lumbopelvic part 2

Question 1

according to fryettes law 1 neutral mechanics what is occurring?

Answer 1

rotation and SB to opposite sides

Question 2

according to fryettes law 2 non-neutral mechanics what is occurring?

Answer 2

rotation and side bending to same side

Question 3

recap: what are the arthrokinematics for flexion?

Answer 3

anterior/superior glide

Question 4

recap: what are the arthrokinematics for extension?

Answer 4

posterior/inferior glide

Question 5

what is occurring with flexion?

Answer 5

the interspinous ligament tension loaded
the posterior IV disc tension loaded
increase intervertebral foramen
anterior IV disc compress
decompress the nerve root

Question 6

what is occurring with extension?

Answer 6

interspinous ligament compressed
posterior IV disc compressed
decreased intervertebral foramen
anterior IV disc tensioned
compress the nerve root

Question 7

what is occurring with rotation?

Answer 7

joint approximation on contra side
joint separation on ipsi side

Question 8

what are the arthrokinematics for lateral flexion?

Answer 8

ipsi: posterior/inferior glide
contra: superior/anterior glide

Question 9

what is the angle of the sacrum?

Answer 9

angle between base of sacrum and the horizontal plane

Question 10

what is the normal angle of the sacrum?

Answer 10

30º

Question 11

what does an increased angle of the sacrum do?

Answer 11

increases lumbar lordosis and anterior shear

Question 12

does the pelvis rotate with an increased angle of the sacrum?

Answer 12

yes increasing the angle = neutating (flexing) sacrum, lumbar spine posterior increasing lordosis causing anterior pelvic rotation

Question 13

what is the lumbrosacral angle?

Answer 13

measured by the obtuse angle of the middle axes of L5 and S1, which is open posteriorly

Question 14

what is the normal lumbrosacral angle?

Answer 14

140º

Question 15

what does the lumbrosacral angle and the wedged shaped L5/S1 disk initiate?

Answer 15

lumbar lordosis

Question 16

in neutral how are the shear forces at L5/S1?

Answer 16

relatively high

Question 17

in extension how are the shear forces at L5/S1?

Answer 17

significantly high

Question 18

with the sacral angle is less than 30º what does the lumbrosacral angle do?

Answer 18

increases (posterior pelvic rotation) which decreases shear force

Question 19

with the sacral angle is more than 30º what does the lumbrosacral angle do?

Answer 19

decrease (anterior pelvic tilt) which increases shear forces

Question 20

what keeps the anterior shear forces in the check and how?

Answer 20

iliolumbar ligaments- inhibit L4 on L5 and L5 on S1 ant. shear forces primarily due to transverse orientated fibers
disk- anterior wedge shaped (bad dont want this bc lead to DJD)
ALL

Question 21

list check rein structures for flexion

Answer 21

anything posterior to AOR:
bilateral transverse ligaments
nucleus pulposus compression wise
erector spinae
spinal cord (but bad option)
PLL
ligamentum flavum
interspinous/supraspinous ligaments
posterior aspect annulus fibrosus
xigopophaseal joint capsules

Question 22

list check rein structures for extension

Answer 22

anything anterior to AOR:
ALL
annulous fibrosus on ant margin disc
closing of facets
rectus abdominis
bilateral intertransverse ligaments

Question 23

list check rein structures for rotation

Answer 23

lamellar rings
annulous fibrosis circumferentially
tension ipsy xigopophaseal joint
contralateral facet joint compression

Question 24

list check rein structures for sidebending

Answer 24

contralateral soft tissue: erector spinae, intertransverse lig, annulous fibrosus fibers
ipsilateral: closure of facet, compression of IV disc, compress spinal nerve root

Question 25

which position loads the disk the least?

Answer 25

laying supine

Question 26

how is the moment arm affected in standing to sitting to slouched sitting?

Answer 26

increases the MA

Question 27

how much forward flexion does the lumbar spine allow in the lumbo-pelvic rhythm?

Answer 27

first 60º

Question 28

how do we achieve terminal flexion?

Answer 28

synergistic pelvic tilting

Question 29

what is the lumbo-pelvic rhythm?

Answer 29

inter connection of movement between the lumbar spine, the sacrum, and the pelvis
combination of lumbar flexion and anterior pelvic rotation
top down motion

Question 30

what is nutation?

Answer 30

(flexion) sacral base moves anterior/inferior, coccyx moves posterior/superior

Question 31

what is counternutation?

Answer 31

(extension) sacral base moves posterior/ inferior, coccyx moves anterior/superior

Question 32

list the order of events for the lumbo-pelvic rhythm?

Answer 32

1. lumbar spine flexion
2. sacral nutation
3. anterior pelvic rotation- controlled by soft tissue tension (hamstrings bc of attachment on ischial tub)
4. sacral counternutation (tighter the hamstrings get the more they restrict anterior pelvic tilt)
5. posterior pelvic translation (so COM doesn’t fall out of BOS)

Question 33

what is the non lumbo-pelvic rhythm?

Answer 33

bottom up motion
supine flexion of hips- posterior pelvic rotation- sacral nutation (fixed sacrum = anterior displaced base if hard surface)- knees to chest motion
supine hip extension- anterior pelvic tilt- sacral counternutation (fixed sacrum= posterior displaced base- if hard surface)- leg off side drop toward floor motion

Question 34

what is spondylosis?

Answer 34

DJD or arthritis

Question 35

what is spondylolysis?

Answer 35

pathological fracture of the pars interarticularis unilateral or bilateral (bridge between articular surfaces)

Question 36

what is spondylolysthesis?

Answer 36

anterior slippage of the vertebral body secondary to bilateral spondylolysis
can grade 1,2,3 depending on degree