Omt - Lumbar

Front 1

Nerve root exit in the thoracic and lumbar region?

Back 1

Intervetebral foramen below its corresponding segment, just above the intervetebral disc.

Front 2

Spina bifida occulta.

Back 2

Failure of fusion of posterior spine w/ intact thecal sac and normal spine core.
No neurologic deficit.

Front 3

Spina bifida meningocele.

Back 3

Failure of fusion of posterior spine element. Cystic outpouching of thecal sac w/ CSF, but no neural tube disruption.
W or W/o intact skin, so no neurologic deficit.

Front 4

Spina bifida meningomyelocele.

Back 4

Significant disruption fo all elements of bony spine w/ open, malformed neural tube w/ membranous sac.
Variable neurologic defects.

Front 5

Erector spinae group.

Back 5

= spinalis, longissimus, iliocostalis.
Large muscle on each side of vertebral column.

Front 6

Multifidus and rotators.

Back 6

= deep muscles of back.
Multifidis span 1 - 3 vertebrae.
Rotators = arise from transverse process of one vertebra and insert onto the base of spinous process of the superior vertebrae.

Front 7

Quadratus lumborum.

Back 7

Originates from medial half of 12th ribs and tips of lumbar transverse processes and inserts onto iliolumbar ligaments and internal lip of iliac crest.
It extends and sidebends the lumbar spine.

Front 8

Iliopsoas.

Back 8

Psoas portion originates from transverse processes and vertebral bodies of T12-L5.
Inserts onto lesser trochanter of femur.
Primary hip flexor and external rotator of lower extremity.

Front 9

Herniated nucleus pulposus.

Back 9

95% between L4 and L5 or L5 and S1.
Thru posteriolateral portion of intervetebral disc b/c posterior longitudinal ligament weakest there.
Herniated disc exert pressure on nerve root of vertebrae below.

Front 10

Psoas syndrome.

Back 10

= flexion contracture of iliopsoas.
Shortening or spasm of iliopsoas muscle.
Cause by sitting, bending over from the waist for a long period of time.
Examination reveals tender points at iliacus muscle, positive Thomas test.
Key problem= nonneutral dysfunction of L1 and L2.
Rx: counterstrain at iliacus and psoas.

Front 11

Spondylolisthesis.

Back 11

One vertebral body slips in relation to the one below.
Usually at L5 and S1.
Defect in region of junction of lamina w/ pedicle.
Pain worse w/ standing.

Front 12

Spondylolysis.

Back 12

Defect in pars interarticularis w/o anterior displacement of vertebral body.
Dx made w/ oblique view of lumbar spine.
Fracture in pars interarticulars = "collar on the Scotty dog."

Front 13

Cauda equina syndrome

Back 13

A large, central disc herniation may compress the tail of lumbar spine --> compression of sacral nerve roots.
Sacra root impingment (S2-4) --> bowel and bladder dysfunction. Decreased rectal tone and saddle anesthesia.