B6.032 Prework 1: Overview of Vertebral Column and Anatomical Causes of LBP Flashcards

1
Q

functions of vertebral column

A
protects spinal cord
point of attachment of ligaments, bone/muscles or upper and lower limbs
allow posture of the trunk
contribute to locomotion
transmit weight of upper body to legs
provide mobility/stability to trunk
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2
Q

lumbar spine

A

least mobility, most stability

site of most pain in the back

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3
Q

components of vertebral column

A
vertebral bodies
joints (facet and intervertebral)
ligaments
discs
muscles
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4
Q

composition of the body of the vertebrae

A

cortical bone- outer

trabecular bone- inner

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5
Q

function of trabecular portion of body

A

assist with compressive forces imparted on spine

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6
Q

risk factors for trabecular fracture

A

lack of activity
smoking
age
osteoporosis

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7
Q

how can you fracture your trabecular bone

A

trauma or sudden forces

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8
Q

how do you maintain trabecular bone

A

physical activity

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9
Q

what part of the neural arch is at risk of fracture

A

pars interarticularis

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10
Q

what is the pars interarticularis

A

bridges superior and inferior spinous processes
important for weight bearing
region where forces are transferred from vertebral body to neural arch

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11
Q

who is at risk of a pars fracture

A

young people who are very active and do a lot of rotation/extension
typically in individuals < 20

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12
Q

fracture of the pars interarticularis

A

spondylosis

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13
Q

fracture on both sides of the pars with slippage

A

spondylolisthesis

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14
Q

pain associated with pars fracture

A

severe pain in center of back
does not radiate unless so severe that slippage compresses nerve roots
palpation reproduces symptoms

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15
Q

diagnosis of vertebral body

A

plain radiograph

bony changes

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16
Q

what is the facet joint

A

joints of spine between superior and inferior articular processes on each side of spine

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17
Q

discuss the angles of the facet joint

A

cervical -45
thoracic- 90
lumbar -0
change in angle limits movements between vertebrae in different regions

18
Q

components of facet joints

A

synovial lining
joint capsule
meniscoid
hyaline cartilage- allows for gliding movement

19
Q

2 types of injury associated with facet joints

A

DJD due to arthritic changes

facet lock due to meniscoid displacement

20
Q

what type of motion can cause facet lock

A

sudden sharp movement

21
Q

pain associated with facet joint damage

A

localized pain in paravertebral region

doesn’t cross sides or back or travel down to legs

22
Q

imaging for facet joint damage

A

none required

23
Q

what are intervertebral joints

A

pseudo joints composed of discs and vertebral bodies

24
Q

components of discs

A

nucleus pulposus- deforms under pressure

annulus fibrosis - resists tensile forces

25
Q

function of intervertebral joints

A

weight bearing and stability

compresses under pressure

26
Q

what is disc herniation

A

annulus tear leads to nucleus migration into spinal cord

this causes a chemical reaction that results in intense back pain

27
Q

what is DDD

A

part of the normal aging process

only causes pain in some people

28
Q

pain associated with intervertebral joints

A

back or back and leg pain

leg symptoms due to nerve root compression

29
Q

imaging needed for intervertebral joint damage

A

MRI if there is evidence of nerve tissue compression

30
Q

major vertebral ligaments

A
anterior longitudinal
posterior longitudinal
ligamentum flavum (between neural arches)
interspinous (connects spinous processes)
supraspinous (lies over the tips of the spinous processes)
31
Q

function of ligaments

A

support facets and IV joints

resist motion in sagittal plane (flexion)

32
Q

what can put stress on the ligaments

A

slouched posture

sustained flexion

33
Q

pain associated with ligament stress

A

central back pain

34
Q

function of superior and intermediate back muscles

A

power
move trunk
anchored to upper and lower limbs to provide stability to trunk when moving extremities

35
Q

result of damage to superior back muscles

A

hypertonic, increase in activity to prevent movement curing acute pain stage

36
Q

function of deep back muscles

A

stabilize vertebral segments

prevents extensive motion at each level which could lead to degenerative changes

37
Q

result of damage to deep back muscles

A

hypotonic, decrease in activity which decreases stability

38
Q

why are rehab programs focusing on deep back muscles

A

activate them to improve stability for back pain

39
Q

what is interesting about lower back muscle injury

A

VERY rarely isolated
everything is too connects
may transmit pain from other etiologies

40
Q

function of transverse abdominis in spine

A

creates natural corset to stabilize lumbar spine

anticipate extremity movements to stabilize spine