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MSK: LQ > lecture 2a: anatomy and biomechanics revie of lumbar spine > Flashcards

lecture 2a: anatomy and biomechanics revie of lumbar spine Flashcards

1
Q

what is the purpose of the vertebral column

A

stability allowing full mobility and to protect SC

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2
Q

what do the curves of the vertebral column allow

A

increased flexibility
shock absorbing capabilities

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3
Q
  • Articular processes
  • Zygapophyseal(facet) joints
  • Provides gliding mechanism for movement

are these structures in the anterior or postieor column of the spine

A

posterior

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4
Q
  • Vertebral bodies
  • IVDs
  • Hydraulic and WB portion provides shock-
    absorption

are these part of the anterior or posterior column of the spine

A

anterior

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5
Q

each spinal segment consists of how many joints

A

3

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6
Q

which articular surfaces of the spine block axial rotation and which part of the spine is this happening at

A

vertical and in the lumbar region

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7
Q

horizontal articular surfaces ____ axial rotation

A

favor

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8
Q

how are the L spine facets orientated

A

vertically in the sagittal plane

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9
Q

the amount of available motion in the spine is affected by what 6 things

A
  • disc vertebral height ratio
  • compliance of fibrocartilage
    • Dimensions and shape of adjacent vertebral end plates
    • Age
    • Disease
    • Gender
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10
Q

the type of motion avaiable at the spine is governed by what 3 things

A

• Shape and orientation of articulations
• Ligaments and muscles of segment
• Size and location of segment’s articulating processes

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11
Q

what is the largest avascular structure in the body

A

intervertebral disc

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12
Q

what are the 3 parts of the IVD and what is injured first

A
  • Np
  • AF
  • end plate
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13
Q

cervical and lumbar IVDs thicker in the ___ portion creating ___

A

anterior and lordosis

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14
Q

what are teh 5 major stresses that the IVD resist

A
  • Axial compression
  • Shearing
  • Bending
  • Twisting
  • Combined motion
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15
Q

what is included in the CV junction

A

atlas , axis and head

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16
Q

where is the thoracolumbar junction located

A

t12-L1 and located in between t spine w large ability to rotate and L spine w limited rotation abilities

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17
Q

where is the lumbosacral junction

A

mobile L spine meets stiff SI joint

L5- S1

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18
Q

for spinal stability what does function =

A

local mobility and global stability

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19
Q

what is the open and closed packed position for the L spine

A

open: midway between flexion and extension

closed: full ext

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20
Q

what is the capsular pattern of the L spine

A

limitation: SB = rotation , extension

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21
Q

what is the shape of the L5 transitional vertebra

A

wedge shaped

disc surface is smaller
TP are larger
SP are smaller

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22
Q

some times ___ may become more motion but sometimes ___ fuses to the sacrum ( sacralization)

A

S1
L5

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23
Q

how many Zygapophyseal (Facet) Joints are there

A

10 (5 pairs)

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24
Q

the spine is comprised of superior and inferior facets orientined in what 2 plains

A

sagiaital plan for upper L spine and coronal plane in the lower L spine

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25
Q

what is the motion of the synovial joints

A

glide 5-8 mm up and down w lumbar rotation

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26
Q

are synovial joints vascular ?

A

no

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27
Q

how much axial load does a facet joint carry for a normal intact disc as compared to a degenerated disc

A

normal- 20-25%
degen: 70%

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28
Q

for the Zygapophyseal Joint Capsule what is the anterior portion formed by

A

ligamentum flavum

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29
Q

when is the Zygapophyseal Joint Capsule tight in

A

all positions

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30
Q

what is the Zygapophyseal Joint Capsule reinforced by

A

multifidus and ligamentum flavum

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31
Q

when does the fibroadipose meniscoid buckle in the Zygapophyseal Joint Capsule

A

buckles during flexion and load goes under the capsule which blocks extension causing acute locking

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32
Q

where are the cartilaginous joints between

A

• B/t IV disc; vertebral end-plates
and adjacent vertebral bodies

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33
Q

the intervertebral joint is ___ of total height of vertebral column

A

25%

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34
Q

what does the intervertebral joint allow and it ____ shock and distributes ___

A

allows movements and absorbs and load

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35
Q

the annulus fibrosis of the IV disc is mostly made out of what and is it the inner or outer layer

A

water and outer

36
Q

there is 10-12 layers of the IV disc w _ zones … what are the zones

A

3

• Outer zone: Sharpey’s fibers (fibrocartilage)
• Intermediate zone: fibrocartilage
• Inner zone: fibrocartilage (most cartilage

37
Q

what completely surrounds the NP

A

annulus fibrosis

38
Q

for the AF there is neuro vascular supply to which part

A

outer 1/3

39
Q

what forces does the **annulus fibrosis **transmit

A

compression , shear and torsion forces

40
Q

what is the nucleus pulpisus made up of and is there blood and nerve supply ?

