Week 1- iRA/tRA: L-Spine Anatomy and Biomechanics Review Flashcards
What are the main osseous structures of the typical lumbar vertebrae?
- Body
- Pedicles
- Transverse Processes
- Spinous Processes
- Lamina
- Foramen (Spinal and Intervertebral)
What is the “kidney shaped” weight bearing component of the lumbar vertebrae?
-Body
- 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.
- cortical, cancellous
- Apophysis
The ___________ are short with thick walls and help to transmit force from posterior components to vertebral bodies.
-Pedicles
- The _________ Processes project posteriolaterally and have mamillary processes on superior articular process.
- The _________ Processes are nearly horizontal.
- Transverse Processes
- Spinous Processes
What are the (2) functions of the lamina?
- ) Protect neural structures.
2. ) Transmit forces from articular and spinous processes.
- The _____________ is located between superior and inferior articular processes and transmits forces from horizontal pedicle to vertically oriented lamina.
- It is subject to what?
- Pars Interarticularis
- Fracture
What are the (2) foramen of the lumbar vertebrae?
- Spinal
- Intervertebral
- The lumbar spinal foramen is ________ than thoracic and ________ than cervical.
- L1 contains _______ _________.
- L2-L5 contains _______ ________ and spinal meninges.
- larger than thoracic, smaller than cervical
- conus medullaris
- Cauda Equina
The intervertebral foramen superior notches are ________, and inferior are ________.
-superior notches are shallow, inferior notches are deep
What are the (6) ligaments of the lumbar spine?
- PLL
- ALL
- Interspinous Ligaments
- Supraspinous Ligaments
- Ligamenta Flava
- Iliolumbar Ligament
- 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?
- PLL
- ALL
- The interspinous ligament attaches superior and inferior _______.
- It is likely __________ in nature.
- SP (spinous processes)
- proprioceptive
The supraspinous ligament attaches to tips of ________ and is less common in the ______ lumbar region.
- SP (spinous processes)
- lower lumbar region
- The ligamenta flava attaches adjacent _______.
- What motion does it check?
- Laminae
- checks flexion
- The iliolumbar ligament spans from the ______ of L5 to anteriomedial surface of ________.
- It prevents _______ slipping of L5 on sacrum.
- What motions does it resist?
- TP (transverse process) of L5 to anteriomedial surface of ilium.
- anterior
- rotation, flexion, and lateral flexion
What group of muscles are important for stabilization of the curvature?
- Longissimus Thoracic and Lumborum
- Iliocostalis Thoracic and Lumborum
- 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?
- 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.
What are the 3 important abdominal muscles?
- External Oblique
- Internal Oblique
- Transverse Abdominis
External Oblique:
- Originates lateral ribs __-__
- Attaches to inguinal ligament, linea alba, ASIS, iliac crest, and pubic tubercle.
- Bilateral activation = ________
- Unilateral activation = ________
- lateral ribs 5-12
- bilateral activation = flexion, posterior rotation of pelvis
- unilateral activation = lateral flexion
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 = __________
- ribs 7-9
- postural control
- bilateral activation = flexion, respiration
- unilateral activation = rotation
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.
- Upper and middle
- Lower
- stabilizer
Quadratus Lumborum:
- Location = ______ to lumbar vertebrae
- Posterior, Middle, and Anterior layers
- Origin = ___________ and _____ of spine
- Insertion = _____ rib and spine
- Innervated = ventral rami ___-___
- lateral
- iliac crest and TP
- 12th
- T12-L2
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 ___-___
- anterior
- TP of lumbar vertebrae, T12-L5 bodies
- lesser trochanter
- L1-L2
What muscle acts as a lumbar stabilizer and may exert up to 100kg of weight on L5-S1 disc during sit ups?
-Psoas Major
- The spinal cord terminates at what level?
- The ___________ includes lumbar, sacral, and coccygeal nerve roots that run within the vertebral canal.
- L1/L2
- Cauda Equina
The IV discs are composed of what 3 structures?
- Nucleus Pulposus
- Annulus Fibrosis
- Vertebral Endplates
Is there a clear boundary between then nucleus and annulus fibrosis?
-No
The nucleus is a semifluid, mucoid material that can be ________ but not _________. What does this mean?
- Can be deformed, but not compressed.
- Transmits pressure in all directions if deformed.
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.
- 50-70%
- collagen
- 10-20
- posteriorly
- 60-70 degrees
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.
- Hyaline cartilage, fibrocartilage
- annulus
- ring apophysis
- Weakly, Strongly
What are the (3) main functions of the IV discs?
- Allow movement between vertebral bodies.
- Transmit loads between adjacent vertebral bodies.
- Absorbs and stores energy.
- Superior z-joints face ____________, inferior z-joints face ____________.
- What is the function of the z-joints?
- What type of joint is the z-joint?
- posteriomedially, anteriolaterally
- Guide and limit movement of the spine.
- Synovial joint
- 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?
- Fibro-adipose meniscoid
- 5mm
- Transmits loads and protects articular cartilage that would otherwise be exposed during motion.
- Highly innervated
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.
- superior and anterior
- compression
- anteriorly, posteriorly
- open
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.
- inferior and posterior
- weight-bearing
- posteriorly, anteriorly
- close
- At the z-joint, lateral flexion is most commonly coupled with what motion?
- Rotation is coupled with flexion and extension variably.
-extension
- 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.
- contralateral
- variable
- ipsilateral
