Lumbar Spine & Pelvis Flashcards by Hannah Bledsoe

The body of lumbar vertebral body is ______. Why is this important?

Large! Can withstand large compression forces

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How is the vertebral foramen different in the lumbar vertebrae?

It is triangular and larger than thoracic and smaller than cervical

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What is special about L5?

It’s a transitional vertebrae
Has a wedge shaped body
Smaller spinous process
Large transverse processes

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Lumbar facet joints are curved and ______

Biplaner

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Anteriorly the lumbar facet jts are aligned to the __________ plane allowing resistance for__________

Frontal plane

Anterior shear force

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Posteriorly, lumbar facet jts are aligned close to the _________ plane. This allows for _____________ and restricts __________

Sagittal plane
Flex/ext
Rotation

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The annulus fibrosus between lumbar vertebrae are formed in alternating layers called ….

Lamellae

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The annulus fibrosus collagen layers in the lumbar spine are oriented ________________. Which allows them to resist __________ forces in ________________ directions.

Opposite

Resist tensile forces in nearly all directions

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The IV disc of the lumbar spine have a ________________. This allows a greater portion of annulus fibrosus located _____________, increasing the ability to resist tension that occurs with _______________.

Posterior concavity
Posteriorly
Forward bending

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The lumbosacral articulation is formed by

L5 and S1

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Lumbosacral Angle is the angle between the

1st sacral segment and the horizontal plane

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greater lumbosacral angle results in

Increased lordosis

Increasing amount of shearing stress

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What structures in the lumbosacral articulation resist natural shear force?

IV disc, facet jt capsule, ALL, and Iliolumbar ligaments

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Spondylolisthesis most commonly occurs at what segment? Why?

L5/S1

Secondary to angulation of this segment

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The anterior sacroiliac articulation is a _______ jt between the ____________

Synovial

Articular surfaces

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The posterior sacroiliac articulation is a _________________ between the ______________________

Syndesmosis

Tuberosity of ilium and sacrum

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The pubis symphysis is a ______________ jt

Cartilaginous

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The anterior portion of the pubis symphysis is reinforced by what muscles?

Transverse abdominals
Rectus abdominals
Internal oblique
Adductor Longus

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Describe the Osteokinematics of the lumbar spine

Flexion (40-60)
Extension (20-35)
Lateral flexion (15-20)
Rotation (3-18)

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Is there coupling in the lumbar spine?

Yes but the pattern is inconsistent

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Describe Arthrokinematics of the lumbar facets in the sagittal plane

Flexion: glide superior and anterior
Extension: glide inferior and posterior

What segments of the lumbar spine have the greates flex/ext?

Inferior lumbar segments

Describe the Arthrokinematics of the lumbar facets in the frontal plane

Contralateral superior glide

Ipsilateral inferior glide

What segment of the lumbar spine has the greatest motion in the frontal plant?

Superior lumbar segments

Describe Arthrokinematics of lumbar facets in the transverse plane

Contralateral: anterior glide in a neutral spine approximation Ipsilateral: posterior glide in a neutral spine distraction (gapping)

What lumbar segments have the greatest motion in the transverse plane

Superior lumbar segments

When does lumbo-pelvis rhythm occur?

During trunk flexion/ext

In lumbo-pelvic rhythm, the movement of the pelvis increases motion but also ________ the amount of flexibility needed of the lumbar spine

Reduces

Describe the lumbo-pelvic rhythm in flexion/ext

Flex: lumbar flexion followed by anterior tilt of the pelvis Ext: posterior tilt of the pelvis followed by lumbar extension

Increased lumbar lordosis (ext) results in a ___________ percentage of the compressive load through the facet jts.

Greater

Causes of increased lumbar lordosis

Weakness of hip extensors or abdominal muscles

Benefits of a stable core

Structural integrity Optimal postural alignment Limits excess micro motion Provides a firm base for extremities to move

The active muscle force essential for stabilizing the vertebral column is often referred to as

Core stability

Intrinsic stabilizers of the trunk include

``` Semospinalis Multifidi Rotatores Interspinalis Intertransversarius ```

Extrinsic stabilizers of the trunk

``` Recuts abdominals External and internal oblique Transverse abdominals Erector Spinae Quadratics lumborum Psoas major ```

A normal sit up has 2 phases. What are they and what order should they occur

Trunk flexion phase > hip flexion phase

Weak abdominals will cause what altered pattern in a sit up?

Results in early hip flexion due to hip flexor dominance

4 ways to reduce force required of extensors with lifting

Reduce velocity Reduce magnitude of external load Reduce length of EMA (bring object closer) Increase length of the IMA

Factors that contribute to safe lifting

Light load held close Lift with lumbar spine as close to neutral as possible Activate hip and knee extensors (decreases demand on lumbar extensors) Minimize vertical and horizontal distance load must be lifted Minimize asymmetric limiting Avoid twisting Lift slow and smooth Use a wide and slightly staggered BOS use a mechanical lifting device or team lift

Which moment arm is easiest to change to reduce force required of extensors when lifting

External moment arm- lift close to the body

Why is a stoop lift not recommended and what lift should you do instead?

Can result in large compression and shear forces on discs Squat lift is safer

A stoop lift is synonymous to lifting with your ________ whole a squat lift is synonymous with lifting with your _______

Back | Legs

Kinematics of sacrum on the innominate

Nutation: sacral promontory moves anterior and inferior, apex moves posterior Counternutation: promontory moves posterior and superior, apex moves anterior

Kinematics of innominate bones

Anterior pelvic tilt: ASIS and pubic symphysis move inferior Posterior pelvic tilt ASIS and public symphysis move superior

Nutation and counternutation can occur from __________ movements, __________ movement, or both

Sacral-on-iliac | Iliac-on-sacral

Near vertical orientation of the SI jt could result in …

Slipping

Full nutation indicates…… Why does this matter

A closed-packed position of the SI jt This is where the SI jt is most congruent

Notation torque stretches what ligaments? What does this cause in the SI jt

Interosseous, sacroslinous, and sacrotuberous ligaments Causing compression and stabilization in the SI jt

Primary function of the lumbar spine. Accomplished secondary to…..

Provide support for the weight of the upper body Withstand lard compressive loads applied with muscle contraction Accomplished secondary to increased size of lumbar vertebral bodies and IV discs

Primary function of pelvis

Transmit force of vertebral column to lower extremities | Relieve stress on the pelvic ring created by movement of the trunk and lower extremities