lecture 12: lumbar Flashcards
1
Q
how many lumbar vert are there
A
5
2
Q
what are the spinal curves
A
cervical lordosis
thoracic kyphosis
lumbar lordosis
3
Q
does the cervical curve go anterior or posterior
is it kyphotic or lordotic
A
goes anterior
lordosis
4
Q
does the thoracic curve go anterior or posterior
is it kyphotic or lordotic
A
posterior
kyphotic
5
Q
does the lumbar curve go anterior or posterior
is it kyphotic or lordotic
A
anterior
lordotic
6
Q
anterior means lordotic or kyphotic
A
lordotic
7
Q
what are the articular processes
A
the facet joints is where the vert articulate with each other
8
Q
why is the lumbar vert body larger
A
more weight bearing
9
Q
what are the 2 main functions of the lumbar ligaments
A
restrain movement
sensory- provide information about vert postition
10
Q
anterior spine ligaments prevent what movment
A
extension
11
Q
posterior spine ligmanets prevent what movement
A
flexion
12
Q
what bony articulations make up the facet joints
A
superior and inferior articular process
13
Q
where does the majority of the movement of the spine occur
A
at the facet joints
14
Q
what makes up the intervertebral joint
A
vert bodies
intervertebral disc
15
Q
true or false: the facet joints are synovial joints
A
truw
16
Q
is there increase loading on the facets with extension ro flexion
A
extension
17
Q
during extension, is there increase or decrease loading on the facet joints
A
increase (getting compression)
18
Q
during flexion, is there increase or decrease loading on the facet joints
A
decrease (opening up)
19
Q
what is the 4 functions of the facet joints
A
guide segmental motion
resist anterior shear
resist torsion
resist compression
20
Q
what are the 4 functions of the intervertebral joints
A
maintain space between vert
allow movement
resist compression
resist rotation
21
Q
how do the intervertebral joints resist compression
A
because of shock absorption
22
Q
what helps the spinal n and structures not get compressed
A
intervertebral joints
23
Q
true or false: there is not a lot of rotation at the lumbar joint
A
true
24
Q
what makes up the outer portion of the intervertebral joint
A
annulus fibrosis
25
what material makes up the annulus fibrosis
fibrocartilage
26
what is the orientation of the annulus fibrosis
obliquely oriented (fibres go in opposite direction)
27
what does the annulus fibrosis resist
tensile force and compression
28
what is the inner portion of the intervertebral disc
nucleus polpusos
29
what is the nucleus polposus made of
70-90% water (fluctuates)
30
what is the function of the nucleus poplusus
resist compression
role in nutrition
31
what are the 3 translation of the lumbar movement
distraction/compression
anterior/posterior shear
left/right shear
32
what movements would cause compression of lumbar
squation
33
what movements would cause distraction of lumbar
hanging from arms
34
what movement would cause anterior/psoteruor shea=r
trauma ex: car accident
35
what are the 3 rotations of the lumbar movement
flexion/extension
left/right sideband (lateral flex)
left/right rotation
36
true or false: lumbar facet joints are more parallel to saigtal plane than thoracic facets
true
37
lumbar facet joints are more parallel to BLANK plane than thoracic facets
sagitall plane
38
the lumbar orientation of the facet joints allows what movements and limits which
allows flexion/extension
limits rotations and lateral flexion
39
the thoracic vert is more parallel to what plaen
frontal plane (allows more rotation)
40
the lumbar vert is more parallel to what plane
lumbar (allows more flexion)
41
what is the lumbar flexion ROM
35-52
42
what is the lumbar extension ROM
15-29
43
what is the lumbar sidebend/lateral flex ROM
16-25
44
what is the lumbar rotation ROM
5-16
45
where is the most rotation located
at the neck cervical (c1-c2)
46
as you get closer to lumbar, what happens to rotation
decrases
47
as you get closer to lumbar what happens to flexion/extension
icnreases
48
true or false: the nucleus polposus moves with lumbar movement
true
49
during lumbar flexion, the nucleus polposus migrates posterior or anterior
posterior
50
during lumbar extension, the nucleus polposus migrates posterior or anterior
anterior
51
as you flex your lumbar spine, it comprises your disk anterior, where does the nucleus move
posterior
52
what is the lumbopelvic rhythm
interplay between lumbar spine and pelvis when movement
53
to touch your toes, what is the movement of the spine and pelvis
lumbar spine flexes and pelvis anterior rotates
54
how do tight hamstrings impact the lumbopelvic rhythem
hamstrings attach to ischial tub (on pelvis) so tight hamstrings will pull the pelvis posterior
55
rotation at the lumbar spine are limited by what 2 things
1) annulus fibrosis (since the different fibre direction)
2) facet joints limit that rotation
56
when do the facet joints offer less protection to rotation
while in flexion
57
what is the most vulnerable spine position
flexed and rotated
58
explain compression of the lumbar spine
hoop stres
vertical load (compression) is converted to circumferential tensile
59
compression tension in the lumbar spine is resisted by what
annulus fibrosis and vertebral end plates
60
what are the lumbar joint reaction forces
