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Kinesio 2 > Lumbar Spine Biomechanics > Flashcards

Lumbar Spine Biomechanics Flashcards

1
Q

What is the main role of the throacolumbar fascia (TLF)

A

Stabilize the spine

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2
Q

Characteristics of the lumbar spine

A

Large

Transverse diameter greater than A-P and height

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3
Q

True or False:

The lumbar vertebral bodies progressively wedge shaped from L1-L5

A

True

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4
Q

What does wedge shaped mean

A

The anterior body is larger than posterior body

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5
Q

How do the spinous processes of the lumbar vertebrae look from a lateral view

A

Broad and thick

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6
Q

How do the spinous processes of the lumbar vertebrae look from a superior view

A

Thin

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7
Q

What does the vertebrae being progressively wedge shaped contribute to

A

Lumbar lordosis

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8
Q

What is the lateral gutter

A

The septum between iliocostalis and longissumus where the transverse processes lay

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9
Q

True or False:

The transverse processes of the lumbar vertebrae are large and at the same level of the spinous process

A

True

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10
Q

How are the facets oriented

A

They are progressing toward the sagittal plane

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11
Q

How close to the sagittal plane is L5

A

90%

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12
Q

How are the superior facets oriented

A

Concave facing medially and slightly posterior

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13
Q

How are the inferior facets oriented

A

Convex facing laterally and slightly anterior

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14
Q

Are the lumbar facets weight bearing structures

A

Yes but not too much

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15
Q

How does the amount of WB change from L1-L5 facets

A

The amount of WB decreases

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16
Q

True or False:

The inferior facets of lumbar vertebrae are more medial than the superior facets

A

True

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17
Q

What is sacraliztion of L5

A

L5 has fused to the sacrum

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18
Q

Is sacralization acquired or congenital

A

Congenital

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19
Q

What occurs because of sacralization of L5

A

L1-L4 have increased mobility to make up for the mobility lost at L5

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20
Q

What is lumbarization of the sacrum

A

S1 is not fused to the sacrum

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21
Q

Is lumbarization acquired or congenital

A

Congenital

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22
Q

What occurs because of lumbarization of the sacrum

A

You have 6 free floating lumbar vertebrae so each segment has decreased mobility

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23
Q

True or False:

The PLL is almost non existence in the lumbar spine

A

True

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24
Q

True or False:

The ligamentum flavum has a higher concentration of elastin which provides preload to motion segments

A

True

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25
Q

What are the iliolumbar ligaments

A

5 bands extending from L4 and L5 transverse processes to the iliac crest just above the PSIS

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26
Q

What do the iliolumbar ligaments prevent

A

Anterior displacement of L4 and L5

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27
Q

True or False:

It is more important to stabilize L5 than L4

A

True

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28
Q

How do nutrients get to the disc

A

The vertebral end plate

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29
Q

What are the 3 layers of the thoracolumbar fascia

A

Anterior, middle, and posterior

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30
Q

Where does the thoracolumbar fascia attach to

A

Spinous and transverse process

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31
Q

Which 2 layers of the TLF are derivatives of the quadratus lumborum

A

Anterior and middle

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32
Q

What does the posterior layer of the TLF fuse with (3)

A
  1. Transversus abdominis
  2. Gluteus maximus
  3. Latissimus dorsi
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33
Q

What fibers of the posterior layer of the TLF attach to the gluteus maximus

A

Vertical fibers

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34
Q

What fibers of the posterior layer of the TLF attach to the abdominal obliques

A

Horizonatl fibers

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35
Q

What fibers of the posterior layer of the TLF attach to the latissimus dorsi

A

Oblique fibers

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36
Q

What layers of the TLF attach to the transverse processes

A

Anterior and Middle

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37
Q

What layer of the TLF attach to the spinous processes

A

Posterior

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38
Q

What is the origin to insertion of the erector spinae considered

A

Diverge

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39
Q

What does a diverging origin to insertion mean

A

Attach central to lateral

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40
Q

Are the erector spinae shunt or spurt muscles

A

Spurt muscles

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41
Q

Are spurt muscles stabilizers or movers

A

Movers

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42
Q

Which way do the erector spinae rotate and side bend

A

Ipsilaterally

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43
Q

What is the origin to insertion considered for the multifidi and rotatores

A

Converge

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44
Q

What does a converging origin to insertion mean

A

Attach lateral to central

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45
Q

Are the multifidi or rotatores shunt or spurt muscles

A

Shunt muscles

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46
Q

Are shunt muscles stabilizers or movers

A

Stabilizers

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47
Q

Which way do the multifidi and rotatores side bend and rotate

A

Side bend ipsilaterally

Rotate contralaterally

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48
Q

True or False:

