Thoracic and Lumbar Spinal Mechanics

Question 1

Describe the body and SP of the thoracic vertebrae.

Answer 1

Body–> medium size, heart shaped, has costal facets

SP- long and slope postero-inferior

Question 2

Describe the body and SP of the lumbar vertebrae.

Answer 2

Body–> large and kidney shaped

SP–> short broad

Question 3

Rule of 3 referes to the location of the _______ in relation to the ______ in the ______ spine

Answer 3

Rule of 3 refers to the location of the SP in relation to the TP in the thoracic spine

Question 4

Anterior longitudinal L

-limits ______

Answer 4

Strong, fibrous band that covers the anterolateral aspects of vertebral bodies and IV discs

-limits extension

Question 5

Posterior longitudinal L

-limits ______

Answer 5

Narrower, weaker band that run in the vertebral canal on the posterior aspect of the vertebral bodies.

-resists hyperflexion

Question 6

What prevents herniation of the nucleus pulposus?

Answer 6

Posterior longitudinal L.

Question 7

Ligamentum flava

Answer 7

connects the lamina of adjacent vertebra

Question 8

Intertransverse L.

Answer 8

connects adjoining transverse processes

Question 9

What are the transversospinalis m. of the spine

Answer 9

1. Semispinalis thoracis
2. Rotator longes
3. Rotatores brevis
4. Multifidus

Question 10

What do the rotatores muscles do?

Answer 10

bilateral–> extend thoracic spine

unilateral–> rotates

Question 11

Multifidus m.

Answer 11

bilateral- extends spine

Unilateral–> flexes spine to the same side; rotates to the opposite.

Question 12

semispinalis m.

Answer 12

Bilateral- extends thoracic and cervical spin

Unilateral- bends head, cervical and thoracic spine to SS and rotates to opposite side

Question 13

Restrictions of motion in the spine

Answer 13

Reduce efficiency
• Impair flow of fluids
• Alter nerve function

• Create structural imbalance

Question 14

Motion is always referenced to the movement of the ________________ of the vertebra

Answer 14

anterior/superior surface

Question 15

Fryetter did what

Answer 15

described physiologic motion of the spine

• published in 1918
• developed 2 principles of spinal motion to the thoracic and lumbar spine

Question 16

who developed the third principle and when?

Answer 16

CR nelson in 1948

Question 17

describe SD

Cervical spine flexion

Answer 17

prefers flexion;

restricted extension

Question 18

Lower back pain with radiation below the knee cause what three things

Answer 18

1. radiculopathy

2. spinal stenosis

3. cauda equina syndrome

Question 19

Radiculopathy

—describe—

Answer 19

typically acute, pain with dermatomal distribution and neurological fx is impaired (LE weekness, diminished reflex)

Question 20

Work up for radiculopathy: ____

+__________

Answer 20

MRI

+ Straight leg raise

Question 21

Straight leg raise

+ test–> pain

indicated –>

Answer 21

pain from 15-30–> problems wil lumbar disk

Question 22

herniation at

L4-5 cause

pain–>

numbness–>

weakness–>

Answer 22

pain–> SI joint, hip, lateral thigh, leg

numbness–> lateral leg, first 3 toes

weakness–> dorsiflexion of big toe and foot; hard to walk on heel

v little atrophy

Question 23

herniation at

L5-S1 cause

pain–>

numbness–>

weakness–>

atrophy–>

Answer 23

pain–> SI joint, hip, PL thight, leg to heel

numbness–> back of calf, lateral heel, foot to toe

weakness–> Plantarflexion of foot and big toe, hard to walk on toes

atrophy–> gastrocnemius and soleus

Question 24

spinal stenosis

Answer 24

bilateral pain in lower limbs with neurogenic claudication (cramping)

Question 25

Spinal stenosis (CHRONIC) Work up: + in what test

Answer 25

MRI +straight leg rause

Question 26

Cauda equina syndrome work up:

Answer 26

Saddle anesthesia, LE weakness, urinary retention TRAUMATIC work up: **MRI**

Question 27

Spina bifida occulta

Answer 27

NT fails to close but no hernia

Question 28

Meningocele

Answer 28

NT fails to close and meninges protrude

Question 29

Myelomenginocele

Answer 29

NT does not close and meninges and SC go through

Question 30

**Sacralization**

Answer 30

one or both TP’s of L5 are long and articulate with the sacrum. (DJD)

Question 31

***Lumbarization***

Answer 31

Lumbarization– failure of S1 to fuse with the rest of the sacrum (not common)

Question 32

Spina Bifida

Answer 32

– defect in the closure of the lamina

Question 33

Spondylysis

Answer 33

bony spurs

Question 34

**Spondylolesthesis**

Answer 34

**slipping of one vertebra on another**

Question 35

Answer 35

Question 36

Answer 36

Spondylysis

Question 37

Answer 37

Spondylysis- bony spurs

Question 38

Answer 38

spondylothesis

Question 39

Question 40

Answer 40

sacralization

Question 41

Answer 41

lumbarization

Question 42

Answer 42

spina bifida

Question 43

Transverse process go \_\_\_\_ SP go \_\_\_\_

Answer 43

TP--\> up SP--\> down