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Semester 2 FS Exam 3 > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

1
Q

Thoracic curvature purpose

A

make cavity for organs

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2
Q

If lumbar was straight… with no curvature then what

A

The torque we would experience above would be enormous because the moment arm of the curvature we have in the thoracic region would be larger than the lumbar region
Moment arm would be double so for the same load, we would have twice the torque

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3
Q

Main role of cervical and lumbar curvatures

A

reduction of the torques (by reducing the moment arm of superincumbent weight)

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4
Q

Anatomy of the spine

A

Extends from base of skull to pelvis
32-33 bones (vert)
Protects spinal cord
Structural support and linkage to extremities

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5
Q 
Cervical
Thoracic
Lumbar
Sacrum
Coccyx
A 
C1 - C7
T1-T12
L1-L5
5 fused bones
3-4 fused bones
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6
Q

Primary vertebral curves

A

Thoracic

Primary = visible before birth

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7
Q

Secondary vertebral curves

A

Cervical and Lumbar
Secondary = develop later and take their final shape because of gravity
Lumbar is greater in F than M because of breasts - larger to reduce the effect of superincumbent weight

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8
Q

Body

A

Anterior potion, thick, dense, contains most of the vertebral mass (cortical - outer, cancellous - interior matrix)

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9
Q

Arch

A

Posterior portion with several finger like projections (processes)

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10
Q

Processes

A

Place for attachment for tendons and ligaments

7 total for typical (1 spinous, 2 transverse, 2 sup articular, 2 inf articular)

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11
Q

Pedicles

A

short round process of thick strong bone linking the anterior and posterior portions

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12
Q

Spinal canal

A

houses the spinal cord, providing protection from external forces

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13
Q

Purpose of processes

A

attachment purposes, muscles ligaments and interact btw two consecutive vertebrae to give you joints
Shape ans size have effect on the effectiveness of the structure attached to them
Longer - maybe longer moment arm

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14
Q

Structure of vertebrae

A

characteristics change all along the vertebral column even within the same region
The lower you go down - the larger the body will be (they have to deal with more gravity)
The way that the facets and processes face is important for their function in respect to motion

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15
Q

Spinal cord

A 
part of CNS
extends from brainstem to L1
Relays infor to and from skin, muscles, ligaments, organs, joints 
Ant nerve roots = motor
Post nerve roots = sensory
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16
Q

Cartilaginous joints

A

Intervertebral disks - btw bodies of vertebrae from cervical to sacrum

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17
Q

Gliding (facet) joints )articular processes)

A

Articular capsules are loose and thin (so capsule is not limiting the joint)
Segmental mobility is related to the orientation of the gliding joints
Facet joints are diathroses synovial (allow movement, synovial cavity, synovial fluid)

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18
Q

Intervertebral discs

A

separate the vertebrae
absorb stress and shock
enable multiplanar motion in spinal column

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19
Q

Intervertebral discs cont

Composed of…

A 
fibrocartilage
transverse shape conforms to the disk bodies
Thickness is not uniform
25% of length of vertral column 
Allows motion in all 3 planes
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20
Q

Composition of intervertebral disks

A 
nucleus pulposas (gel like mass) = semi fluid jelly of proteoglycans in water 
Annulus fibrosus (fibrocartilage that encases the nucleus) = collagen fibers arranged in criss cross fashion
These allow the disc to withstand greater tensile and rotational forces
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21
Q

Intervertebral disk degeneration

A

Degeneration with age
Reduction of elasticity
Inability to resist loading/dampening

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22
Q

Motions of ID and and Vertebrae

A

12 segmental motions
Translations –> Ant/Post, Lateral (left/Right) and vertical (compr/distract)
Rotations –> Ant/Post, Lateral tilt (Left/right), Lateral rotation (left/ right)

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23
Q

The thicker the intervertebral disc…

A

the larger the movement will be

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24
Q

Effect of bending - backward bending moment

A

Ant = tension
Post = compression
Annulus bulges = posterior
Nucleus shifts = anterior

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25
Q

Effect of torsion - torsion moment

A

Shear stress increases from the center to the periphery

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26
Q

Facets

A

Change orientation from cervical to lumbar regions
Articular joints allow smooth articulation btw vertebrae
Resist motion through bony interactions, aided by ligaments

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27
Q

More on Facets…

Shape is diff at thoracic and lumbar regions

A

Thoracic AP direction is longer than in ML direction
Lumbar ML is longer than AP
Longer the direction, the more stability
Facet is covered by hyaline cartilage