People with chronic back pain have atrophy of the multifidi and rotatores

A

True

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49
Q

What type of motion does the rectus abdominis create with top down motion

A

Trunk flexion

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50
Q

What type of motion does the rectus abdominis create with bottom up motion

A

Posterior pelvic rotation

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51
Q

What is the agonist to trunk flexion

A

Gravity

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52
Q

How do the internal obliques rotate the trunk

A

Ipsilaterally

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53
Q

What does contraction of both the trunk flexors and extensors simultaneously cause

A

Co-contraction and stability

54
Q

What does co-contraction cause

A

Increased compressive forces and decreased shear forces

55
Q

How do the external obliques rotate the trunk

A

Contralaterally

56
Q

What does co-contraction increase (3)

A
  1. Intrathecal pressure
  2. Intra-abdominal pressure
  3. Intradiskal pressure
57
Q

What happens when the erector spinae contract

A

They become shortened and thickened which pushes into the TLF

58
Q

What does the erector spinae pushing into the TLF do

A

Increases passive stabilization

59
Q

What does neutral spine refer to

A

Point at which normal lumbar lordosis is maintained

60
Q

What does the compressive force via superincumbent body weight and muscle contraction do to the disc

A

Increases hydrostatic pressure in the disc

61
Q

What does increased hydrostatic pressure in the disc result in

A

Increased tension in the annulus fibrosis

62
Q

What does the increased annular tension causes

A

Inhibits radial expansion of the nucleus

63
Q

What does inhibiting the radial expansion of the nucleus result in

A

Rise in nuclear pressure that is exerted on the endplates

64
Q

What does the rise in nuclear pressure that is exerted on the enplates cause

A

Hoop stress

65
Q

What is hoop stress

A

Annulus fibrosis pushing back providing stability

66
Q

What does hoop stress do

A

Reinforces the peripheral annulus fibrosis

67
Q

What does reinforcing the peripheral annulus fibrosis do

A

Converts the disc into a stable WB structure

68
Q

Where is the pressure in the disc transmitted ultimately

A

To the endplates to the next bertebrae

69
Q

What is imbibation

A

Absorbing water in disc while lying at night

70
Q

True or False:

Every other layer of the annulus fibrosis runs in the same direction

A

True

71
Q

What is the angle at which the annulus fibers run

A

65-80

72
Q

What happens to the disc with rotation

A

The disc is wound up increasing tension

73
Q

What is the most common place for lumbar problems

A

L4/L5 followed by L5/S1

74
Q

What direction do the facet joints allow the most motion in

A

Flexion and extension

75
Q

What is more limited flexion or extension

A

Flexion

76
Q

What does flexion require

A

Synergistic activity by the pelvis

77
Q

Where does the greatest flexion occur in the lumbar spine

A

L4/L5 and lumbosacral junction

78
Q

What percent of the flexion occurs at L4/L5 and L1-L4

A

L4/L5: 80-90%

L1-L4: 10-20%

79
Q

How does side bending and rotation change as you go down the lumbar spine segments

A

They decrease

80
Q

How much side bending occurs in the lumbar spine

A

Left and right: 20

Total: 40

81
Q

How much rotation occurs in the lumbar spine

A

1 degree per segment so total of 5 degrees left and right

82
Q

What do facets dictate

A

The direction of motion

83
Q

What does disc size dictate

A

Amount of motion

84
Q

How much flexion occurs because of the lumbar spine

A

60

85
Q

What is fryette’s law 1

A

Rotation and side bending occur to opposite sides in a neutral spine

86
Q

What is fryette’s law 2

A

Rotation and side bending occur to opposite sides in a non-neutral spine

87
Q

Fryette’s Laws refer to which plane of motion

A

Sagittal plane

88
Q

What is fryette’s law 3

A

If you introduce motion in 1 plane or direction adding another motion will result in that motion being limited

89
Q

What happens to the facets during right rotation

A

Left facet is compressed

Right facet is decompressed

90
Q

What happens to the facets during right side bending

A

Left facet is decompressed

Right facet is compressed

91
Q

What is the angle of the sacrum

A

The angle between the base of the sacrum and the horizontal plane

92
Q

What is the normal angle of the sacrum

A

30

93
Q

What does increasing the angle of the sacrum do to the lordosis and shear

A

Increases lumbar lordosis and anterior shear

94
Q

Does the sacrum move the same direction as the pelvis or in a different direction as the pelvis

