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MSK PT > Lumbar Spine Anatomy > Flashcards

Lumbar Spine Anatomy Flashcards

(86 cards)

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1
Q

the top and bottom surfaces of the VB are smooth and have perforation holes for …

A

nutrition

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2
Q

what structure articulates with the disc and holds the end plate in place

A

ring apophysis

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3
Q

the posterior surface of the VB have large holes for…

A

nutrient arteries and basovertebral vein

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4
Q

what 2 trabecular systems are in the VB and what is the significance of each?

A

transverse - resists tension
vertical - resists compression

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5
Q

what is important about having trabeculae systems in the VB?

A

keep it light

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6
Q

what 4 structures make up the neural arch?

A
  • pedicle
  • lamina
  • SP
  • TP
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7
Q

what forces do the pedicles resist?

A

bending and tension

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8
Q

what is significant about the accessory or mamillary processes?

A

provide surface for m attachment (miltifidi)

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9
Q

describe the orientation of the superior facet

A

concave and faces medially and posteriorly

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10
Q

describe the orientation of the inferior facet

A

convex and face laterally and anteriorly

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11
Q

what structure sustains bending force from pedicle to lamina

A

pars interarticularis

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12
Q

what motion is favored by the orientation of the Lumbar facets?

A

sagittal plane motion - flex/ext

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13
Q

what shape is the VB of L5

A

wedge

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14
Q

describe the characteristics of the following structures for L5
- disc
- TP
- SP
- Z joint

A

disc = smaller surface
TP = larger
SP = smaller
Z - joint = orientation in coronal plane

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15
Q

what is the significance of the shape of the L5 VB

A

it can accommodate for the lumbosacral angle

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16
Q

how many articulations are at each vertebral segment of the lumbar spine

A

6 articulations
- superior and inferior IV joints (2)
- bilat superior and inferior Z joints (4)

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17
Q

what type of joint is the IV join

A

cartilagenous

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18
Q

what structure:
- accounts for 25% of total height of vertebral column
- allows mvmt
- absorbs shock and distributes load

A

IV disc

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19
Q

collagen fibers in the AF are oriented _____ off the vertical line and ______ opposite to each other

A

60
120 degrees

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20
Q

what forces does the AF resisit

A

compression, shear and torsion

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21
Q

what forces does the NP resist

A

compression and shear

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22
Q

what happens to the NP with axial loading

A

does not deform
reduces in height and expands radially toward AF, end plate and VB

