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Axial Anatomy > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

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1
Q

What are the 3 distinct components of the IVD?

A

A central nucleus pulposus
A peripheral annulus fibrosus
Two vertebral endplates

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2
Q

What is the nucleus pulposus?

A

Gelatinous and absorbs compression forces between vertebrae

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3
Q

What is the annulus fibrosus comprised of?

A

Outer ring of collagen surrounding a wider zone of fibrocartilage arranged in a laminar configuration

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4
Q

What movement is limited by annulus fibrosus in the IVD?

A

Rotation between vertebrae

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5
Q

What are the 6 ligaments within the spine?

A

1) Anterior longitudinal ligament
2) Posterior longitudinal ligament
3) Ligamentum flavum
4) Supraspinous ligament
5) Interspinous ligament
6) Intertransverse ligament

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6
Q

What are the anterior/posterior longitudinal ligaments?

A

Long ligaments that run down the length of the vertebral column, covering the vertebral bodies and intervertebral discs

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7
Q

What does the anterior longitudinal ligament limit?

A

Extension

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8
Q

What does the posterior longitudinal ligament limit?

A

Flexion

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9
Q

What is the ligamentum flavum?

A

A short but thick ligament that connects the laminae of adjacent vertebrae from C2 to S1

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10
Q

What is the ligamentum flavum like in the cervical region?

A

Thin but broad and long

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11
Q

What is the ligamentum flavum like in the thoracic region?

A

Thicker

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12
Q

Where is the ligamentum flavum the thickest?

A

In the lumbar region

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13
Q

What does the ligamentum flavum limit?

A

Flexion

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14
Q

What is the origin of the supraspinous ligament?

A

C7 vertebra

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15
Q

What is the insertion of the supraspinous ligament?

A

Sacrum

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16
Q

What does the supraspinous ligament limit?

A

Flexion

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17
Q

Where is the interspinous ligament?

A

Anteriorly, its fibres connect with the ligamentum flavum, whilst posteriorly its fibres connect with the supraspinous ligament

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18
Q

What are the ligaments of the interspinous ligament like?

A

Narrow and elongated in the thoracic region
Broader, thicker and quadrilateral in the lumbar region
Only slightly developed in the neck
Often considered part of the nuchal ligament in the neck

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19
Q

What does the interspinous ligament limit?

A

Flexion

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20
Q

Where are the intertransverse ligaments?

A

They are placed between the transverse processes of the spine

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21
Q

What do the intertransverse ligaments also blend with?

A

Intertransverse muscles

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22
Q

What are the ligaments like in the intertransverse ligament?

A

Cervical region - a few irregular, scattered fibres, often replaced by muscles
Thoracic region - rounded cords connected with the deep muscles of the back
Lumbar region - thin and membranous

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23
Q

What does the intertransverse ligament limit?

A

Lateral flexion of the lumbar spine

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24
Q

What are the 2 joints of the lumbar spine?

