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Semester 2 FS Exam 3 > Lumbar Spine > Flashcards

Lumbar Spine Flashcards

(94 cards)

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1
Q

Thoracic curvature purpose

A

make cavity for organs

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2
Q

If lumbar was straight… with no curvature then what

A

The torque we would experience above would be enormous because the moment arm of the curvature we have in the thoracic region would be larger than the lumbar region
Moment arm would be double so for the same load, we would have twice the torque

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3
Q

Main role of cervical and lumbar curvatures

A

reduction of the torques (by reducing the moment arm of superincumbent weight)

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4
Q

Anatomy of the spine

A

Extends from base of skull to pelvis
32-33 bones (vert)
Protects spinal cord
Structural support and linkage to extremities

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5
Q 
Cervical
Thoracic
Lumbar
Sacrum
Coccyx
A 
C1 - C7
T1-T12
L1-L5
5 fused bones
3-4 fused bones
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6
Q

Primary vertebral curves

A

Thoracic

Primary = visible before birth

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7
Q

Secondary vertebral curves

A

Cervical and Lumbar
Secondary = develop later and take their final shape because of gravity
Lumbar is greater in F than M because of breasts - larger to reduce the effect of superincumbent weight

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8
Q

Body

A

Anterior potion, thick, dense, contains most of the vertebral mass (cortical - outer, cancellous - interior matrix)

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9
Q

Arch

A

Posterior portion with several finger like projections (processes)

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10
Q

Processes

A

Place for attachment for tendons and ligaments

7 total for typical (1 spinous, 2 transverse, 2 sup articular, 2 inf articular)

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11
Q

Pedicles

A

short round process of thick strong bone linking the anterior and posterior portions

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12
Q

Spinal canal

A

houses the spinal cord, providing protection from external forces

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13
Q

Purpose of processes

A

attachment purposes, muscles ligaments and interact btw two consecutive vertebrae to give you joints
Shape ans size have effect on the effectiveness of the structure attached to them
Longer - maybe longer moment arm

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14
Q

Structure of vertebrae

A

characteristics change all along the vertebral column even within the same region
The lower you go down - the larger the body will be (they have to deal with more gravity)
The way that the facets and processes face is important for their function in respect to motion

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15
Q

Spinal cord

A 
part of CNS
extends from brainstem to L1
Relays infor to and from skin, muscles, ligaments, organs, joints 
Ant nerve roots = motor
Post nerve roots = sensory
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16
Q

Cartilaginous joints

A

Intervertebral disks - btw bodies of vertebrae from cervical to sacrum

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17
Q

Gliding (facet) joints )articular processes)

A

Articular capsules are loose and thin (so capsule is not limiting the joint)
Segmental mobility is related to the orientation of the gliding joints
Facet joints are diathroses synovial (allow movement, synovial cavity, synovial fluid)

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18
Q

Intervertebral discs

A

separate the vertebrae
absorb stress and shock
enable multiplanar motion in spinal column

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19
Q

Intervertebral discs cont

Composed of…

A 
fibrocartilage
transverse shape conforms to the disk bodies
Thickness is not uniform
25% of length of vertral column 
Allows motion in all 3 planes
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20
Q

Composition of intervertebral disks

A 
nucleus pulposas (gel like mass) = semi fluid jelly of proteoglycans in water 
Annulus fibrosus (fibrocartilage that encases the nucleus) = collagen fibers arranged in criss cross fashion
These allow the disc to withstand greater tensile and rotational forces
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21
Q

Intervertebral disk degeneration

A

Degeneration with age
Reduction of elasticity
Inability to resist loading/dampening

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22
Q

Motions of ID and and Vertebrae

A

12 segmental motions
Translations –> Ant/Post, Lateral (left/Right) and vertical (compr/distract)
Rotations –> Ant/Post, Lateral tilt (Left/right), Lateral rotation (left/ right)

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23
Q

The thicker the intervertebral disc…

A

the larger the movement will be

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24
Q

Effect of bending - backward bending moment

A

Ant = tension
Post = compression
Annulus bulges = posterior
Nucleus shifts = anterior

