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MSK LQ > Lecture 2A: Lumbar Spine Anatomy > Flashcards

Lecture 2A: Lumbar Spine Anatomy Flashcards

1
Q

Axial Rotation

horizontal articular surfaces
vertical articular surfaces

clarifier

footnote

A

horizontal structres favor axial rotation
vertical blocks axial rotation (i.e. lumbar spine)
note: facets of the lumba are oriented vertically in the sagittal plane

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2
Q

spinal motion amount of available motion is affected by?

A
  • disc vertebral height ratio
  • compliance of fibrocartilage
  • dimention / shape of adj vertebral end plate
  • age
  • disease
  • gender
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3
Q

type of motion available govered by

A

shape and orientation of the articulation
ligaments / mm
size and location fo the articulation

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4
Q

most available motion is in the____spine bc it has largest facets

A

Lumbar

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5
Q

what’s the largest avascular structure in the body?

A

IVD

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6
Q

5 major stresses that the IVD Can resist are:

A
  1. axial compression
  2. shearing
  3. bending
  4. twisting
  5. combinted motion
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7
Q

T/F IVD does not resist tension

A

T

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8
Q

What makes the cervical and lumbar segments more lordotic than thoracic and sacral?

A

IVD is thicker anteriorly
IVD is uniform in thoracic

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9
Q

CV junction

A

atlax, axis and head

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10
Q

CT junction

A

mobile lower cervical movement meets super stiff thoracic t-spine

note: upper cervical spine is more mobile than the lower

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11
Q

the most rotation occuring at a junction is at

A

Thoracolumbar junction

thoracic has a larger ability to rotate than lumbar

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12
Q

lumbosacral junction

A

mobile l spine meets stiff SIJ ..
LESS ROTATION

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13
Q

two types of spinal stability

A

mechanical (static) stability = when body is still (equilibrium)

conrolled (dynamic) stability
- passive system= resisting forces of translation, compresson and torsion (esp at end range)
- active system= mm coordination to control body relative to environment
- CNS= feedforward/feedback

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14
Q

function equals=

A

local mobility
global stability

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14
Q

if the passive system is damaged

A

active system picks up slack, hence fatigues quicker

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15
Q

open pack position of the lumbar spine

A

midway flx/ext

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16
Q

close packed position of lumbar s

A

full ext

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17
Q

capsular patter of lumbar s (limitations)

A

SB = Rotation, Extension

more info slide 13

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18
Q

lumbarization
(less common)

A

S1 more mobile

more info slide 13

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19
Q

sacralization

A

L5 fuses to sacrum

more info slide 13

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20
Q

how much axial load do the facets carry with a normal intact disc carry?
how about a degenerated disc?

A

normal = 20-25%
degenerated disc = facets take up to 70% of axial load

more info slide 14

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21
Q

anterior facet joint capsule formed by
facet joints are reinforced by__

A

anterior = ligamentum flavum
reinforced by: multifidus and ligamantum flavum

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22
Q

facet joints are tight in

A

ALL POSITIONS

23
Q

how does the fibroadipose meniscoid “buckle”

A

buckles during flexion and “lodges” under the capsule

it blocks extension which causes acute “locking”

24
Q

the structure that absorbs shock and distributes load (compression)

A

IV disc

25
Q

Annulus fibrosus surrounds the NP with neurovacular supply to ___
attached to ___
transmitting (3) forces
____H20

A
  • outer 1/3
  • end plates
  • compression, shear, torsion
  • 60-70%
26
Q

which AF zone bas the most fibrocartilage?

A

inner zone

27
Q

Nucleus pulposus:
- % H20
- NO _
- Absorbs___ and__ forces

A

70-90%
NO BLOOD AND NERVE SUPPLY
absorb compression and shear

28
Q

what structure isweak to resist compression?

A

end-plate b/c mostly has no blood/nerve

29
Q

if the IV disc is avascular, how does it recieve nutrients?

A

by diffusion via end-plates (cartilaginous)

30
Q

everytime there’s a compression/tracton to the spine, blood goes

A

away from bone and to disc via endplate

31
Q

D/T lumbosacral angle, L5 tends to slide __and___

A

ant and inf

more info slide 20 (spondy)

32
Q

greatest tensile strength in lumbar region, resisting extension and excessive lordosis

A

ALL

33
Q

resistns flexion and traction and is weak in the lumbar region and causes HNP

A

PLL

34
Q

resising flexion ; **slack only w/ extension

strongest in lumbar region

A

ligamentum flavum

35
Q

posterior ligaments

interspionous ligament and supraspinous ligaments

A

resists hyperflexion

36
Q

intertransverse ligaments

A

limit contrallateral flexion (side bend)

37
Q

iliolumbar ligament

A

resist ipsilateral side bend and translation of L5

38
Q

Superior band of iliolumbar ligament

A

prevents flexion

39
Q

inferior band of iliolumbar ligament

A

taut in extension

40
Q

posterior band of iliiolumbar ligament

A

prevents flexion and resist side bending at L4, stabilzing L5 from ant displacement

41
Q

the activation of this mm increases fascial tension, causes limitation intersegmental mobility and ant translation

A

TA

(in relation to thoracolumbar fascia)

42
Q

thoracolumbar fascia functions

A
  • mm attach
  • resisted segmental flexion
  • assist transmission of extension during lifting
43
Q

which mm is most effective in side bendig in the ES group?

A

iliocostalis

44
Q

this mm is the “rotator cuff: of facet joint: produces compression force during contraction and will stabilize the facet joint

A

multifidi

45
Q

review the slides

31-35

A

slide 31-35

45
Q
A
46
Q

during axial compression:

A

NP pressure rise and AF bulges (posteroir or posterior lat)
end plate bows foward vertebra and can fracture if the load is too quick (weakest)

Disc: squeez out H2o during axial compression and “shortens”

47
Q

T/F facet joint sustains verticlaly applied load in neutral position

A

FALSE

severe axial compression overtime will lead to fatigue failure.

more info slide 37

48
Q

intradiscal pressures

bending fwd and lifting 20 kg weight w/back bent and knees straight

lifting 20 kg weight w/ back straight and knees bent

A

150%
169%
73%

49
Q

facet joints are strong during ____

A

traction

creep 1-2 mm immediately

lenghening will cause flattening of lumbar lordosis curve

50
Q

“opening” movementof the lumbar spine is

flexion occurs in all segments except

A

anterior rock + anterior translation
L5-S1

51
Q

flexion is restained due to

A

joint capsule (mainly)
IV disc

52
Q

this motion increases the risk of damaging annulus fibrosus

A

rotation in flexion b/c facets are minimal contact

53
Q

axial rotation restrains

A

interspinous and supraspinous lig

54
Q

interspinous ligament buckles b/t SPs during

A

extension

55
Q

read the last couple of slides

A

MSK LQ (15 decks)

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