Midterm 2 Flashcards
What are some general trends regarding the incidence of back injuries? Who is affected? How long do these injuries last?
Getting better through automation, 56% of back injuries are lower only. Working population aged 25-55 affected the most. Over 25% of injuries are 31+ days of lost time, 20% 3-5 days
What does the front part of the vertebra do?
Vertebral body is the load bearing structure.
What do the components on the posterior portion of the vertebra do?
Posterior elements are where the muscles attach via tendons. 7 cervical, 2 thoracic, 5 lumbar.
How are the posterior portions of the vertebra injured?
High rate of loading, pulling, pushing, repeated full motions
What are the factors that affect whether tendons and ligaments will be injured?
Direct trauma (lacerations, contusions, overuse). Rate of loading, amount of load, repetition. Ligaments - bone to bone, slow to heel, sprains, high % of collagen. Tendon - muscle to bone, overuse, higher % of collagen.
What does cartilage do?
Absorbs shock and distributes loads, prevents direct wear on bones by allowing relative movement of opposing joint surfaces with minimum friction and wear.
Where is cartilage found in the human body?
Fibrocartilage in discs, Hyaline in synovial joints and vertebral end-plates.
How are nutrients delivered to these tissues?
No blood vessels, through diffusion, slow recovery.
What are the two main parts of bone?
Outer(cortical) - compact bone provides strength and stiffness. Inner(trabecular) - provides large capacity for energy storage.
What is Wolf’s Law?
Bone remodels in response to mechanical load.
What kind of occupational injury concerns exist with bone tissue?
Fatigue fracture - osteoporosis in older workers, susceptibility to crush, military boot camps.
What are the primary parts of the intervertebral disc?
Nucleus Pulposus - resists compressive spinal loads, gelatinous mass in center, dries up with age. Annulus Firbrosus - elestic properties of disc, resists shear loads on the spine (along with facet joints).
What does the disc do?
Shock absorber, movable joint where motion occurs in spine, spacer allows room for nerve roots, nutrients diffuse through end plates and annulus, spinal motion acts as nutrition pump.
What is the vertebral end plate?
Connection between disc and vertebral body, made of hyaline cartilage.
Why is the vertebral end plate important?
It is porous and allows nutrient exchange with blood vessels in the vertebral body.
What type of health concerns exist for the intervertebral disc?
End plate fractures due to excessive compression loads, herniation associated with full end range of motion, cell death within the nucleus pulposus under loading, degeneration with age and load exposure.
What tissues can potentially be the source of back pain?
Disc, ligament, tendon, facet joint, muscle.
What is meant by “idiopathic low back pain?
85% of lower back pain you can’t see on x-rays.
Where is the Latissimus Dorsi and where does it connect?
Right and left side of the mid-back that connects to tissue called fascia, from the sacrum to the under arm.
Where is the Erector Spinae and where does it connect?
Fibers that run parallel to the spine and originate from the sacrum to the rib cage(Longissiums, illiocostallis, multifidus).
When do people use their Latissimus Dorsi muscle?
Pulling tasks.
When do people use their Erector Spinae muscle?
Lifting tasks.
In addition to back muscles, what other muscles support and help move the back and torso?
Posterior trunk muscles (deepest layer), Rectus abdominus, External/internal oblique, Transverse abdominus.
What is the difference between an agonist and an antagonist muscle?
Agonist(prime mover) initiates contraction necessary to move a limb through joins range of motion. Antagonist(reactionary) lengthens or stretches to allow agonist to complete action then contracts to return to original position.
For the spine which muscles are agonist muscles are which are antagonist muscles for flexion of the spine?
Agonist - rectus abdominus
Antogonist - erector spinae
For the spine which muscles are agonist muscles are which are antagonist muscles for holding a box?
Agonist - erector spinae
Antagonist - rectus abdominus
The amount of back muscle force needed in a particular lifting task depends on what?
Weight lifted and distance of reach (torque). Torque from the box equals the torque from the back.
What do the disc pressure studies show us?
Body position has a great effect on amount of load on the disc, angle of flexion and load both linearly correlate with disc pressure.
What is the relationship between spine compression force and low pain incidence rates?
Increased compression force leads to increased risk of injury. Incident rates jump when compression force is greater than 250 kg and again when greater than 650 kg.
How does the tolerance to spine compression change as a function of age?
The compression force resulting in disc-vertebrae failure goes down with age. Age less than 40 at 650 kg. Age greater than 60 at 375 kg.
Describe three loading scenarios by which tissues can become injured.
- When applied load is greater than tissue strength tissue failure occurs.
- When a single high intensity excessive load occurs tissue tolerance is exceeded.
- During repeated low level loading over time under a constant low applied load the tissue tolerance is reduced.
What are generic physical risk factors for musculoskeletal discomfort?
Awkward postures, excessive force, repetitive activity, lack of rest, environmental stressors.
Why is posture a risk factor for low back injury?
Muscle length changes with posture, pressure on facet joints increases, extreme forward bending puts stress on spinal ligaments.
Why are we concerned about spine twisting?
Twisting increase pressure on sliding spine joints and strains selected disc fibers.