Thoracolumbar Spine/SIJ Osteology and Arthrology

Question 1

What are the 3 divisions of vertebrae:

Answer 1

vertebral body
posterior elements
pedicles

Question 2

Function/role of vertebral body:

Answer 2

anterior, primary weight-bearing component

Question 3

What makes up the posterior elements of the vertebrae:

Answer 3

transverse/spinous process, laminae, articular process

Question 4

Function/role of pedicles:

Answer 4

the bridge that connects body posterior elements; thick and strong, transfers mm. forces applied to posterior elements for dispersion across body/disc

Question 5

What is the purpose of spinal curves:

Answer 5

provides strength and resilience (spring-like) but is vulnerable to shear forces at transitions

Question 6

What is the function/role of spinal ligamentous:

Answer 6

limits motions help maintain natural curves, protect the spinal cord/nerve roots by stabilizing the spine

Question 7

Ligamentum Flavum location and function:

Answer 7

ant. lamina to pos. lamina
end ROM flexion 80% elastin, pos. to spinal cord

Question 8

Interspinous ligament location and function:

Answer 8

between the adjacent SPs; blends with LF
more elastin; more superficial, more collagen, and blend w/SS lig, directions varies-L/S

Question 9

Superspinous Ligament location and function:

Answer 9

between tips of SPs
resists separation -flexion, less developed in L/S

Question 10

Intertranverse Ligamnet location and function:

Answer 10

thin taut in contralateral SB
Between TPS

Question 11

Ant. longitudinal ligament (ALL) location and function:

Answer 11

long, strong strap-like, occiput to the sacrum,
fibers into and reinforce ant. disc

Question 12

Pos. longitudinal ligament (PLL) location and function:

Answer 12

posterior surfaces of vertebral bodies, C2-sacrum (in canal),
blends w/ and reinforces posterior discs

Question 13

Capsular ligaments (facets): location and function:

Answer 13

the entire rim of facets, connects and stabilize
reinforced by adjacent muscles (multifidus)

Question 14

What is the neutral zone?

Answer 14

the amount of intervertebral movement that occurs with the least passive resistance from the surrounding tissues (minimal stiffness zone)

Question 15

If the neutral zone grows larger as disc degeneration or ligamentous injury occurs what happens:

Answer 15

there is more laxity or instability in the spine to control and more demands are placed on the stabilizing systems

Question 16

T or F: the larger the neutral zone the more slide, glide, and rotation between vertebrae.

Answer 16

True

Question 17

This system is thought to send feedback to the neural subsystem about joint positions and challenges at the passive level

-what structures are involved?

Answer 17

passive system
-bony structures, ligaments, joint capsules discs and passive portion of musculotendinous units

Question 18

_______ system is composed of the muscles and tendons and is the subject of the core exercises

Answer 18

active system

Question 19

__________ system receives and transmits information from and to the other two systems to manage spinal stability

Answer 19

neural system

Question 20

What is the SPs alignment in relation to the vertebral bodies in the t-spine?

Answer 20

SPs are pointing downward

Question 21

What is the orientation of the articular facts in the t-spine?

Answer 21

-sup/inf. oriented vertically
-sup facing posterior/inf.
-anterior; aligned close to the frontal plane

Question 22

What is the orientation of the articular facets in the L/S

Answer 22

articular facets oriented vertically
–sup; concave, face medial to med-pos.
–inf; articular facet convex, lateral to ant. lateral

Question 23

What are the arthokinematics of flexion in the t-spine and lumbar spine?

Answer 23

facets slide sup. and slightly ant.

flexion - limited by connective tissues located posterior to the vertebral bodies

Question 24

What are the arthokinematics of extension in the t-spine and L-spine?

Answer 24

facets slide inf. and slightly post.

15-20º of extension limited by tension in ALL and lamina of adjacent vertebrae

Question 25

Why is there more flexion/extension in the lower T/S in relation to the upper T/S:

Answer 25

free floating ribs and facets more sagittal

Question 26

What are the arthokinematics of lateral flexion (SB) in the thoracic and lumbar spine?

-what structure prohibits greater SB?

Answer 26

contralateral facets slide sup. ant. and ipsilateral facets slide inf. pos.

-ribs

Question 27

What are the arthokinematics of rotation in the thoracic and lumbar spine?

Answer 27

contralateral facets slide sup. ant. and ipsilateral facets slide inf. pos.

Question 28

Ant. pelvic tilt with lumbar extensions leads to excessive ________ and tight _______ muscles

-migration fo NP?

-nutation or counternutation of the sacrum?

Answer 28

lordosis; hip flexors and back extensors
-NP migrates ant.
-in extension of the vertebral column sacrum moves forward: nutation

Question 29

The annulus fibrous has _______ concentric rings of ________ fibers.
-Prevents?
-Entraps?
-Outer layer contain?

Answer 29

15-25; collagen
-prevents distraction/shear/torsion
-entraps encase liquid-based nucleus
-outer layer contains disc-only sensory nerves, binds to ALL, PLL ( outer more collagen inner more water)

Question 30

How does the AF get nutrition?

Answer 30

through normal compressive forces that produce evenly distributed loads. - GAGs

Question 31

Can the vertebral endplate calcify/crack? If so what happens?

Answer 31

Yes, which can lead to reduced permeability and PGs
-less water
-less ability to absorb and transfer loads
-not just with aging but with excessive/abnormal loads

Question 32

IVD as a hydrostatic pressure distributor:
Where is most of the load during standing?
Compressive loads push endplate ______ to _______

Answer 32

80% carried on the intervertebral joint at L/S
20% posterior elements
inward;NP

Question 33

What is viscoelasticity?

Answer 33

resists a fast/strongly applied load;
less resistance to slow or light compression
**(flexible low loads/rigid higher loads)

Question 34

What is the migration of the disc in flx/ext?

Answer 34

flx- posterior mirgration
ext- ant. migration

Question 35

What is the difference between diurnal fluctuations: morning and evening?

Answer 35

morning: supine low pressure- attract water, swell slightly when sleeping
—1% height change–
evening: PGs reduces-water retaining reduces, less hydrostatic pressure

Question 36

The function of the thoracic spine during inspiration/expiration:

Answer 36

inspiration=extension
expiration=flexion

Question 37

What is contracting/tight in post. pelvic tilt:

Answer 37

abdominals and hip extensors

Question 38

What are the structures resisting shear at L5-S1

Answer 38

disc, capsule of facets, ALL
-iliolumbar ligament and QL is a firm anchor between L5 and ilium/sacrum

Question 39

What is centralization and peripheralization?

Answer 39

centralization: full lumbar ext. reduces pressure and reduces contact pressure between discs and neural tissues; abolination of distal to promixal P!

-perpherialziation opposite

Question 40

What are the three phases of lumbopelvic rhythm:
-what happens if the hamstrings are tight?

Answer 40

1. lumbar flexion
2. lumbar flexion (45º) + hip flexion (60º)
3. hip flexion

Limited hip flexion and thoracic and/or lumbar spine have to compensate.