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POTH 225: BIOMECHANICS > lecture 12: lumbar > Flashcards

lecture 12: lumbar Flashcards

1
Q

how many lumbar vert are there

A

5

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2
Q

what are the spinal curves

A

cervical lordosis
thoracic kyphosis
lumbar lordosis

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3
Q

does the cervical curve go anterior or posterior
is it kyphotic or lordotic

A

goes anterior
lordosis

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4
Q

does the thoracic curve go anterior or posterior
is it kyphotic or lordotic

A

posterior
kyphotic

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5
Q

does the lumbar curve go anterior or posterior
is it kyphotic or lordotic

A

anterior
lordotic

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6
Q

anterior means lordotic or kyphotic

A

lordotic

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7
Q

what are the articular processes

A

the facet joints is where the vert articulate with each other

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8
Q

why is the lumbar vert body larger

A

more weight bearing

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9
Q

what are the 2 main functions of the lumbar ligaments

A

restrain movement
sensory- provide information about vert postition

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10
Q

anterior spine ligaments prevent what movment

A

extension

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11
Q

posterior spine ligmanets prevent what movement

A

flexion

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12
Q

what bony articulations make up the facet joints

A

superior and inferior articular process

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13
Q

where does the majority of the movement of the spine occur

A

at the facet joints

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14
Q

what makes up the intervertebral joint

A

vert bodies
intervertebral disc

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15
Q

true or false: the facet joints are synovial joints

A

truw

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16
Q

is there increase loading on the facets with extension ro flexion

A

extension

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17
Q

during extension, is there increase or decrease loading on the facet joints

A

increase (getting compression)

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18
Q

during flexion, is there increase or decrease loading on the facet joints

A

decrease (opening up)

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19
Q

what is the 4 functions of the facet joints

A

guide segmental motion
resist anterior shear
resist torsion
resist compression

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20
Q

what are the 4 functions of the intervertebral joints

A

maintain space between vert
allow movement
resist compression
resist rotation

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21
Q

how do the intervertebral joints resist compression

A

because of shock absorption

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22
Q

what helps the spinal n and structures not get compressed

A

intervertebral joints

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23
Q

true or false: there is not a lot of rotation at the lumbar joint

A

true

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24
Q

what makes up the outer portion of the intervertebral joint

A

annulus fibrosis

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25
Q

what material makes up the annulus fibrosis

A

fibrocartilage

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26
Q

what is the orientation of the annulus fibrosis

A

obliquely oriented (fibres go in opposite direction)

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27
Q

what does the annulus fibrosis resist

A

tensile force and compression

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28
Q

what is the inner portion of the intervertebral disc

A

nucleus polpusos

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29
Q

what is the nucleus polposus made of

A

70-90% water (fluctuates)

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30
Q

what is the function of the nucleus poplusus

A

resist compression
role in nutrition

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31
Q

what are the 3 translation of the lumbar movement

A

distraction/compression
anterior/posterior shear
left/right shear

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32
Q

what movements would cause compression of lumbar

A

squation

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33
Q

what movements would cause distraction of lumbar

A

hanging from arms

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34
Q

what movement would cause anterior/psoteruor shea=r

A

trauma ex: car accident

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35
Q

what are the 3 rotations of the lumbar movement

A

flexion/extension
left/right sideband (lateral flex)
left/right rotation

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36
Q

true or false: lumbar facet joints are more parallel to saigtal plane than thoracic facets

A

true

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37
Q

lumbar facet joints are more parallel to BLANK plane than thoracic facets

A

sagitall plane

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38
Q

the lumbar orientation of the facet joints allows what movements and limits which

A

allows flexion/extension
limits rotations and lateral flexion

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39
Q

the thoracic vert is more parallel to what plaen

A

frontal plane (allows more rotation)

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40
Q

the lumbar vert is more parallel to what plane

A

lumbar (allows more flexion)

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41
Q

what is the lumbar flexion ROM

A

35-52

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42
Q

what is the lumbar extension ROM

A

15-29

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43
Q

what is the lumbar sidebend/lateral flex ROM

A

16-25

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44
Q

what is the lumbar rotation ROM

A

5-16

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45
Q

where is the most rotation located

A

at the neck cervical (c1-c2)

46
Q

as you get closer to lumbar, what happens to rotation

47
Q

as you get closer to lumbar what happens to flexion/extension

48
Q

true or false: the nucleus polposus moves with lumbar movement

49
Q

during lumbar flexion, the nucleus polposus migrates posterior or anterior

50
Q

during lumbar extension, the nucleus polposus migrates posterior or anterior

51
Q

as you flex your lumbar spine, it comprises your disk anterior, where does the nucleus move

52
Q

what is the lumbopelvic rhythm

A

interplay between lumbar spine and pelvis when movement

53
Q

to touch your toes, what is the movement of the spine and pelvis

A

lumbar spine flexes and pelvis anterior rotates

54
Q

how do tight hamstrings impact the lumbopelvic rhythem

A

hamstrings attach to ischial tub (on pelvis) so tight hamstrings will pull the pelvis posterior

55
Q

rotation at the lumbar spine are limited by what 2 things

A

1) annulus fibrosis (since the different fibre direction)

