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Functional Anatomy > Lumbar Spine Ligaments and Muscles > Flashcards

Lumbar Spine Ligaments and Muscles Flashcards

1
Q

Anterior Longitudinal Ligament

A
  • Well developed along lumbar lordosis
  • Tensile strength is greatest in lumbar region
    • Supports weight of lumbar spine, especially at L/S junction (sling)
    • 2x stronger than PLL

-Superficial fibers span multiple levels, Deep fibers span single level (deep blend with AF to reinforce disk)

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2
Q

Role of Anterior Longitudinal Ligament

A

Resists:

  • *Anterior shear/ translation
  • *Extension
  • Axial rotation
  • Distraction

Slacks with flexion
Proprioception with extension

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3
Q

Posterior Longitudinal Ligament

A

Ventral surface of vertebral canal
Very thin in lumbar region (thicker in C spine)
Resistance to axial tension is 1/6 that of ALL

Superficial span multiple levels, deep attach adjacent vertebrae and interlace with outer AF

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4
Q

Role of Posterior Longitudinal Ligament

A

Resist:

  • Posterior translation
  • Flexion (minimally)

Slacks with extension
Proprioception with flexion

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5
Q

Ligamentum Flavum

A
  • Postero-lateral surface of vertebral canal
  • Connect lamina to lamina
  • Highly elastic and thick
  • Includes slips to anterior facet joint capsule

With aging: Stretches out – can buckle in spinal canal

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6
Q

Role of Ligamentum Flavum

A
  • Resists flexion
  • Slacks with extension
  • May assist with return to extension
  • Elasticity –> constant tension, creating compressive force on disk –> Increase disk stiffness
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7
Q

Interspinous ligament

A
  • Spinous process to spinous process

- Well developed in lumbar region

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8
Q

Supraspinous ligament

A
  • Runs along tips of spinous processes from C7 to L3 (some individuals to L4)

**Absent at L5-S1

In lumbar region, blends with thoracolumbar fascia and multifidus

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9
Q

Role of supraspinous ligament

A

Resists:

  • Flexion
  • Separation of spinous processes
  • Rotation (to a lesser degree)

Slacks with extension

Dense with mechanoreceptors –> Proprioception

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10
Q

Intertransverse ligament

A
  • Bilateral transverse process to transverse process
  • Blend with thoracolumbar fascia, TA, EO, lats
  • Thickest in lumbar region
  • Alternately stretched and compressed during lateral bending
  • *Absent at L4 and L5
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11
Q

Role of intertransverse ligament

A

Resists:

  • Lateral bending on contralateral side
  • Rotation

Slack with lateral bending to ipsilateral side
Proprioception during lateral bending and rotation

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12
Q

Iliolumbar ligaments

A
  • Ventral band and dorsal band: L4/5 Transverse process –> Iliac crest
  • Sacral band: L4/5 TP and sacral ala –> Iliac crest (AKA lumbosacral ligament)
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13
Q

Role of iliolumbar ligaments

A

Prevent anterior displacement of L5 on sacrum (sliding off)

Resists motion in all planes

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14
Q

Lumbar mobilizers

A 
Rectus abdominus
abdominal obliques
psoas major (ant fibers)
iliocostalis
longissimus
quadratus lumborum
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15
Q

Lumbar stabilizers

A

Multifidus
Transversus abdominus
Psoas major (post fibers)
Muscular attachments to thoracolumbar fascia

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16
Q

Muscle function: Lumbar flexors

A
  • Attachments on ribs, sternum, pelvis
  • Rectus abdominus, psoas, obliques
  • Other functions: Increasing intra-abdominal pressure (decrease stress on lumbar spine)
17
Q

Muscle function: Lumbar extensors

A

Acting bilaterally: Dorsal muscles are extensors

Acting unilaterally: Dorsal muscles are lateral rotators and lateral flexors

18
Q

Multifidus

A

Transverse process (and adjacent facet jt/ capsule) –> Spinous process 2-3 levels superior

From sacrum

To activate: Contralateral rotation

19
Q

Multifidus action

A
  1. Increases spine stiffness (stabilization)**
  2. Avoid painful nipping of capsule by facet joint (approximates facets)
  3. Secondary:
    - Extension (bilateral)
    - Ipsilateral side bend
    - Contralateral rotation
20
Q

Transverse Abdominus

A

Ribs, iliac crest, thoracolumbar fascia –> Linea alba

21
Q

Action of TA

A
  1. Stabilizes spine
  2. Narrows waist
  3. Generates tension on thoracolumbar fascia
22
Q

Psoas major (posterior)

A

Transverse process (T12-L5), anterolateral vertebral bodies, intervertebral disks –> Lesser trochanter

23
Q

Action of psoas major (posterior)

A
  1. Stabilizes spine (axial compression)
  2. Can generate anterior sheer
  3. Assist with trunk flexion
24
Q

Thoracolumbar Fascia

A
  1. Superficial and deep
  2. Multiple muscular attachments of superficial and deep muscles
  3. Compressive “corset” to stabilize spine
25
Q

Spinal Cord

A

Ends L1-L2
Cauda Equina
Nerve roots L2-S5 continue to run through central canal

26
Q

What structures are innervated?

A

Lumbar disk
PLL and ALL
Interspinous ligament
Facet joints

27
Q

What structure is not innervated?

A

Main ligamentous substance of ligamentum flavum (superficial surface is innervated)

Functional Anatomy (14 decks)

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