lumbopelvic part 1

Question 1

describe the vertebral body

Answer 1

large, transverse diameter greater than A-P and height
progressively wedge shaped L1-L5 (L5 greatest) - anterior body larger than posterior

Question 2

describe the spinous processes

Answer 2

broad, thick from lateral view, thin superior view
large muscular attachments
attachment of thoracolumbar fascia

Question 3

describe the transverse processes

Answer 3

large for muscular and ligamentous attachments
at same level of own spinous process

Question 4

describe the facets

Answer 4

lie in sagittal plane
superior facets are concave and face medially and slightly posteriorly
inferior facets are convex and face laterally and slightly anterior

Question 5

are the facets a weight bearing structure?

Answer 5

technically yes because they are not 100% in the sagittal plane but not much

Question 6

what are some passive stabilizers to the lumbopelvic region?

Answer 6

ALL
PLL
interspinous, supraspinous and ligamentum flavum
iliolumbar ligaments
thoracolumbar fascia

Question 7

describe the anterior longitudinal ligament

Answer 7

very strong and broad
anterior to AOR

Question 8

describe the posterior longitudinal ligament

Answer 8

narrows to non existence in the lumbar spine
some don’t even have a PLL at this level
posterior to AOR

Question 9

describe the iliolumbar ligaments

Answer 9

5 bands extending from L4 and L5 TPs to iliac crests just above the PSIS
as a whole are very strong and prevent anterior displacement of L4 and L5
posterior to AOR

Question 10

describe the thoracolumbar fascia

Answer 10

3 layers, ant/middle/post
attached to SP and TP and other tissues and muscles

Question 11

what are the anterior and middle layers of the throacolumbar fascia derivatives of?

Answer 11

the quadratus lumborum and attaches to TPs

Question 12

what does the posterior layer of the thoracolumbar fascia fuse with?

Answer 12

the transverse abdominis, gluteus maximus and latisimus dorsi then attaches to the SPs

Question 13

what do the vertical fibers of the thoracolumbar fascia attach to?

Answer 13

gluteus maximus and SP

Question 14

what do the horizontal fibers of the thoracolumbar fascia attach to?

Answer 14

the transverse abdominus and abdominal obliques to SP

Question 15

what do the oblique fibers of the thoracolumbar fascia attach to?

Answer 15

the latissimus dorsi and SP

Question 16

active muscles create tension of the fascia which transmit what?

Answer 16

longitudinal tension to the tips of lumbar SPs for passive stability

Question 17

describe what happens with co-contraction during lifting in regards to the thoracolumbar fascia?

Answer 17

it gets pulled in all directions which means the spine stays in neutral and is safe

Question 18

what muscles make up the erector spinae group?

Answer 18

iliocostalis, longisimus, and spinalis

Question 19

describe the erector spinae muscles as a group

Answer 19

common origin on iliac crest and sacrum and insert laterally
diverse= origin to insertion is relatively central to lateral
very long cross many motion segments as well as having multiple attachments

Question 20

what kind of muscle is the erector spinae group? (spurt or shunt)

Answer 20

spurt they are a mover muscle

Question 21

what movements does the erector spinae muscles do?

Answer 21

extension, lateral bending, and rotation to ipsilateral side

Question 22

describe the multifidi and rotatores

Answer 22

short muscles, TP to SP
converge= origin to insertion is relatively lateral to central

Question 23

what kind of muscle are the multifidi and rotatores (shunt or spurt)?

Answer 23

shunt muscle because they are stabilizers and cross 1 or 2 segments however have low angle of pull secondary to converging

Question 24

what movements do the multifidi and rotatores do?

Answer 24

create SB to same side and rotation to opposite side acting unilaterally, extend.

Question 25

what is the action of the rectus abdominus?

Answer 25

to create trunk forward flexion (top-down motion) or posterior pelvic rotation (bottom-up motion)

Question 26

what are the agonists and antagonists to standing trunk flexion?

Answer 26

agonist: con RA to initiate flex then gravity antagonist: ecc errector spinae

Question 27

what are the agonists and antagonists to standing trunk extension?

Answer 27

agonist: initial burst of erector spinae then gravity antagonist: ecc RA

Question 28

is lying on your back going to do a crunch a top down or bottom up motion?

Answer 28

top down

Question 29

is a reverse crunch (bringing your knees to chest) a top down or bottom up motion?

Answer 29

bottom up

Question 30

how do the external obliques run?

Answer 30

start superolateral and run inferomedial "hands in front pockets" - ribs 5-12 to anterior iliac crest and pubic tubercle

Question 31

what is the action of the external obliques?

Answer 31

rotate trunk to contralateral side

Question 32

how do the internal obliques run?

Answer 32

"hands in back pockets" - inguinal lig, anterior crest to inferior ribs 10-12 and linea alba

Question 33

what is the action of the internal obliques?

Answer 33

rotate trunk to ipsilateral side

Question 34

do both the internal and external obliques attach to thoracolumbar fascia?

Answer 34

external obliques are questionable but internal definitely do

Question 35

describe co-contraction at the trunk

Answer 35

contraction of trunk flexors and extensors simultaneously = core stability compressive forces inc shear forces dec

Question 36

what 3 things increase with co contraction?

Answer 36

intrathecal pressure intra-abdominal pressure intradiskal pressure

Question 37

when the erector spinae contract they shorten and thicken which pushes the TFL to do what?

Answer 37

increase its passive stabilization component

Question 38

what is the mechanism of force transmission through an IV disc?

Answer 38

compression force via superincumbent BW and muscle contraction raise hydrostatic pressure in disc increased pressure increases tension in annulus fibrosis this increased annular tension inhibits radial expansion on nucleus-rise in nuclear pressure is exerted on endplates proximal and distal (hoop stress) increased nuclear pressure reinforces the peripheral annulus fibrosis converting it into a stable WB structure the pressure is ultimately transmitted across the endplates to the next vertebrae

Question 39

what is the orientation of the lamellar ring of the annulus fibrosis?

Answer 39

arranged in multiple concentric layers every other layer running in the same direction approx 65-80º from vertical entire disc itself is a check rein to rotation

Question 40

describe the osteokinematics of the lumbar kinematics

Answer 40

facet orientation dictates flexion/extension is primary direction of motion flexion more limited than extension- flexion requires synergistic activity of pelvis

Question 41

where does the greatest flexion occur?

Answer 41

at L4/5 and lumbrosacral junction

Question 42

does SB and rotation increase or decrease from L1-L5?

Answer 42

decrease

Question 43

what are the arthrokinematics for flexion?

Answer 43

superior and anterior slide (more anterior than superior)

Question 44

what are the arthrokinematics for extension?

Answer 44

posterior and inferior