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OMM M1T2E3 > Lumbar Biomechanics > Flashcards

Lumbar Biomechanics Flashcards

(64 cards)

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1
Q

Describe Type I (Neutral) Fryette mechanics.

A

Sidebending and Rotation are coupled to opposite sides

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2
Q

Describe Type II (Non-neutral) Fryette mechanics.

A

Sidebending and rotation are coupled to the same sides

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3
Q

What is the exception to Fryette’s rule?

A

L5/S1 - lots of spinal anomalies here; trauma can also negate Fryette mechanics

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4
Q

In lumbar kinesiology, motion is….

A

permitted by bones and joints, restrained by ligaments, and produced/stabilized by muscles

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5
Q

What is the functional range of the lumbar spine?

A

T11-L5

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6
Q

What is the lumbar spine designed for?

A

weight bearing design

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7
Q

In what plane do the lumbar facets orient?

A

Sagittal plane

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8
Q

Lumbar superior articular facets face…

A

posteromedially

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9
Q

Lumbar inferior articular facets face…

A

anterolaterally

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10
Q

How does lumbar osteology affect movement?

A

allows good forward bending and back bending; discourages rotation and sidebending

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11
Q

Where is the most movement in the lumbar spine?

A

L4 on L5 14-21 degrees

L5 on S1 18-22 degrees

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12
Q

How much sidebending is in lumbar vertebrae?

A

10 degrees each segment

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13
Q

How much rotation is in L1-L3? L4 & L5?

A

L1-L3 - 2 degrees each segment

L4&L5 - 3-4 degrees each segment (most rotation in lumbar thoracic)

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14
Q

How do intervertebral discs receive nutrients?

A

diffusion (they are avascular)

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15
Q

Motion loss can impair nutrition leading to____

A

premature disc degeneration

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16
Q

Lumbar discs are thicker anteriorly or posteriorly?

A

anteriorly contributing to lumbar lordosis

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17
Q

What is the purpose of the fiber arrangement of the annulus?

A

checks rotary motion and screws down the disc

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18
Q

Where is the nucleus pulposus located?

A

posterior surface of disc

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19
Q

When does disc degeneration begin in men? women?

A

Men - 11-20

Women - 21-30

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20
Q

Where is the most common herniation?

A

L5/S1

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21
Q

Does trauma alone cause herniation?

A

No, must be coupled with degeneration

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22
Q

This ligament reinforces the strength of the disc posteriorly in the midline.

A

Posterior longitudinal ligament

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23
Q

Describe the impact of the narrowing and weaker posterior longitudinal ligament on discs.

A

In lumbar region causes higher likelihood of disc herniation

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24
Q

List the two types of ligaments and their purposes.

A

Check ligaments (forward backward and lateral bending, rotation); kinetic ligaments (absorb energy)

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25
What are the 4 forward bending check ligaments?
supraspinous, interspinous, posterior longitudinal, capsular ligaments
26
What feel would present with a torn supraspinous ligament?
tender, boggy
27
Name the kinetic ligament and its function.
ligamentum flavum; stores kinetic energy to assist musculature in returning spine to upright position
28
Name the sidebending check ligament
intertransverse check ligaments
29
Which ligaments are injured in the classic lumbosacral sprain and strain?
Iliolumbar ligaments (rotational check ligaments)
30
How do discs check rotation?
alternating direction of fibers in adjacent lamina of disc
31
This backbending check ligament is broad and flat and reinforces the disc anteriorly and is twice as strong as the posterior longitudinal ligament.
Anterior longitudinal ligament
32
Anterior lipping and osteophyte formation is seen when?
When traction on anterior longitudinal ligament causes bone reformation
33
This fascia is critical to the maintenance of lumbar stability.
Thoracolumbar fascia
34
What help keeps the thoracolumbar fascia taut?
Always positive pressure in abdomen
35
What can generate instability in the thoracolumbar fascia?
weakness, hernias, incisions, pregnancy
36
Which muscles are involuntary and used to stabilize?
short muscles
37
Which muscles are voluntary and movers of the spine?
long muscles
38
Which muscles respond to viscera-somatic and somato-somatic reflexes?
deep paraspinal muscles (intertransverse, interspinalis, rotator brevis and longus)
39
List the attachment, action and innervation of the intertransverse muscles.
Attachment: between lumbar t.p. Action: segmental sidebending/stabilization Innervation: posterior primary division of spinal nerves
40
List the attachment, action and innervation of the interspinalis muscles?
Attachment: T11 to S1 Action: segmental Extension/ stabilizer Innervation: posterior primary division of spinal nerves
41
List the attachment, action and innervation of rotator brevis and longus.
Brevis: tp of spinous process 1 segment above Longus: tp of spinous process 2 segments above Action: rotate to opposite side/stabilizer Innervation: posterior primary division of spinal nerve
42
What initiates flexion of the trunk?
rectus abdominus; further control by erector spinae muscles
43
Which muscles extend the spine?
Iliocostalis lumborum, longissimus thoracis, spinalis thoracis, multifidus (I love spaghettis mom)
44
When acting unilaterally what movement do the voluntary muscles create? combined with internal obliques?
sidebending; rotation
45
What other 5 muscles attach to the lumbar spine?
diaphragm, psoas major, quadratus lumborum, latissimus dorsi, serratus posterior inferior
46
Diaphragmatic overuse (asthma or COPD) will tend to create what dysfunction?
flexed dysfuntions of upper lumbar segments
47
Upper lumbar somatic dysfunction mechanically interferes with the function of ____ and results in _____?
diaphragm; shortness of breath
48
Psoas major is active in the standing or seated position?
seated
49
Prolonged sitting causes?
shorten psoas, anterior tilt of pelvis and increase lumbar lordosis
50
Which nerves are vulnerable to compression by hypertonicity of psoas major?
lumbar nerve roots which pass anteriorly between proximal attachments
51
Acute psoas spasm causes sidebending to same or opposite side of spasm?
same
52
Psoas spasm causes type 1 or type 2 Fryette mechanics?
Type 2; flexed, rotated and sidebent to the same side
53
If there is a psoas spasm with extended dysfunction of L1-L3 which gets treated first?
Treat L1-L3 extension first
54
If there is a psoas spasm with flexed dysfunction which gets treated first?
Psoas
55
Hypertonicity of the quadratus lumborum creates sidebending to the same or opposite side?
same; usually group curve
56
Problems with the latissimus dorsi usually causes pain in which region?
shoulder
57
List an accessory muscle for forced exhalation.
Serratus Posterior Inferior
58
If ribs are held in fixed inhalation, unilateral contraction of serratus posterior inferior will rotate L1-L3 (towards or away) from side of muscle contracture.
away
59
Asthma or emphysema can create flexed postures which can provoke what type of dysfunction?
Type II
60
Batson's veins are the principle route of travel for? and clogs in the IVC can cause?
infection and metastasis of pelvic cancers; headaches
61
What maneuver can you use to reproduce symptoms?
Valsalva
62
Which nerve root is most susceptible to neuropathy?
S1 due to length
63
Fibrosis of nerve roots or entrapment will cause nerves to become ____?
ischemic
64
Blood flow in vasa nervorum is reduced when a nerve is stretched ____% and blood flow ceases entirely at ____ %.
8%; 15%

OMM M1T2E3 (9 decks)

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