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Musculoskeletal 2 > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

1
Q

Vertebral bodies

A

large, kidney shaped

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2
Q

Pedicles

A

Connect vertebral bodies with facet joints

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3
Q

Lamina

A

Absorbs forces from the spinous and articular processes

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4
Q

Pars Interarticularis

A

connects lamina and pedicle

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5
Q

Spinous and transverse processes

A

Serve as attachment sites for muscles

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6
Q

What is the number 1 diagnosis for PTs and Physicians to see?

A

Low back pain

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7
Q

Are PTs the #1 choice for treating low back pain?

A

no

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8
Q

The spinous and transverse processes are __________ in the lumbar spine

A

larger

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9
Q

What are the two parts of the intervertebral disc?

A

Annulus Fibrosis and Nucleus pulposus

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10
Q

The annulus fibrosis _______________ the nucleus pulposus

A

surrounds

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11
Q

What is the annulus pulposus is made up of?

A

10-20 concentric rings of Type 1 collagen bound together with proteoglycan gel

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12
Q

As we age, we lose layers of the annulus fibrosis, but what happens to the remaining layers?

A

they thicken

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13
Q

The layers of the annulus fibrosis alternate fiber orientation direction to resist what kinds of forces?

A

torsional

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14
Q

The annulus fibrosis is thinner ________________ and predisposed to injury.

A

posteriorly

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15
Q

The nucleus pulposus is mostly ___________ filled.

A

water

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15
Q

What percent of the nucleus pulposus is water at birth?

A

80

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16
Q

What percent of the nucleus pulposus is water in the elderly?

A

68

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17
Q

The nucleus pulposus is __________ the annulus fibrosis

A

encased within

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18
Q

What is the nucleus pulposus is made up of?

A

Type 2 Collagen

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19
Q

Where is the vertebral end plate located?

A

Where the vertebral body meets the vertebral disc

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20
Q

What is the vertebral end plate made of?

A

Hyaline and fibrocartilage

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21
Q

What is the vertebral end plate more firmly attached to: the disc or the vertebral body?

A

the vertebral disc

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22
Q

Nutrients pass through the ___________ portion of the endplate into the discs

A

center

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23
Q

The vertebral end plates become _____________ with normal aging, and the nutrition to the disc gets disrupted

A

thinner

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24
Q

Facet joints protects motion segment from what 3 things?

A

anterior shear forces, excessive rotation, and flexion forces

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25
Q

Facet joints are mostly oriented in what plane?

A

coronal

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26
Q

Facet joints are what shapes?

A

C and L

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27
Q

The Anterior Longitudinal ligament (ALL) runs from the __________ to ___________ on the ____________ surface of the vertebral bodies

A

Sacrum to occiput; anterior

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28
Q

The anterior longitudinal ligament prevents _________________ of the lumbar spine and ________________ of the vertebral segment

A

excessive extension; anterior translation

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29
Q

The anterior longitudinal ligament connects loosely to _______________ by ____________ tissue

A

intervertebral disc; loose areolar

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30
Q

The posterior longitudinal ligament runs from the ________________ to ____________ on the ___________ surface of the vertebral bodies

A

sacrum; C2; posterior

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31
Q

The posterior longitudinal ligament helps prevent ____________________.

A

Intervertebral disc protrusion (posteriorly) and hyperflexion of the lumbar spine

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32
Q

The posterior longitudinal ligament connects to __________________

A

intervertebral discs

33
Q

Ligamentum Flavum is comprised of 80% ________________ and 20% ___________________

A

Elastin; collagen

34
Q

Ligamentum flavum connects 2 consecutive _________________

A

Laminae

35
Q

Ligamentum Flavum forms the _______________________ of the facet joint

A

anterior capsule

36
Q

Ligamentum Flavum is stretched during __________________ and returns to normal length during ____________________

A

lumbar flexion; neutral and extension

37
Q

Ligamentum Flavum helps resist __________________ and connects to the intervertebral disc

A

separation of the lamina during lumbar flexion

38
Q

The interspinous ligament lies deep between 2 adjacent ____________________ and fills the gap between them

A

spinous processes

39
Q

The interspinous ligament resists ______________

A

separation of spinous processes during lumbar flexion

40
Q

Supraspinous Ligament

A

Broad, thick, cordlike ligament that attaches tips of spinous processes

41
Q

What is the most superficial spinal ligament?

A

Supraspinous ligament

42
Q

Which ligament is furthest from the axis of flexion?

