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S6- MSK 2 > Week 1- iRA/tRA: L-Spine Anatomy and Biomechanics Review > Flashcards

Week 1- iRA/tRA: L-Spine Anatomy and Biomechanics Review Flashcards

1
Q

What are the main osseous structures of the typical lumbar vertebrae?

A
  • Body
  • Pedicles
  • Transverse Processes
  • Spinous Processes
  • Lamina
  • Foramen (Spinal and Intervertebral)
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2
Q

What is the “kidney shaped” weight bearing component of the lumbar vertebrae?

A

-Body

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3
Q
  • The body of the lumbar vertebrae has a shell of _________ bone and inner __________ bone.
  • The Ring __________ is a ring on the periphery of caudal and cranial surfaces of the body.
A
  • cortical, cancellous

- Apophysis

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4
Q

The ___________ are short with thick walls and help to transmit force from posterior components to vertebral bodies.

A

-Pedicles

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5
Q
  • The _________ Processes project posteriolaterally and have mamillary processes on superior articular process.
  • The _________ Processes are nearly horizontal.
A
  • Transverse Processes

- Spinous Processes

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6
Q

What are the (2) functions of the lamina?

A
  1. ) Protect neural structures.

2. ) Transmit forces from articular and spinous processes.

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7
Q
  • The _____________ is located between superior and inferior articular processes and transmits forces from horizontal pedicle to vertically oriented lamina.
  • It is subject to what?
A
  • Pars Interarticularis

- Fracture

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8
Q

What are the (2) foramen of the lumbar vertebrae?

A
  • Spinal

- Intervertebral

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9
Q
  • The lumbar spinal foramen is ________ than thoracic and ________ than cervical.
  • L1 contains _______ _________.
  • L2-L5 contains _______ ________ and spinal meninges.
A
  • larger than thoracic, smaller than cervical
  • conus medullaris
  • Cauda Equina
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10
Q

The intervertebral foramen superior notches are ________, and inferior are ________.

A

-superior notches are shallow, inferior notches are deep

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11
Q

What are the (6) ligaments of the lumbar spine?

A
  • PLL
  • ALL
  • Interspinous Ligaments
  • Supraspinous Ligaments
  • Ligamenta Flava
  • Iliolumbar Ligament
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12
Q
  • Which ligament blends with IV discs and spans from posterior body of C2 to sacrum?
  • Which ligament mostly attaches to margins of anterior vertebral bodies?
A
  • PLL

- ALL

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13
Q
  • The interspinous ligament attaches superior and inferior _______.
  • It is likely __________ in nature.
A
  • SP (spinous processes)

- proprioceptive

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14
Q

The supraspinous ligament attaches to tips of ________ and is less common in the ______ lumbar region.

A
  • SP (spinous processes)

- lower lumbar region

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15
Q
  • The ligamenta flava attaches adjacent _______.

- What motion does it check?

A
  • Laminae

- checks flexion

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16
Q
  • The iliolumbar ligament spans from the ______ of L5 to anteriomedial surface of ________.
  • It prevents _______ slipping of L5 on sacrum.
  • What motions does it resist?
A
  • TP (transverse process) of L5 to anteriomedial surface of ilium.
  • anterior
  • rotation, flexion, and lateral flexion
17
Q

What group of muscles are important for stabilization of the curvature?

A
  • Longissimus Thoracic and Lumborum

- Iliocostalis Thoracic and Lumborum

18
Q
  • What is the largest, most medial lumbar muscle that stabilizes against shear during rotation and eccentrically controls flexion of vertebrae inter-segmentally when oblique abdominal muscles rotate the spine?
  • What is a second important function of this muscle in regards to the z-joints?
A
  • Multifidus
  • Inserts onto z-joint capsules to pull out of way during extension or motions where the joints are closing down so it prevents impingement on structures.
19
Q

What are the 3 important abdominal muscles?

A
  • External Oblique
  • Internal Oblique
  • Transverse Abdominis
20
Q

External Oblique:

  • Originates lateral ribs __-__
  • Attaches to inguinal ligament, linea alba, ASIS, iliac crest, and pubic tubercle.
  • Bilateral activation = ________
  • Unilateral activation = ________
A
  • lateral ribs 5-12
  • bilateral activation = flexion, posterior rotation of pelvis
  • unilateral activation = lateral flexion
21
Q

Internal Oblique:

  • Attaches to inguinal ligament, thoracolumbar fascia, iliac crest, pubic crest, TrA, costal cartilage, and ribs __-__.
  • Assists with _______ control during static and dynamic activities.
  • Bilateral activation = _________
  • Unilateral activation = __________
A
  • ribs 7-9
  • postural control
  • bilateral activation = flexion, respiration
  • unilateral activation = rotation
22
Q

Transverse Abdominis (TrA):

