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OMM M1T2E3 > Lumbar Biomechanics > Flashcards

Lumbar Biomechanics Flashcards

1
Q

Describe Type I (Neutral) Fryette mechanics.

A

Sidebending and Rotation are coupled to opposite sides

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2
Q

Describe Type II (Non-neutral) Fryette mechanics.

A

Sidebending and rotation are coupled to the same sides

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3
Q

What is the exception to Fryette’s rule?

A

L5/S1 - lots of spinal anomalies here; trauma can also negate Fryette mechanics

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4
Q

In lumbar kinesiology, motion is….

A

permitted by bones and joints, restrained by ligaments, and produced/stabilized by muscles

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5
Q

What is the functional range of the lumbar spine?

A

T11-L5

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6
Q

What is the lumbar spine designed for?

A

weight bearing design

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7
Q

In what plane do the lumbar facets orient?

A

Sagittal plane

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8
Q

Lumbar superior articular facets face…

A

posteromedially

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9
Q

Lumbar inferior articular facets face…

A

anterolaterally

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10
Q

How does lumbar osteology affect movement?

A

allows good forward bending and back bending; discourages rotation and sidebending

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11
Q

Where is the most movement in the lumbar spine?

A

L4 on L5 14-21 degrees

L5 on S1 18-22 degrees

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12
Q

How much sidebending is in lumbar vertebrae?

A

10 degrees each segment

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13
Q

How much rotation is in L1-L3? L4 & L5?

A

L1-L3 - 2 degrees each segment

L4&L5 - 3-4 degrees each segment (most rotation in lumbar thoracic)

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14
Q

How do intervertebral discs receive nutrients?

A

diffusion (they are avascular)

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15
Q

Motion loss can impair nutrition leading to____

A

premature disc degeneration

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16
Q

Lumbar discs are thicker anteriorly or posteriorly?

A

anteriorly contributing to lumbar lordosis

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17
Q

What is the purpose of the fiber arrangement of the annulus?

A

checks rotary motion and screws down the disc

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18
Q

Where is the nucleus pulposus located?

A

posterior surface of disc

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19
Q

When does disc degeneration begin in men? women?

A

Men - 11-20

Women - 21-30

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20
Q

Where is the most common herniation?

A

L5/S1

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21
Q

Does trauma alone cause herniation?

A

No, must be coupled with degeneration

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22
Q

This ligament reinforces the strength of the disc posteriorly in the midline.

A

Posterior longitudinal ligament

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23
Q

Describe the impact of the narrowing and weaker posterior longitudinal ligament on discs.

A

In lumbar region causes higher likelihood of disc herniation

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24
Q

List the two types of ligaments and their purposes.

A

Check ligaments (forward backward and lateral bending, rotation); kinetic ligaments (absorb energy)

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25
Q

What are the 4 forward bending check ligaments?

A

supraspinous, interspinous, posterior longitudinal, capsular ligaments

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26
Q

What feel would present with a torn supraspinous ligament?

A

tender, boggy

27
Q

Name the kinetic ligament and its function.

A

ligamentum flavum; stores kinetic energy to assist musculature in returning spine to upright position

28
Q

Name the sidebending check ligament

A

intertransverse check ligaments

29
Q

Which ligaments are injured in the classic lumbosacral sprain and strain?

A

Iliolumbar ligaments (rotational check ligaments)

30
Q

How do discs check rotation?

A

alternating direction of fibers in adjacent lamina of disc

31
Q

This backbending check ligament is broad and flat and reinforces the disc anteriorly and is twice as strong as the posterior longitudinal ligament.

A

Anterior longitudinal ligament

32
Q

Anterior lipping and osteophyte formation is seen when?

A

When traction on anterior longitudinal ligament causes bone reformation

33
Q

This fascia is critical to the maintenance of lumbar stability.

A

Thoracolumbar fascia

34
Q

What help keeps the thoracolumbar fascia taut?

