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MSK Lower Quarter > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

1
Q

What are some functions of the Lumbar spine?

A
  • Supports the upper body
  • Transmits force (weight) of the upper body to pelvis and lower limbs
  • Protects spinal cord
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2
Q

What is the:
- Resting position of the lumbar spine
- Closed packed position of the lumbar spine
- Capsular pattern of the Lumbar spine

A
  • Midway between flexion and extension
  • Full Extension
  • Side flexion and rotation is equally limited, extension
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3
Q

How many pairs of facet joints (apophyseal or zygoapophyseal joints) are in the lumbar spine?

A

5 pairs of joints; 10 facets in total

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4
Q

The facets carry _______% of the load

A

20%
Most of the vertebral load goes through the large body

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5
Q

The __________________ processes are typically at the same level as the spinous process

A

Transverse

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6
Q

What is the function of the facet joints in the lumbar spine?

A

It orientates the direction that the spine can move.

Rotation is limited and the facets control flexion, extension, and side bend (lateral flexion)

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7
Q

In the lumbar spine, the facet joint orientation gradually changes from the __________ plane to the __________ plane

A

Sagittal plane (flexion/extension)
Frontal plane (lateral flexion)

*The frontal plane orientation provides restriction from anterior shear

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8
Q

The superior articulating process faces __________ and __________.

A

Medially
Posteriorly

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9
Q

The inferior articulating process faces __________ and __________.

A

Laterally
Anteriorly

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10
Q

What are the 6 main ligaments of the lumbar spine?

A
  1. Anterior Longitudinal Ligament
  2. Posterior Longitudinal Ligament
  3. Ligamentum Flavum
  4. Supraspinous ligaments
  5. Interspinous ligaments
  6. Intertransverse ligaments
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11
Q

Which ligament helps to stabilize the L5 with the ilium to prevent anterior displacement of the L5?

A

Iliolumbar ligament

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12
Q

What are some functions of the intervertebral discs?

A

Acts as a shock absorber
Distributes load applied to the spine
Allows movement between the vertebra

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13
Q

Functional Segment Unit (view picture)

A
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14
Q

What is the Annulus Fibrosis?

A

The cartilaginous outer rim of the disc

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15
Q

What are two components of the Annulus Fibrosis?

A

Fibrocartilage-
Encases Nucleus Pulposus in center
Circular distribution in many rows

Sharpey’s fibers in the outer ring-
Attaches to the vertebral bodies (bony components)

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16
Q

What does the Nucleus Pulposus consist of?

A

Hydrophilic mucous tissue

It’s water-binding capacity decreases with age (starting at 20yrs old). The vertical space decreases and so does the extensibility & ability to shock absorb

17
Q

What is the function of the Endplate?

A

Allows fluid to move between disc and vertebral body.

*Overnight, this fluid hydrates the disc and it becomes larger and more replenished in the morning.

18
Q

What causes Schmorl’s nodules?

A

Vertical pressure that causes Nucleus Pulposus herniation into the vertebral body, causing defects in the cartilaginous end plate.

19
Q

Does “jumping” or “lifting wrong” have a greater load on the lumbar disc?

A

Lifting Wrong

20
Q

What passes through the Intervertebral Foramina?

A

Nerve Roots

21
Q

Where does the L4 nerve root exit?

A

L4 exits between the L4 and L5.

*The nerve root is named for the vertebra above

22
Q

Which part of the spine is the most common site for problems? Why?

A

L5-S1
It bears more weight than other vertebral levels and has a greater angle than others

23
Q

Lumbar Flexion Biomechanics:
1. Inferior articulated process moves __________/__________.
2. __________ tilt and glide of the vertebral body.

A
  1. Anterior/Superior
  2. Superior
24
Q

Lumbar Extension Biomechanics
1. Inferior articulate process moves __________/__________.
2. __________ tilt and glide of the vertebral body.

A
  1. Posterior/Inferior
  2. Inferior
25
Q

Lumbar Lateral Flexion
1. Ipsilateral inferior articular process moves __________/__________.
2. Contralateral inferior process moves __________/__________.

A
  1. Inferior/Posterior
  2. Superior/Anterior

*There is a coupled motion of ipsilateral rotation towards the side of lateral flexion

26
Q

Lumbar Rotation (not a primary motion)
1. Ipsilateral inferior articular process moves __________.
2. Contralateral inferior process moves __________.

A
  1. Medial
  2. Lateral
27
Q

What are the 4 types of disc herniations?

A
  1. Protrusion
  2. Prolapse
  3. Extrusion
  4. Sequestrated
28
Q

What are some symptoms of Myelopathy?

A

Can cause cervical pain
Canal pressure can cause difficulty walking or numbness

Fragments that exited into the canal could cause this.

29
Q

What are some symptoms of Cauda Equina syndrome?

A

Saddle anesthesia
Bowel/bladder dysfunction

30
Q

What are some symptoms of Nerve Root Compression?

A

Radicular symptoms
Radiating pain, besides at the local area of injury or insult.

31
Q

Does disc degeneration increase or decrease load pressure?

A

Disc degeneration causes an increased load pressure.

32
Q

T/F
The outer ring of the annulus is innervated

A

True

33
Q

T/F
The Nucleus Pulposus is innervated

A

False
The inner 2/3 of the annulus and the Nucleus Pulposus do not have any vascular or neurological input

34
Q

What are 3 other structures impacted by disc injury?

A

Anterior Longitudinal Ligament
Facets
Nerve Root

35
Q

What is a typical disc injury presentation?

A
  • Typically 30-50 years old
  • Across the back, can be unilateral and can radiate into the leg (radicular symptoms)
  • Difficulty moving in the morning (Inhibition and Inflammation)
  • Sitting or painful flexion
  • Pain with coughing, sneezing, straining
36
Q

What are some favorable conditions of LBP?

A

Absence of crossed SLR
No leg pain with extension
More than 50% relief of leg pain in first 6 weeks since onset

37
Q

What are some unfavorable conditions of LBP?

A

Positive crossed leg SLR
Leg pain with extension
Less than 50% or greater pain relief in first 6 weeks since onset

MSK Lower Quarter (4 decks)

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