MPM Test 1 Study Set @
2024-2025
What percent of the total compressive load does the vertebral body bear in upright
postures? - Answer 80-90%
Vertebral bodies made out of what kind of bone?
good or bad blood supply? - Answer cancellous bone
good supply
Function of the pedicles? - Answer bony struts that connect posterior elements and
vertebral body and transfer forces
Function of the lamina? - Answer Completes formation of neural arch and transfers
forces from posterior elements
What is the pars interarticularis?
why is it important? - Answer junction between the lamina and pedicle
area of high bending forces so location of fatigue fractures/spondylolysis
What type of joint is the facet joint? - Answer synovial joint with hyaline cartilage
Functions of the facet joint? (2) - Answer protects the disc
limits anterior translation and rotation
Function of the meniscoids in the facet joint? - Answer protects exposed articular
cartilage during flexion
vertebral body compression fracture characteristics? (2) - Answer typically thoracic
spine T11-T12
leads to wedge shape
What is a spondylolysis? - Answer defect or break in the area between the
superior/inferior articular process (fatigue fracture)
What is a spondylolytic spondylolisthesis? - Answer fatigue fracture with associated
slippage of the anterior aspect of the vertebral body
What is a degenerative spondylolisthesis? - Answer forward slippage of vertebrae
without fracture
,Clinical presentation of spondylolysis/spondylolytic spondylolisthesis (6) - Answer
young people
mild-mod somatic localized pain (LB, glut, post thigh)
hypermobility/instability
pain with extension/rotation
palpable step
significant hamstring tightness
Clinical presentation of degenerative spondylolisthesis (4) - Answer age 30-50
spinal stenosis symptoms
instability symptoms
possible neuro signs
Which ligament is known to play a role in spinal stenosis if pathological? - Answer
ligamentum flavum - degeneration of elastic fibers and proliferation of collagen fibers
and/or calcification of ligament
Which disc is normally wedge shaped? Which vertebral body? - Answer L5-S1 disc
L5 body
What controls the lordosis liability? (4) - Answer bony locking mechanism of the facet
orientation
annulus fibrosus
iliolumbar ligament
anterior longitudinal ligament
What is the benefit of lordosis? - Answer dissipate compressive forces through disc,
shape, and created ALL tension
What is a motion segment? - Answer Functional unit of the spine: two vertebrae, disc
between them
How does the vertebral body move with flexion?
With extension? - Answer up and forward
down and backward
How much flexion movement at each lumbar level?
,extension? - Answer 5degrees or so
5degrees or so
With left rotation, which facet gaps?
which one compresses? - Answer left facet gaps
right facet compresses
Main symptoms of instability? (7) - Answer history of chronic LBP
short term relief from manipulation
poor outcome with general exercise program
increased pain with static postures, and decreased with change in position
descriptions of catching, locking, giving way
inconsistent sympomatology
positive change in status with supportive device
Instability clinical signs (7) - Answer ROM with presence of painful arc vs end range
positive gowers sign
reversal of lumbopelvic rhythm
points of hinging
decreased pain with deep muscle contraction during provocative movement
unremarkable neuro exam
positive prone instability test
Where does spinal cord terminate and cauda equina begin? - Answer L1-L2
What spinal nerve is the most susceptible to foraminal stenosis? Why? - Answer L5
because they increase in size from L1-L5 so L5 is the biggest in cross sectional area
If you have a unilateral symptom, is it likely intervertebral or central stenosis?
If bilateral? - Answer intervertebral
central
Posterolateral herniation typically affects nerve root at what level? - Answer nerve root
exiting one vertebrae lower UNLESS its a FAR lateral herniation where it affects the
same level nerve root
, Medial herniation affects what root level? - Answer more than one!
Central herniation in lumbar spine affects what nerve(s)? - Answer cauda equina so
multiple levels below it
Characteristics of spinal stenosis (3) - Answer narrowing of the spinal canal or IV
foramen
creates mechanical AND vascular compression of the cauda equina called neurogenic
claudication
males more common than females
Developmental stenosis characteristics (3) - Answer shape and size of vertebral canal is
abnormally small because of neural arch aberrations
short thick pedicles and large articular processes
increases compression likelihood
Acquired stenosis characteristics (2) - Answer any structure surrounding the vertebral
canal affected by disease or degeneration resulting in enlargement of those structures
into the canal
typically due to aging (osteophytes, cancer, ligamentum flavum, many options)
Central stenosis clinical presentation (5) - Answer narrowing of the central canal
bilateral multisegmental LE pain
cauda equina compression-neurogenic claudication
somatic LBP
aggravated by extension, eased by flexion
Foraminal stenosis characteristics (4) - Answer IVF narrowing with decreased IVF
height from disc degradation
unilateral symptoms or bilateral but one side is worse
LE pain somatic or radicular and follows dermatome
aggravated by extension and eased by flexion
Differential diagnosis for stenosis: intermittent vascular claudication (6) - Answer
compromise arterial supply
mimic spinal stenosis symptoms
pain begins in calf and extends proximally
2024-2025
What percent of the total compressive load does the vertebral body bear in upright
postures? - Answer 80-90%
Vertebral bodies made out of what kind of bone?
