Lumbar Flashcards
What is this called?
L5 fuses with sacral segment, mobile l5 fuses with immobile s1
Sacralization of L5
What type of curve is observed in the lumber spine, what degree?
Lordosis (50 deg)
RESTING POSITION of the lumbar facets
Midway between flexion and extension
Capsular pattern of the lumbar facet
full extension
Capsular pattern of the Lumbar facets
Side flexion and rotation equally limited, extension
Why is L5 as transitional vertebra?
Because the L5 tends to fuse with the sacral joint
If the L5 fuses with the Sacrum, this is called SACRALIZATION
Mobility of the L5 is sacrificed as it joins the segment (decreased ROM)
🔖 Sometimes the S1 fuses with the Lumbar segment
it will result in?
It results in an increased range of motion for the S1
Found over the lamina
Bony connection between the facets
Pars Interarticularis
Facets:
Superior Facets contains and positioned?
Inferior Facets is positioned?
Superior Facets
Mamillary process (multifidus muscle)
Positioned posteriorly and medially
Inferior Facets
Positioned anteriorly and lateral
T or F
Transverse Process = Accessory Process
Spinous Process = Short but thick
TRUE
The common site of fracture for the lumbar segment
PARS INTERARTICULARIS
At the upper tubercle of the superior articular facet
Important attachment for the MULTIFIDUS MUSCLE
MAMILLARY PROCESS
ACCESSORY PROCESS is located at?
Located over the transverse process
Ligament that Connects the different lumbar segments
INTERSEGMENTAL
Ligament that Within the lumbar segment
Keeps the vertebrae in place
INTRASEGMENTAL
Ligament that At the L5 segment, posterior portion of the ileum
Connects the transverse process of the L5 to the Ileum
Forms a Iliolumbar Canal
ILIOLUMBAR LIGAMENT
degeneration of IV disc (lumiliit)
SPONDYLOSIS
unilateral defect, unilateral Fx of pars interarticularis
SPONDYLOLYSIS or SCOTTIE DOG
bilat. Fx of pars interarticularis = anterior slippage
SPONDYLOLISTHESIS/SCOTTIE DOG DECAPITATED:
backward/posterior displacement of vertebral body
RETROLISTHESIS
T or F
with intact disc: carry about 10% to 25% of the axial load
with disc degeneration: reaches 80%
FALSE
with intact disc: carry about 20% to 25% of the axial load
with disc degeneration: reaches 70%
abnormality on the shape of facet joint
TROPISM
20-33% of V-height
due to fluidity, collagenous
INTERVERTEBRAL DISC
T or F
mobility order: cervical > lumbar > thoracic
TRUE
T or F
IV Discs are ideally innervated and avascular but the peripheral and outer components are innervated and a little vascularized
FALSE
IV Discs are ideally non-innervated and avascular but the peripheral and outer components are innervated and a little vascularized
Dics herniation is Most common in
L4-L5; L5-S1
Posterolateral herniation
If the disc herniates anteriorly where will the pain be felt?
Lumbar pain
If the disc herniates posteriorly where will the pain be felt?
Myelopathy
Ipit spinal cord
Cauda Equina Syndrome
If the disc herniates Vertically towards the vertebral body where will the pain be felt?
Schmorl’s nodes / Scheuermann’s
If the disc herniates medially where will the pain be felt?
Nerves/Nerve roots are affected
Most common disc herniation and this will result to
POSTEROLATERAL
Consequence = PARESTHESIA AT THE LE/ RADICULOPATHY
Herniation of the nucleus pulposus into the vertebral body
SCHORL’S NODES
Macnab’s Classification for Disc Herniation
PROTRUSION (grade 1)
PROLAPSE(grade 2)
EXTRUSION (grade 3)
SEQUESTRATION (grade 4)
SEQUESTRATION (grade 4) indicates?
Nucleus pulposus is completely separated from the disc
EXTRUSION (grade 3) indicates?
Leakage of nucleus pulposus
Annulus fibrosus perforated
PROLAPSE(grade 2) indicates?
Nucleus pulposus goes over annulus fibrosus
PROTRUSION (grade 1) indicates?
Bulge posteriorly without rupture of the annulus fibrosus
L3-L4 Herniation -> ___ Disc is affected
L4-L5 -> __nerve root exits here
L3-L4 Herniation -> L3 Disc is affected
L4-L5 -> L5 nerve root exits here
Normal angles of the spine
Lumbosacral angle =
Lumbar lordotic curve =
Sacral angle =
Pelvic angle =
Normal angles of the spine
Lumbosacral angle = 140 degrees
Lumbar lordotic curve = 50 degrees
Sacral angle = 30 degrees
Pelvic angle = 30 degrees
BACK PAIN VS LEG PAIN DOMINANT
Pattern 1
Pattern 2
BACK PAIN VS LEG PAIN DOMINANT
Pattern 1 = Disc involvement
Pattern 2 = Facet joint involvement
BACK PAIN VS LEG PAIN DOMINANT
Pattern 3
Pattern 4
Pattern 3 = Nerve root involvement
Pattern 4 = Neurogenic Intermittent claudication
Age-related conditions and patient’s gender
Disc problems; ___ year old
Ankylosing spondylitis; __year old (men); Bamboo spine; Inflammation of joint
Age-related conditions and patient’s gender
Disc problems; 15-40 year old
Ankylosing spondylitis; 18-45 year old (men)
Age-related conditions and patient’s gender
OA and spondylosis; __ year old and above
Malignancy; __year old and above
Age-related conditions and patient’s gender
OA and spondylosis; 45 year old and above
Malignancy; 50 year old and above
T or F
Males are more common to have low back pain due to hormones; pregnant women have laxed ligament
FALSE
Females are more common to have low back pain due to hormones; pregnant women have laxed ligament
Duration of back pain
Acute; ___
Subacute; ___
Chronic; ___
Duration of back pain
Acute; 3-4 weeks
Subacute; 4-12 weeks
Chronic; > 3 months
T or F
Long term use of physiotherapy can lead to osteoperosis
FASLE
Long term use of steroid therapy can lead to osteoperosis
Body type
Ectomorph ?
Mesomorph ?
Endomorph ?
Body type
Ectomorph -> payat, Thin body type
Mesomorph -> normal, Muscular or Sturdy body type
Endomorph -> taba, Heavy or fat body type
