Anatomy and Biomechanics of L Spine Flashcards

1
Q

what composes the anterior column of the spine?

A

vertebral bodies
intervertebral discs

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2
Q

function of anterior column of the spine

A

hydraulic and WB
shock-absorption

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3
Q

what composes the posterior column of the spine?

A

articular processes
facet joints

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4
Q

purpose of posterior column of spine

A

gliding mechanisms for movement

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5
Q

what joints compose each spinal segment?

A

anterior: 2 vertebral bodies + IVD
posterior: 2 facet joints

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6
Q

which articular orientation facilitates axial rotation? blocks?

A

facilitates - horizontal
block - vertical

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7
Q

how are L spine facets oriented?

A

sagittal

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8
Q

what does the AMOUNT of available spine motion depend on?

A

disc-vertebral height ratio
compliance of fibrocartilage
dimensions & shape of adjacent end plates
age
disease
gender

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9
Q

what does the TYPE of available spine motion depend on?

A

shape & orientation of articulations
ligaments & muscles of segment
size and location of segment’s articulating processes

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10
Q

what is the largest avascular structure in the body?

A

intervertebral discs

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11
Q

C & L IVDs are thicker in the _____ portion

A

anterior

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12
Q

which segment’s IVDs are uniform?

A

T

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13
Q

which 5 stresses does IVDs resist?

A

axial compression
shearing
bending
twisting
combined motion

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14
Q

T/F: IVDs resists tension forces

A

F

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15
Q

what are the 2 types of stability of the spine?

A

mechanical - static
controlled - dynamic

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16
Q

what 3 components make up controlled (dynamic) stability of spine?

A

passive
active
CNS

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17
Q

which forces does the passive stability of the spine resist?

A

translation
compression
torsion

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18
Q

local ___ and global ____ = function

A

local mobility and global stability = function

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19
Q

what is the capsular pattern of the L spine?

A

SB = rotation then extension

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20
Q

which is larger in the L spine: spinous or transverse process

A

transverse

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21
Q

what is lumbarization?

A

S1 more mobile than normal

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22
Q

what is sacralization?

A

L5 fuses to sacrum

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23
Q

how are the facets of the upper L spine oriented? lower?

A

upper - sagittal
lower - coronal

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24
Q

T/F: the articular cartilage of the synovial joints of the L spine are avascular and aneural

A

T

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25
Q

normal intact disc: facet joints carry ____% of axial load

A

20-25%

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26
Q

when a disc is degenerated the facet joints carry ___% of axial load

A

70%

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27
Q

what positions in the facet joint tight in?

A

ALL

28
Q

which structure can buckle during flexion of spine and lodge under the capsule which blocks extension and causes locking?

A

fibroadipose meniscoid

29
Q

which structure s usually the 1st to be injured in the spine?

A

end plates

30
Q

what are the 3 components of IVDs?

A

annulus fibrosus
nucleus pulposus
end plates

31
Q

which part of the IVD has neurovascular supply?

A

outer 1/3

32
Q

which forces does the annulus fibrosus transmit?

A

compression
shear
torsion

33
Q

what are the 3 zones of annulus fibrosus?

A

outer: Sharpey’s fibers (fibrocartilage)
intermediate: fibrocartilage
inner: fibrocartilage (most cartilage)

34
Q

which forces does the nucleus pulposus absorb?

A

compression and shear

35
Q

T/F: there is no blood or nerve supply to the nucleus pulposus

A

T

36
Q

how does the IVD get nutrients?

A

diffusion through the cartilaginous end plates

37
Q

L5 tends to slide ___ and ___ d/t lumbrosacral angle

A

anterior and inferior
(where spondy more likely)

38
Q

what motions does the ALL resist?

A

extension
excessive lordosis

39
Q

what motions does the PLL resist?

A

flexion
traction

40
Q

where is PLL weak?

A

lumbar

41
Q

what motions does the lig flav resist?

A

flexion

42
Q

when is lig flav slacked?

A

ONLY with extension

43
Q

which ligament covers the z joints and is strongest in the L region?

A

lig flav

44
Q

what motions does the interspinous lig resist?

A

hyper-flexion

45
Q

what motions does the supraspinous lig resist?

A

hyper-flexion

46
Q

what motions does the interspinous lig resist?

A

contra flexion (SB)

47
Q

activation of ____ increases fascial tension of TL fascia and limits ____ & ____

A

transverse abdominis
mobility & anterior translation

48
Q

coupled motion of ES

A

SB with ipsi rotation

49
Q

which layer of the ES is most effective in SB

A

iliocostalis

50
Q

which muscles are considered the rotator cuff of facet joints?

A

multifidi
(compresses and stabilizes)

51
Q

which ab mm is a primary stabilizer and synergist of multifidi?

A

transverse abdominis

52
Q

which mm gets short or atrophies in LBP pts?

A

iliopsoas

53
Q

where do all lumbar veins drain?

A

inf vena cava

54
Q

what is Schmorl’s node?

A

end plate fx in center when overloaded with axial compression

55
Q

how much intradiscal pressure occurs in bending forward?

A

150%

56
Q

how much intradiscal pressure occurs in lifting 20 kg weight w/ back bent and knees straight?

A

169%

57
Q

axial distraction causes a creep of ___ mm immediately

A

1-2 mm

58
Q

there is ___% lengthening of spine during traction d/t decreased lordosis

A

40%

59
Q

there is ___% lengthening of spine during traction d/t separating of vertebral bodies

A

60%

60
Q

during flexion of spine, there is ___ rocking and ___ translation

A

anterior rocking and translation

61
Q

which structure has the largest resistance to flexion?

A

joint capsule

62
Q

what motion causes the entire IV joint to be compressed?

A

extension

63
Q

during axial rotation, there is gapping of the ____ facet joint and compression of the ____ joint

A

gapping - ipsi
compression - contra

64
Q

which lig resist rotation?

A

inter and supra spinous

65
Q

rotation in flexion increases the risk of injury to the _____

A

annulus fibrosus

66
Q

SB is coupled with

A

rotation

67
Q

during SB, the the ipsi facet slides ___ and the contra glides ___

A

ipsi - inferior
contra - superior