Lumbar Spine/Ribs Flashcards

1
Q

Describe the structure of the lumbar vertebrae.

A
  • Large body
  • Vertebral foramen > than thoracic but < cervical
  • L5 wedge shaped body for transition
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2
Q

How are the facet joints oriented in the lumbar spine?

A
  • Curved and biplanar (frontal and sagittal plane)
  • Anteriorly = aligned with frontal plane resisting anterior shearing forces
  • Posteriorly = aligned nearly with sagittal plane allowing for greater flex/ext but restricting rotation
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3
Q

What is the lumbrosacral angle?

A

formed by 5th lumbar vert and 1st sacral segment

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4
Q

Why is the lumbosacral junction an area susceptible to injury and shearing?

A

increased angle = increased lordosis of lumbar spine which increases amount of shearing stress

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5
Q

Describe the intervertebral discs of the lumbar spine.

A
  • Largest discs in the spine

- Able to resist tensile forces in nearly all directions

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6
Q

What kind of joints make up the sacroiliac joint?

A
  1. Anterior synovial joint with articular surfaces

2. Posterior syndesmosis with tuberosities

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7
Q

What is the structure of the pubic symphysis and what muscles provide support to this area?

A
  • Cartilaginous joint

- Anterior portion of joint reinforced by transversus abdominis, restuc abdominis, internal oblique, adductor longus

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8
Q

What are the osteokinematics of the lumbar spine?

A

Flex/Ext
Lateral flex
Rotation

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9
Q

What are the arthrokinematics of the interbody joints and facet joints for flex/ext:

A

Flex - facet glide superior and anterior

Ext - facet will glide inferior and posterior

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10
Q

Greatest motion flex/ext occurs in which part of lumbar spine?

A

Inferior segment

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11
Q

What are the arthrokinematics of the interbody joints and facet joints for side bending:

A
  • Superior glide in facet contralateral to side bend

- Inferior glide in facet ipsilateral to side-bend

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12
Q

Greatest motion of side bending occur in which part of lumbar spine?

A

Superior lumbar

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13
Q

True/False: coupling pattern in inconsistent in lumbar region

A

True

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14
Q

What are the arthrokinematics of the interbody joints and facet joints for rotation:

A
  • Facet contralateral to rotation with approximate

- Facet ipsilateral to rotation will distract

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15
Q

Greatest motion of rotation occur in which part of lumbar spine?

A

superior lumbar segments

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16
Q

What is the normal lumbo-pelvic rhythm for flexion and for extension?

A

Bending over to touch toes:

  1. Flexion- initially lumbar flexion followed by anterior tilt of pelvis
  2. Extension - posterior tilt of pelvis followed by extension of lumbar
17
Q

What two things does movement of the pelvis do?

A
  1. Increases motion

2. Reduces amount of flexibility required of lumbar region

18
Q

What muscles provide muscular stability to the trunk? Which are intrinsic?

A

Intrinsic - semsispinalis, multifidi, rotatores, interspinalis, intertransversarius

19
Q

What muscles provide muscular stability to the trunk?Which are extrinsic?

A

Extrinsic - rectus abdominis, external/internal oblique, transverse abdominis, erector spinae, quadratus lumborum, psoas major

20
Q

Why is a stable core important?

A
  1. Provides structural integrity
  2. Optimizes postural alignment
  3. Limits excess micromotion
  4. Provides firm base for extremities to move
21
Q

What is the muscle activation that occurs with a full sit-up?

A

Trunk flexion phase - abdominals

Hip flexion phase - continued activation of abdominals with hip flexor muscles

22
Q

Weak abdominals will result in what during a full sit-up?

A

Early hip flexion due to hip flexor dominance = increase compression of lumbar spine

23
Q

What are recommended lifting mechanics? Why are these strategies preferred?

A
  • Reduce force required of extensors with lifting
    1. Reduce velocity of lifting
    2. Reduce magnitude of external load
    3. Reduce length of EMA
24
Q

What is the stoop lift?

A
  • Greater flexion of lower back
  • Greater extension force required from low back and truck due to longer EMA
  • Large compression and shear forces on disc
25
Q

What is the squat lift?

A
  • Max knee flexion
  • EMA is reduced between load and trunk and decrease extensor torque
  • Safer
26
Q

What is the difference between nutation and counter-nutation compared to anterior and posterior pelvic tilting?

A

Nutation/counternutation - describe movement of sacrum on innominate

Ant/post pelvic tilt - describe movement of innominate bones

27
Q

Anterior pelvic tilt:

A

ASIS and pubic symphysis move inferiorly

28
Q

Posterior pelvic tilt:

A

ASIS and pubic symphysis move superiorly

29
Q

Nutation:

A

Sacral promontory moves anteriorly and inferiorly and sacral apex moves posteriorly and superiorly

30
Q

Counternutation:

A

sacral promontory moves posteriorly and superiorly and sacral apex moves anteriorly

31
Q

True/False: near vertical orientation of SI joint could result in slipping

A

True

32
Q

How does nutation provide stability?

A

Provides increased compression improving stability

33
Q

What are forces contributing to nutation torque?

A
  1. Gravity (1st line stability)
  2. Stretched ligaments (interosseous and sacrotuberous lig)
  3. Muscle activation
34
Q

What is the close-packed position of SI joint?

A

Full nutation

35
Q

What muscles reinforce the SI joint?

A
  1. Erector spinae & lumbar multifidi
  2. Diaphragm and pelvic floor
  3. Abdominal muscles
  4. Hip ext
  5. Lats
  6. Iliacus and piriformis
36
Q

How does different posture/alignment effect the lumbar spine in sitting?

A
  1. Anterior pelvic tilt with lumbar extension - alleviates posterior pressure
  2. Posterior pelvic tilt with lumbar flex - anterior pressure on disc and tension in zygoapophyseal joints
37
Q

What are the primary functions of the lumbar spine?

A
  • Provide support for weight of upper body

- Withstand compressive loads applied with muscle contraction

38
Q

hat are the primary functions of the pelvis?

A
  • Transmit force of vert column to lower extremities

- Relieve stress on pelvic ring created by movement of trunk and lower extremities