Lumbar Spine & Pelvis Flashcards
The body of lumbar vertebral body is ______. Why is this important?
Large! Can withstand large compression forces
How is the vertebral foramen different in the lumbar vertebrae?
It is triangular and larger than thoracic and smaller than cervical
What is special about L5?
It’s a transitional vertebrae
Has a wedge shaped body
Smaller spinous process
Large transverse processes
Lumbar facet joints are curved and ______
Biplaner
Anteriorly the lumbar facet jts are aligned to the __________ plane allowing resistance for__________
Frontal plane
Anterior shear force
Posteriorly, lumbar facet jts are aligned close to the _________ plane. This allows for _____________ and restricts __________
Sagittal plane
Flex/ext
Rotation
The annulus fibrosus between lumbar vertebrae are formed in alternating layers called ….
Lamellae
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
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
The lumbosacral articulation is formed by
L5 and S1
Lumbosacral Angle is the angle between the
1st sacral segment and the horizontal plane
greater lumbosacral angle results in
Increased lordosis
Increasing amount of shearing stress
What structures in the lumbosacral articulation resist natural shear force?
IV disc, facet jt capsule, ALL, and Iliolumbar ligaments
Spondylolisthesis most commonly occurs at what segment? Why?
L5/S1
Secondary to angulation of this segment
The anterior sacroiliac articulation is a _______ jt between the ____________
Synovial
Articular surfaces
The posterior sacroiliac articulation is a _________________ between the ______________________
Syndesmosis
Tuberosity of ilium and sacrum
The pubis symphysis is a ______________ jt
Cartilaginous
The anterior portion of the pubis symphysis is reinforced by what muscles?
Transverse abdominals
Rectus abdominals
Internal oblique
Adductor Longus
Describe the Osteokinematics of the lumbar spine
Flexion (40-60)
Extension (20-35)
Lateral flexion (15-20)
Rotation (3-18)
Is there coupling in the lumbar spine?
Yes but the pattern is inconsistent
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
