Tri 9 Advanced Biomechanics Mid-Term Study Guide

1) In Magee, systemic and musculoskeletal pain is differentiated (chapter 1). List the
differences between musculoskeletal pain and systemic pain.

2) According to McGill and the notes from class, why are bending stress highest in the rst hour
of the morning for the lumbar disc? 3) As described by Magee and in class, what is the typical presentation for a cervical disc lesion? 4) List the structures of the dorsal oblique and deep longitudinal slings? 5) List the differences in history and physical exam ndings between a patient with a central disc lesion and one with a posterolateral disc lesion. 6) Describe the structural biases of the lumbar spine and sacrum between a hyperlordotic patient and one that is hypolordotic. Which muscles are tight (eccentrically/concentrically) and which muscles are inhibited for each? 7) What motions are required for normal overhead motion (i.e. cervical, thoracic, glenohumeral)? 8) According to the notes, what are the different coupling patterns of the lumbar spine based on patient position (i.e. neutral LF, Flexed LF, Rotation)? 9) Describe the positioning of the cervical spine, cervicothoracic junction, and upper thoracic spine with both retraction and protraction of the head/neck. 10) In class, we were reminded by Karel Lewit that many cervical spine cases will also involve this joint system and is often neglected by clinicians. 11) With improper respiration we often will overuse a certain set of muscles and not use one muscle in particular. Know these muscle relationships and be able to describe what joint xations result from these poor patterns. 12) In lecture, we described that overhead athletes should have plenty of this motion. Describe what the screen is and what information should be gleaned from this screen. 13) In the lumbar section of the course, we talked about one major factor from the physical exam that should alert the clinician to consider referral or more imaging. Also, be able to describe in depth the different visceral conditions that can refer to the back. 14) Stewart McGill has become famous for his big 3 exercises. Know what these three exercises are and when to use each. Be able to describe what exercises especially target QL (etc). What cases what you consider Bird-Dog for? 15) Be able to describe the core muscles of the back. Also, be able to describe how the diaphragm is able to become one of the main postural stabilizers for the low back. When this does not occur, certain orthopedic conditions are always present. 16) Understand which of the low back pain conditions (i.e. posterolateral disc, central disc, stenosis, facet syndrome, ligamentous sprain, spondylolisthesis, nerve root impingement) typically respond best to to exion biased treatment plans and those that respond to extension biased plans. 17) What symptoms should would you consider suspicious for pathology or space occupying lesion in the thoracic spine? 18) According to the notes, what ndings should drive you to seriously consider referring for surgical consult or at least ordering an MRI?