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2013-09-15 16:14:02

facets, disc protrusion,
Show Answers:

  1. how to name facet joint dysfunction
    • name for the direction the pt can't move or where pt feels pain
    • ex: pain on flexion  = flexion dysfunction
  2. type I disc protrusion
    • peripheral annular bulge
    • the annulus fibrosis protrudes beyond the vertebral body, but no serious nerve compromise
  3. type II disc protrusion
    • localized annular bulge
    • annulus fibrosis bulges and causes clinical signs, usually unilat
  4. type I disc herniation or prolapse
    prolapsed IV disc - displaced material is confined to only a few strands of the annulus fibrosis
  5. type II disc herniation or prolapse
    • extruded IV disc
    • displaced nucleus goes thru annulus and pushes the PLL
  6. prolapse, extrusion, sequestration?
    • prolapse: nucleus pulposus pushes out but doesn't get thru the annulus
    • extrusion: it breaks thru the annulus
    • sequestration: chunks of the nucleus escape
  7. type III disc herniation or prolapse
    • sequestered IV disc
    • extruded material is in the spinal canal and it can get trapped btwn nerve root and disc, or migrate and lie behind the vertebral body in the nerve root, or migrate to the IV foramen, or migrate midline, just ant to dural sac
  8. schmorl's nodes
    herniations of the nucleus pulposus into the vertebral body
  9. fawn's beard
    hairy over sacrum (sign of spina bifida)
  10. quadratus lumborum
    aponeurotic fibers arising from the iliolumbar ligament and the adjacent part of the iliac crest -->  medial half of lower border of 12thrib, and the apices of TPs of L 1-4
  11. QL
    • bilat: depress thoracic rib cage
    • unilat: lat flexion or hip hike
  12. psoas major
    TPs T12-L5 and lat aspects of the discs between them --> lesser trochanter
  13. psoas major
    • flex hip
    • lat rotate thigh
  14. psoas minor
    Lat surface bodies of T12 and L1 and intervening IV disc --> Pectineal line and iliopubic eminence
  15. psoas minor
    weak trunk flexor
  16. 3 things to read in a Thomas test
    • opposite hip flexes w/o knee extension = tight iliopsoas
    • hip abducts = tight IT band
    • knee extends = tight rectus femoris
  17. which vert is at level of iliac crests?
  18. which vert do you find from PSIS, and how?
    L5 SP is med and sup at ~30 degree angle
  19. lumbarization & sacralization
    • lumbarization: S1 doesn't fuse to the sacrum, so it's basically L6
    • sacralizatoin: L5 is fused to the sacrum
  20. 3 things to look for in movement testing
    • quality of movement
    • willingness to move
    • quantity of movement
  21. what is sustained ROM
    hold at end range for 15-20 sec to see how pt responds
  22. what is repetitive ROM
    go into motion, come out, repeat. See how pt responds.
  23. what's combined ROM
    ex: flex w rot w side bending
  24. lumbar ROM per Magee (and American academy orthopedic surgeons)
    • flex: 40-60 (80)
    • ext: 20-35 (30)
    • lat flex: 15-20 (35)
    • rot: 3-18 (45)