Vertebral biomechanics

1.

1 point

When examining a patient, you observe that the transverse processes of L2-L5 are all posterior on the right. How would you record this finding in his chart according to its motion restriction?

L2-L5 NSrRl

L2-L5 RNSlRr

L2-L5 RNRrSl

L2-L5 RNSrRl

2.

1 point

When testing a patient's range of motion, you discern that his rotation is restricted both left and right. This condition

can be cured with OMT

is normal in patients over 40

is a combination of Type I and Type II somatic dysfunctions

is likely a capsular pattern and warrants further diagnosis

3.

1 point

A serratus posterior superior trigger point may be confused with

sacral tender points due to pain referred through the anterior rami

tender points in the lower thoracic spine due to the radiating pain pattern

a thoracic iliocostalis trigger point due to the overlapping radiating pain patterns

tender points along the shoulder and arm due to referred pain

4.

1 point

Which of the following is true concerning the erector spinae muscles?

they contract during extension and are stretched during flexion

they are antagonized by the splenius muscles

they contract during rotation and are stretched during extension

they are stretched during extension and contract during flexion

5.

1 point

Which of the following apply to the thoracic region of the spine?

kyphosis

relative extension

parasagittal facets

relative flexion

lordosis

coronal intervertebral facets

6.

1 point

**YOUR HONOR, PLEASE STRIKE THIS QUESTION FROM THE RECORD.**

Dr. Beatty sent out an email saying that this slide was ambiguous and that we wouldn't be tested on it.

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Which of the following is true?

The coronal facets of lumbar vertebrae limit rotation.

The coronal facets of thoracic vertebrae limit rotation.

The coronal facets of thoracic vertebrae limit sidebending.

The coronal facets of lumbar vertebrae limit sidebending.

7.

1 point

Uncovertebral joints serve to limit

sidebending and rotation of the cervical spine

flexion and extension of the thoracic spine

flexion and extension of the cervical spine

sidebending and rotation of the thoracic spine

8.

1 point

Which of the following muscles resist flexion of the spine?

longissimus

splenius

serratus posterior inferior

transversospinalis

9.

1 point

You notice that your patient's L1 vertebra appears to be rotated to the right. The rotation is not noticeable when she leans forward. How would you record this finding in her chart?

L1 FRrSr

L1 ERlEl

L1 ERrSr

L1 FRlSl

10.

1 point

The ligamentum flavum is found

on the posterior side of the lamina and spinous processes

on the medial side of the lamina

on the posterior side of the lamina

on the medial side of the lamina and spinous processes

11.

1 point

Which of the following are useful in diagnosing thoracolumbar somatic dysfunctions?

motion testing

location of tender points

paraspinal palpation

postural exam

12.

1 point

The iliolumbar ligament attaches to

the transverse processes of L2 and L3

the spinous processes of L2 and L3

the transverse processes of L4 and L5

the mammillary processes of L4 and L5

13.

1 point

You suspect a somatic dysfuction in a patient with mechanical back pain. What should you look for first?

postural asymmetry

a bulging disc

a rotated vertebral segment

signs of infection

14.

1 point

A scoliotic patient will display a rib hump during Adam's test because

the muscles on the convex side undergo significant hypertrophy

the intercostal facets are deformed

rotation and sidebending are coupled

the ribs on the concave side undergo significant atrophy

15.

1 point

Which of the following correctly associates a plane of vertebral motion with its corresponding type of motion and its axis of rotation?

coronal plane, sidebending, transverse axis

sagittal plane, flexion/extension, transverse axis

horizontal plane, flexion/extension, vertical axis

horizontal plane, rotation, anterior-posterior axis

16.

1 point

The primary function of the vertebral body is concerned with

rotation

load bearing

protecting the spinal cord

flexion

17.

1 point

When performing segmental motion testing in the lumbar region of your prostrate patient, you encounter resistance when applying pressure in the posterior->anterior direction to the right transverse process of L2. You do not note any other remarkable findings. What should you do next?

retest the region with the patient in a neutral seated position

retest L2 in flexion and extension

ask the patient to tell you a little bit more about that

apply pressure to the same process in the reverse direction

18.