A

The same direction

95
Q

What happens to the angle of the sacrum during anterior pelvic tilting

A

Sacral angle increases which increases the lumbar lordosis

96
Q

What is the lumbosacral angle

A

Measured of the obtuse angle formed by the middle axes of L5 and S1

97
Q

Which way does the lumbosacral angle open

A

Posterior

98
Q

What is the normal lumbosacral angle

A

140

99
Q

What does the lumbosacral angle and wedged shape of the L5/S1 disc initiate

A

Lumbar lordosis

100
Q

How does flexion effect the lumbosacral angle

A

Increases the lumbosacral angle

101
Q

How does anterior pelvic tilt effect the sacral angle and lumbosacral angle

A

Increases sacral angle, increases lordosis, and decreases lumbosacral angle

102
Q

What happens to the amount of shear force if you increase the lumbar lordosis

A

The amount of shear force increase

103
Q

What prevents L4 and L5 vertebrae from slipping forward

A

Iliolumbar ligaments

104
Q

What are the 3 structures that keeps the anterior shear forces in check

A
  1. Iliolumbar ligaments
  2. Disc
  3. ALL
105
Q

True or False:

The surface of the disc is able to counteract shear forces because the superior fibers are horizontal

A

True

106
Q

Do you want the disc to combat the shear forces

A

Not really because it leads to DDD

107
Q

Is there more or less load on the disc while sitting with erect posture when compared to standing

A

More

108
Q

Is there more or less load on the disc while sitting with a slumped posture when compared to standing

A

More

109
Q

Is there more or less load on the disc while sitting with erect posture or slumped posture

A

Slumped posture

110
Q

Is there more or less load on the disc while sacral sitting when compared to standing

A

Less

111
Q

Why does the amount of load increase when sitting with a slumped posture

A

The MA of gravity increases increasing the torque of gravity

112
Q

True or False:

The lumbar spine allows for the first 60 of flexion

A

True

113
Q

How do we achieve terminal flexion

A

Synergistic pelvic tilting

114
Q

What is lumbo-pelvic rhythm

A

Inter connection of movement between the lumbar spine, sacrum and pelvis

115
Q

What is normal lumbo-pelvic rhythm discussed in

A

Top down motion

116
Q

What are the tissues that move in the lumbar spine with flexion in order

A

1st segment moves then posterior ligaments tighten then next segment moves so on so forth

117
Q

What is nutation a term for

A

Sacral flexion

118
Q

What is nutation

A

Sacral base moves anterior/inferior and coccyx moves posterior/superior

119
Q

What is counternutation a term for

A

Sacral extension

120
Q

What is counternutation

A

Sacral base moves posterior/inferior and coccyx moves anterior/superior

121
Q

What are the motions that occur due to lumbo-pelvic rhythm following lumbar flexion (4)

A
  1. Sacral nutation (flexion)
  2. Anterior pelvic tilt
  3. Sacral counternutation
  4. Posterior pelvic translation
122
Q

What is the anterior pelvic tilt controlled by

A

Hamstring tension

123
Q

How does hamstring tension control the anterior pelvic tilt

A

Part of the biceps femoris long head attaches to the sacrotuberous ligament that tethers the sacrum which when tensioned pulls on the sacrotuberous ligament

124
Q

True or False:
The sacral counternutation is relative to the pelvis because the anterior rotation makes it appear that the sacrum has counternutated (extended)

A

True

125
Q

What does the posterior pelvic translation do

A

Pushes the COM posteriorly

126
Q

Why do we need the posterior pelvic translation

A

To prevent us from falling flat on our face

127
Q

What is non-lumbo-pelvic rhythm

A

Bottom up motion

128
Q

What occurs with supine flexion of the hips

A

Posterior pelvic rotation and sacral nutation

129
Q

True or False:

For the relative sacral nutation to occur during supine flexion you need to be lying on a relatively stiff surface

A

True

130
Q

What occurs with supine extension of the hips

A

Anterior pelvic tilt and sacral counternutation

131
Q

True or False:
For the relative sacral counter nutation to occur during supine extension you need to be lying on a relatively stiff surface

A

True

132
Q

Motivation

A

Keep pushing through only a few more days!

Kinesio 2 (5 decks)

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