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28
Q

Facet and lumbar region

A

Facet orientation does not allow rotation at lumbar region

Facet orientation changes from cervical to lumbar

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29
Q

Lumbar region motions

A

Ample flexion/extension and nc as go from top to bottom of lumbar region
Lateral flexion is allowed but is less and is consistent throughout levels (limited at lumbosacral joint)
Rotation is very limited - little more at lumbosacral joint

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30
Q

Joint coupling

A

If it is not a pure motion, it is joint coupling

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31
Q

Side bending and lumbar rotation

A

Side bending can’t occur without some lumbar rotation

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32
Q

Lumbar spine in neutral or extended position

A

Side bending and rotation in opposite direction

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33
Q

Lumbar spine in flexed position

A

Side bending and rotation in same direction

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34
Q

Cervical Vertebrae C3-C7

A

Facets 45 degrees
FL-EX (sagittal plane)
Lateral flex (frontal)
Rotation (transverse)

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35
Q

Thoracic Vertebrae

A

Facets 60 degrees
FL-EX (limited), higher at lower part
Lateral flexion, same all across
Rotation (mostly)

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36
Q

Lumbar vertebrae

A

Facets 90 Degrees
FL-Ex
Lateral flexion (limited)
No Rotation

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37
Q

Anterior Longitudinal Ligament

A

From axis to sacrum
Adheres to disks and prominent margins of vertebrae
Strained during extension
Holds disks in place with vert bodies

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38
Q

Posterior longitudinal ligament

A

from axis to sacrum
Posterior of the bodies inside the vertebral canal
Contributes to stability in the intervertebral joints

39
Q

Ligamentum Flavum

A

From axis to sacrum
Connect adjacent laminae
Strained during flexion and lateral flexion
Limits contralateral flexion (R will be stretched when leaning L)

40
Q

Supraspinal Ligament

A

C7 to sacrum
Tips of spinous processes
Strained during flexion
Btw two consecutive spinous processes

41
Q

Interspinous Ligament

A

btw spinous processes

Strained during flexion

42
Q

Capsular ligaments

A

Ligaments of the capsule of facet joints

Strained during rotation

43
Q

Transverse ligaments

A

btw consecutive trans processes

Strained during rotation and lateral bending in opp direction

44
Q

Iliolumbar ligaments

A

L4/L5 trans processes to iliac bone
Offer stability
Strained during rotation and lateral bending

45
Q

Most ligaments limi

A

flexion

abdominals do a good job of limiting extension

46
Q

Lumbosacral or Ferguson’s Angle

A

angle formed by the line parallel to the sup aspect of the sacrum and the horizontal

47
Q

Lumbosacral angle on sagittal plane Range observed and typical

A

Observed = 26-57 deg
Typical = 35-45
Hyperlordosis = > 45
Hypolordosis =

48
Q

High lumbosacral angle =

A

high anterior convexivity of lumbar spine = high shear stress at lumbosacral joint = larger lumbar curvature = anteriorly rotated

49
Q

Lower lumbosacral angle

A

posteriorly rotated

50
Q

Flexor Muscles

A 
Rectus Abdominis
IO
EO
TA
Psoas Muscles
51
Q

When a muscle is producing force… its fibers will

A

become shorter

52
Q

External Oblique fibers

A

superior and lateral to inferior and medial

53
Q

EO Action

A

laterally flex to same side

rotate to opposite side

54
Q

Internal Oblique fibers

A

inferior and lateral to superior and medial

55
Q

IO Action

A

laterally flex to same side

rotate to same side

56
Q

IO and EO together will

A

Tighten the abdominal region and pull in abdominal organs

Can also help into flexion - more when in supine than in standing

57
Q

Right EO is activated so…

A

laterally flexing to the right
OR
rotating to the left

58
Q

Rotating to the right activates what

A

Left EO Right IO

59
Q

Transverse abdominis fibers

A

transverse

60
Q

TA action

A

tighten organs in abdominal cavity

61
Q

Rectus abdominis fibers

A

short fibers that are compartmentalized –> FL/ML ratio that is small so force muscle –> strong

62
Q

Rectus abdominis goes from

A

pubic symphysis to sternum and ribs 67

63
Q

Action of RA

A

flexion of trunk - best when in supine to flex from lumbar vertebrae
RA also has largest MA in terms of producing flexion at lumbar spine

64
Q

Psoas Major

A

Assisted by iliacus
Crosses lumbar and hip joints
Pulls on lumbar region and counters the tendency of the motion of the femur and pelvis?
Hip flexor

