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S2 Biomechanics > Lumbar Spine Part 2 > Flashcards

Lumbar Spine Part 2 Flashcards

1
Q

decreased lordosis

  • lumbar spine arthrokinematics
  • why is this important
A

bilateral upslide

  • decreased contact area
  • -more force/area (while there is decreased pressure overall at the facet joint, there is decreased contact area so there is more force/area)
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2
Q

decreased lordosis

  • loading differences on spine
  • what structures are affected
A

more compression

-pressure movign from facets to anterior IVD and vertebral bodies

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3
Q

increased lordosis

-lumbar spine arthrokinematics

A

downslide

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4
Q

increased lordosis: position of

  • lumbar spine
  • pelvis
  • hip
  • knee
A 
spine
-extension
pelvis
-anterior tilt
hip
-flexion
knee
-flexion or extension
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5
Q

increased lordosis

  • loading
  • affected structures
A 
increased shear (particularly at L5S1)
increased pressure on posterior IVD
compression of interspinous ligaments
reduced diameter of intervertebral foramina
-nerve entrapment
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6
Q

importance of lumbar facet downslide with increased lordosis

A

increase force

will be almost locked out in resting posture

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7
Q

effect of prolonged flexion (seated or standing) on dysfunction

A

adaptive shortening of muscles and connective tissues
increased flexor moment on the spine
increased pressure on anterior aspect of IVD
-may weaken posterior annulus fibrosis over time
impact on the entire kinetic/kinematic chain

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8
Q

effect of prolonged hyperextension on dysfunction

A

compression of facets
increased anterior shear at lumbosacral junction
may lead to development of spondylolisthesis
-anterior ligaments are compromised
effect on kinetic/kinematic chain

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9
Q

posterior muscles of the trunk: intermediate later

  • what
  • function
A

serratus posterior
little contribution to movement or stability
primarily contribute to ventilation

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10
Q

erector spinae

-function

A

control gross movement across a large part of axial skeleton

generate large extensor moment for lifting/carrying (bilateral)

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11
Q

erector spinae group

-can _____ tilt pelvis and _____ lordosis

A

can anteriorly tilt pelvis and increase lordosis

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12
Q

multifidi function

A

extension torque and stability

-multiple attachments and overlapping fibers

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13
Q

transversospinalis functions

A

bilateral extension

unilateral contralateral rotation, ipsilateral lateral flexion

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14
Q

short segmental group

  • most prominent in…
  • blend with…..
  • most important role
A

most prominent in craniocervical region for control of neck
blend with interspinous ligaments
-intervertebral stabilizers
most important role
-sensory feedback (high density of muscle spindles)

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15
Q

anterior rectus sheath

-comes from

A

internal and external obliques

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16
Q

posterior rectus sheath

-comes from

A

interal oblique and transversus abdominus

17
Q

sheaths thicken and cross at midline to form…

A

linea alba

18
Q

rectus abdominus

-actions

A

trunk flexion

posteirior rotation of pelvis

19
Q

internal, external oblique, and transversus abdominus

-function

A

“hoop” muscles - important stabilizers

20
Q

external oblique actions

A

bilateral
-trunk flexion, posterior pelvic tilt
unilateral
-lateral flexion, contralateral rotation

21
Q

internal oblique actions

A 
bilateral
-trunk flexion, posterior pelvic tilt
-tensions thoracolumbar fascia
unilateral
-lateral flexion
-ipsilateral rotation
22
Q

transversus abdominus

-function

A

stabilizes attachment sites for other muscles
compresses abdominal cavity
tension thoracolumbar fascia

23
Q

“additional” muscles of the trunk

A

psoas major

quadratus lumborum

24
Q

psoas major function

A

vertically stabilizes the lumbar spine
-line of action close to rotation axes
strong hip flexor

25
Q

QL functions

A

bilateral
-extension
unilateral
-lateral flexion (open chain - elevates pelvis)

26
Q

sagittal plane muscles (erector, rectus)

  • orientation
  • motions
A

primarily flexion/extension (bilateral)

lateral flexion depends on moment arm from midline

27
Q

frontal plane movers

  • what muscles
  • vertical force component gives
  • horizontal force component gives
A 
any muscle with oblique orientation
vertical force
-lateral flexion
horizontal force
-transverse rotation
28
Q

transverse plane

-what muscles

A

multifidus

external oblique

29
Q

extrinsic stabilizers of the trunk

  • what are they
  • what do they do
A

attach to structures outside the vertebral column

global stability

30
Q

what muscles are extrinsic?

A 
abs
erector spinae
hip muscle
QL
psoas
lat
scapular muscles
31
Q

intrinsic stabilizers

  • what are they
  • what do they do
A

segmental stability

short, deep muscles that attach to structures within spinal column

32
Q

what muscles

A 
transversospinalis
-semispinalis
-multifidi
-rotatores
short segmental group
-interspinalis
-intertransversarii
33
Q

“general” versus “specific” stabilization

A

better short-term outcomes with “specific (ultrasound feedback) motor control exercises but no differences long term
specific stabilization exercises effective for chronic but not acute LBP
individually designed, higher intensity programs may be most beneficial

34
Q

TrA

  • theory
  • selectively activate through…
A

theory
-a primary specific stabilizer for lumbar spine
–based on findings that TrA function impaired in people with LBP
selectively activate through “drawing in maneuver”

35
Q

drawing in maneuver

-function

A

increases intra-abdominal puressure and tension thoracolumbar fascia without moving lumbar spine

36
Q

how to teach drawing in maneuver

A

use biofeedback - EMG or pressure

37
Q

TrA: pressure biofeedback

-diagnostic accuracy

A

no correlation bewteen pressure biofeedback and TrA activation on ultrasound
no difference in TrA activation between those who were and were not able to perform exercise successfully (no change in pressure)

38
Q

implications for pressure biofeedback

A

success with pressure biofeedback has been associated with improved outcomes
-pressure biofeedback is good, but it doesn’t necessarily mean they have learned how to use their TrA

39
Q

TrA take-home messages

A

muscles do not work in isolation
-there is more to it than TrA alone
focus on perfect performance of the desired movement/task
-atypical compensations should become apparent
likely using a combination of global and segmental stabilizing muscles
always return to foundation principles, function anatomy, motor control

S2 Biomechanics (13 decks)

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