Deck 4: The Vertebral Column

Question 1

The physical therapy evaluation of a patient's cervical spine determines that compression of the (R)C5/C6 facet joint reproduces the patient's symptoms.Which of the following osteokinematic movements would be primarily responsible for reproducing the patient's symptoms?

A) Flexion
B) (R)rotation
C) (L)rotation and (R)lateral flexion
D) (R)rotation and (L)lateral flexion

Answer 1

C

Question 2

If you needed to perform joint mobilization on the transverse processes of T9,you could locate them by which of the following landmarks?

A) Just lateral to the spinous process of T11
B) Just lateral to the spinous process of T10
C) Just lateral to the spinous process of T9
D) Just lateral to the spinous process of T8

Answer 2

D

Question 3

Which of the following best describes the function of the sacrotuberous and sacrospinous ligaments?

A) They prevent excessive counternutation of the sacrum on the innominates.
B) They become most taut with end range of hip extension to effectively lock the sacrum and innominates together.
C) They counterbalance the trunk forces that flex the sacral promontory.
D) They form the superior border of the lesser sciatic foramen.

Answer 3

C

Question 4

Which of the following statements best fits the description of the sacroiliac ligaments?

A) The sacroiliac ligaments are reinforced by fibrous expansions from the erector spinae and gluteus maximus.
B) The fascial support is greater anteriorly than posteriorly.
C) The sacrotuberous and sacrospinous ligaments are not part of the sacroiliac ligaments.
D) The short posterior sacroiliac ligament is considered by some just a capsular reinforcement.

Question 5

Which of the following most accurately describes the primary tissue biomechanics that occur during lumbar rotation in a neutral position?

A) Shear force on the vertebral body; ipsilateral facet compressed
B) Compression on the vertebral body; ipsilateral joint capsule on slack
C) Shear force on the vertebral body; ipsilateral joint capsule stretched
D) Compression on the vertebral body; ipsilateral facet compressed

Question 6

The orientation of the uncinate processes in the cervical spine function to limit which of the following motions?

A) Vertebral body anterior shear
B) Vertebral body lateral translation
C) Vertebral body superior translation
D) Vertebral body posterior shear

Question 7

Which of the following may contribute to a dysfunction of trunk deviation (L)with forward bending?

A) Tight erector spinae muscles (R)
B) Stiff facet joint capsule on (L)
C) Poor strength (L)internal and external oblique muscles
D) Facet joint osteophyte on (R)

Question 8

Which of the following is true with regard to the structure of the anulus fibrosis of the normal intervertebral disc?

A) Annular lamina are oriented 60° to the horizontal plane of the intervertebral disc.
B) It resists tensile forces in all directions.
C) The water and proteoglycans content of the anulus is greater than the collagen content.
D) Anulus is vascular in the adult.

Question 9

If a person stands and bends forward while attempting to touch his or her toes (keeping knees extended),this produces ________________at the innominates,________________at the sacrum and flexion of the lumbar spine.

A) posterior rotation,nutation
B) anterior rotation,counternutation
C) posterior rotation,counternutation
D) anterior rotation,nutation

Question 10

Which of the following statements is true concerning the surface of the sacroiliac joints?

A) The sacral surface is formed from the fused bodies of S1 to S4.
B) Both the sacral and innominate articular surfaces are covered with fibrocartilage.
C) There is a pattern of elevations and ridges only on the sacral surfaces.
D) The innominate articular surface is "C" shaped.

Question 11

Which of the following accurately describes what happens to the intervertebral foramen during extension?

A) Intervertebral foramen becomes smaller.
B) Intervertebral foramen remains the same size.
C) Intervertebral foramen becomes larger.
D) Intervertebral foramen becomes square in shape.

Question 12

In the cervical spine,the greatest amount of rotation is available at which of the following motion segments?

A) C0 to C1
B) C1 to C2
C) C4 to C5
D) C6 to C7

Question 13

Which of the following structures would be best suited to resist the tensile forces produced during spinal extension?

A) Posterior vertebral body
B) Posterior longitudinal ligament
C) Anterior longitudinal ligament
D) Facet capsule

Question 14

Which of the following describes biochemical changes that occur in the intervertebral disc with aging?