good or bad blood supply? - Answer cancellous bone
good supply
Function of the pedicles? - Answer bony struts that connect posterior elements and
vertebral body and transfer forces
Function of the lamina? - Answer Completes formation of neural arch and transfers
forces from posterior elements
What is the pars interarticularis?
why is it important? - Answer junction between the lamina and pedicle
area of high bending forces so location of fatigue fractures/spondylolysis
What type of joint is the facet joint? - Answer synovial joint with hyaline cartilage
Functions of the facet joint? (2) - Answer protects the disc
limits anterior translation and rotation
Function of the meniscoids in the facet joint? - Answer protects exposed articular
cartilage during flexion
vertebral body compression fracture characteristics? (2) - Answer typically thoracic
spine T11-T12
leads to wedge shape
What is a spondylolysis? - Answer defect or break in the area between the
superior/inferior articular process (fatigue fracture)
What is a spondylolytic spondylolisthesis? - Answer fatigue fracture with associated
slippage of the anterior aspect of the vertebral body
What is a degenerative spondylolisthesis? - Answer forward slippage of vertebrae
without fracture
,Clinical presentation of spondylolysis/spondylolytic spondylolisthesis (6) - Answer
young people
mild-mod somatic localized pain (LB, glut, post thigh)
hypermobility/instability
pain with extension/rotation
palpable step
significant hamstring tightness
Clinical presentation of degenerative spondylolisthesis (4) - Answer age 30-50
spinal stenosis symptoms
instability symptoms
possible neuro signs
Which ligament is known to play a role in spinal stenosis if pathological? - Answer
ligamentum flavum - degeneration of elastic fibers and proliferation of collagen fibers
and/or calcification of ligament
Which disc is normally wedge shaped? Which vertebral body? - Answer L5-S1 disc
L5 body
What controls the lordosis liability? (4) - Answer bony locking mechanism of the facet
orientation
annulus fibrosus
iliolumbar ligament
anterior longitudinal ligament
What is the benefit of lordosis? - Answer dissipate compressive forces through disc,
shape, and created ALL tension
What is a motion segment? - Answer Functional unit of the spine: two vertebrae, disc
between them
How does the vertebral body move with flexion?
With extension? - Answer up and forward
down and backward
How much flexion movement at each lumbar level?
,extension? - Answer 5degrees or so
5degrees or so
With left rotation, which facet gaps?
which one compresses? - Answer left facet gaps
right facet compresses
Main symptoms of instability? (7) - Answer history of chronic LBP
short term relief from manipulation
poor outcome with general exercise program
increased pain with static postures, and decreased with change in position
descriptions of catching, locking, giving way
inconsistent sympomatology
positive change in status with supportive device
Instability clinical signs (7) - Answer ROM with presence of painful arc vs end range
positive gowers sign
reversal of lumbopelvic rhythm
points of hinging
decreased pain with deep muscle contraction during provocative movement
unremarkable neuro exam
positive prone instability test
Where does spinal cord terminate and cauda equina begin? - Answer L1-L2
What spinal nerve is the most susceptible to foraminal stenosis? Why? - Answer L5
because they increase in size from L1-L5 so L5 is the biggest in cross sectional area
If you have a unilateral symptom, is it likely intervertebral or central stenosis?
If bilateral? - Answer intervertebral
central
Posterolateral herniation typically affects nerve root at what level? - Answer nerve root
exiting one vertebrae lower UNLESS its a FAR lateral herniation where it affects the
same level nerve root
, Medial herniation affects what root level? - Answer more than one!
Central herniation in lumbar spine affects what nerve(s)? - Answer cauda equina so
multiple levels below it
Characteristics of spinal stenosis (3) - Answer narrowing of the spinal canal or IV
foramen
creates mechanical AND vascular compression of the cauda equina called neurogenic
claudication
males more common than females
Developmental stenosis characteristics (3) - Answer shape and size of vertebral canal is
abnormally small because of neural arch aberrations
short thick pedicles and large articular processes
increases compression likelihood
Acquired stenosis characteristics (2) - Answer any structure surrounding the vertebral
canal affected by disease or degeneration resulting in enlargement of those structures
into the canal
typically due to aging (osteophytes, cancer, ligamentum flavum, many options)
Central stenosis clinical presentation (5) - Answer narrowing of the central canal
bilateral multisegmental LE pain
cauda equina compression-neurogenic claudication
somatic LBP
aggravated by extension, eased by flexion
Foraminal stenosis characteristics (4) - Answer IVF narrowing with decreased IVF
height from disc degradation
unilateral symptoms or bilateral but one side is worse
LE pain somatic or radicular and follows dermatome
aggravated by extension and eased by flexion
Differential diagnosis for stenosis: intermittent vascular claudication (6) - Answer
compromise arterial supply
mimic spinal stenosis symptoms
pain begins in calf and extends proximally
