Exam #3 - Lumbar Spine Flashcards
(60 cards)
1
Q
The vertebral column consits of how many vertebral bony segments?
A
33
2
Q
Normal Curvatures
- Define the ____ position of different regions
- Considered ____
A
- Define the neutral position of different regions
- Considered dynamic
3
Q
Cervical & lumbar curves develope with ____ maturation & assuming a more ____ posture
A
Cervical & lumbar curves develope with motor maturation & assuming a more upright posture
4
Q
Anatomical factors influencing the curves of the spine (4)
A
- Wedge-shaped intervertebral discs or vertebral bodies
- Spatial orientation of apophyseal joints
- Tension in ligaments
- Degree of natural muscle stiffness
5
Q
Line of gravity (ideal posture)
- Passes near the ____ ____
- Anterior to the 2nd ____ ____
- Posterior to the ____
- Anterior to the ____
- Anterior to the ____
A
- Passes near the mastoid process
- Anterior to the 2nd sacral vertebra
- Posterior to the hip
- Anterior to the knee
- Anterior to the ankle
6
Q
The line of gravity (ideal posture) promotes ____ shape of spinal curves
A
promotes optimal shape of spinal curves
7
Q
These factors affect what?
- Fat deposition
- Specific shapes of regional spinal curvatures
- Static posture of the head & limbs
- Muscle strength
- Connective tissue extensibility
- Position & magnitude of loads supported by the body
A
Spatial Relationships of vertebrae
8
Q
The lumbar vertebrae increases in size from ____ to ____ in order to accomidate progressively ____ loads
A
The lumbar vertebrae increases in size from L1 to L5 in order to accomindate progressively increasing loads
9
Q
Lateral recess is located medial to the
A
Intervertebral foramen
10
Q
What structures makeup the neural arch?
A
- 2 pedicles
- 2 laminae
- 2 superior articular processes
- 2 inferior articular processes
- 2 transverse processes
- 1 spinous process
11
Q
Three functional components of the Intervertebral Junctions
A
- Transverse & spinous processes
- Apophyseal joints
- Interbody joint
12
Q
Function of Interbody Joints
- Transmit forces from ____ & ____ to cranial
- Promotes ____ & ____ throughout the vertebral column
A
- Transmits forces from cranial & caudal to cranial
- Promotes stabilization & mobility throughout the vertebral column
13
Q
Interbody Joints
- 23 interbody joints
- From ____ to ____
- Classified as a ____
- Consists of an intervertebral disc, vertebral endplate & adjacent vertebral bodies
A
- 23 interbody joints
- From C2-3 to L5-S1
- Classified as a cartilaginous
- Consists of an intervertebral disc, vertebral endplate & adjacent vertebral bodies
14
Q
The state of leaning, resting or reclining
A
recumbency
15
Q
Is the IV disc taller or shorter in the morning?
A
Taller
16
Q
The combined heights of the intervertebral disc accounts for ~____ - ____% of the total length of the spinal column
A
~20-33%
17
Q
- Diurnal (daily) changes occur within the disc
- Sustained compression removes fluid from disc (dehydrates)
- Unloading the disc (recumbency) results in imbition of fluid
- 2cm taller in the morning
A
Intervertebral Discs
18
Q
- Pulplike gel located in the mid-to-posterior part of the disc
- 70-90% water
- 15-20% type II collagen
- Thickened into gel-like consistency via proteoglycans
A
Nucleus Pulposus
19
Q
Function of Nucleus Pulposus
- Allows the disc to act as a modified ____ ____
A
Hydraulic shock
20
Q
- Encases the nucleus pulposus
- Type 1 & Type 2 collagen make up 50-60% of the dry weight
- Elastic protein
A
Annulus Fibrosus of intervertebral disc
21
Q
Function of Annulus Fibrosus
- Constrain the nuclear material during ____ loading thereby promoting an ____ hydrostatic pressure
A
Constrain the nuclear material during compressive loading thereby promoting an increased hydrostatic pressure
22
Q
Function of End Plate
- Adhere the discs to the vertebral bodies & promote ____ of nutrients to the intervertebral disc
A
Adhere the discs to the vertebral bodies & promote diffusion of nutrients to the intervertebral disc
23
Q
Intervertebral Disc: End Plate
- Thin cartilaginous caps that cover most the ____ & ____ surfaces of the vertebral bodies
- Disc surface is ____
- Vertebral surface is ____ cartilage (weak link)
A
- Thin cartilaginous caps that cover most the superior & inferior surfaces of the vertebral bodies
- Disc surface is fibrocartilage
- Vertebral surface is calcified cartilage (weak link)
24
Q
Intervertebral Disc: Axial Loading
When a load is applied vertically
* Nuclear pressure ____
* The nucleus ____ & ____ the compressive forces
A
- Nuclear pressure rises
- The nucleus absorbs & transmits the compressive forces
25
During axial loading the nucleus absorbs & transmits the compressive forces to...
