Chapter 12 Lumbar spinal conditions

Hip flexion tests which nerve root myotome segment? A) L1-L2 B) L3 C) L5 D) S1

A) L1-L2

True or False? An individual with lumbar spinal stenosis develops back and leg pain after walking a limited distance, which concomitantly increases as distance increases. A) True B) False

A) True

True or False? The sacral curve is convex posteriorly. A) True B) False

A) True

True or False? The sciatic nerve can be palpated midway between the ischial tuberosity and the greater trochanter. A) True B) False

A) True

A fracture of the pars interarticularis is termed A) spondylolysis B) spear tackler's spine C) spinal stenosis D) spondylolithesis

A) spondylolysis

True or False? Spinal rotation capability is greatest in the lower lumbar region. A) True B) False

B) False

If an athlete has a diminished patellar reflex and weak ankle dorsiflexion, which nerve root is injured? A) L3 B) L4 C) L2 D) S1

B) L4

If an individual has a diminished quadriceps reflex and weak ankle dorsiflexion, what nerve root is injured? A) L3 B) L4 C) L5 D) S1

B) L4

During spondylolysis and spondylolisthesis, muscle spasms often occur in the A) rectus abdominis B) erector spinae and hamstrings C) erector spinae and quadriceps D) rectus abdominis and quadriceps

B) erector spinae and hamstrings

A person with sciatica, with sensory and reflex changes, muscle weakness, and normal bowel and bladder function, may return to sports participation A) in 6 to 12 weeks B) in 12 to 24 weeks C) after surgical decompression and rehabilitation D) probably never

B) in 12 to 24 weeks

If nerve root L5 is irritated or damaged, myotome weakness will be found in A) toe flexion NOT A B) toe extension C) ankle dorsiflexion D) ankle plantarflexion

B) toe extension

The top of the iliac crest is the landmark for which vertebrae? Question 5 options: A) T12 B) L2 C) L4 D) S1

C) L4

When viewing an athlete from a posterior view the spine is found to be curved. This condition is known as A) kyphosis B) lordosis C) scoliosis D) spondylolysis

C) scoliosis

A bilateral separation in the pars interarticularis that leads to anterior displacement of a vertebra is A) lordosis B) spina bifida C) spondylolisthesis D) spondylolysis NOT D

C) spondylolisthesis

Which of the following is not a characteristic of facet joint pathology? A) nonspecific low back pain of a deep and achy quality NOT A B) visible flattening of lumbar lordosis NOT B C) pain that radiates into the posterior thigh D) pain that radiates into the posterior lower leg.

C,D

Which of the following tests is not used to assess sacroiliac dysfunction? A) approximation test B) Fabere test C) Gaenslen's test NOT C D) Oppenheim test

D) Oppenheim test

A loss of cerebrospinal fluid around the spinal cord because of deformation of the spinal cord or a narrowing of the neural canal is called A) spina bifida NOT A B) Scheuermann's disease C) Spinal occlusion D) Spinal stenosis

D) Spinal stenosis

Lumbar facet pathology may involve

D) all the above

Compression loads on the lumbar spine are greatest during A) walking B) back hyperextension C) trunk flexion D) sitting in a slouched position

D) sitting in a slouched position

Lordosis is often associated with A) strong abdominal muscles and a posterior pelvic tilt B) strong abdominal muscles and a forward pelvic tilt C) weak abdominal muscles and a posterior pelvic tilt NOT C D) weak abdominal muscles and a forward pelvic tilt

D) weak abdominal muscles and a forward pelvic tilt

True or False? Axial compression loading has been identified as the leading mechanism of injury for severe cervical spine injuries. A) True B) False

A) True

True or False? Because the spinal cord ends at about L1 or L2 level, fractures of the lumbar vertebrae below this point do not pose a serious threat but should be handled with care to minimize potential nerve damage to the cauda equina. A) True B) False

A) True

True or False? During the straight leg raising test, pain that occurs opposite the leg lifted indicates a herniated disk. A) True B) False

A) True

True or False? Low back pain is common in runners who have muscle tightness in the hip flexors and hamstrings. A) True B) False

A) True

True or False? When lifting a heavy weight, it is important to inhale deeply as the lift is initiated and exhale forcefully throughout the lift until the end. A) True B) False

