Lumbosacral Spine Flashcards
week 6 and 7
SLR - SPIN vs SNOUT
high specificity + positive test =
confident in result (positive)
SPIN
good screen test
positive test rules IN lumbar radiculopathy
SLR - SPIN vs SNOUT
high sensitivity + negative test =
confident in result (negative)
SNOUT
good screen test
negative test rules OUT lumbar radiculopathy
capsular pattern vs hypomoblity
what is expected to be seen in a capsular pattern?
what is expected to be seen in hypomobility?
capsular pattern:
- whole capsule involved (tight)
- expected % loss of motion (capsular pattern)
hypomobility:
- likley includes only part of capsule (or other tissue)
- non capsular pattern of motion loss
- i.e. opening and/or closing restriction
what is fryettes first law?
neutral mechanics:
- specific to lumband lower thoracic spine (T9-12)
- when spine is in neutral
- contralateral coupled motions
- this means - side bend to left, rotate to right and vice versa
what is fryettes second law?
non neutral mechanics:
- lumbar and lower thoracic spine
- when spine is flexed/extended
- ipsilateral coupled motion
- example: in extension, verterbra will side bend and rotate to the same side (body goes to R side so does vertebra)
what is fryettes third law?
whole spine
- motion in one plane reduces available motion in other two planes (joint capsule can only take so much tensile load)
sacrum and pelvis
what muscles attach to iliac crest?
- abdominal muscles
- iliacus m.
- internal oblique m.
- QL m.
sacrum and plevis
what muscles attach to ASIS?
sartorius
TFL
sacrum and pelvis
what muscle attaches to AIIS?
rectus femoris
sacrum and pelvis
what muscles attach to greater trochanter?
Hip rotators:
- quadratus femoris
- gemelli mm.
- obturator externus m.
- piriformis m.
- glute med m.
- glute min m.
sacrum and pelvis
what muscle attaches to lesser trochanter?
iliopsoas (mainly iliacus)
pelvis and sacrum
what muscles attach to ischial tuberosity?
hamstrings:
- semitendinosus
- long head of biceps femoris
- semimembranosus
- quadratus femoris
- inferior gemellus
sacrum and pelvis
what muscles attach to body of pubis and inferior pubic ramus?
adductors:
- add long
- add brev
- add magnus
- gracilis
effect of pelvic position on lumbar spine
anteriro pelvic tilt causes what in lumbar spine?
extension
*sacrum will also move anteriorly, pulling L5 also into extension
effect of pelvic position on lumbarspine
posterior pelvic tilt causes what on lumbar spine?
flexion
- sacrum pulls L5 posteriorly as well
what muscles will be shortened with anterior pelvic tilti?
erector spinae muscles
psoas muscle (flexors)
rectus femoris (flexors)
what muscles will be lengthened (weak) in anterior pelvic tilt?
- think attachment sites are they getting closer or moving away?
- abdominal muscles
- glute max
- hamstrings?
what muscles will be shortened in posterior pelvic tilt?
- think attachement sites moving closer or further away
hamstrings
abdominal m.
proximal stability - local muscles of spine
muscles and motions
- diaphragm:diaphragmaticbreating
- pelvic floor: abdominal bracing
- transversus abdominis: drawing in
- multifidus: 1000 lb gorilla
lateral sling gives stability to what plane?
frontal plane
what muscles are involved in lateral sling?
- gluteus medius
- gluteus minimus
- TFL
- IT band
- fibular longus
- fibularis brevis
oblique plane stability
posterior oblique sling is comprised of what muscles/tissues?
- glute maximus
- thoracolumbar fascia
- contralateral latissimus dorsi
posterior longitudinal sling provides stability in which plane?
sagittal plane stability
what muscles/tissues are apart of posterior longitudinal sling?
- erector spinae
- thoracolumbar fascia
- sacrotuberous ligament
- bicceps femoris
think nutation/non nutation
provide contrasting force at SI joint
nutation is the closed packed position for what joint?
sacroiliac (SI) joint
anterior longitudinal sling provides stability in what plane?
sagittal plane
anterior longitidinal sling is an anatagonist to what?
posterior longitudinal sling
*vise versa
what tissues make up the anterior longitudinal sling?
- lower abdominal muscles
- TA
- rectus abdominis
- internal oblique
- external olique
oblique plane stability
the anterior oblique sling is an antagonist to?
- posterior oblique spling
*vice versa
what tissues make up the anteriro oblique sling?
- ipsilateral internal obliques
- ipsilteral external obliques
- contralateral adductors
- correlation between groin pain and oblique abdominal pain
step off deformity
high specificity + positive test =
confident in spondylolithesis
single leg drop jump test
what two angle are added together to get the femoral adduction angle?
femur-plevic angle + pelvic dorp angle
look for femoral adduction angle after landing vertical jump.