A) Increased proteoglycan concentration in the nucleus pulposus
B) Increased water-binding capacity
C) Increased collagen content in nucleus pulposus
D) Increased elastin content in the anulus fibrosis

Question 15

The orientation of the facet joints in the thoracic spine causes the facets to function best in which of the following functions?

A) Limiting lateral flexion
B) Limiting rotation
C) Limiting extension
D) Limiting lateral translation

Question 16

The (R)alar ligament limits ________________of C1 on C2.

A) (R)rotation
B) (L)rotation
C) Extension
D) Both (R)and (L)lateral flexion

Question 17

Which of the following abdominal muscles would be active during trunk rotation to the right?

A) Right internal oblique,right external oblique
B) Left internal oblique,left external oblique
C) Right internal oblique,left external oblique
D) Left internal oblique,right external oblique

Question 18

Which of the following describes the lumbar spine facet joint arthrokinematic motion during (L)lateral flexion in the neutral position?

A) Ipsilateral facet moves caudal and anterior; contralateral facet moves caudal and lateral.
B) Ipsilateral facet moves cephalic and posterior; contralateral facet moves caudal and posterior.
C) Ipsilateral facet moves caudal and anterior; contralateral facet moves cephalic and posterior.
D) Ipsilateral facet moves cephalic and medial; contralateral facet moves cephalic and medial.

Question 19

Which of the following muscles flexes the mid/lower cervical spine and extends the upper cervical spine?

A) Sternocleidomastoid muscles
B) Anterior scalene muscles
C) Rectus capitus muscles
D) Oblique capitus muscles

Question 20

Which of the following most accurately describes the motion segment anatomical structures that will limit anterior translation of L5 on S1?

A) Shape of the intervertebral disc and the anterior annular fibers of the intervertebral disc
B) The iliolumbar ligament and posterior annular fibers of the intervertebral disc
C) The anterior longitudinal ligament and iliolumbar ligament
D) Posterior longitudinal ligament and intertransverse ligament

Question 21

Given the vertebral structure and orientation of the facet joints in the thoracic spine,which of the following motions would be most limited?

A) Lateral flexion
B) Rotation
C) Flexion
D) Extension

Question 22

Identify and describe the three articulations of the atlantoaxial joint.

Question 23

Give the new name acquired by each of the following ligaments as it passes cephalad to the axis: anterior longitudinal ligament,posterior longitudinal ligament,ligamentum flavum,and supraspinous.

Question 24

Describe the role of the disc in compressive loading of the spine.What happens under normal circumstances? What happens when normal forces are exceeded?

Question 25

Describe how maintaining the head in normal vertical alignment (head/optical righting)causes the pelvis,spine,and joints of the lower extremities to behave as part of a closed kinematic chain.

Question 26

Identify the ligaments that are unique to each of the areas,including the motions each ligament checks.

Question 27

Which of the following accurately describes what happens to the articular surface of the facet joints of the mid/lower cervical spine during cervical extension?

A) Distraction of articular surfaces
B) Compression of articular surfaces
C) No change at the articular surfaces

Question 28

What parts of the typical vertebra are included in the anterior portion of the vertebra? In the posterior portion?

Question 29

What is the predominant motion of the lumbar region? Where is the most motion occurring? Contrast the mobility and stability demands of this area.

Question 30

Describe age-related changes in the spinal column.

Question 31

Which of the following factors is the primary contributor to the vertebral body's decreased ability to withstand compressive forces as it ages?

A) Loss of horizontal trabeculae
B) Loss of vertical trabeculae
C) Loss of osteophyte formation
D) Loss of cortical bone

Question 32

What is the difference between the lamina and the pedicle of the vertebrae?

Question 33

What is the function of lumbopelvic rhythm? To what is this analogous?

Question 34

Compare the mobility-stability of the cervical (C2 to C7)and thoracic regions,including the structures implicated.

Question 35

What effect will normal gravitational moments tend to have on a weak sacroiliac joint?

Question 36

Which muscle serves as an important frontal and horizontal plane stabilizer of the trunk?

A) Longissimus thoracis
B) Quadratus lumborum
C) Rectus abdominus
D) Iliocostalis lumborum