A

water and no

41
Q

what forces does teh NP absorb

A

compression and shear forces

no torsion as compaired to the AF

42
Q

what is .6-1 mm thick fibrocartilage and hyaline cartilage and is weak to resist compression

A

end plate

43
Q

L5 tends to slide __ and ___ d/t lumbosacral angle

A

ant and inf

44
Q

if the pars interarticularis (isthmus) breaks what is it called? and what is it called if L5 displaced anteriorly

A

If isthmus breaks = spondylolysis
• If L5 displaced ant = spondylolisthesis

45
Q

what does the anterior longitudinal ligament resist

A

extension or excessive lordosis

46
Q

which spinal ligament is located at the x Ant surface of vertebral bodies; from
sacrum to C2

A

anterior longitudinal ligament

47
Q

where is the Posterior longitudinal ligament (PLL) located

A

within vertebral canal on post surface of vertebral bodies ; from sacrum to C2

48
Q

what does the Posterior longitudinal ligament (PLL) resists

A

flexion adn traction

49
Q

which ligament is located • B/t ant surface of 1 lamina and post surface of the lamina below; from sacrum to C2

A

Ligament Flavum

50
Q

what does the Ligament Flavum resist

A

Resists flexion; slack only w/ extension

51
Q

what are teh 2 postieor ligaments in the spine

A

Interspinous ligament

Supraspinous ligaments

52
Q

where is the Supraspinous ligaments located

A

runs from SP to SP posteriorly .. from sacrum to C7

53
Q

what does the Supraspinous ligaments resist

A

hyper flexion

54
Q

where is the Interspinous ligament located

A

between adjacent SP

55
Q

what does the Interspinous ligament resist

A

hyper flexion

56
Q

where is the Intertransverse Ligament located and what does it limit

A

between adjacent transfer processes and limits contralateral flexion

57
Q

how many bands are there for the Iliolumbar Ligament

A

5

58
Q

where is the Thoracolumbar Fascia

A

T12 SP to PSIS and iliac crest

59
Q

what is the superficial layer of the Thoracolumbar Fascia derived from

A

lats

60
Q

what is the function of the Thoracolumbar Fascia

A

• Muscle attachment
• Resisted segmental flexion
• Assists in transmission of extension during lifting

61
Q

what increased the Thoracolumbar Fascia tension and what does it limit

A

activation of the TA increased facial tension which leads to limits intersegmental mobility and anterior translation

62
Q

what is the superficial layer of the posteior mm of the back

A

erector spinae

63
Q

which superficial layer of the posteior mm of the back is most effective in SB

A

iliocostalis

64
Q

if there is bilateral contraction of the Erecotr spinae what happens

A

ES extends the trunk which leads to anterior pelvic tilt and increase lumbar lordosis

65
Q

if there is unilateral contraction of the Erecotr spinae what happens

A

ES side bends the trunk along with ipsilateral rotation

66
Q

what is the deep layer of the posteior mm of the back

A

transverso spinal group: semispinals , multifidi and rotators

67
Q

what mm is considered the Rotator cuff of facet joint: produces compression force during contraction → stabilize facet joint

A

multifidi

68
Q

what does the EO do bilaterally and unilaterally

A

Bilaterally:trunk flex and post pelvic tilt

  • Unilaterally:trunk side bending and contralateral rotation
69
Q

what does the IO do bilaterally and unilaterally

A
  • Bilaterally: same a sexterna loblique (flexs the trunk and postieor pelvic tilt)
  • Unilaterally:trunk sidebending and ipsilateral rotation
70
Q

what is the primary anterolateral ab mm and what is it a synergist of

A

TA and multifidi

71
Q

what mm is a predominant hip flexor

A

iliacus

72
Q

what does the psoas do

A

lumbar SB and vertical stabilizer

73
Q

what does the quad lum do bilaterally and unilaterally

A

bilateral: extends lumbar region
unilateral: sb L spine or elevate pelvis

74
Q

all lumbar veins drain to what

A

inf vena cava

75
Q

what are the 4 biomechanics of the lumbar spine

A

flexion
extension
R anf L slide bending
r and l rotation

76
Q

In pathologically narrowed discs, facets take ___% load

A

70

77
Q

intradiscal pressure is measure at what joint

A

L 3

78
Q

what is the intradiscal pressure for stnasding

A

100%

79
Q

what activity has the most intradiscal pressure

A

lifting 20kg w back bend and knees straight

80
Q

what sleeping position has the least intradiscal pressure

A

sleeping on back > sleeping on side

81
Q

does sitting or standing put more instradiscal pressure on ur spine

A

sitting

82
Q

what is the lumbar AROM for flexion and extension (sagittal plane) , axial rotation (horizontal plane) and side bending (frontal plane)

A

flexion: 70-90°
extension : 30-50°

rotation: 20-40°
SB: 25-35°

83
Q

is flexion primarily in the upper L spine or lower ? and where does it not occur at all

A

upper and L5-S1

84
Q

what happens in the lumbar spine with flexion

A

facet joints and posteiror disc compression decreases and the anterior disc is compressed

85
Q

the anterior rock i the lumbar spine during flexion is primarily resisted by tension of ___

A

the capsule

86
Q

what happens at the lumbar spine during R axial rotation

A

TP: compression/closure on R side and opens on the L side
SP: gapping on R facet joint and compression on L joint

87
Q

what happens with L SB at the lumbar spine

A

compression on L side and enlogation on R side

L facet glides inf and R facet glides sup

MSK: LQ (22 decks)

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