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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
what is the motion of the synovial joints
glide 5-8 mm up and down w lumbar rotation
26
are synovial joints vascular ?
no
27
how much **axial load** does a facet joint carry for a **normal** intact disc as compared to a **degenerated** disc
normal- 20-25% degen: 70%
28
for the Zygapophyseal Joint Capsule what is the anterior portion formed by
ligamentum flavum
29
when is the Zygapophyseal Joint Capsule tight in
all positions
30
what is the Zygapophyseal Joint Capsule reinforced by
multifidus and ligamentum flavum
31
when does the **fibroadipose meniscoid buckle** in the Zygapophyseal Joint Capsule
buckles during flexion and load goes under the capsule which blocks extension causing acute locking
32
where are the cartilaginous joints between
• B/t IV disc; vertebral end-plates and adjacent vertebral bodies
33
the intervertebral joint is ___ of total height of vertebral column
25%
34
what does the intervertebral joint allow and it ____ shock and distributes ___
allows movements and absorbs and load
35
the **annulus fibrosis** of the IV disc is mostly made out of what and is it the inner or outer layer
water and outer
36
there is 10-12 layers of the IV disc w _ zones … what are the zones
3 • Outer zone: Sharpey’s fibers (fibrocartilage) • Intermediate zone: fibrocartilage • Inner zone: fibrocartilage (most cartilage
37
what completely surrounds the NP
annulus fibrosis
38
for the AF there is neuro vascular supply to which part
outer 1/3
39
what forces does the **annulus fibrosis **transmit
compression , shear and torsion forces
40
what is the nucleus pulpisus made up of and is there blood and nerve supply ?
water and no
41
what forces does teh NP absorb
compression and shear forces ## Footnote no torsion as compaired to the AF
42
what is .6-1 mm **thick fibrocartilage** and **hyaline cartilage** and is weak to resist compression
end plate
43
L5 tends to slide __ and ___ d/t lumbosacral angle
ant and inf
44
if the pars interarticularis (isthmus) breaks what is it called? and what is it called if L5 displaced anteriorly
If isthmus breaks = spondylolysis • If L5 displaced ant = spondylolisthesis
45
what does the **anterior longitudinal ligament** resist
extension or excessive lordosis
46
which spinal ligament is located at the x Ant surface of vertebral bodies; from sacrum to C2
anterior longitudinal ligament
47
where is the Posterior longitudinal ligament (PLL) located
within vertebral canal on post surface of vertebral bodies ; from sacrum to C2
48
what does the **Posterior longitudinal ligament** (PLL) resists
flexion adn traction
49
which ligament is located • B/t ant surface of 1 lamina and post surface of the lamina below; from sacrum to C2
Ligament Flavum
50
what does the **Ligament Flavum** resist
Resists flexion; slack only w/ extension
51
what are teh 2 postieor ligaments in the spine
Interspinous ligament Supraspinous ligaments
52
where is the Supraspinous ligaments located
runs from SP to SP posteriorly .. from sacrum to C7
53
what does the Supraspinous ligaments resist
hyper flexion
54
where is the **Interspinous** ligament located
between adjacent SP
55
what does the **Interspinous ligament** resist
hyper flexion
56
where is the **Intertransverse Ligament** located and what does it limit
between adjacent transfer processes and limits contralateral flexion
57
how many bands are there for the Iliolumbar Ligament
5
58
where is the **Thoracolumbar Fascia**
T12 SP to PSIS and iliac crest
59
what is the superficial layer of the Thoracolumbar Fascia derived from
lats
60
what is the function of the Thoracolumbar Fascia
• Muscle attachment • Resisted segmental flexion • Assists in transmission of extension during lifting
61
what increased the Thoracolumbar Fascia tension and what does it limit
activation of the TA increased facial tension which leads to limits intersegmental mobility and anterior translation
62
what is the superficial layer of the posteior mm of the back
erector spinae
63
which **superficial** layer of the **posteior** mm of the back is most effective in **SB**
iliocostalis
64
if there is bilateral contraction of the Erecotr spinae what happens
ES extends the trunk which leads to anterior pelvic tilt and increase lumbar lordosis
65
if there is unilateral contraction of the Erecotr spinae what happens
ES side bends the trunk along with ipsilateral rotation
66
what is the deep layer of the posteior mm of the back
transverso spinal group: semispinals , multifidi and rotators
67
what mm is considered the Rotator cuff of facet joint: produces compression force during contraction → stabilize facet joint
multifidi
68
what does the EO do bilaterally and unilaterally
Bilaterally:trunk flex and post pelvic tilt * Unilaterally:trunk side bending and contralateral rotation
69
what does the IO do bilaterally and unilaterally
* Bilaterally: same a sexterna loblique (flexs the trunk and postieor pelvic tilt) * Unilaterally:trunk sidebending and ipsilateral rotation
70
what is the primary anterolateral ab mm and what is it a synergist of
TA and multifidi
71
what mm is a predominant hip flexor
iliacus
72
what does the **psoas** do
lumbar SB and vertical stabilizer
73
what does the **quad lum** do bilaterally and unilaterally
bilateral: extends lumbar region unilateral: sb L spine or elevate pelvis
74
all lumbar veins drain to what
inf vena cava
75
what are the 4 biomechanics of the lumbar spine
flexion extension R anf L slide bending r and l rotation
76
In pathologically narrowed discs, facets take ___% load
70
77
intradiscal pressure is measure at what joint
L 3
78
what is the intradiscal pressure for **stnasding**
100%
79
what activity has the **most** intradiscal pressure
lifting 20kg w back bend and knees straight
80
what sleeping position has the least intradiscal pressure
sleeping on back > sleeping on side
81
does sitting or standing put more instradiscal pressure on ur spine
sitting
82
what is the lumbar AROM for **flexion** and **extension** (sagittal plane) , axial **rotation** (horizontal plane) and **side bending** (frontal plane)
flexion: 70-90° extension : 30-50° rotation: 20-40° SB: 25-35°
83
is flexion primarily in the upper L spine or lower ? and where does it not occur at all
upper and L5-S1
84
what happens in the lumbar spine with flexion
facet joints and posteiror disc compression decreases and the anterior disc is compressed
85
the anterior rock i the lumbar spine during flexion is primarily resisted by tension of ___
the capsule
86
what happens at the lumbar spine during R axial rotation
TP: compression/closure on R side and opens on the L side SP: gapping on R facet joint and compression on L joint
87
what happens with L SB at the lumbar spine
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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