A

Always positive pressure in abdomen

35
Q

What can generate instability in the thoracolumbar fascia?

A

weakness, hernias, incisions, pregnancy

36
Q

Which muscles are involuntary and used to stabilize?

A

short muscles

37
Q

Which muscles are voluntary and movers of the spine?

A

long muscles

38
Q

Which muscles respond to viscera-somatic and somato-somatic reflexes?

A

deep paraspinal muscles (intertransverse, interspinalis, rotator brevis and longus)

39
Q

List the attachment, action and innervation of the intertransverse muscles.

A

Attachment: between lumbar t.p.
Action: segmental sidebending/stabilization
Innervation: posterior primary division of spinal nerves

40
Q

List the attachment, action and innervation of the interspinalis muscles?

A

Attachment: T11 to S1
Action: segmental Extension/ stabilizer
Innervation: posterior primary division of spinal nerves

41
Q

List the attachment, action and innervation of rotator brevis and longus.

A

Brevis: tp of spinous process 1 segment above
Longus: tp of spinous process 2 segments above
Action: rotate to opposite side/stabilizer
Innervation: posterior primary division of spinal nerve

42
Q

What initiates flexion of the trunk?

A

rectus abdominus; further control by erector spinae muscles

43
Q

Which muscles extend the spine?

A

Iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidus (I love spaghettis mom)

44
Q

When acting unilaterally what movement do the voluntary muscles create? combined with internal obliques?

A

sidebending; rotation

45
Q

What other 5 muscles attach to the lumbar spine?

A

diaphragm, psoas major, quadratus lumborum, latissimus dorsi, serratus posterior inferior

46
Q

Diaphragmatic overuse (asthma or COPD) will tend to create what dysfunction?

A

flexed dysfuntions of upper lumbar segments

47
Q

Upper lumbar somatic dysfunction mechanically interferes with the function of ____ and results in _____?

A

diaphragm; shortness of breath

48
Q

Psoas major is active in the standing or seated position?

A

seated

49
Q

Prolonged sitting causes?

A

shorten psoas, anterior tilt of pelvis and increase lumbar lordosis

50
Q

Which nerves are vulnerable to compression by hypertonicity of psoas major?

A

lumbar nerve roots which pass anteriorly between proximal attachments

51
Q

Acute psoas spasm causes sidebending to same or opposite side of spasm?

A

same

52
Q

Psoas spasm causes type 1 or type 2 Fryette mechanics?

A

Type 2; flexed, rotated and sidebent to the same side

53
Q

If there is a psoas spasm with extended dysfunction of L1-L3 which gets treated first?

A

Treat L1-L3 extension first

54
Q

If there is a psoas spasm with flexed dysfunction which gets treated first?

A

Psoas

55
Q

Hypertonicity of the quadratus lumborum creates sidebending to the same or opposite side?

A

same; usually group curve

56
Q

Problems with the latissimus dorsi usually causes pain in which region?

A

shoulder

57
Q

List an accessory muscle for forced exhalation.

A

Serratus Posterior Inferior

58
Q

If ribs are held in fixed inhalation, unilateral contraction of serratus posterior inferior will rotate L1-L3 (towards or away) from side of muscle contracture.

A

away

59
Q

Asthma or emphysema can create flexed postures which can provoke what type of dysfunction?

A

Type II

60
Q

Batson’s veins are the principle route of travel for? and clogs in the IVC can cause?

A

infection and metastasis of pelvic cancers; headaches

61
Q

What maneuver can you use to reproduce symptoms?

A

Valsalva

62
Q

Which nerve root is most susceptible to neuropathy?

A

S1 due to length

63
Q

Fibrosis of nerve roots or entrapment will cause nerves to become ____?

A

ischemic

64
Q

Blood flow in vasa nervorum is reduced when a nerve is stretched ____% and blood flow ceases entirely at ____ %.

A

8%; 15%

OMM M1T2E3 (9 decks)

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