

60
Q

In KLAPP’s Exercise, a PT decides to let her pt do it in a heel sitting position, what spine segment did he wanted to target?

A

thoracic spine

61
Q

Determine whether the spinal changes are seen on the concave or convex side in a structural scoliosis.

  1. Rib hump
  2. Distortion of vertebral body
  3. Thinner lamina
  4. Rib prominence
  5. Narrower vertebral canal

A. Concave
B. Convex

A
  1. B
  2. B
  3. B
  4. A
  5. B
62
Q

In scoliosis, muscles are (1)____ on the concave side and (2)____ on the convex side.

A
  1. Tight
  2. Stretched
63
Q

If core muscles are postural muscles, then they muscle be abundant with what kind of muscle fibers?

A

type I

64
Q

TRUE OR FALSE: In ankylosing spondylitis, some of the pt education must be:

  1. Ample rest
  2. Firm mattress
  3. Rest with one pillow on head
A

False

No pillows are recommended to prevent FHP.

(2) Evaluation & Intervention of MSK Conditions 💪 (14 decks)

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