Spinal Lecture 5

Question 1

what do the vertebrae do to accommodate forward flexion

Answer 1

the vertebrae rotate anteriorly (anterior sagittal rotation) and translate forward (anterior sagittal translation)

Question 2

during forward flexion the __ of the upper vertebrae can not move and thefore the upper surface of the vertebral bodies lean ___

Answer 2

inferior articular facet of the upper vertebrae can not move and therfore the upper surface of the vertebral bodies lean downwards

Question 3

what limits forward flexion

Answer 3

IVD, facet joint capsule, supraspinous ligament, interspinous ligament, ligamentum flavum and posterior longitudinal ligament

Question 4

what spinal section has the greatest amount of forward flexion

Answer 4

L5/S1

Question 5

during extension what movement do the vertebrae undergoe

Answer 5

posterior sagittal rotation and slight posterior translation

Question 6

during extension __ move downward and impact against the ___ of the vertebrae below so that there is a bone-on-bone end feel

Answer 6

during extension INFERIOR articular processes move downward and impact against the LAMINA of the vertebrae below so that there is a bone-on-bone end feel

Question 7

what limits extension of the spine

Answer 7

anterior fibres of the annulus fibrosus, anterior longitudinal ligament and a bit of the anterior part of the IVD

Question 8

what spinal level does most extension occur at

Answer 8

l5-s1 but only 5-6 degrees

Question 9

what happens to the body of the vertebrae and disc during side bending

Answer 9

body of the vertebrae tilts and the nucleus of the disc is displaced to the opposite side

Question 10

with side bending where does the least/most amount of movement occur

Answer 10

least - at l5-s1 most - at l3/l4

Question 11

what structures limit side bending of the spine

Answer 11

lumbrosacral fascia, capsular ligaments of facet joints, iliolumbar ligament and intertransverse ligament

Question 12

T/F the spine was not built for rotation

Answer 12

TRUE

Question 13

what is the max degrees of rotation at each spinal segment

Answer 13

3 degrees

Question 14

which spinal segment has the least amount of rotation

Answer 14

L5

Question 15

what structures limit spinal rotation

Answer 15

facet joints limit rotation first, then the disc, supraspinous ligament and interspinous ligament

Question 16

what happens with the vertebrae, posterior facets and annulus of the disc during rotation

Answer 16

vertebrae tilt forward slightly, opening the posterior facets and stretching the posterior lateral annulus of the disc

Question 17

what happens to the right facet during right rotation

Answer 17

with right rotation the right facet opens and the left facet closes and vice versa

Question 18

if there is pain on the same side as rotation there is a ___ problem

Answer 18

if there is pain on the same side as rotation there is a CAPSULAR problem

Question 19

if pain is on the opposite side as rotation there is an ___ problem

Answer 19

INTRA-ARTICULAR problem

Question 20

Answer 20

Question 21

Answer 21

Question 22

Answer 22

Question 23

What is the physiological movement with forward flexion and what is the accessory movement(s)?

Answer 23

Anterior sagittal rotation and anterior sagittal translation are Accessory movements – small involuntary movements

Physiologic movement is the forward flexion – large voluntary movements So with each physiological movement you get accessory movement as well

Question 24

What things are restricted, pulled tight and compressed at end-range of motion for forward flexion?

Answer 24

Pulled tight:

Supra, inter, ligamentum flavum and posterior longitudinal, zygoapopheaseal, posterior annulus fibres

Relaxed:

Anterior longitudinal

Compressed:

Anterior portion of IVD will become compressed pushing the nucleus pulposus posteriorly

Question 25

Forward rotation of the pelvis is limited by the ____ ligament and ____.

Answer 25

Forward rotation of the pelvis is limited by the sacrotuberous ligament and hamstrings

Question 26

Posterior pelvic rotation is limited by tension in the ____ ligaments and the ____.

Answer 26

Posterior pelvic rotation is limited by tension in the iliolumbar ligaments and the hip flexors

Question 27

What limits extension?

Answer 27

Anterior longitudinal ligament

Anterior fibres of annulus fibrosis

Zygoapopheseal joint – bony block

SP bony block

Psoas

Iliofemoral ligament

Question 28

Whats relaxed in extension?

Answer 28

Posterior longitudinal

Supra, inter, flavum

Question 29

What is compressed in extension?

Answer 29

Posterior aspect of disc – nucleus pulposus pushed anteriorly

Facet – articular capsule

Capsule and fat pad can become compressed if not moved out of the way quick enough

Question 30

What things are restricted, pulled tight and compressed at end-range of motion for this movement? – SIDE BENDING ON RIGHT SIDE

Answer 30

Intertransverse tight on left relax on right

Ligamentum flavum as well

Facet compressed on right side open on left – capsule would be stressed on left d

IVD disc compressed right side taught on left pushing nucleus pulposus left

Iliolumbar taught on left side relaxed on right side

Narrowing of intervertebral foramen on right side which will cause pressure on the nerves over time

Opening of space on left side but also more pull on nerve roots as they are being streatch

Question 31

Orientation of facets in l-spine are facing largely lateral-medial which would limit _____.

Answer 31

Side bending

Question 32

Ribs prevent side bending in t-spine despite the fact the orientation of the facets are ____.

Answer 32

anterior / posterior

Question 33

You should see a ____ curve with side bending. Most people have restrictions which is causing _____ at specific areas not a steady curve. Implication is a lot of movement is going through a small area making it prone to ____.

Answer 33

You should see a gradual curve with side bending. Most people have restrictions which is causing hinging at specific areas not a steady curve. Implication is a lot of movement is going through a small area making it prone to injury

Question 34

What happens to the facets and IVD during right rotation?

Answer 34

Left facets compress

Right facets open

IVD 50% annulus fibres are lax 50% are taught

Question 35

Do not get much rotation in the lumbar spine because of …….

Answer 35

Do not get much rotation in the lumbar spine because of the orientation of the facets

Question 36

What limits t-spine rotation?

Answer 36

The ribs except in the very low t-spine

In 9, 10, 11 and 12 the ribs do not attach to the transverse process

So that where the majority of your rotation in your thoracic spine should occur is in the lower t-spine