  • Attaches to inguinal ligament (lateral third), 2/3 of iliac crest, thoracolumbar fascia, lower (6) costal cartilages (along with diaphragm).
  • ________ and _________ fibers run transversely around the trunk.
  • ________ fibers insert on pubic crest with internal obliques.
  • Role as lumbar and SIJ ___________.
  • Anticipatory activation prior to movement/perturbation.
A
  • Upper and middle
  • Lower
  • stabilizer
23
Q

Quadratus Lumborum:

  • Location = ______ to lumbar vertebrae
  • Posterior, Middle, and Anterior layers
  • Origin = ___________ and _____ of spine
  • Insertion = _____ rib and spine
  • Innervated = ventral rami ___-___
A
  • lateral
  • iliac crest and TP
  • 12th
  • T12-L2
24
Q

Psoas Major:

  • Location = _________ to quadratus, running oblique course anteriolaterally following the pelvic rim
  • Origin = _______ of lumbar vertebrae, ___-___ bodies and IV discs
  • Insertion = tip of the _____________
  • Innervated by ventral rami ___-___
A
  • anterior
  • TP of lumbar vertebrae, T12-L5 bodies
  • lesser trochanter
  • L1-L2
25
Q

What muscle acts as a lumbar stabilizer and may exert up to 100kg of weight on L5-S1 disc during sit ups?

A

-Psoas Major

26
Q
  • The spinal cord terminates at what level?

- The ___________ includes lumbar, sacral, and coccygeal nerve roots that run within the vertebral canal.

A
  • L1/L2

- Cauda Equina

27
Q

The IV discs are composed of what 3 structures?

A
  • Nucleus Pulposus
  • Annulus Fibrosis
  • Vertebral Endplates
28
Q

Is there a clear boundary between then nucleus and annulus fibrosis?

A

-No

29
Q

The nucleus is a semifluid, mucoid material that can be ________ but not _________. What does this mean?

A
  • Can be deformed, but not compressed.

- Transmits pressure in all directions if deformed.

30
Q

Annulus:

  • Weight = __-__% water
  • Dry weight 50-60% _______ (Type I predominantly), 20% proteoglycans, 10% elastic fibers
  • ___-___ lamellae arranged in concentric rings
  • In which direction is the annulus fibrosis thinner?
  • Within lamellae, collagen fibers are parallel and __-__ degrees from vertical.
A
  • 50-70%
  • collagen
  • 10-20
  • posteriorly
  • 60-70 degrees
31
Q

Vertebral Endplate:

  • ________ cartilage towards vertebral body, _______ cartilage towards nucleus.
  • Covers sup/inf vertebral body and nucleus, does not cover entire ________.
  • Encircled by ___________.
  • _________ attached to vertebral bodies and ________ attached to IV disc.
A
  • Hyaline cartilage, fibrocartilage
  • annulus
  • ring apophysis
  • Weakly, Strongly
32
Q

What are the (3) main functions of the IV discs?

A
  • Allow movement between vertebral bodies.
  • Transmit loads between adjacent vertebral bodies.
  • Absorbs and stores energy.
33
Q
  • Superior z-joints face ____________, inferior z-joints face ____________.
  • What is the function of the z-joints?
  • What type of joint is the z-joint?
A
  • posteriomedially, anteriolaterally
  • Guide and limit movement of the spine.
  • Synovial joint
34
Q
  • What is the leaf-like fold of synovium that encloses fat, collagen, and blood vessels?
  • It projects up to ___mm into the joint cavity.
  • What is its function?
  • Is it innervated?
A
  • Fibro-adipose meniscoid
  • 5mm
  • Transmits loads and protects articular cartilage that would otherwise be exposed during motion.
  • Highly innervated
35
Q

Lumbar Kinematics: Flexion

  • Which direction does the inferior articular process of the superior vertebrae move during flexion?
  • We have a “opening” of the joints bilaterally with _______ at end-range flexion motion.
  • At the disc we have compression _________, and stretching _________.
  • Lateral foramen _______ as we flex.
A
  • superior and anterior
  • compression
  • anteriorly, posteriorly
  • open
36
Q

Lumbar Kinematics: Extension

  • Which direction does the inferior articular process of the superior vertebrae move during extension?
  • We have a compression of the joint and it becomes _______-________.
  • At the disc we have compression __________, and stretching ___________.
  • Lateral foramen _______ as we extend.
A
  • inferior and posterior
  • weight-bearing
  • posteriorly, anteriorly
  • close
37
Q
  • At the z-joint, lateral flexion is most commonly coupled with what motion?
  • Rotation is coupled with flexion and extension variably.
A

-extension

38
Q
  • At the upper lumbar spine (L1/L2-L3/L4) we have __________ rotation and lateral flexion motions.
  • At the mid lumbar spine (L4/L5) we have __________ lateral flexion and rotation.
  • At the lower lumbar spine we have ________ lateral flexion and rotation motions.
A
  • contralateral
  • variable
  • ipsilateral

S6- MSK 2 (21 decks)

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