shear and compression forces
61
forces on the vert is due to what
gravity on trunk, loading in arms, and muscles/ligaments
62
there is increase loading on facets with flexion or extnsion
extension
63
what is another name for spondylolysis
scotty dog fracture
64
what is spondylolysis
pars interarticularis (b/w sup and inf facet)
65
what is spondylolysis due to
large magnitude anterior shear (>2000N)
due to repetitive lumbar extension and rotation
66
what are some sports that cause spondylolysis
sports that are more upright vertically loaded
throwing in track
gymnastics
weightlifting
rowing
67
understand spondylolysis as Scottie dog fracutre
68
spondylolysis can result in what
spondylolisthesis
69
what is spondylolisthesis
anterior displacement of a vertebrae
70
where does disc herniation usually occur
posterior-lateral
71
why does disc herniation occur more posterior and lateral
1) annulus fibrosis is thinner in that spot
2) posterior ligs dont run posterior lat (do not protect that spot)
72
what can disc herniation cause
can impinge on nerve root
-weakness
radiating pain
sensory changes
73
disc herniation is when what protrudes out
nucleus polposus
74
when is disc herniation usually occur
injured near the end range of motion (does not have to be high load)
75
why is disc herniation more common in middle aged adults
they have higher water content (more ability for it to herniate out)
lower water content in older adults
76
disc herniation is associated with what
repetitive bending
77
which movement would you want to discourage with posterior lateral lumbar disc herniation
limit flexion since it pushes the n.p posteriorly
78
what is the intradiscal pressure during lying supine
250 N
79
what is the intradiscal pressure during standing
500N
80
what is the intradiscal pressure during coughing
700N
81
what is the intradiscal pressure during forward bending
1000N
82
what is the intradiscal pressure during lifting 23 lbs
1700 N
83
what position caused the highest intradiscal pressure
sitting slouched
84
what is osteoporosis
lose of bone mass (bone mineral density)
85
true or false: osteoporosis affects 100 million people worldwide
true
86
when is osteoporosis more common
frequently after menopause in women
87
due to osteoporosis, what is the prevalence of vertebral body compression fractures in women
less than 60: 3-17%
greater than 70: 19-46
88
due to osteoporosis, what is the prevalence of vertebral body compression fractures in men
less than 65: 2-8
greater than 75: 15-21
89
is osteoporosis more common in men or women
women
90
what are common areas of vert body compression fractures
thoracolumbar junction and mid thoracic spine
91
looking at a stress;/strain curve of the femur, what is the relationship of ultimate failure
failure point occurs later in normal ppl than osteroporotic
92
true or false: when you sit, you are subject to creep
yes because there is a constant load and increase in tissue deformation when sittign
93
prolonged flexion (slouched sitting) results i nwhat
slow lengthening of lumbar ligaments (increased range of motion) = impaired ligament sensory function
=altered muscle activation
94
what were the results of sit/stand desks in the graves 2015 group
sit stand desk reduces sitting time by 80 mins/workday in health people
no change in body discomfrot
95
what were the results of sit/stand desks in the agarwal 2018 group
sit stand desk reduced body discomfort (less than 1 out of 10) in healthy people
96
what were the results of sit/stand desks in the barony gibbers 2018
sit stand desk reduced disability but not pain in patients with low back pain
97
what is the risk of stoop lifting with flexed spine
greater anterior shear forces
greater load on ligaments
98
what is the benefit of squat lifting with neutral spine
muscles provide a posterior shear force to limit the anterior shear
99
true or false: there is less shearing force when using stoop lifting
false, less when squatting
100
true or false: educating on lifting is useful
false
no evidence that lifting education can decrease injuries from lifting
101
during compression, what tissues are loaded
vertebra body and disc muscles
102
during compression, what is the common injury
vert body or end plate fracture
103
during roation/side bend, what is the tissue loaded
facet, pedicles, muscles
104
during roation/sidebend, what is the common injury
pars interarticularis or pedicle fracture
105
during flexion, what is the tissues loaded
posterior ligaments, posterior annulus fibrosis, fascia, muscles
106
during flexion, what is the common back injury
annular tear, disk herniation, muscle injury
107
during spine extension, what is the tissues loaded
anterior ligaments, posterior body elements, muscles
108
during spine extension, what is the common injury
pars interarticularis fracture,
spondylolisthesis
109
how do you prevent back injuries
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
what is cumulative loading
additive effect of shear and impressive forces
considers the magnitude of loading (eg: peak forces or moment) and the frequency of loading)
111
explain the study of peak force/moments and cumulative loading on predicting injuries in autowrokers
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
