Lumbar Spine Flashcards
lumbar spine joints
diarthrodial
superior and inferior facets w capsule
10 or 5 pairs of facet joints in lumbar spine
facets located on vertebral arches
facets carry 20-25% of axial load can increase to 70% w degeneration
degeneration of vertebral disc =
spondyLOSIS
defect in pars interarticularis arch of vertebrae
spindyLOLysis
forward displacement of one vertebrae over another
spondylolisthesis
backward displacement of one vertebrae on another
retrolisthesis
which way do superior facets or articular processes face
medially and backward
generally concave
which way do inferior facets face
laterally and forward
convex
opposite for superior facets
medially and backward
concave
in the lumbar spine the TVPS are at the _______ as SPs
same level
if S1 segment is mobile, it results in 6th lumbar vertebra
lumbarization
(hypermobility tx)
the 5th lumbar segment is fused to the sacrum and ilium, resulting in 4 lumbar vertebra
sacralization
(treated for hypomobility)
which ligament connects the transverse process of L5 to the posterior ilium and prevents anterior displacement of L5
iliolumbar
(prevents spondylolisthesis)
purpose of intervertebral discs
- shock absorbers
- hold vertebrae together, allow movement between bones
- separate vertebrae as part of funtional segmental unit
- separate vertebrae and allow the passage of nerve roots from the spinal cord through intervertebral foramina
which annulus fibrosis zone: fibrocartilage that attaches to outer aspect of vertebral body, contains lots of cartilage cells
outer zone
which annulus fibrosis zone contains the largest number of cartilage cells
inner zone
which part of intervertebral disc receives blood supply
periphery
the other parts receive nutrition by diffusion through the cartilaginous end plate
if the pressure is great enough on discs, defects can occur in cartilaginous end plate resulting in
Schmorl’s nodules that are herniation’s of the nucleus pulposus into the vertebral body
disc bulges posteriorly without rupture of annulus fibrosis
protrusion
only the outermost fibres of annulus fibrosis contain the nucleus
prolapse
the annulus fibrosis is perforated and the discal matter moves into epidural space
extrusion
formation of discal fragments from the annulus fibrosus and nucleus pulposus outside the disc proper
sequestrated
injury to disc, list 4 problems from least to worst
- protrusion
- prolapse
- extrusion
- sequestration
each nerve root in lumbar spine is named for the vertebra ______
above it
L4 n. root exits between L4 and L5
where is the most common site of problems in L spine
L5-S1
b/c it bears most weight
centre of gravity passes directly through this vertebra
resting position of lumbar spine
midway between flexion and extension
close packed position of lumbar spine
full extension
capsular pattern of lumbar spine
side flexion and rotation equally limited, extension
pain is more likely to be bilateral if it is a
central protrusion
spondylolisthesis
spinal stenosis
metastases
_______implies that pain is moving toward or is centered in lumbar spine
centralization
________- implies that pain is being referred or is moving into the limb
peripheralization
in pelvic cross syndrome what mms are weak, long and inhibited
abdominals
glutes
in pelvic cross syndrome what mms are strong, tight, short
hip flexors
back extensors
a tuft of hair that can indicate a spina bifida occulta or diastematomyelia
Faun’s beard
in the lumbar spine why does a “step deformity” occur
b/c the spinous process of one vertebrae becomes prominent when either the vertebra above or the affected vertebra slips forward on the one below
S1 myotome=
lift a tonne
ankle plantar flexion & eversion, hip extension
this nerve, which lies within the transverse abdominus mm, may be compressed by spasm of the mm
ilioinguinal
in the extended position, patient complains of strong pain, heavy feeling in
lumbar area or low back is ‘coming off’ - what test is this
passive lumbar extension test
what variation of the straight leg raise increases the dural stretch through cervical flexion?
Brudzinski’s sign (flexing neck to chest)
Bragards (dorsiflex foot)
what is the best special test to assess for stress fracture of the pars interarticularis?
one leg (stork) standing lumbar extension test
when the lumbar spine is laterally flexed to the left, the vertebrae translate and rotate to the _____
right
following the coupled motion of the spine
Tx of sacralization is equal to treatment for ____ while Tx of lumbarization is equal to treatment for ____
sacralization = hypomobility
lumbarization = hypermobility
when suggesting home-care for a patient with an acute disc herniation, you should…
suggest pain free ROM
reduce herniation by maintaining lumbar lordosis
extension strenghening for posterolateral herniaiton
which ligament prevents spondylolisthesis
iliolumbar
