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Foundations > Lumbo-Pelvic Girdle > Flashcards

Lumbo-Pelvic Girdle Flashcards

Improve Understanding of Foundations Lumbo Pelvic Girdle

1
Q

Lumbar lordosis is primarily due to the angle of the ________

A

Sacrum

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2
Q

The angle of the sacrum is ___-___ degrees from the horizontal in supine

A

42-45

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3
Q

The L5 disc is higher _____ than _____ making it wedge shaped

A

Anterior than posterior

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4
Q

The L5-S1 disc has __-__ mm less height posteriorly

A

6-7

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5
Q

Lumbar lordosis causes an increased compression on the _____ and the ______

A

Z joints and discs

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6
Q

The ______ ligament and the ______ anteriorly resist stretch from lumbar lordosis

A

Anterior Lumbar Ligament, Annulus

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7
Q

There is no correlation between increased lumbar lordosis and ______

A

Back Pain

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8
Q

There is a tendency for the vertebra of the lumbar spine to slide ______ especially when in weight bearing

A

Forward

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9
Q

The _____ joints and ______ largely resist the anterior slide of the vertebrae in weight bearing

A

Z joints and discs

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10
Q

The secondary restraints to anterior sliding of lumbar vertebrae are the _______

A

ligaments

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11
Q

The Anterior Lumbar Ligament resists anterior _______ and ______

A

Separation and bowing

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12
Q

Lordosis adds _______ and helps to further absorb ______ than an otherwise straight spine

A

Tension, Shock

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13
Q

Lordosis ability to absorb shock takes pressure off of the _______ and ________

A

Intervertebral discs and bodies

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14
Q

Curves of the spine allow us to do three things:

A

Absorb and attenuate forces,
Provide Nutrition throughout the spine by undulating movements through the curves,
Allowing us to maintain a bipedal visual orientation to the world.

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15
Q

We can _______ better than any animal in the animal kingdom

A

Locomote

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16
Q

The change in directions of the curves of the spine are also unique for __________ related to locomotion

A

Energy distribution

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17
Q

Degeneration of the structure at a segmental level of the spine will lead to rapid ________ and _______ at a segmental level

A

Muscle atrophy and dysfunction

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18
Q

Multifidi inhibition occurs with trauma to the spine and will lead to rapid _________

A

Degeneration/degredation

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19
Q

Multifidis-muscle recovery not spontaneous on remission of __________

A

Symptoms

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20
Q

We assess moving segments which may give us provocation because _______ can be confusing to locate due to multiple levels of innervation of the lumbar spine

A

Pain

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21
Q

Stability from joints in the lumbar spine come from what structures and in what percentages

A

29% disc
20% from each Z joint
31% from lymphatic, vascular, ligamentous, etc

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22
Q

The muscle and ligament that helps the articular capsules at the z joints to promote stability is the ______ muscle and ________

A

multifidus, ligamentum flavum

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23
Q

Apophysis is latin for _____

A

outgrowth

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24
Q

Zygos is latin for ______

A

yoke or bridge

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25
Q

Zygapophysial are _____ type joints

A

synovial

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26
Q

Z joints in the lumbar spine vary considerably but primarily limit _______ and _______

A

Forward bending and rotation

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27
Q

The surfaces of z joints are covered with ________ cartilage

A

Articular

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28
Q

The collagen fibers that surround the zygapophysial joint run from ________ to _______ in the lumbar spine

A

medial to lateral

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29
Q

To intra-articular structures exist in the lumbar Z joints the _______ and the ________

A

fat pad, meniscoid

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30
Q

The meniscoid structures in Z joints have three types - they are:

A

The connective tissue rim
The adipose tissue pad
The fibro-adipose meniscoid structures

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31
Q

The meniscoid structures in the lumbar spine increase the _________ between the two joints and help to transmit ________

A

Contact area, load

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32
Q

We need _______ to keep the nutrition of cartilage healthy

A

loading

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33
Q

__________is the process of synovial fluid being pushed into cartilage

A

Imbibition

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34
Q

The facet capsule is protected by the ________, _________, and _______ from impingement

A

meniscus, multifidus, ligamentum flavum

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35
Q

The ________ is a semifluid mass similar to toothpaste

A

Nucleus Pulposus

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36
Q

The nucleus pulposus becomes more fibrotic after the ge of _____ to ______

A

21 to 25

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37
Q

The Pressure in one direction of the nucleus pulposus results in deformation and the nucleus transmitting pressure in _______ directions

A

All

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38
Q

The nucleus pulposis is made up of _____ to ______% water

A

70-90% water

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39
Q

Most of the dry weight of the nucleus pulposis (65% of dry weight) is made up of _________ aggregate

A

Proteoglycan

40
Q

___________ makes up the remaining dry weight of the nucleus pulposus that is not made up of proteoglycan aggregate

A

Type II Collagen

41
Q

The Annulus fibrosus is made up of 10-20 _______ of lamellae

A

layers

42
Q

The annulus is thicker in the ____ and _____ portions and thinner (thus weaker) in the ______ portions

A

anterior, lateral

posterior

43
Q

The angle of the layers of the annulus fibrosis are ___-____ degrees from vertical

A

65-70

44
Q

The angle of each layer of the annulus is the same but the ______ of each concentric layer changes

A

direction

45
Q

The annulus is made up of 60-70% _______

A

water

46
Q

________ accounts from 50-60% of the dry weight of the annulus fibrosus

A

collagen

47
Q

________ gel binds the collagen to the lamellae in the annulus and prevents them from buckling or fraying

A

Proteoglycan

48
Q

The annulus contains about 10% ________ fibers which are circular, oblique, and vertical which strengthens the lamellae and most highly concentrated where the annulus meets the endplate