A

Facet joints
Intervertebral joints

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25
What are the movements available in the lumbar spine?
Flexion, extension, rotation and lateral flexion
26
What is the degree of movement of flexion in the lumbar spine?
50-60 degrees
27
What is the degree of movement of extension in the lumbar spine?
30 degrees
28
What is the degree of movement of side flexion in the lumbar spine?
25 degrees
29
Where does the most degree of flexion occur in the lumbar spine?
Lower segments (L4/5, L5/S1)
30
What is side flexion also coupled with?
Rotation
31
What is the range of motion of rotation in the lumbar spine?
1 degree at each segmental level with less rotation available at L5-S1 Mean rotation of 8-12 degrees in each direction
32
What is rotation limited by in the lumbar spine?
Orientation of the facet joints (wrapped)
33
Where is the posterior layer of the thoracolumbar fascia?
Superficial to erector spinae and attached to the spinous processes
34
Where is the middle layer of the thoracolumbar fascia?
Between erector spinae and quadratus lumborum, attached to transverse tips
35
Where is the anterior layer of the thoracolumbar fascia?
Deep to quadratus lumborum, attached to anterior of transverse process
36
What are the 3 layers of the anterior lateral wall?
1) External oblique 2) Internal oblique 3) Transversus Abdominis
37
What are the vertical muscles of the anterior lateral wall?
Rectus abdominis
38
What are the origins of the external oblique?
Muscular slips from the outer surfaces of the lower eight ribs (5-12)
39
What are the insertions of the external oblique?
Lateral lip of iliac crest Aponeurosis ending in midline raphe (linea alba)
40
What are the actions of the external oblique?
Compress abdominal contents Flexion of the trunk Ipsilateral side flexion Contralateral rotation
41
What is the nerve supply of the external oblique?
Anterior rami of lower 6 thoracic spinal nerves (T7-T12)
42
What are the origins of the internal oblique?
Thoracolumbar fascia Iliac crest between origins of external oblique and transversus abdominis Lateral 2/3 of inguinal ligament
43
What are the insertions of the internal oblique?
Inferior border of the lower 3 or 4 ribs Aponeurosis ending in linea alba Pubic crest and pectineal line
44
What are the actions of the internal oblique?
Compress the abdominal contents Flexion of the trunk Ipsilateral side flexion Ipsilateral rotation
45
What is the nerve supply of the internal oblique?
Anterior rami of lower 6 thoracic spinal nerves (T7 to T12) and L1
46
What are the origins of the transverse abdominus?
Thoracolumbar fascia Medial lip of iliac crest Lateral 1/3 of inguinal ligament, costal cartilages lower 6 ribs
47
What are the insertions of the transverse abdominus?
Aponeurosis ending in linea alba Pubic crest and pectineal line
48
What is the action of the transverse abdominus?
Compress abdominal contents
49
What is the nerve supply of the transverse abdominus?
Anterior rami of lower 6 thoracic spinal nerves (T7-T12) and L1
50
What are the origins of the rectus abdominis?
Pubic crest Pubic tubercle Pubic symphysis
51
What are the insertions of the rectus abdominis?
Costal cartilages of ribs 5 to 7 Xiphoid process
52
What are the actions of the rectus abdominis?
Compress abdominal contents Flex vertebral column Tense abdominal wall
53
What is the nerve supply of the rectus abdominis?
Anterior rami mainly of the lower 6 thoracic spinal nerves (T7-12)
54
What are the functions of the abdominals?
Trunk movement Protection of the abdominal viscera Spinal stabilisation Abdominal pressure (for forced expiration, micturition, defecation, parturition and vomiting)
55
Where is the rectus sheath?
Covers anterior and posterior surface of the upper 3/4 of the rectus abdominis and the lower 1/4 of its anterior surface
56
What is the rectus sheath?
A multilayered Aponeurosis (durable and resilient fibrous compartment containing the rectus abdominis and the promedialis muscle)
57
What does the anterior layer of the rectus sheath consist of?
external oblique and internal oblique
58
What does the posterior layer of the rectus sheath consist of?
Internal oblique and transversus abdominus
59
where do the layers of the rectus sheath interlace?
linea alba
60
what is rectus diastasis?
separation of the rectus abdominis from the linea alba
61
when is rectus diastasis common?
pregnancy
62
can you recover from rectus diastasis?
yes, generally comes back together. However, sometimes it won’t return
63
what does the posterior wall consist of?
diaphragm Thoracolumbar fascia Lumbar vertebrae and discs Muscles (psoas, iliacus, QL, TrA, obliques)
64
what are the attachments of the quadratus lumborum?
posterior border of the iliac crest Iliolumbar ligament Transverse processes L1-5 inferior border of the 12th rib
65
what are the actions of the quadratus lumborum?
muscle of inspiration Ipsilateral side flexion Lumbar extension
66
what is the nerve supply of the quadratus lumborum?
ventral rami (T12-L4)
67
what are the 3 components of the erector spinae?
1) Iliocostalis 2) Longissimus 3) Spinalis
68
what is the erector spinae?
The largest group of intrinsic back muscles
69
where is the erector spinae?
posterior and lateral to the spinal column
70
what is the erector spinae covered in?
thoracic and lumbar regions by the thoracolumbar fascia
71
what are the origins of the erector spinae?
lower 6 ribs and rib angles
72
what are the insertions of the erector spinae?
T11-L5 spinous processes Supraspinous / sacrosanct iliac ligament Sacral crests Posterior part of the iliac crest Iliac tuberosity Inner lip of iliac crest Thoracolumbar fascia
73
what are the actions of the erector spinae?
bilateral extension Bilateral control of flexion Maintenance of lumbar lordosis Unilateral Ipsilateral side flexion and rotation
74
what is the nerve supply of the erector spinae?
dorsal rami of adjacent thoracolumbar nerves
75
what are the 5 transversospinalis stability muscles?
Semispinalis thoracics Multifidus Rotatores Interspinalis Intertransversus
76
what are the origins of the semispinalis thoracics?
Transverse processes of T6-T10
77
What are the insertions of the semispinalis thoracics?
Spinous processes of upper 4 thoracic and lower 2 cervical vertebrae
78
What are the origins of the multifidus?
Sacrum Origin of erector spinae PSIS Mamillary process of lumbar vertebrae Transverse processes of thoracic vertebrae Articular processes of lower 4 cervical vertebrae
79
What are the insertions of the multifidus?
Base of spinous processes of all vertebrae from L5 to C2
80
what is the rotatores?
Deepest but present throughout the length of the vertebral column, most developed in the thoracic region
81
in which direction do fibres run in the rotators?
Fibres pass upwards and medially from transverse processes to spinous processes, crossing the vertebrae
82
Where do interspinales pass?
Pass between adjacent spinous processes
83
Where do intertransversaii pass?
Between adjacent transverse processes
84
What is the role of intertransversaii?
Postural muscles stabilise the adjourning vertebrae during movements of vertebral column to allow for more effective action
85
What active movements are available at the lumbar spine?
Flexion Extension Side flexion Rotation
86
What muscles are shortening during posterior pelvic tilt?
Hip Extensors (gluteus maximus, bicep fem) Rectus abdominis External and internal oblique muscles
87
What muscles lengthen during posterior pelvis tilt?
Hip flexors Erector spinae Quadratus lumborum
88
What muscles shorten during anterior pelvic tilt?
Hip flexors Erector Spinae Quadratus Lumborum
89
What muscles lengthen during anterior pelvic tilt?
Hip extensors Rectus abdominis External and internal obliques
90
What are the origins of the rotatores in the lumbar and thoracic regions?
Transverse processes of each vertebrae
91
What are the insertions of the rotatores in lumbar and thoracic regions/?
Base of the spinous process of each adjacent superior vertebra (1 and 2 levels above)
92
What is the origins of the interspinales?
Spinous processes of the lumbar spine
93
What is the insertion of interspinales?
Spinous process of adjacent superior vertebra
94
What is the origins of intertransversus muscle?
Transverse processes L1-5
95
What is the insertion of the intertransversus muscl?
Transverse processes of adjacent superior vertebra

Axial Anatomy (8 decks)

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