Spine check off Lumbar Flashcards
what structure is responsible for the audible pops when hear during manipulations of the spine?
the facet joints
what are the 3 zones of the lumbar spine in the vertical sagittal plane?
vertebral body
pedicles, neural foramen
posterior arch
what structures compose the posterior arch zone of the lumbar spine?
lamina, facets, TPs, and SPs
what muscle attaches to the TPs of the lumbar vertebrae?
QL
what type of bone is the vertebral body made up of?
cortical bone on the outside and cancellous/trabecular bone on the inside
what portion of the vertebral body is more susceptible to fractures? Why?
the cortical bone because it is more rigid and less flexible as the cancellous/trabecular bone.
what is the superior portion of the vertebral body and what is its function?
the endplate. it allows nutrition for the discs to pass thru with compression.
what is inside the vertebral body that increases its load-bearing capacity?
Blood
what portion of the vertebrae do the nerves exit between?
pedicles
which way do the superior facet joint surfaces face? what about the inferior surfaces facet joints?
posterior and anterior.
which spinal nerves innervate the L4-L5 facet joint?
L3, L4, L5
which motion of the spine increase the compressive load on the facet joints?
extension
If a pt has degenerative disc problems, which position of the spine will result in decrease of pain? Why?
extension because it takes some of the load off the discs and puts it on the facet joints
explain what pathology forced extension can cause and why
forced extension results in the facet joints impacting the lamina and causes a pars fx
what motion is most conducive for people with spinal stenosis and why?
Flexion because it open up the intervertebral foramen
which ligament is being pulled taught during flexion? how bout extension?
supra spinous ligament. Anterior longitudinal ligament
rate the positions in order of least amount of pressure on the disc to the most:
bending over, deadlifting, sitting neutral, sitting slumped, side lying, lying flat, sitting slumped over while holding a load
lying flat
side lying
standing neutral
sitting
standing with slight bend
sitting slumped
deadlifting
sitting slumped w/ load
explain what facet tropism is
the facet joints are supposed to be symmetrical on both sides. Tropism just means that one side of the vertebra has an abnormal angle or shape of the facet surface.
for the lumbar spine, what is the best test to determine the source of pain?
injections
sensitivity vs specificity. which helps with screening pts and which helps with dx
sensitivity for screening
specificity for dx
in general terms, explain the facet orientation throughout the 3 regions of the spine
cervical: horizontal, slight angle. Slightly facing medially
thoracic: closer to vertical. slightly facing laterally
Lumbar: vertical and facing medial
explain the make up of the pelvic girdle and sacroiliac joint and the bones that comprise them
the ilium attach to the sacrum. then the ischium attach to the ilium. the pubic bones attach to the ilium and are connected to the other side’s pubic bone by the pubic symphysis
which muscles help flexion of the lumbar spine eccentrically?
multifidus and erector spinae
which level in the lumbar spine does not normally reverse its curve during flexion?
L5-S1