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23
Q

what is the end plate made of

A

fibrocartilage and hyaline cartilage

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24
Q

what forces does the end plate resist

A

it is weak when exposed to compression forces

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25
when you have a normal/intact disc, how much force does the z joint carry? How much is it when the disc is diseased?
normal = 20-25% diseased = up to 70% force thru the Z joint
26
how does the IV disc receive nutrients
by diffusion thru cartilagenous end plate
27
how does the disc receive its nerve supply
peripherally by branches of anterior rami and gray rami communicans
28
what are the pain sensitive structures surrounding the disc
ALL, PLL, nerve roots, VB, cartilage of z joint
29
what shape is ideal/normal for the Z joint
C or L (J) shape
30
how much motion occurs are the Z joint
5-8mm up and down
31
what is the function of the miltifidi
approximation of the z joint - stabilization
32
what is the significance of having J shaped z joints
resist anterior shear force on anteromedial aspect of z joint
33
what is the significance of C and J shaped joints
increases bony congruence = stability
34
what strucutre reinforces the z joint capsule anteriorly
ligamentum flavum
35
what position is the z joint capsule tight in?
all positions
36
what 2 structures reinforce the z joint capsule
miltifidi and lig flavum
37
what is the function of the fibroadipose meniscoid
protect z joint surface during motion
38
what happens when the fibroadipose meniscoid malfunctions
becomes buckled/relaxed in flexion and lodged under the capsule --> blocking extension and causing acute locking
39
where does the z joint get its nerve supply
medial branch of the dorsal root of the same segment and the segment below
40
how many and what articulations occur at the lumbosacral junction
3 articulations - IV joint and bilat facet joints
41
what is the normal LS angle
40 deg
42
describe the incline of S1 at the LS angle
inclines inferiorly and anteriorly forming and angle to horizontal line
43
what determines the lumbar curve
LS angle
44
what structures stabilize LS junction anteriorly and posteriorly
ALL and iliolumbar ligaments
45
where does the L5 VB tend to slide
anteriorly and inferiorly
46
what counterbalances the translation of L5 on S1
vertebral arch junction b/w superior and inferior facets
47
if the pars interarticularis breaks =
spondylolysis
48
if L5 is displaced anteriorly =
spondylolisthesis
49
what radiographic view can you see spondylolysis
oblique view = broken neck of scottie dog
50
the ALL has the greatest tensile strength in what region
lumbar region
51
what forces does the ALL resist
extension or excessive lordosis
52
what structure is diamond shaped and deviates laterally at disc level to support AF
PLL
53
why is it significant that the PLL is weak in the lumbar region
high incidence of HNP in this region
54
what forces does the PLL resist
flexion and traction
55
the ligamentum flavum extends _____ to cover the ______
laterally to cover the z joints
56
the ligamentum flavum contains a high % of ________ what does this allow it to do?
- elastin - able to recoil and not buckle
57
where is the ligamentum flavum strongest and weakest
stringest - L region weakest - cervical
58
what direction dies the lig flavum resist
flexion slack in ext
59
what are the posterior ligaments of the vertebral column
interspinous, supraspinous and intertransverse
60
what direction does the interspinous and supraspinous ligaments resist
hyperflexion
61
palpable tenderness of the interspinous ligament may indicate...
hypermobility or instability
62
the supraspinous ligament does not have direct attachment to ______
thoracolumbar fascia at L4 - L5
63
what motion does the intertransverse ligament resist? what is its contribution to stability
contralateral flexion - no contribution to stability - it is just there
64
what are the 5 bands of the iliolumbar ligament
anterior, superior, inferior, vertical and posterior
65
what motion does the posterior band of the iliolumbar ligament resist
flexion
66
what is the function of the posterior band of the iliolumbar ligament
stabilize L5 from anterior displacement and resist lateral flexion at L5
67
where do the superficial layers of the Thoracolumbar fascia come from
latissimus dorsi
68
4 functions of thoracolumbar fascia
- m attachment - resist segmental flexion - assist in transmission of extension during lifting ** pull of TrA --> increase in tension of fascia --> limit intersegmental flexion and anterior translation
69
what is the most effect lateral flexors of the trunk
erector spinae
70
bilateral contraction of erector spinae will create what 3 things
- extend trunk - tilt pelvis anterior - increase L lordosis
71
unilateral contraction of erector spinae will create what 2 motions
- lateral flexion and rotation of trunk to SS
72
what 3 m groups make up the deep layers of the back m
transversospinal m group = semispinalis, miltifidi, rotatores
73
what is the "rotator cuff" of the z joint and why is it called that
multifidi - produces compression force during contraction to stabilize joint
74
pts with segmental instability show what 2 characterisitics of the multifidi
fatty replacement and atrohpy
75
as a group, the transversosponal muscles do what?
fine control of spinal motions
76
what does the evidence say about multifidi m recovery after decrease of LBP
m recovery is not automatic
77
what is one of the biggest findings in pts with LBP
m atrophy of multifidi --> inability to contract
78
bilateral contraction of the EO m will create... Unilateral contraction ...
bilat - trunk flex, post tilt of pelvis unilat - I/L trunk lateral flex and C/L rotation
79
bilat contraction of IO m will create... unilateral contraction ...
bilat - trunk flexion and post tilt pelvis unilat - I/L tunk lateral flex, I/L rotation
80
bilat contraction of TrA...
compression of abdominal cavity and increase tension of thoracolumbar fascia - primary stabilizer
81
LBP pts failed to recruit _____ and ____ with fast speed arm mvmts
TrA and IO
82
what is the predominant hip flexor
iliacus
83
contraction of the psoas will create...
lateral lumbar flexion and vertical stabilization
84
the iliopsoas creates ________ by tilting the pelvis ______
lumbar lordosis anteriorly
85
what characteristics does the iliopsoas present with in a pt with LBP
short (spasm) and atrophied
86
bilat QL contraction ... Unilat QL contraction ...
bilat = extend lumbar unilat = lateral flex L spine or elevate pelvis

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