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Lumbo-Pelvic Girdle Flashcards

Improve Understanding of Foundations Lumbo Pelvic Girdle

1
Q

Lumbar lordosis is primarily due to the angle of the ________

A

Sacrum

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2
Q

The angle of the sacrum is ___-___ degrees from the horizontal in supine

A

42-45

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3
Q

The L5 disc is higher _____ than _____ making it wedge shaped

A

Anterior than posterior

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4
Q

The L5-S1 disc has __-__ mm less height posteriorly

A

6-7

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5
Q

Lumbar lordosis causes an increased compression on the _____ and the ______

A

Z joints and discs

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6
Q

The ______ ligament and the ______ anteriorly resist stretch from lumbar lordosis

A

Anterior Lumbar Ligament, Annulus

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7
Q

There is no correlation between increased lumbar lordosis and ______

A

Back Pain

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8
Q

There is a tendency for the vertebra of the lumbar spine to slide ______ especially when in weight bearing

A

Forward

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9
Q

The _____ joints and ______ largely resist the anterior slide of the vertebrae in weight bearing

A

Z joints and discs

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10
Q

The secondary restraints to anterior sliding of lumbar vertebrae are the _______

A

ligaments

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11
Q

The Anterior Lumbar Ligament resists anterior _______ and ______

A

Separation and bowing

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12
Q

Lordosis adds _______ and helps to further absorb ______ than an otherwise straight spine

A

Tension, Shock

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13
Q

Lordosis ability to absorb shock takes pressure off of the _______ and ________

A

Intervertebral discs and bodies

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14
Q

Curves of the spine allow us to do three things:

A

Absorb and attenuate forces,
Provide Nutrition throughout the spine by undulating movements through the curves,
Allowing us to maintain a bipedal visual orientation to the world.

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15
Q

We can _______ better than any animal in the animal kingdom

A

Locomote

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16
Q

The change in directions of the curves of the spine are also unique for __________ related to locomotion

A

Energy distribution

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17
Q

Degeneration of the structure at a segmental level of the spine will lead to rapid ________ and _______ at a segmental level

A

Muscle atrophy and dysfunction

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18
Q

Multifidi inhibition occurs with trauma to the spine and will lead to rapid _________

A

Degeneration/degredation

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19
Q

Multifidis-muscle recovery not spontaneous on remission of __________

A

Symptoms

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20
Q

We assess moving segments which may give us provocation because _______ can be confusing to locate due to multiple levels of innervation of the lumbar spine

A

Pain

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21
Q

Stability from joints in the lumbar spine come from what structures and in what percentages

A

29% disc
20% from each Z joint
31% from lymphatic, vascular, ligamentous, etc

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22
Q

The muscle and ligament that helps the articular capsules at the z joints to promote stability is the ______ muscle and ________

