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

Question 1

functions of vertebral column

Answer 1

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

Question 2

lumbar spine

Answer 2

least mobility, most stability

site of most pain in the back

Question 3

components of vertebral column

Answer 3

vertebral bodies
joints (facet and intervertebral)
ligaments
discs
muscles

Question 4

composition of the body of the vertebrae

Answer 4

cortical bone- outer

trabecular bone- inner

Question 5

function of trabecular portion of body

Answer 5

assist with compressive forces imparted on spine

Question 6

risk factors for trabecular fracture

Answer 6

lack of activity
smoking
age
osteoporosis

Question 7

how can you fracture your trabecular bone

Answer 7

trauma or sudden forces

Question 8

how do you maintain trabecular bone

Answer 8

physical activity

Question 9

what part of the neural arch is at risk of fracture

Answer 9

pars interarticularis

Question 10

what is the pars interarticularis

Answer 10

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

Question 11

who is at risk of a pars fracture

Answer 11

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

Question 12

fracture of the pars interarticularis

Answer 12

spondylosis

Question 13

fracture on both sides of the pars with slippage

Answer 13

spondylolisthesis

Question 14

pain associated with pars fracture

Answer 14

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

Question 15

diagnosis of vertebral body

Answer 15

plain radiograph

bony changes

Question 16

what is the facet joint

Answer 16

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

Question 17

discuss the angles of the facet joint

Answer 17

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

Question 18

components of facet joints

Answer 18

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

Question 19

2 types of injury associated with facet joints

Answer 19

DJD due to arthritic changes

facet lock due to meniscoid displacement

Question 20

what type of motion can cause facet lock

Answer 20

sudden sharp movement

Question 21

pain associated with facet joint damage

Answer 21

localized pain in paravertebral region

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

Question 22

imaging for facet joint damage

Answer 22

none required

Question 23

what are intervertebral joints

Answer 23

pseudo joints composed of discs and vertebral bodies

Question 24

components of discs

Answer 24

nucleus pulposus- deforms under pressure

annulus fibrosis - resists tensile forces

Question 25

function of intervertebral joints

Answer 25

weight bearing and stability | compresses under pressure

Question 26

what is disc herniation

Answer 26

annulus tear leads to nucleus migration into spinal cord | this causes a chemical reaction that results in intense back pain

Question 27

what is DDD

Answer 27

part of the normal aging process | only causes pain in some people

Question 28

pain associated with intervertebral joints

Answer 28

back or back and leg pain | leg symptoms due to nerve root compression

Question 29

imaging needed for intervertebral joint damage

Answer 29

MRI if there is evidence of nerve tissue compression

Question 30

major vertebral ligaments

Answer 30

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

Question 31

function of ligaments

Answer 31

support facets and IV joints | resist motion in sagittal plane (flexion)

Question 32

what can put stress on the ligaments

Answer 32

slouched posture | sustained flexion

Question 33

pain associated with ligament stress

Answer 33

central back pain

Question 34

function of superior and intermediate back muscles

Answer 34

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

Question 35

result of damage to superior back muscles

Answer 35

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

Question 36

function of deep back muscles

Answer 36

stabilize vertebral segments | prevents extensive motion at each level which could lead to degenerative changes

Question 37

result of damage to deep back muscles

Answer 37

hypotonic, decrease in activity which decreases stability

Question 38

why are rehab programs focusing on deep back muscles

Answer 38

activate them to improve stability for back pain

Question 39

what is interesting about lower back muscle injury

Answer 39

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

Question 40

function of transverse abdominis in spine

Answer 40

creates natural corset to stabilize lumbar spine | anticipate extremity movements to stabilize spine