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Biomechanics > Exam 2: Lumbars > Flashcards

Exam 2: Lumbars Flashcards

1
Q

Lumbar spine is largely responsible for

A

Trunk mobility

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2
Q

Inferior articular processes are ____ and face ____

A

Convex; anterolaterally

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3
Q

Orientation of inferior articular processes

A

AIL

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4
Q

Superior articular processes are ___ and face ____

A

Concave; posteromedially

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5
Q

Lumbar facets lie primarily in

A

Sagittal plane

Coronal at lumbosacral jxn

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6
Q

Sagittal facet configuration limits _____

A

Rotational flexibility

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7
Q

Sagittal facet configuration allows for greater mobility in

A

Flexion and extension

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8
Q

L1-L4 facets have ___ orientation and limit ____

A

Sagittal; axial rotation (thetaY)

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9
Q

L5-S1 facets have ___ orientation and limit _____

A

Coronal; P/A shear (z translation)

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10
Q

Lumbar facets normally carry ____% of axial load and up to ___% in extension

A

18% normally; 33% in extension

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11
Q

Primary movement in lumbar spine

A

Flexion/extension

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12
Q

___% of trunk Flex/ext occurs in lumbar spine

A

75%

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13
Q

Lumbar spine exhibits ___ times as much flexion as extension

A

2x

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14
Q

Lateral bending is coupled w/

A

Axial rotation

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15
Q

Spinous rotates to ___ side

A

Ipsilateral side

EXCEPT it may switch at L4/5

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16
Q

Nucleus pulposus in lumbar IVD are oriented

A

Posteriorly

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17
Q

Disc height to body height ratio =

A

1:3

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18
Q

The ratio gives disc greater

A

Resistance to axial compressive forces

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19
Q

Lumbar spinal canal contains/protects _____ proximally and the ____ distally

A

Lumbar enlargement (conus medullaris) proximally; cauda equina w/ spinal nerves distally

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20
Q

CNS is tethered to coccyx by

A

Filum terminale

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21
Q

Is the dural sac and its contents freely mobile?

A

No, Hoffman ligs stabilize them

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22
Q

Lumbar lordotic curve is a ____ curve

A

Secondary

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23
Q

Lumbar curve starts to develop

A

9-12 months of age (beginning to sit up)

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24
Q

Apex of lumbar curve

A

L3-4 disc

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25
Q

Normal lumbar lordosis should be ____ degrees

A

20-60 degrees

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26
Q

Sacral base angle increases with ant pelvic tils which results in

A

Inc in lumbar lordosis, and mor weight-bearing responsibility on facets

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27
Q

Sacral base angle dec w/ a posterior pelvic tilt which results in

A

Dec in lumbar lordosis, and more weight on disc

Dec in spines ability to absorb axial compression forces

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28
Q

Major stabilizer of L spine

A

Quadratus lumborum

29
Q

QL is most active during

A

Heavy lifts (74%)
Isometric lateral bending (54%)
Standing isometric twists (42%)

30
Q

ALL/PLL in lumbar spine restrict

A

Flexion/extension

31
Q

This ligament provides stability by preventing excess motion btw vertebrae

A

Ligamentum flavum

32
Q

Lumbodorsal fascia acts like a large

A

Extensor retinaculum: constrains long tendons of T/L extensors

33
Q

Interspinous ligament controls what movement

A

Rotation

Also guards against posterior shear

34
Q

Supraspinous ligament provides resistance against

A

Excessive forward flexion

35
Q

Facet capsule restricts

A

Joint flexion and distraction of facet surfaces

36
Q

Trauma causes ligament damage which causes _____

A

Joint laxity

37
Q

Joint ____ follows joint laxity

A

Degeneration

38
Q

Percent of adults that will experience low back pain sometime in their lives

39
Q

Back pain ranks second to ___ as most frequent location for pain

40
Q

Poor and constrained posture can lead to

A

LBP and muscle fatigue
Inc, asymmetric disc pressure
Stress/irritation of facet/ligaments

41
Q

Most pressure on disc is in what position

A

Forward flexed (less than 80 degrees btw trunk and legs)

42
Q

Extension increases

A

Tensile force at ant annulus

Loading/compression of posterior facets

43
Q

Flexion increases

A

Posterior annulus tensile forces

Inc in AP shear on posterior facets

44
Q

Static sitting/standing is concerning because of

A

Fatigue mechanisms

45
Q

Human body requires movement to

A

Nourish structures (nucleus pulposus and IVD)

46
Q

Dangers of sustained static posture

A

Creates stress at posterior annulus and PLL

Stress at posterior facet damages hyaline cartilage

47
Q

Recommendations to reduce static compressive forces

A

Alternate sitting and standing

Change 20-30 minutes w/ 2 mins of movement in between

48
Q

Spondylolisthesis is a defect of the

A

Pars interarticularis

49
Q

Pars fractures are from

A

Posterior shear force to inf articular process

Repeatedly alternating flex/ext

50
Q

Spondylolisthesis definition

A

Anterior displacement of vertebra

51
Q

Spondys are usually at what level

52
Q

Overall incidence of spondys

A

5-7%

Higher in males

53
Q

Type I Spondy

A

Congenital

Abnormal neural arch

54
Q

Type II Isthmic Spondy

A

Defect of pars interarticularis (stress fracture)

55
Q

Isthmic spondy are MC in _____ patients and typically occurs at ____

A

Younger; L5

56
Q

Type III degenerative spondy

A

Segmental instability secondary to advanced DDD

57
Q

Degenerative spondy MC in ____ patients and typically occur at ___

58
Q

Type IV Traumatic spondy

A

Fracture of neural arch, NOT pars interarticularis

59
Q

Type V pathologic spondy

A

Osseous deformity secondary to pathology

60
Q

Spondylolysthesis Grade I

A

0-25% slippage

61
Q

Spondy grade II

A

26-50% slippage

62
Q

Grade III

63
Q

Grade IV

A

76-100% slippage

64
Q

Grade V

A

Spondyloptisis (VB falls of VB below it)

65
Q

Burst fractures

A

Comminuted VB fractures, disruption of A and P walls

66
Q

Burst fractures cause severe neurological problems from

A

Retropulsion of bone into spinal canal

67
Q

Burst fractures result from high-energy axial load

A

Traffic collisions
Falls w/ great height/speed
Seizures

68
Q

Fracture type w/ compression of Ant and middle column, posterior column intact

69
Q

Type of fracture w/ anterior column intact, middle and posterior columns w/ distraction

Biomechanics (15 decks)

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