A) True

A positive Spurling test suggests A) a nerve root impingement due to a narrowing of the neural foramina B) hypomobility of the vertebrae C) occlusion of the cervical vertebral artery D) a herniated disc NOT D

A) a nerve root impingement due to a narrowing of the neural foramina

Hip flexion consists of A) anteriorly directed sagittal plane rotation of the femur with respect to the pelvic girdle B) posteriorly directed sagittal plane rotation of the femur with respect to the pelvic girdle C) anteriorly directed movement of the anterior superior iliac spine with respect to the pubic symphysis D) posteriorly directed movement of the anterior superior iliac spine with respect to the pubic symphysis

A) anteriorly directed sagittal plane rotation of the femur with respect to the pelvic girdle

A patient with sciatica caused by an annular tear will report A) pain localized over a facet joint on spinal extension B) back pain is greater than greater than radiating leg pain C) radiating pain is greater than back pain D) pain that is not reproduced with straight leg raising NOT D

A,B,C

The focus of a rehabilitation program following spondylolithesis should be A) flexibility of the quadriceps and gluteal muscles; strengthening of the abdomen B) flexibility of the quadriceps and gluteal muscles; strengthening of the back extensors C) flexibility of the hamstrings and gluteal muscles; strengthening of the abdomen and back extensors D) flexibility of the hamstrings and gluteal muscles; strengthening back extensors NOT D

A,B,C

Which of the following signs and symptoms is not related to neurological deficits or damage? A) radiating pain B) loss of bladder control C) referred pain D) weakness in myotomes NOT D

A,B,C

The development of one or more wedge shaped vertebrae in the thoracic or lumbar regions through abnormal epiphyseal plate behavior is called A) spondylolysis B) spear tackler's spine C) spinal stenosis NOT C D) Scheuermann's disease

A,B,D

When disk nuclear material moves into the spinal canal and impinges on adjacent nerve roots it is called a(n) A) extruded disk B) herniated disk NOT B C) prolapsed disk NOT C D) sequestrated disk

A,C,D

True or False? A lumbar fracture at the L5 level could be catastrophic if a bony fragment pierces the spinal cord and could result in total nerve disruption distal to that site. A) True B) False

B) False

True or False? Approximately 70 to 90% of all cases of scoliosis can be directly linked to overdevelopment of muscles on the dominant side of the thorax or to a leg length discrepancy. A) True B) False

B) False

True or False? Large compressive loads, such as those sustained during weight lifting, can cause fractures of the vertebral endplates, leading to a wedge fracture in the cervical area. A) True B) False

B) False

True or False? The lumbar region permits the largest cumulative range of motion in flexion/extension with 46 degrees, compared with 16 degrees in the thoracic region. A) True B) False

B) False

True or False? The most commonly herniated disks are the lower two lumbar disks, with ruptures occurring on the anterior or anterolateral aspect of the disk. A) True B) False

B) False

True or False? To reduce some compressive loading on lumbar region, runners should run with a slight forward lean and avoid overstriding to increase speed. Question 8 options: A) True B) False

B) False

True or False? Weak ankle plantar flexion and a reduced Achilles tendon reflex indicate an L5 nerve root injury. A) True B) False

B) False

Runners are often at risk for low back pain due to A) tight hip extensors and quadricep muscles B) tight hip flexors and hamstrings muscles C) tight abdominal muscles D) tight back muscles

B) tight hip flexors and hamstrings muscles

A patient with sciatica caused by an annular tear will report A) pain localized over a facet joint on spinal extension NOT A B) back pain is greater than greater than radiating leg pain C) radiating pain is greater than back pain D) pain that is not reproduced with straight leg raising

B,C,D

Ipsilateral pain during the first 70 degrees of a straight leg raising test indicates a possible A) herniated disk NOT A B) irritation of the sacroiliac joint C) sciatica D) tight hamstrings

B,C,D

The condition in which the nuclear material bulges into the spinal canal and runs the risk of impinging adjacent nerve roots is termed A) prolapsed disc NOT A B) extruded disc C) sequestrated disc D) sciatica

B,C,D

Hard disc disease is associated with A) uncontrolled lateral bending of the neck B) herniation of the nucleus propulus through the posterior annulus NOT B C) a diminished disc height and the formation of marginal osteophytes D) physically active adolescents Save

C) a diminished disc height and the formation of marginal osteophytes