2) facet joints limit that rotation

56
Q

when do the facet joints offer less protection to rotation

A

while in flexion

57
Q

what is the most vulnerable spine position

A

flexed and rotated

58
Q

explain compression of the lumbar spine

A

hoop stres
vertical load (compression) is converted to circumferential tensile

59
Q

compression tension in the lumbar spine is resisted by what

A

annulus fibrosis and vertebral end plates

60
Q

what are the lumbar joint reaction forces

A

shear and compression forces

61
Q

forces on the vert is due to what

A

gravity on trunk, loading in arms, and muscles/ligaments

62
Q

there is increase loading on facets with flexion or extnsion

63
Q

what is another name for spondylolysis

A

scotty dog fracture

64
Q

what is spondylolysis

A

pars interarticularis (b/w sup and inf facet)

65
Q

what is spondylolysis due to

A

large magnitude anterior shear (>2000N)
due to repetitive lumbar extension and rotation

66
Q

what are some sports that cause spondylolysis

A

sports that are more upright vertically loaded

throwing in track
gymnastics
weightlifting
rowing

67
Q

understand spondylolysis as Scottie dog fracutre

68
Q

spondylolysis can result in what

A

spondylolisthesis

69
Q

what is spondylolisthesis

A

anterior displacement of a vertebrae

70
Q

where does disc herniation usually occur

A

posterior-lateral

71
Q

why does disc herniation occur more posterior and lateral

A

1) annulus fibrosis is thinner in that spot
2) posterior ligs dont run posterior lat (do not protect that spot)

72
Q

what can disc herniation cause

A

can impinge on nerve root

-weakness
radiating pain
sensory changes

73
Q

disc herniation is when what protrudes out

A

nucleus polposus

74
Q

when is disc herniation usually occur

A

injured near the end range of motion (does not have to be high load)

75
Q

why is disc herniation more common in middle aged adults

A

they have higher water content (more ability for it to herniate out)
lower water content in older adults

76
Q

disc herniation is associated with what

A

repetitive bending

77
Q

which movement would you want to discourage with posterior lateral lumbar disc herniation

A

limit flexion since it pushes the n.p posteriorly

78
Q

what is the intradiscal pressure during lying supine

79
Q

what is the intradiscal pressure during standing

80
Q

what is the intradiscal pressure during coughing

81
Q

what is the intradiscal pressure during forward bending

82
Q

what is the intradiscal pressure during lifting 23 lbs

83
Q

what position caused the highest intradiscal pressure

A

sitting slouched

84
Q

what is osteoporosis

A

lose of bone mass (bone mineral density)

85
Q

true or false: osteoporosis affects 100 million people worldwide

86
Q

when is osteoporosis more common

A

frequently after menopause in women

87
Q

due to osteoporosis, what is the prevalence of vertebral body compression fractures in women

A

less than 60: 3-17%
greater than 70: 19-46

88
Q

due to osteoporosis, what is the prevalence of vertebral body compression fractures in men

A

less than 65: 2-8
greater than 75: 15-21

89
Q

is osteoporosis more common in men or women

90
Q

what are common areas of vert body compression fractures

A

thoracolumbar junction and mid thoracic spine

91
Q

looking at a stress;/strain curve of the femur, what is the relationship of ultimate failure

A

failure point occurs later in normal ppl than osteroporotic

92
Q

true or false: when you sit, you are subject to creep

A

yes because there is a constant load and increase in tissue deformation when sittign

93
Q

prolonged flexion (slouched sitting) results i nwhat

A

slow lengthening of lumbar ligaments (increased range of motion) = impaired ligament sensory function
=altered muscle activation

94
Q

what were the results of sit/stand desks in the graves 2015 group

A

sit stand desk reduces sitting time by 80 mins/workday in health people
no change in body discomfrot

95
Q

what were the results of sit/stand desks in the agarwal 2018 group

A

sit stand desk reduced body discomfort (less than 1 out of 10) in healthy people

96
Q

what were the results of sit/stand desks in the barony gibbers 2018

A

sit stand desk reduced disability but not pain in patients with low back pain

97
Q

what is the risk of stoop lifting with flexed spine

A

greater anterior shear forces
greater load on ligaments

98
Q

what is the benefit of squat lifting with neutral spine

A

muscles provide a posterior shear force to limit the anterior shear

99
Q

true or false: there is less shearing force when using stoop lifting

A

false, less when squatting

100
Q

true or false: educating on lifting is useful

A

false
no evidence that lifting education can decrease injuries from lifting

101
Q

during compression, what tissues are loaded

A

vertebra body and disc muscles

102
Q

during compression, what is the common injury

A

vert body or end plate fracture

103
Q

during roation/side bend, what is the tissue loaded

A

facet, pedicles, muscles

104
Q

during roation/sidebend, what is the common injury

A

pars interarticularis or pedicle fracture

105
Q

during flexion, what is the tissues loaded

A

posterior ligaments, posterior annulus fibrosis, fascia, muscles

106
Q

during flexion, what is the common back injury

A

annular tear, disk herniation, muscle injury

107
Q

during spine extension, what is the tissues loaded

A

anterior ligaments, posterior body elements, muscles

108
Q

during spine extension, what is the common injury

A

pars interarticularis fracture,
spondylolisthesis

109
Q

how do you prevent back injuries

A

avoid repeated or prolonged end range lumbar flexion
vary positions and loads

allow time for tissues to restore normal length after prolonged loads
do not sit too long
keep loads close

110
Q

what is cumulative loading

A

additive effect of shear and impressive forces
considers the magnitude of loading (eg: peak forces or moment) and the frequency of loading)

111
Q

explain the study of peak force/moments and cumulative loading on predicting injuries in autowrokers

A

peak shear and compression higher in workers that had a previous lumbar injury
cummularitve shear and compressive higher in workers that had a previous lumbar injury

cumulative load predicted development of low back pain in workers

POTH 225: BIOMECHANICS (15 decks)

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