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25
Effect of torsion - torsion moment
Shear stress increases from the center to the periphery
26
Facets
Change orientation from cervical to lumbar regions Articular joints allow smooth articulation btw vertebrae Resist motion through bony interactions, aided by ligaments
27
More on Facets... | Shape is diff at thoracic and lumbar regions
Thoracic AP direction is longer than in ML direction Lumbar ML is longer than AP Longer the direction, the more stability Facet is covered by hyaline cartilage
28
Facet and lumbar region
Facet orientation does not allow rotation at lumbar region | Facet orientation changes from cervical to lumbar
29
Lumbar region motions
Ample flexion/extension and nc as go from top to bottom of lumbar region Lateral flexion is allowed but is less and is consistent throughout levels (limited at lumbosacral joint) Rotation is very limited - little more at lumbosacral joint
30
Joint coupling
If it is not a pure motion, it is joint coupling
31
Side bending and lumbar rotation
Side bending can't occur without some lumbar rotation
32
Lumbar spine in neutral or extended position
Side bending and rotation in opposite direction
33
Lumbar spine in flexed position
Side bending and rotation in same direction
34
Cervical Vertebrae C3-C7
Facets 45 degrees FL-EX (sagittal plane) Lateral flex (frontal) Rotation (transverse)
35
Thoracic Vertebrae
Facets 60 degrees FL-EX (limited), higher at lower part Lateral flexion, same all across Rotation (mostly)
36
Lumbar vertebrae
Facets 90 Degrees FL-Ex Lateral flexion (limited) No Rotation
37
Anterior Longitudinal Ligament
From axis to sacrum Adheres to disks and prominent margins of vertebrae Strained during extension Holds disks in place with vert bodies
38
Posterior longitudinal ligament
from axis to sacrum Posterior of the bodies inside the vertebral canal Contributes to stability in the intervertebral joints
39
Ligamentum Flavum
From axis to sacrum Connect adjacent laminae Strained during flexion and lateral flexion Limits contralateral flexion (R will be stretched when leaning L)
40
Supraspinal Ligament
C7 to sacrum Tips of spinous processes Strained during flexion Btw two consecutive spinous processes
41
Interspinous Ligament
btw spinous processes | Strained during flexion
42
Capsular ligaments
Ligaments of the capsule of facet joints | Strained during rotation
43
Transverse ligaments
btw consecutive trans processes | Strained during rotation and lateral bending in opp direction
44
Iliolumbar ligaments
L4/L5 trans processes to iliac bone Offer stability Strained during rotation and lateral bending
45
Most ligaments limi
flexion | abdominals do a good job of limiting extension
46
Lumbosacral or Ferguson's Angle
angle formed by the line parallel to the sup aspect of the sacrum and the horizontal
47
Lumbosacral angle on sagittal plane Range observed and typical
Observed = 26-57 deg Typical = 35-45 Hyperlordosis = > 45 Hypolordosis =
48
High lumbosacral angle =
high anterior convexivity of lumbar spine = high shear stress at lumbosacral joint = larger lumbar curvature = anteriorly rotated
49
Lower lumbosacral angle
posteriorly rotated
50
Flexor Muscles
``` Rectus Abdominis IO EO TA Psoas Muscles ```
51
When a muscle is producing force... its fibers will
become shorter
52
External Oblique fibers
superior and lateral to inferior and medial
53
EO Action
laterally flex to same side | rotate to opposite side
54
Internal Oblique fibers
inferior and lateral to superior and medial
55
IO Action
laterally flex to same side | rotate to same side
56
IO and EO together will
Tighten the abdominal region and pull in abdominal organs | Can also help into flexion - more when in supine than in standing
57
Right EO is activated so...
laterally flexing to the right OR rotating to the left
58
Rotating to the right activates what
Left EO Right IO
59
Transverse abdominis fibers
transverse
60
TA action
tighten organs in abdominal cavity
61
Rectus abdominis fibers
short fibers that are compartmentalized --> FL/ML ratio that is small so force muscle --> strong
62
Rectus abdominis goes from
pubic symphysis to sternum and ribs 67
63
Action of RA
flexion of trunk - best when in supine to flex from lumbar vertebrae RA also has largest MA in terms of producing flexion at lumbar spine
64
Psoas Major