A

elastic

49
Q

________ is a layer of cartilage approximately 0.6-1 mm thick that covers the nucleus pulposus in its entirety

A

vertebral end plate

50
Q

The vertebral end plate consistes of both _______ and ________ cartilage

A

hyaline and fibrocartilage

51
Q

End plates are strongly connected to the ________ and weakly connected to the ________

A

intervertebral disc, vertebral body

52
Q

Functions of the disk are:

A

Allow movement

Transmit force

53
Q

Prolonged loads on the disc will cause buckling of the ______ of the annulus

A

lamellae

54
Q

The annulus is capable of resisting ________ without the nucleus pulposus

A

vertical loads

55
Q

The metabolic maintenance of ______ and _______ is critical for disc function

A

water and proteoglycan aggregate

56
Q

Distraction of two vertebrae is resisted by all fibers of the ________ of the disc

A

annulus

57
Q

Sliding movements cause ______ on some fibers aligned in that direction but _____ on those not aligned

A

tension, slack

58
Q

In effect, half of the fibers of the annulus resist twisting in each direction, this makes the annulus particularly susceptible to ______ when twisting

A

injury

59
Q

It is normal for there to be cracks, fissures, and degeneration in the spine by the age of ____

A

15

60
Q

There is a shorter and more narrow disc space but an increased _____ in the disc as we age contrary to popular belief

A

fluid volume

61
Q

Loss of disc height is often due to the disc shaping into the vertebrae due to the loss of ________

A

trabeculae

62
Q

In normal aging it is usually the ________ getting smaller, not the disc

A

bone

63
Q

As we age our disc loses its ability to _______ forces thus creating _______

A

attenuate, instability

64
Q

In old models, spinal instability was described as __________ that produced excessive movement in an intervertebral joint at end range

A

ligamentous laxity

65
Q

Thanks to the work of ____________ it is now known that stabilization of the spine relates mainly to muscular factors rather than ligamentous factors, and is probably far more common than the ligamentous type.

A

Manohar Panjabi

66
Q

________ may be the factor that leads to most cases of mechanical back pain. Its correction is essential to the appropriate management of the mechanical spine disorders.

A

instability

67
Q

Panjabi describes three subsystems of spinal stabilization. They are:

A

Passive, active, nervous system

68
Q

The subsystems described by panjabi work on a ________ level

A

segmental

69
Q

Three things can happen when a subsystem of spinal stability becomes dysfunctional. They are:

A
  1. immediate adaptation from another subsystem
  2. long term compensatory adaptation
  3. injury to any component of one or more system
70
Q

One point Panjabi makes is that the breakdown of the _________ or reaction time, of the small intrinsic muscles can cause breakdown of the system and that improving __________ can enhance stability

A

time to peak contraction, time to peak contraction

71
Q

Panjabi asserts that the time to peak contraction of the ______, _______ muscles can cause breakdown of the system

A

small, intrinsic

72
Q

The passive subsystem of control as described by Panjabi consists of:

A

Osseous
Articular
Ligamentous

73
Q

The active subsystem of control as described by Panjabi consists of:

A

Muscular

Active Stabilization

74
Q

The neural subsystem of control as described by panjabi consists of:

A

Sensory feedback

Control, timing, and modulation

75
Q

The neutral zone is defined as:

A

Small range of displacement near the joint’s neutral position where minimal resistance is given by the osteoligamentous structures

76
Q

The intervertebral motion which occurs in neutral posture, where minimal resistance to movement is offered by the passive vertebral column is Panjabi’s definition of _________

A

the neutral zone

77
Q

The lax zone is different than the neutral zone because it is where there is _________ of ligamentous resistance

A

slight displacement

78
Q

The lax zone is bigger or smaller than the neutral zone

A

bigger

79
Q

The ______ zone describes the region of ligamentous laxity

A

lax

80
Q

The neutral zone is a smaller subset of the ______ zone

A

lax

81
Q

The loss of the ability of the spine under physiological loads to maintain its pattern of displacement so that there is not initial or additional neurological deficits, no major deformity, and no incapacitating pain is the definition of _______

A

clinical instability

82
Q

The symptomatic condition where in the absence of a new injury, a physiological load induces abnormally large deformations at the intervertebral joint is a definition of

A

clinical instability

83
Q

The clinical state in which the most minor of provocations will shift the patient from being mildly symptomatic to a severely painful distabiling episode is

A

clinical instability

84
Q

_________ is the intermediate phase of the process of degenenration of the spinal segment following dysfunction and preceding restabilization

A

instability

85
Q

Passive stability of the spine is tested with _______ _______ tests

A

linear shear

86
Q

If a passive subsystem is damaged the _____ or ______ subsystems can compensate

A

active, neural

87
Q

A segment will only become symptomatic if one of the subsystems of control cannot _______

A

compensate

88
Q

According to Bergmark the muscles that are deep in our core are our __________ __________ system

A

local stabilization

89
Q

According to Bergmark the muscles that are superficial in our core are our _______ ________ system

A

global stabilization

90
Q

Local stabilizers add ______ to the spine

A

stiffness

91
Q

Local stabilization controls in the ________ zone

A

neutral

92
Q

The ______ ______ system controls intersegmental motions

A

local stabilization

93
Q

The________ _________ system is the primary movers of the spine

A

global stabilization system

94
Q

The global stabilization system _______ load between the thoracic spine, costal cage, lumbar spine, and pelvis

A

transfers

95
Q

The global stabilization system transfers load to the _______ stabilizers

A

local stabilizers

Foundations (3 decks)

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