Thoracic and Lumbar Spinal Mechanics Flashcards
Describe the body and SP of the thoracic vertebrae.
Body–> medium size, heart shaped, has costal facets
SP- long and slope postero-inferior
Describe the body and SP of the lumbar vertebrae.
Body–> large and kidney shaped
SP–> short broad
Rule of 3 referes to the location of the _______ in relation to the ______ in the ______ spine
Rule of 3 refers to the location of the SP in relation to the TP in the thoracic spine
Anterior longitudinal L
-limits ______
Strong, fibrous band that covers the anterolateral aspects of vertebral bodies and IV discs
-limits extension
Posterior longitudinal L
-limits ______
Narrower, weaker band that run in the vertebral canal on the posterior aspect of the vertebral bodies.
-resists hyperflexion
What prevents herniation of the nucleus pulposus?
Posterior longitudinal L.
Ligamentum flava
connects the lamina of adjacent vertebra
Intertransverse L.
connects adjoining transverse processes
What are the transversospinalis m. of the spine
- Semispinalis thoracis
- Rotator longes
- Rotatores brevis
- Multifidus
What do the rotatores muscles do?
bilateral–> extend thoracic spine
unilateral–> rotates
Multifidus m.
bilateral- extends spine
Unilateral–> flexes spine to the same side; rotates to the opposite.
semispinalis m.
Bilateral- extends thoracic and cervical spin
Unilateral- bends head, cervical and thoracic spine to SS and rotates to opposite side
Restrictions of motion in the spine
Reduce efficiency
• Impair flow of fluids
• Alter nerve function
• Create structural imbalance
Motion is always referenced to the movement of the ________________ of the vertebra
anterior/superior surface
Fryetter did what
described physiologic motion of the spine
- published in 1918
- developed 2 principles of spinal motion to the thoracic and lumbar spine
who developed the third principle and when?
CR nelson in 1948
describe SD
Cervical spine flexion
prefers flexion;
restricted extension
Lower back pain with radiation below the knee cause what three things
1. radiculopathy
2. spinal stenosis
3. cauda equina syndrome
Radiculopathy
—describe—
typically acute, pain with dermatomal distribution and neurological fx is impaired (LE weekness, diminished reflex)
Work up for radiculopathy: ____
+__________
MRI
+ Straight leg raise
Straight leg raise
+ test–> pain
indicated –>
pain from 15-30–> problems wil lumbar disk
herniation at
L4-5 cause
pain–>
numbness–>
weakness–>
pain–> SI joint, hip, lateral thigh, leg
numbness–> lateral leg, first 3 toes
weakness–> dorsiflexion of big toe and foot; hard to walk on heel
v little atrophy
herniation at
L5-S1 cause
pain–>
numbness–>
weakness–>
atrophy–>
pain–> SI joint, hip, PL thight, leg to heel
numbness–> back of calf, lateral heel, foot to toe
weakness–> Plantarflexion of foot and big toe, hard to walk on toes
atrophy–> gastrocnemius and soleus
spinal stenosis
bilateral pain in lower limbs with neurogenic claudication (cramping)
Spinal stenosis (CHRONIC)
Work up:
+ in what test
MRI
+straight leg rause
Cauda equina syndrome
work up:
Saddle anesthesia, LE weakness, urinary retention
TRAUMATIC
work up: MRI
Spina bifida occulta
NT fails to close but no hernia
Meningocele
NT fails to close and meninges protrude
Myelomenginocele
NT does not close and meninges and SC go through
Sacralization
one or both TP’s of L5 are long and articulate with the sacrum. (DJD)
Lumbarization
Lumbarization– failure of S1 to fuse with the rest of the sacrum (not common)
Spina Bifida
– defect in the closure of the lamina
Spondylysis
bony spurs
Spondylolesthesis
slipping of one vertebra on another
Spondylysis
Spondylysis- bony spurs
spondylothesis
sacralization
lumbarization
spina bifida
Transverse process go ____
SP go ____
TP–> up
SP–> down