Vertebral end plates & annulus fibrosus
26
# Axial Loading
Peripheral pressure ____ the tension on the collagen fibers, which resis it until a ____ is reached
Peripheral pressure **increases** the tension on the collagen fibers, which resis it until a **balance** is reached
27
# Axial Loading
The point when radial pressure is matched by the collagen tension
* Pressure is transfered from one end plate to another
* Nucleus pulposus braces the annulus fibrous preventing buckling under sustained loads
Peripheral pressure of the intervertebral disc is balanced
28
The nucleus pulposus is ____ but relatively incompressible
Deformable
29
The **extent & magnitude of compression** of the intervertebral disc depends on what 3 components
1. Amount of applied compressive force
2. Disc height
3. Cross-sectional area of the disc
30
Primary factors that affect intervertebral disc height variations
Related to intrinsic individual factors such as (5)
1. body height
2. gender
3. age
4. disc level
5. geographic region
31
Secondary factors that affect intervertebral disc height variations
Associated with extrinsic factors such as (3)
1. degeneration
2. abnormality
3. clinical management
32
# Intradiscal Pressure Studies
Disc pressures are large when holding a load in
front of the body especially when bending forward
33
# Intradiscal Pressure Studies
Sitting in a forward-slouched position proceduces ____ disc pressure than sitting erect
greater disc pressure
34
# Intradiscal Pressure Studies
Lifting a load with knee flexed places ____ pressure on the lumbar disc than does lifting a load with the knees straight
less pressure
35
# Intervertebral Disc: Torsion
Segmental rotation of 3° or greater could
Promote injury
36
# Intervertebral Disc: Torsion
What increases the potential for a **lateral shear on the annulus & tension at the contralateral ZAJ**
The superior vertebrae pivot backwards on impacted joint causing vertebrae to swing laterally & backward
37
Intervertebral Disc: Torsion potential results
1. Compression fx of ____ ____
2. Subchondral fx
3. Fragmentation of the articular surface & ____
4. Avulsion of the ____ joint capsule
5. Pars interarticularis fx
Compression fx of the **contralateral lamina**
Fragmentation of the articular surface & **tearing**
38
* 24 pairs throughout the spine
* Formed between opposing articular facet surfaces
* Planar joint
Apophyseal joints
39
**Apophyseal Joint Function:** Permit certain movements & block other movements
* Horizontal facets promote ____ ____
* Vertical facets ____ axial rotation
* Horizontal facets promote **axial rotation**
* Vertical facets **block** axial rotation
40
L1 to L4 region forms what function
Thoracolumbar junction
41
L5 to S1 region forms what function
Lumbosacral junction
42
* Axial rotation between L1 and L2
* Move **closer** to its partner facet
* Caused by **compression force**
approximation of joint surfaces
43
* Therapeutic traction as a way to decompress
* Move **away** from partner facet
* Caused by **distraction forces**
Seperation (gapping) between joint surfaces
44
* Flexion-extension of the mind to lower cervical spine
* **Translates** linear or curvilinear direction
* Caused by **forced directed tangential** to the joint surfaces
Sliding (gliding) between joint surfaces
45
# Lumbopelvic Rhythm
Pelvis & spine rotate in **same** direction
Ipsidirectional Lumbopelvic Rhythm
46
# Lumbopelvic Rhythm
Pelvis & spine rotate in **opposite** directions
Contradirectional Lumbopelvic Rhythm
47
# Lumbopelvic Rhythm
Three different lumbopelvic rhythms used to...
flex the trunk forward & toward the floor with knees held straight
48
# Lumbopelvic Rhythm
40° flexion of lumbar spine & 70° of hip flexion
Normal lumbopelvic rhythm
49
# Lumbopelvic Rhythm
Limited hip flexion =
Greater flexion of the lumbar & thoracic spine
50
# Lumbopelvic Rhythm
Limited lumbar mobility =
Greater flexion of the hip joints
51
* **Flexes** lumbar spine
* **Decreases** lordosis
* Shifts nucleus pulposus **posteriorly**
* **Increases** the diameter of the intervertebral foramen
Posterior pelvic tilt
52
* **Extends** the lumbar spine
* **Increases** lordosis
* Shifts the nucleus pulposus **anteriorly**
* **Reduces** the diameter of the intervertebral foramen
Anterior Pelvic Tilt
53
Sacroiliac Joint is classified as what type of joint?
Modified synarthrodial joint
54
* Provides stress relief within the pelvic ring
* Provide a stable means of load transfer bw the axial skeleton & lower limbs
Function of Sacroiliac joint
55
* Provides stress relief within the pelvic ring
* Provide a stable means of load transfer bw the axial skeleton & lower limbs
Function of Sacroiliac joint
56
Relative **anterior tilt** of the base of sacrum relative to ilium
Anterior sacral-on-iliac rotation **+** Posterior iliac-on-sacral rotation
Nutation (nod) of the SIJ
57
Relative **posterior tilt** of the base of sacrum relative to ilium
Posterior sacral-on-iliac rotation **+** Anterior-on-sacral rotation
Counternutation
58
Iliac surface is made up of what?
Fibrocartilage
59
Sacral surface is made up of what?
Hyaline cartilage (3-5x thicker)
60
* Self-locking mechanism
* "Step-wise" creep deformation
SIJ bony MACROscopic state