A

multifidus, ligamentum flavum

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23
Q

Apophysis is latin for _____

A

outgrowth

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24
Q

Zygos is latin for ______

A

yoke or bridge

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25
Zygapophysial are _____ type joints
synovial
26
Z joints in the lumbar spine vary considerably but primarily limit _______ and _______
Forward bending and rotation
27
The surfaces of z joints are covered with ________ cartilage
Articular
28
The collagen fibers that surround the zygapophysial joint run from ________ to _______ in the lumbar spine
medial to lateral
29
To intra-articular structures exist in the lumbar Z joints the _______ and the ________
fat pad, meniscoid
30
The meniscoid structures in Z joints have three types - they are:
The connective tissue rim The adipose tissue pad The fibro-adipose meniscoid structures
31
The meniscoid structures in the lumbar spine increase the _________ between the two joints and help to transmit ________
Contact area, load
32
We need _______ to keep the nutrition of cartilage healthy
loading
33
__________is the process of synovial fluid being pushed into cartilage
Imbibition
34
The facet capsule is protected by the ________, _________, and _______ from impingement
meniscus, multifidus, ligamentum flavum
35
The ________ is a semifluid mass similar to toothpaste
Nucleus Pulposus
36
The nucleus pulposus becomes more fibrotic after the ge of _____ to ______
21 to 25
37
The Pressure in one direction of the nucleus pulposus results in deformation and the nucleus transmitting pressure in _______ directions
All
38
The nucleus pulposis is made up of _____ to ______% water
70-90% water
39
Most of the dry weight of the nucleus pulposis (65% of dry weight) is made up of _________ aggregate
Proteoglycan
40
___________ makes up the remaining dry weight of the nucleus pulposus that is not made up of proteoglycan aggregate
Type II Collagen
41
The Annulus fibrosus is made up of 10-20 _______ of lamellae
layers
42
The annulus is thicker in the ____ and _____ portions and thinner (thus weaker) in the ______ portions
anterior, lateral | posterior
43
The angle of the layers of the annulus fibrosis are ___-____ degrees from vertical
65-70
44
The angle of each layer of the annulus is the same but the ______ of each concentric layer changes
direction
45
The annulus is made up of 60-70% _______
water
46
________ accounts from 50-60% of the dry weight of the annulus fibrosus
collagen
47
________ gel binds the collagen to the lamellae in the annulus and prevents them from buckling or fraying
Proteoglycan
48
The annulus contains about 10% ________ fibers which are circular, oblique, and vertical which strengthens the lamellae and most highly concentrated where the annulus meets the endplate
elastic
49
________ is a layer of cartilage approximately 0.6-1 mm thick that covers the nucleus pulposus in its entirety
vertebral end plate
50
The vertebral end plate consistes of both _______ and ________ cartilage
hyaline and fibrocartilage
51
End plates are strongly connected to the ________ and weakly connected to the ________
intervertebral disc, vertebral body
52
Functions of the disk are:
Allow movement | Transmit force
53
Prolonged loads on the disc will cause buckling of the ______ of the annulus
lamellae
54
The annulus is capable of resisting ________ without the nucleus pulposus
vertical loads
55
The metabolic maintenance of ______ and _______ is critical for disc function
water and proteoglycan aggregate
56
Distraction of two vertebrae is resisted by all fibers of the ________ of the disc
annulus
57
Sliding movements cause ______ on some fibers aligned in that direction but _____ on those not aligned
tension, slack
58
In effect, half of the fibers of the annulus resist twisting in each direction, this makes the annulus particularly susceptible to ______ when twisting
injury
59
It is normal for there to be cracks, fissures, and degeneration in the spine by the age of ____
15
60
There is a shorter and more narrow disc space but an increased _____ in the disc as we age contrary to popular belief
fluid volume
61
Loss of disc height is often due to the disc shaping into the vertebrae due to the loss of ________
trabeculae
62
In normal aging it is usually the ________ getting smaller, not the disc
bone
63
As we age our disc loses its ability to _______ forces thus creating _______
attenuate, instability
64
In old models, spinal instability was described as __________ that produced excessive movement in an intervertebral joint at end range
ligamentous laxity
65
Thanks to the work of ____________ it is now known that stabilization of the spine relates mainly to muscular factors rather than ligamentous factors, and is probably far more common than the ligamentous type.
Manohar Panjabi
66
________ may be the factor that leads to most cases of mechanical back pain. Its correction is essential to the appropriate management of the mechanical spine disorders.
instability
67
Panjabi describes three subsystems of spinal stabilization. They are:
Passive, active, nervous system
68
The subsystems described by panjabi work on a ________ level
segmental
69
Three things can happen when a subsystem of spinal stability becomes dysfunctional. They are:
1. immediate adaptation from another subsystem 2. long term compensatory adaptation 3. injury to any component of one or more system
70
One point Panjabi makes is that the breakdown of the _________ or reaction time, of the small intrinsic muscles can cause breakdown of the system and that improving __________ can enhance stability
time to peak contraction, time to peak contraction
71
Panjabi asserts that the time to peak contraction of the ______, _______ muscles can cause breakdown of the system
small, intrinsic
72
The passive subsystem of control as described by Panjabi consists of:
Osseous Articular Ligamentous
73
The active subsystem of control as described by Panjabi consists of:
Muscular | Active Stabilization
74
The neural subsystem of control as described by panjabi consists of:
Sensory feedback | Control, timing, and modulation
75
The neutral zone is defined as:
Small range of displacement near the joint's neutral position where minimal resistance is given by the osteoligamentous structures
76
The intervertebral motion which occurs in neutral posture, where minimal resistance to movement is offered by the passive vertebral column is Panjabi's definition of _________
the neutral zone
77
The lax zone is different than the neutral zone because it is where there is _________ of ligamentous resistance
slight displacement
78
The lax zone is bigger or smaller than the neutral zone
bigger
79
The ______ zone describes the region of ligamentous laxity
lax
80
The neutral zone is a smaller subset of the ______ zone
lax
81
The loss of the ability of the spine under physiological loads to maintain its pattern of displacement so that there is not initial or additional neurological deficits, no major deformity, and no incapacitating pain is the definition of _______
clinical instability
82
The symptomatic condition where in the absence of a new injury, a physiological load induces abnormally large deformations at the intervertebral joint is a definition of
clinical instability
83
The clinical state in which the most minor of provocations will shift the patient from being mildly symptomatic to a severely painful distabiling episode is
clinical instability
84
_________ is the intermediate phase of the process of degenenration of the spinal segment following dysfunction and preceding restabilization
instability
85
Passive stability of the spine is tested with _______ _______ tests
linear shear
86
If a passive subsystem is damaged the _____ or ______ subsystems can compensate
active, neural
87
A segment will only become symptomatic if one of the subsystems of control cannot _______
compensate
88
According to Bergmark the muscles that are deep in our core are our __________ __________ system
local stabilization
89
According to Bergmark the muscles that are superficial in our core are our _______ ________ system
global stabilization
90
Local stabilizers add ______ to the spine
stiffness
91
Local stabilization controls in the ________ zone
neutral
92
The ______ ______ system controls intersegmental motions
local stabilization
93
The________ _________ system is the primary movers of the spine
global stabilization system
94
The global stabilization system _______ load between the thoracic spine, costal cage, lumbar spine, and pelvis
transfers
95
The global stabilization system transfers load to the _______ stabilizers
local stabilizers

Foundations (3 decks)

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