Assisted by iliacus Crosses lumbar and hip joints Pulls on lumbar region and counters the tendency of the motion of the femur and pelvis? Hip flexor
65
Psoas Minor
``` Crosses only lumbar region Stops at pelvis Posterior pelvis rotation extends lumbar region in a way Hip flexor ```
66
Extensor Muscles
``` Erector Spinae (9 muscles 3x3 on each side) Semispinalis (CA, CE, T) Multifidus Rotators (CE, T, L) Interspinales Intertransversarii ```
67
Erector Spinae
Spinalis (Ca, Ce, T) Longissimus (CA, CE, T) Iliocostalis (CE, T, L)
68
Erector Spinae Spinalis
very tightly related to vertebrae | Parallel to spinous processes of vertebrae
69
Erector Spinae Longissimus
A bit lateral to spinalis
70
Erector Spinae Iliocostalis
Even more lateral than longissimus
71
Erector Spiane Muscles bilaterally
extend the vertebral column | Active in flexion though because they are resisting flexion and controlling it
72
Erector Spinae Muscles unilaterally
not much of an ability (spinalis) long and ilio - more of an action Lateral flexion and rotation ipsilateral for both Iliocostalis is most effective
73
Multifidus
``` span more than one level more efficient than rotators in action of rotation orientation like an x-mas tree unilateral rotation - contralateral Any flexion would be ipsilateral ```
74
Semispnalis
no effect on lumbar region
75
Rotators fiber orientation and action
sup and med to inf and lateral rotation is contralateral under unilateral activation (pull spinous process closer to inf transverse process) They are more stability muscles than rotators
76
Quadratus Lumborum
attached to last pair of ribs and trans processes of all lumbar vertebrae and iliac
77
Quadratus lumborum action
Stability muscle! Active in any motion of lumbar region Works as a brace and braces the lumbar region and creates stability in everything that we do Unilateral - limits contralateral flexion
78
Interspinalis
muscle fibers invested in and around interspinal ligament btw consecutive vertebrae Resist flexion
79
Intertransversarii
Help quad lumborum MA is small but segmentally can produce support from both sides Unilaterally = ipsilateral flexion and resist contralateral flexion
80
Flexion-Relaxation Phenomenon
``` Posterior Trunk muscles Increase lumbar curve Produce extension Initiate hyperextension Control forward flexion ```
81
What controls flexion at extreme forward flexion ranges
passive elastic response of the thoracolumbar fascia and the posterior ligamentous system
82
Flexion forward - erector spinae
active for the first 30 degrees and their activity becomes less and less in a specific range, erector spinae resist flexion, but past that point won't be functinal anymore - lumbosacral fascia is helping and the fascia will be effective forever - like aligament in that it can elongate a ton
83
Shear and Compression force
``` Compression = perpendicular Shear = parallel ```
84
Pelvic orientation - larger the lumbar curvature with ant tilt
the larger the shear
85
Pelvic Orientation with shear and compression - post tilt
compression forces are high
86
Pelvic orientation with shear and compression - ant tilt
shear forces are high
87
What forces contribute to load we feel at the joint
``` Body weight above the joint Weight itself of what you are picking up Moment arms Erector Spinae muscle force Motion - inertia ```
88
``` Load on spine Laying down Sitting Sitting slouched over Standing Standing slouched over ```
``` Laying = less than 50 Standing = 100 Sitting = 150 Standing slouched = close to 150 Sitting slouched = close to 200 ```
89
Why higher load on spine when simply sitting?
You are in a slight ant rotation so this is increasing lordosis
90
Spondylolysis
separation of vertebra | L5 S1 is most common but can also be found at L4 L5 lumbosacral junction
91
Spondylolisthesis
forward movement of vertebral body
92
LBP
``` 75-80% of pop will experience Mechanical stress plays significant role Pregnancy Relative stbaility of spne 60% are idiopathic Abdominal exercises are helpful treatment ```
93
Two common causes of LBP
Compressive or neurogenic = symptoms are referred due to spinal nerve compression Mechanical = localized pain due to damage to facets, discs, or soft tissue
94
Lifting recommendations
Bend knees Keep weight close to hips Avoid lifting while twisting (places 3 times more stress on spine) Avoid rapid, jerking motion while lifting

Semester 2 FS Exam 3 (1 decks)

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