1 point

Rotation of a vertebral segment can most easily be confused with

scoliosis

fullness of the erector spinae muscles

an enlarged transverse process

a malignant tumor

19.

1 point

When treating patients using counterstrain, you should always start with

the most tender point

the tender point closest to the patient's chief complaint

the first tender point

the most superior tender point

20.

1 point

Generally, spinal ligaments limit

extenstion

lateral bending

flexion

rotation

21.

1 point

A patient is suffering from a herniated nucleus pulposus in the L2/L3 disc. Which spinal nerve is most likely affected?

L2

L2 and L3

a spinal nerves below the hernia

L3

22.

1 point

Which of the following applies to single segment motion testing?

it is only useful for diagnosing Type I somatic dysfunction

rotation decreases in the direction of extension

it must be performed on a prone patient

rotation decreases in the direction of ease

23.

1 point

A patient exhibits sidebending to the right in the L1-L4 region in the neutral position. How would you record this finding in her chart according to the position of ease?

L1-L4 NSrRr

L1-L4 NSrRl

L1-L4 RSrRl

L1-L4 RSrRr

24.

1 point

You have determined that your patient has a facet that is locked in the open position. How would you arrive at this conclusion?

There would be noticeable asymmetry when the patient leans forward, toward the locked facet.

There would be noticeable sidebending and rotation when the patient leans backward, toward the closed facet.

The bilateral disparity between the locked and normal facets would be readily palpable.

By ordering an MRI

25.

1 point

You observe that your patient has pronounced neutral sidebending left from L1-L5. Where would you expect to find a Type II somatic dysfunction?

near L1

near L3

near L5

any of the above

None of the above, because this is a Type I somatic dysfunction which precludes Type II

26.

1 point

A vertebral unit is

a single vertebra and all associated elements immediately inferior to it

two adjacent vertebrae and all associated elements between them

a single vertebra and all associated elements immediately superior to it

a single vertebra and all structures it surrounds

27.

1 point

The key difference between trigger points and tender points is that

a tender point is located in the muscle tissue

a trigger point elicits a radiating pain pattern when pressed

a tender point is locally tender

a trigger point elicits a jump response when pressed

28.

1 point

The nucleus pulposus is deformed by all of the following except:

extension

rotation

flexion

compression

29.

1 point

You discover that your patient exhibits both Type I and Type II somatic dysfunctions. You should:

recommend rest as they will likely subside on their own

treat the Type II first, as the Type I is likely compensatory

order an imaging study because something is seriously wrong with this guy

treat the Type I first, as it affects more vertebral units

30.

1 point

Which of the following would cause excessive lumbar lordosis?

pregnancy

decrease in abdominal muscle tone

excess abdominal adipose tissue

scoliosis

31.

1 point

Which of the following ligaments serves as an attachment site for the trapezius muscle?

nuchal ligament

posterior longitudinal ligament

costotransverse ligament

ligamentum flavum

32.

1 point

Which of the following correctly summarizes Fryette's laws

I: neutral position, group of vertebrae, opposite directions

II: flexed/extended position, vertebral unit, opposite directions

I: neutral position, vertebral unit, opposite directions

II: flexed/extended position, group of vertebrae, same direction

33.

1 point

Which of the following correctly describes Type II somatic dysfunctions?

rotation away from the load, apices and crossovers

facets engaged, single units, primary, requires first treatment

facets engaged, multiple segments, adaptive, requires secondary treatment if necessary

rotation toward convexity, smooth curves

facets not engaged, single units, primary, requires first treatment

34.

1 point

Which of the following is not a mechanism involved in counterstrain?

active shortening of muscles

resetting proprioceptive reflexes

gamma efferent system

reducing nociceptive reflexes

35.

1 point

Each zygophophyseal joint is innervated by

posterior rami from two spinal nerves

an anterior ramus from one spinal nerve

anterior rami from two spinal nerved

a posterior ramus from one spinal nerve