the lumbar spine - week 3 Flashcards

1
Q

What 3 distinct components does the intervertebral disc consist of?

A

a central nucleus pulposus
a peripheral annulus fibrosus
two vertebral endplates

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2
Q

What are the 6 main ligaments within the spine?

A

anterior longitudinal ligament
posterior longitudinal ligament
ligamentum flavum
supraspinous ligament
interspinous ligament
intertransverse ligament

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3
Q

Which ligaments are long ligaments that run the length of the vertebral column, covering the vertebral bodies and intervertebral discs?

A

Anterior and posterior longitudinal ligaments

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4
Q

What does the anterior longitudinal ligament limit?

A

extension

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5
Q

What does the posterior longitudinal ligament limit?

A

flexion

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6
Q

Describe ligamentum flavum

A

It is a short but thick ligament that connects the laminae of adjacent vertebrae from C2 to S1

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7
Q

What is ligamentum flavum like in the neck region?

A

thin but broad and long

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8
Q

Where is ligamentum flavum thickest?

A

lumbar region

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9
Q

What does ligamentum flavum limit?

A

flexion

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10
Q

Where does the supraspinous ligament originate?

A

it originates from C7 vertebra

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11
Q

Where does the supraspinous ligament terminate?

A

sacrum

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12
Q

What does the supraspinous ligament limit?

A

flexion

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13
Q

What does the interspinous ligament fibres connect to?

A

Anteriorly its fibres connect with ligamentum flavum, whilst posteriorly its fibres connect with the supraspinous ligament

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14
Q

What are the interspinous ligaments like in the thoracic region?

A

narrow and elongated

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15
Q

What are the interspinous ligaments like in the lumbar region?

A

broader, thicker and quadrilateral in form

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16
Q

What are interspinous ligaments like in the neck?

A

only slightly developed
They are often considered part of the nuchal ligament

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17
Q

What do the interspinous ligaments limit?

A

flexion

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18
Q

Where are the intertransverse ligaments?

A

They are placed between the transverse processes of the spine

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19
Q

What are the intertransverse ligaments like in the cervical region?

A

They consist of a few irregular, scattered fibres that are often replaced by muscles

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20
Q

What are intertransverse ligaments like in the thoracic region?

A

They are rounded cords intimately connected with the deep muscles of the back

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21
Q

What are the intertransverse ligaments like in the lumbar region?

A

they are thin and membranous

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22
Q

What do the intertransverse muscles often blend with?

A

Intertransverse muscles

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23
Q

What do the intertransverse muscles limit?

A

limit lateral flexion of the spine

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24
Q

What movements occur at the lumbar spine?

A

flexion
extension
rotation
lateral flexion

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25
Q

In which area of the lumbar spine is their more flexion?

A

in lower segments L4/5, L5/S1

26
Q

What is the approximate ROM for flexion in the lumbar spine?

A

50-60 degrees

27
Q

What is the approximate ROM for extension in the lumbar spine?

A

30 degrees

28
Q

What is the approximate ROM of side flexion in the lumbar spine?

A

25 degrees

29
Q

What amount of rotation is available at each segmental level of the lumbar spine?

A

1 degree

30
Q

What is rotation limited by in the lumbar spine?

A

orientation of the facet joints

31
Q

Describe the position of the posterior layer of the thoracolumbar fascia

A

superficial to erector spinae and attached to spinous processes

32
Q

Describe the position of the middle layer of the thoracolumbar fascia

A

between erector spinae and quadratus lumborum, attached to transverse tips

33
Q

Describe the position of the anterior layer of the thoracolumbar fascia

A

deep to quadratus lumborum, attached to anterior of transverse process

34
Q

Where does the external oblique originate?

A

muscular slips from the outer surfaces of the lower eight ribs

35
Q

Where does the external oblique insert?

A

lateral lip of the iliac crest
aponeurosis ending in midline raphe (Linea alba)

36
Q

What are the actions of the external oblique?

A

compress abdominal contents
both muscles flex trunk
each muscle bends trunk to same side, turning anterior part of abdomen to opposite side

37
Q

What is the nerve supply of the external oblique?

A

anterior rami of lower six thoracic spinal nerves

38
Q

What are the origins of the internal oblique?

A

thoracolumbar fascia
iliac crest between origins of external oblique and transversus abdominis
lateral two thirds of inguinal ligament

39
Q

What are the insertions of the internal oblique?

A

inferior border of the lower three or four ribs
aponeurosis ending in Linea alba
pubic crest and pectineal line

40
Q

What are the actions of the internal oblique?

A

compress abdominal contents
both muscles flex trunk
each muscle bends trunk and turns anterior part of abdomen to same side

41
Q

What is the nerve supply of the internal oblique?

A

anterior rami of lower six thoracic spinal nerves (T7 to T12) and L1

42
Q

Where is the internal oblique in comparison to the external oblique?

A

lies slightly deeper to external oblique

43
Q

Where does the transverse abdominus originate?

A

thoracolumbar fascia
medial lip of iliac crest
lateral one third of inguinal ligament; costal cartilages lower six ribs

44
Q

Where does the transverse abdominus insert?

A

aponeurosis ending in linea alba
pubic crest and pectineal line

45
Q

What is the action of the transverse abdominus?

A

compress abdominal contents

46
Q

What is the nerve supply of the transverse abdominus?

A

anterior rami of lower six thoracic spinal nerves (T7 to T 12) and L1

47
Q

What are the origins of rectus abdominus?

A

pubic crest
pubic tubercle
pubic symphysis

48
Q

What are the insertions of rectus abdominus?

A

costal cartilages of ribs 5 to 7
xiphoid process

49
Q

What are the actions of rectus abdominus?

A

compress abdominal contents
flex vertebral column
tense abdominal wall

50
Q

What is the nerve supply of rectus abdominus?

A

anterior rami mainly of the lower six thoracic spinal nerves (T7 to T12)

51
Q

What are the functions of the abdominals?

A

trunk movement
sitting up from lying, getting out of bed
protection of the abdominal viscera
spinal stabilisation
abdominal pressure for:
-forced expiration
-micturition
-defecation
-parturition
-vomiting

52
Q

What is the origin of quadratus lumborum?

A

posterior border of iliac crest

53
Q

What are the insertions for quadratus lumborum?

A

inferior border of 12th rib and L1-L5

54
Q

What are the actions of Quadratus Lumborum?

A

muscle of inspiration
ipsilateral side flexion
lumbar extension (both acting)

55
Q

What is the nerve supply for quadratus lumborum?

A

ventral rami T12-L4

56
Q

What is the name of the largest group of intrinsic back muscles?

A

erector spinae

57
Q

What is the nerve supply of erector spinae?

A

dorsal rami of adjacent thoracolumbar nerves

58
Q

Where does semispinalis originate?

A

Transverse processes of T6 to T10

59
Q

Where does semispinalis insert?

A

spinous processes of upper four thoracic and lower two cervical vertebrae

60
Q

Where does multifidus originate?

A

sacrum
origin of erector spinae
posterior superior iliac spine
mamillary processes of lumbar vertebrae
transverse processes of thoracic vertebrae
articular processes of lower four cervical vertebrae

61
Q

Where does multifidus insert?

A

base of spinous processes of all vertebrae from L5 to C2