A

supraspinous ligament

43
Q

The supraspinous ligament is more susceptible to ______________

A

sprains

44
Q

The supraspinous ligament may help prevent excessive ____________________

A

lumbar flexion

45
Q

The Iliolumbar ligament travels from the ________________ to ____________________

A

Transverse process of L5 to Posterior inner lip of the iliac crest

46
Q

The iliolumbar ligament is made up of the ______________ and ____________ bands

A

anterior and posterior

47
Q

The iliolumbar ligament restrains _________________

A

flexion, extension, rotation, and SB of L5 on S1

48
Q

What are the attachment sites of quadratus lumborum?

A

12th rib, transverse processes of L1-L4, iliolumbar ligament, and iliac crest

49
Q

What is the action of quadratus lumborum?

A

Stabilizes the 12th rib during inspiration and controls contralateral lumbar SB

50
Q

Innervation of Quadratus Lumborum

A

Ventral Rami of T12 - L2

51
Q

What muscle is the largest of the intrinsic back muscles?

A

Multifidus

52
Q

Action of Multifidus

A

Intrinsic spinal stabilizer during all movements

53
Q

What are the 3 muscles that make up Erector Spinae?

A

Longissimus, Spinalis, and iliocostalis

54
Q

What is the action of Erector Spinae?

A

Extends the spine

55
Q

Innervation of Erector Spinae

A

Dorsal rami of spinal nerves

56
Q

With LBP, the multifidi become ______________, and the erector spinae become _______________ and compensate to provide _____________

A

inhibited; overactive; spinal stability

57
Q

What is the origin of Rectus Abdominis?

A

Ends of Ribs 5-7 and Xiphoid

58
Q

What is the insertion of Rectus Abdominis?

A

Superior aspect of the pubic bone

59
Q

What is the action of Rectus Abdominis?

A

Flexes the trunk and stabilizes the lumbar spine anteriorly in the sagittal plane

60
Q

What is the innervation of Rectus Abdominis?

A

Thoraco-abdominal nerves

61
Q

Which muscle is the deepest of the abdominal muscles?

A

Transverse abdominis

62
Q

Transverse abdominis wraps around the trunk from ____________ to _________________

A

anterior to posterior

63
Q

Action of Transverse Abdominis

A

Segmental, local spinal stabilization through a variety of movements

64
Q

Origin of Transverse Abdominis

A

Lateral 1/3 of inguinal ligament, anterior 2/3 of iliac crest, thoracolumbar fascia, costal cartilages of ribs 7-12

65
Q

Insertion of Transverse Abdominis

A

Linea Alba, Aponeurosis of internal oblique muscle, pubic crest, pectineal line of pubis

66
Q

Innervation of Transverse Abdominis

A

Lower 5 intercostal nerves and subcostal nerve

67
Q

What two muscles does internal oblique sit between?

A

transverse abdominis and external oblique

68
Q

Action of Internal Oblique

A

Side-bending of trunk (unilateral contraction), Flexion of trunk (bilateral contraction, helps maintain intra-abdominal pressure

69
Q

Origin of Internal Oblique

A

Lateral 2/3 of inguinal ligament, anterior 2/3 of iliac crest, thoracolumbar fascia

70
Q

Insertion of Internal Oblique

A

Ribs 9-12, abdominal aponeurosis of Linea alba, pubic crest

71
Q

Innervation of Internal Oblique

A

Ventral Rami of Intercostal Nerves (T7-T11), Ilioinguinal Nerve (L1)

72
Q

External oblique is ________________ to internal oblique and transverse abdominis

A

Superficial

73
Q

Action of External Oblique

A

Side-bending of trunk (unilateral contraction), Flexion of trunk and posterior pelvic tilt (bilateral contraction), helps maintain intraabdominal pressure

74
Q

Origin of External Oblique

A

Lateral aspect of 5th-12 ribs

75
Q

Insertion of External Oblique

A

Linea alba, pubic tubercle, ASIS, inguinal ligament

76
Q

Innervation of External Oblique

A

Ventral branches of lower 6 thoracoabdominal nerves, subcostal nerve

77
Q

Psoas major combines with _______________ muscle to attach lumbar spine to _____________________

A

iliacus; lesser trochanter of femur

78
Q

Action of Psoas Major

A

Flexes trunk when femur fixed, flexes hip when trunk fixed, SB the spine ipsilaterally, eccentric control when striding

79
Q

Origin of Psoas Major

A

Anterolateral aspects of vertebral bodies, intervertebral discs of T12-L5, Transverse processes of L1-L5

80
Q

Insertion of Psoas Major

A

Lesser Trochanter of Femur

81
Q

Innervation of Psoas Major

A

Ventral rami of L1 & L2

Musculoskeletal 2 (4 decks)

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