Lumbar Anatomy and Biomech (PPT 1&2)

Question 1

Which way do superior facets of inferior vertebra face

Answer 1

medially

Question 2

Which way do inferior facets of superior vertebra face

Answer 2

laterally

Question 3

Describe what happens to the facets, NP, and annulus fibrosis during lumbar flex

Answer 3

-inf facet of superior vertebra glides UP and FWD
-NP moves POST
-annulus fibrosis bulges ANT

Question 4

Describe what happens to the facets, NP, and annulus fibrosis during lumbar ext

Answer 4

-inf facet of superior vertebra glides DOWN and BACK
-NP move ANT
-annulus fibrosis POST

Question 5

What happens to the spinal canal and intervertebral foramen in lumbar ext

Answer 5

shorten and close

Question 6

Describe what happens to the facets and intervertebral foramen during lumbar R SB

Answer 6

-inf facet of superior vertebra UPGLIDE on L and DOWNGLIDE on R
-R intervertebral foramen closes, L opens

Question 7

Open pack for L/S

Answer 7

flexion, contra SB, ipsi rot

Question 8

Closed pack for L/S

Answer 8

ext, ipsi SB, contra rot

Question 9

L/S flex ROM

Answer 9

70-90

Question 10

L/S SB ROM

Answer 10

25-35

Question 11

L/S ext ROM

Answer 11

30-50

Question 12

L/S rot ROM

Answer 12

20-40

Question 13

Describe the orientation of the disc fibers

Answer 13

-oriented ~65 degrees from vertical
-alternate direction for each sheet

Question 14

Why is the orientation of the disc fibers important

Answer 14

to resist torsional forces

Question 15

What is the largest structure w/o vascular supply

Answer 15

disc

Question 16

What type of CT is a disc made of? NP?

Answer 16

-type I collagen
-type II collagen

Question 17

Purpose of NP

Answer 17

-distributes compressive stresses equally
-flexibility at low loads
-stability at high loads

Question 18

Primary fxn of lumbar facet

Answer 18

-protect motion segment from ant shear forces and excessive rot
-allow flex > ext

Question 19

Where is the anterior longitudinal lig found? Fxn?

Answer 19

-sacrum to c/s in front of bodies
-limits ext; strongest in L/S

Question 20

Where is the posterior longitudinal ligament found? How does it compare to ALL?

Answer 20

-embedded into outside of disc
-smaller to accommodate spinal nerves

Question 21

Where is supraspinous lig found?

Answer 21

connect SP’s C7-L3/4

Question 22

Where is ligamentum flavum found?

Answer 22

connect laminae from C2-S1

Question 23

Where is interspinous lig found?

Answer 23

thin sheets connect SP from C1-S1

Question 24

Describe the facet orientation in t/s-l/s transitional zone

Answer 24

facets frontal to sagittal plane
-T12 superior is frontal, inferior is sagittal

Question 25

Describe the facet orientation in L1-L4

Answer 25

vertically oriented in sagittal plane -flex/ext facilitated while SB and rot limited by opposition of facets

Question 26

Describe the facet orientation of L5-S1 (lumbosacral jt)

Answer 26

facets in sagittal plane, obliquely into frontal ; limits SB and rot

Question 27

Trunk extensor muscles

Answer 27

multifidus and rotator; erector spinae, interspinalis, intertrasversarii

Question 28

Trunk flexor muscles

Answer 28

internal oblique; external oblique, TA, rectus abdom

Question 29

Trunk rotator muscles

Answer 29

ipsilat internal oblique; contralat external oblique, multifidus

Question 30

Trunk SB muscle

Answer 30

QL

Question 31

Fryette's Law 1

Answer 31

in neutral, rotation is OPP of SB (l/s and t/s)

Question 32

Fryette's Law 2

Answer 32

in full flex/ext, rot and SB occur to the SAME side

Question 33

Fryette's Law 3

Answer 33

motion introduced into a segment in any place, motion in other planes is REDUCED -vertebral motion usually coupled

Question 34

Define closing restriction

Answer 34

limitation in EXT, ipsilat SB, opp rot of painful side -movements produce compression of structures on symptomatic side

Question 35

Define opening restriction

Answer 35

limitation of FLEX, contralat SB, and rot same side of pain -movements produce stx of structures on symp side

Question 36

Name 4 forces that act on the spine

Answer 36

compression, torsional, tension, shear

Question 37

Describe compression

Answer 37

increased force on vertebra -> squish disc and causes to bulge or shorten and widen

Question 38

Describe tension

Answer 38

pulls apart structures being loaded

Question 39

Describe shear

Answer 39

load parallel to vertebral surface -fwd bending causes vertebra to slide fwd on the one below it

Question 40

Describe torsional

Answer 40

twist - causes soft tissue strain thru lg mus forces and loads on discs - causes SOFT TISSUES to be exposed to combo of comp, shear and tension

Question 41

When is disc pressure the greatest

Answer 41

sitting, leaning fwd 20 degrees, w/ weights in hands

Question 42

What is one of the most important things to a LB pt

Answer 42

explanation of what is causing pain

Question 43

What are 5 aberrant motions?

Answer 43

-painful arc in flexion -painful arc -Gower's sign -instab catch -reversal of lumbopelvic rhythm

Question 44

What is Gower's sign

Answer 44

"thigh climb"; assist during return to flex

Question 45

What is instability catch?

Answer 45

trunk movement outside of plane of specified motion during particular motion w/ sudden accel/decel

Question 46

What is reversal of lumbopelvic rhythm

Answer 46

trunk ext first -> ext of hips and pelvis to bring body upright