Spinal Lecture 5 Flashcards
what do the vertebrae do to accommodate forward flexion
the vertebrae rotate anteriorly (anterior sagittal rotation) and translate forward (anterior sagittal translation)
during forward flexion the __ of the upper vertebrae can not move and thefore the upper surface of the vertebral bodies lean ___
inferior articular facet of the upper vertebrae can not move and therfore the upper surface of the vertebral bodies lean downwards
what limits forward flexion
IVD, facet joint capsule, supraspinous ligament, interspinous ligament, ligamentum flavum and posterior longitudinal ligament
what spinal section has the greatest amount of forward flexion
L5/S1
during extension what movement do the vertebrae undergoe
posterior sagittal rotation and slight posterior translation
during extension __ move downward and impact against the ___ of the vertebrae below so that there is a bone-on-bone end feel
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
what limits extension of the spine
anterior fibres of the annulus fibrosus, anterior longitudinal ligament and a bit of the anterior part of the IVD
what spinal level does most extension occur at
l5-s1 but only 5-6 degrees
what happens to the body of the vertebrae and disc during side bending
body of the vertebrae tilts and the nucleus of the disc is displaced to the opposite side
with side bending where does the least/most amount of movement occur
least - at l5-s1 most - at l3/l4
what structures limit side bending of the spine
lumbrosacral fascia, capsular ligaments of facet joints, iliolumbar ligament and intertransverse ligament
T/F the spine was not built for rotation
TRUE
what is the max degrees of rotation at each spinal segment
3 degrees
which spinal segment has the least amount of rotation
L5
what structures limit spinal rotation
facet joints limit rotation first, then the disc, supraspinous ligament and interspinous ligament
what happens with the vertebrae, posterior facets and annulus of the disc during rotation
vertebrae tilt forward slightly, opening the posterior facets and stretching the posterior lateral annulus of the disc
what happens to the right facet during right rotation
with right rotation the right facet opens and the left facet closes and vice versa
if there is pain on the same side as rotation there is a ___ problem
if there is pain on the same side as rotation there is a CAPSULAR problem
if pain is on the opposite side as rotation there is an ___ problem
INTRA-ARTICULAR problem
What is the physiological movement with forward flexion and what is the accessory movement(s)?
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
What things are restricted, pulled tight and compressed at end-range of motion for forward flexion?
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
Forward rotation of the pelvis is limited by the ____ ligament and ____.
Forward rotation of the pelvis is limited by the sacrotuberous ligament and hamstrings
Posterior pelvic rotation is limited by tension in the ____ ligaments and the ____.
Posterior pelvic rotation is limited by tension in the iliolumbar ligaments and the hip flexors
What limits extension?
Anterior longitudinal ligament
Anterior fibres of annulus fibrosis
Zygoapopheseal joint – bony block
SP bony block
Psoas
Iliofemoral ligament
Whats relaxed in extension?
Posterior longitudinal
Supra, inter, flavum
What is compressed in extension?
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
What things are restricted, pulled tight and compressed at end-range of motion for this movement? – SIDE BENDING ON RIGHT SIDE
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
Orientation of facets in l-spine are facing largely lateral-medial which would limit _____.
Side bending
Ribs prevent side bending in t-spine despite the fact the orientation of the facets are ____.
anterior / posterior
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 ____.
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
What happens to the facets and IVD during right rotation?
Left facets compress
Right facets open
IVD 50% annulus fibres are lax 50% are taught
Do not get much rotation in the lumbar spine because of …….
Do not get much rotation in the lumbar spine because of the orientation of the facets
What limits t-spine rotation?
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