65
Q

Psoas Minor

A 
Crosses only lumbar region
Stops at pelvis
Posterior pelvis rotation 
extends lumbar region in a way 
Hip flexor
66
Q

Extensor Muscles

A 
Erector Spinae (9 muscles 3x3 on each side)
Semispinalis (CA, CE, T)
Multifidus
Rotators (CE, T, L)
Interspinales
Intertransversarii
67
Q

Erector Spinae

A

Spinalis (Ca, Ce, T)
Longissimus (CA, CE, T)
Iliocostalis (CE, T, L)

68
Q

Erector Spinae Spinalis

A

very tightly related to vertebrae

Parallel to spinous processes of vertebrae

69
Q

Erector Spinae Longissimus

A

A bit lateral to spinalis

70
Q

Erector Spinae Iliocostalis

A

Even more lateral than longissimus

71
Q

Erector Spiane Muscles bilaterally

A

extend the vertebral column

Active in flexion though because they are resisting flexion and controlling it

72
Q

Erector Spinae Muscles unilaterally

A

not much of an ability (spinalis)
long and ilio - more of an action
Lateral flexion and rotation ipsilateral for both
Iliocostalis is most effective

73
Q

Multifidus

A 
span more than one level
more efficient than rotators in action of rotation
orientation like an x-mas tree
unilateral rotation - contralateral
Any flexion would be ipsilateral
74
Q

Semispnalis

A

no effect on lumbar region

75
Q

Rotators fiber orientation and action

A

sup and med to inf and lateral
rotation is contralateral under unilateral activation (pull spinous process closer to inf transverse process)
They are more stability muscles than rotators

76
Q

Quadratus Lumborum

A

attached to last pair of ribs and trans processes of all lumbar vertebrae and iliac

77
Q

Quadratus lumborum action

A

Stability muscle!
Active in any motion of lumbar region
Works as a brace and braces the lumbar region and creates stability in everything that we do
Unilateral - limits contralateral flexion

78
Q

Interspinalis

A

muscle fibers invested in and around interspinal ligament btw consecutive vertebrae
Resist flexion

79
Q

Intertransversarii

A

Help quad lumborum
MA is small but segmentally can produce support from both sides
Unilaterally = ipsilateral flexion and resist contralateral flexion

80
Q

Flexion-Relaxation Phenomenon

A 
Posterior Trunk muscles 
Increase lumbar curve
Produce extension
Initiate hyperextension
Control forward flexion
81
Q

What controls flexion at extreme forward flexion ranges

A

passive elastic response of the thoracolumbar fascia and the posterior ligamentous system

82
Q

Flexion forward - erector spinae

A

active for the first 30 degrees and their activity becomes less and less
in a specific range, erector spinae resist flexion, but past that point won’t be functinal anymore - lumbosacral fascia is helping and the fascia will be effective forever - like aligament in that it can elongate a ton

83
Q

Shear and Compression force

A 
Compression = perpendicular
Shear = parallel
84
Q

Pelvic orientation - larger the lumbar curvature with ant tilt

A

the larger the shear

85
Q

Pelvic Orientation with shear and compression - post tilt

A

compression forces are high

86
Q

Pelvic orientation with shear and compression - ant tilt

A

shear forces are high

87
Q

What forces contribute to load we feel at the joint

A 
Body weight above the joint
Weight itself of what you are picking up
Moment arms
Erector Spinae muscle force
Motion - inertia
88
Q 
Load on spine
Laying down
Sitting
Sitting slouched over
Standing
Standing slouched over
A 
Laying = less than 50
Standing = 100
Sitting = 150
Standing slouched = close to 150 
Sitting slouched = close to 200
89
Q

Why higher load on spine when simply sitting?

A

You are in a slight ant rotation so this is increasing lordosis

90
Q

Spondylolysis

A

separation of vertebra

L5 S1 is most common but can also be found at L4 L5 lumbosacral junction

91
Q

Spondylolisthesis

A

forward movement of vertebral body

92
Q

LBP

A 
75-80% of pop will experience
Mechanical stress plays significant role
Pregnancy
Relative stbaility of spne
60% are idiopathic
Abdominal exercises are helpful treatment
93
Q

Two common causes of LBP

A

Compressive or neurogenic = symptoms are referred due to spinal nerve compression
Mechanical = localized pain due to damage to facets, discs, or soft tissue

94
Q

Lifting recommendations

A

Bend knees
Keep weight close to hips
Avoid lifting while twisting (places 3 times more stress on spine)
Avoid rapid, jerking motion while lifting

Semester 2 FS Exam 3 (1 decks)

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