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Manual II > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

1
Q

How many lumbar vertebrae are there?

A

5

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2
Q

True or false; lumbar vertebrae can make blood

A

True apparently

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3
Q

What is the orientation of the lumbar facets?

A

90 degrees

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4
Q

Which plane are the facets oriented in?

A

L1-L5: Sagital
L5-S1: Coronal

**unless theres facet trophism

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5
Q

What is the promontory inclination angle?

A

50

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6
Q

What is the angle of the L5-S1 disc?

A

Wedge shaped 16

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7
Q

What is the angle of the sacral inclination?

A

23

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8
Q

What are the lumbosacral slippage safe guards?

A

◼ Facet orientation
◼ Disc shape
◼ Iliolumbar Ligaments

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9
Q

Anterior longitudinal ligament

A

◼ Anterior bodies/discs
◼ Restrains extension
◼ Occiput to sacrum

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10
Q

Posterior longitudinal ligament

A

◼ Posterior bodies/discs
◼ Restrains flexion
◼ C2 to sacrum

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11
Q

Supraspinous ligament

A

◼ Spinous processes
◼ C7 to L3-4
◼ Restrains flexion

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12
Q

Interspinous ligament

A

◼ Spinous processes
◼ C7 to L3-4
◼ Restrains flexion
◼ Anchors T-L fascia

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13
Q

Which ligament anchors to the thoracolumbar fascia and helps to restrain flexion?

A

Interspinous ligament

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14
Q

Ligamentum Flavum

A 
◼ C2 to sacrum along
posterior canal 
◼ 80% Elastin “yellow” 
◼ Assists regaining
upright position 
◼ Attaches to facet
anteromedially and
prevents impingement
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15
Q

Iliolumbar ligament

A 
◼ TP’s of L4 and L5 to
postero-superior Ilium 
◼ Portion of QL ‘til 20’s 
◼ Prevents L4 and L5
contra-lateral rotation 
◼ Prevents ilial rotation posteriorly
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16
Q

What are the deep unisegmental muscles of the lumbar spine?

A
  • Rotatores brevis
  • Intertranversarii
  • Interspinalis
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17
Q

What are the deep polysegmental muscles of the lumbar spine?

A
  • Rotatores longus

* Multifidi (Force Closure)

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18
Q

Which lateral border does the transversus abdominous attach to?

A

Lateral raphe

Middle layer of thoracolumbar fascia

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19
Q

___________ is the ability to produce force, whereas ___________ is the act of controlling force. Core training will lay the foundation for strength, power, speed and agility training. The core is the ‘powerhouse’ of the body.

A

Strength

stability

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20
Q

Who’s idea was the spinal stability triad?

A

Punjabi

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21
Q

Who came up with form and force closure?

A

Vleeming and Lee

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22
Q

What are Panjabi’s 3 components of spinal stability?

A

Passive system/ spinal column
Active system/ spinal muscles
Control system/ CNS

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23
Q

What is form closure?

A

Stable situation with

bony congruency where no additional forces are required to maintain the systems state.

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24
Q

What is force closure?

A

The additional,

active support provided to the bony congruency by the surrounding muscles.

25
Q

What were Richardson et al’s classification of muscles?

A

Local muscles : intersegmental stabilizers

Global muscles: multi-segmental movers/ powerhouse

26
Q

Is it a stabilizer or a mover: intertransversarii

A

Stabilizer

27
Q

Is it a stabilizer or a mover: interspinals

A

Stabilizer

28
Q

Is it a stabilizer or a mover: multifidus

A

Stabilizer

29
Q

Is it a stabilizer or a mover: longissimus/ iliocostalis pars lumborum

A

Stabilizer

30
Q

Is it a stabilizer or a mover: medial fibers of QL

A

Stabilizer

31
Q

Is it a stabilizer or a mover: transversus abdominis

A

Stabilizer

32
Q

Is it a stabilizer or a mover: internal obliques (T-LF)

A

Stabilizer

33
Q

Is it a stabilizer or a mover: longissimus/ iliocostalis pars thoracis

A

Mover

34
Q

Is it a stabilizer or a mover: lateral fibers of QL

A

Mover

35
Q

Is it a stabilizer or a mover: rectus abdominis

A

Mover

36
Q

Is it a stabilizer or a mover: external obliques

A

Mover

37
Q

Is it a stabilizer or a mover: internal obliques

A

Mover

38
Q

Characteristics of stabilizing muscles

A

⦿ Cross one to three segments
⦿ Deep, close to joint
⦿ Attachment to non-contractile structures
⦿ Often pennate (wing-shaped)
⦿ Tonic, anti-gravity muscles
⦿ Short length
⦿ Designed to increase joint stiffness (not really stiffness but stability)

39
Q

What are the four components of the inner support unit?

A

⦿ Transversus Abdominis
⦿ Lumbar Multifidus
⦿ Respiratory Diaphragm
⦿ Pelvic Diaphragm

40
Q

By increasing intra-abdominal pressure, the diaphragm is pushed up and the pelvic floor is pushed down. This tends to _____________, thereby ___________________

A

Elongate the lumbar spine

Taking weight off the discs and posterior joints

41
Q

In terms of the outer support unit, who’s partner is the right gluteus Maximus ?

A

Left latissimus dorsi

42
Q

In terms of the outer support unit, who’s partner is the left latissimus dorsi?

A

Right gluteus Maximus

43
Q

In terms of the outer support unit, who’s partner is the left external obliques?

A

Right adductors

44
Q

In terms of the outer support unit, who’s partner is the right gluteus medius?

A

Right adductors

45
Q

In terms of the outer support unit, who’s partner are the adductors?

A

External obliques AND Glute Medius

46
Q

In terms of the outer support unit, who is attached to the thoracolumbar fascia?

A

Glute max and lats

47
Q

In terms of the outer support unit, who is attached to the anterior, lower abdominal fascia?

A

Obliques and adductors

48
Q

____________ of a motion segment is undermined by a deficit in normal inter-segmental stability.

A

Form closure

49
Q

The articular/neuromuscular deficits which develop secondary to lumbar spine pathology may account for…

A

LBP and/or lower extremity symptoms.

50
Q

What are the components of biomechanical Rx model?

A
  1. Mobilize/manipulate segmental hypomobility.
  2. Stabilize clinical segmental instability as follows:
    a. Attain neutral spinal position.
    b. Activate the local segmental muscles of core stability (i.e., TA and Multifidus)
    c. Motor control of the pelvic floor, especially the pubococcygeus).
  3. Strengthen the multi-segmental, spinal muscles.
51
Q

Where is the greatest source of dysfunction in the spine?

A

Where ever the curves reverse

52
Q

How many lumbar nerves are there?

A

5

53
Q

True or false; you can diagnose a motion loss with static palpation

A

False

54
Q

_ _ _ gets worse with extension

A

FRS

55
Q

_ _ _ gets worse with flexion

A

ERS

56
Q

Which muscles are the most common culprits for myofascial dysfunction associated with a type 1 dysfunction in the lumbar spine?

A

Intermediate iliocostalis, longissimus, and spinalis muscles

57
Q

Always confirm the diagnosis of an ERS in a _______ position

A

Flexed

58
Q

Always confirm a diagnosis of an FRS in an ________ position

A

Extended

Manual II (11 decks)

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