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95 Cards in this Set
- Front
- Back
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What is a cartilage covering of superior/inferior vertebral body that provides and attachment for IVD?
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Endplates
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How many fused vertebrae are in the sacrum?
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5
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How many fused vertebrae are in the coccyx?
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4
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What is the purpose of the sacrum?
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Provide strength and stability
Occasional lumarization |
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Which ligaments in the lumbar region are extrasegmental?
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Anterior Longitudinal
Posterior Longitudinal Supraspinal |
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Which ligaments in the lumbar spine are intersegmental?
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Flavum
Interspinal Intertransverse |
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What motion does the ligamentum flavum resist?
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Lamia separation
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What motion does the interspinal ligament resist?
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Separation of vertebral bodies
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What motion does the intertransverse ligament prevent?
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Separation of t-processes
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What motion does the anterior longitudinal ligament prevent?
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Excessive Hyperextension
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What motion does the posterior longitudinal ligament prevent?
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Excessive Flexion
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What motion the supraspinal ligament prevent?
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Excessive Flexion
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What motion does the iliolumbar ligament resist?
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Most motions
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What are purposes of the thoracolumbar fascia?
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Connect with abdominal fascia:
Direct connection from anterior to posterior Multiple bony and muscle attachments |
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What vertebral level is approximately at the iliac crest?
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L4-L5
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What vertebral level is approximately at the PSIS?
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S2
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What types of joints are the interbody joints of the lumbar spine?
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Symphyses
Amphiarthroses |
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What type of joint is the Z joint?
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Synovial Planar
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What is the purpose of the interbody joint?
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Minimal deformity/translation
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What is the purpose of the anulus fibrosis?
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Tolerate high tensile loads
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What composes the nucleus pulposus?
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Mucopolysaccaride of about 70-90% water.
The rest is collagen, elastic fibers, and proteins |
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What is the purpose of the nucleus pulposus?
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Important for nutrition
Compression tolerance in conjuction with annulus |
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What can change the shape of the IVD?
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Hydration
Reduce or increase loading |
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The IVD has potential to ______ ________ __________ during compression
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store elastic energy
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During side bending, where is compression of the disc?
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Ipsilateral
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What is the importance of the IVD and rotation?
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Only a portion of oblique fibers under tension-thus reduced ability to resist torsion
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During normal lordosis, what is the approximate intradiscal pressure?
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400 N
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During sitting unsupported, has much can the intradiscal pressure in the lumbar spine increase?
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200-300 N
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What type of motion does the Z joint resist?
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Shear forces
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Stability in the lumbar spine is a combination of what?
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Bony congruency/architecture
Muscle activity/motor control Ligamentous/passive stabilizers Intraabdominal pressure |
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What are the osteokinematics of the lumbar spine?
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Flexion: 50-60 degrees
Extension: 15-30 degrees Lateral flexion: 15-25 degrees Rotation: up to 16 degrees |
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What is the open pack position of the lumbar spine?
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Neutral
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What is the closed pack position of the lumbar spine?
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Full extension
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What is the capsular patter of the lumbar spine?
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Side flexion and rotation equally limited, then extension
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What are normal endfeels of the lumbar spine?
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Firm
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What is joint coupling in the lumbar spine is the neutral or extended position?
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Contralateral
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What is joint coupling in the lumbar spine in the flexed position?
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Ipsilateral
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What are muscle functions in the lumbar spine?
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Movement
Stability Posture |
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What are the normal maximum forces in the lumbar spine?
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Compression: 10 kN
Shear: 1000 N |
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What can assist the stability of the lumbar spine?
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Distribution of load appropriately
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During walking, what is the load distribution of the lumbar spine?
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Relatively low load (Compressive up to 2.5 times body weight)
Mild shear |
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During bending, what is the load distribution of the lumbar spine?
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With maintenance of lordorsis:
Improved muscle ability to resist shear and distribute forces appropriately |
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During sitting, what does an increased flexion in the lumbar spine influence?
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Increase compression
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What are the complications with respect to forces and moments with a slouched sitting posture?
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Increased torque, compression, and shear force
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What are important in stability of the lumbar spine?
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Co-contraction
Lumbodorsal fascia Intraabdominal pressure Posture |
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How might abdominal bracing decrease injury to posterior structures?
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What is the main idea of the ball in a bowl model?
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Useful for conceptualizing dynamic stability/instability
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What exercises can help with spine stability?
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Aerobic
Endurance with strength Core stability and abdominal bracing |
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What are guidelines with developing lumbar exercises?
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Start with motion
Strengthening Low load high rep Initial and maintenance Higher load lower rep to build bulk/power Curl ups Lateral stabilizers Extensors Dosing Daily preferably unless irritable Include cardio Be careful with positioning |
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What are functions of the pelvic girdle?
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Supports the weight of the body
Transmits ground forces upward to the vertebral column. Supports and protects pelvic viscera Muscle attachment Birth canal |
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What is commonly known as the hip bone?
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Os Coxae
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What 3 bones compose the Os Coxa?
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Ilium
Ischium Pubis |
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The inlet superior of the pelvis oriented in which direction?
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Vertically
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The outlet inferior of the pelvis oriented in which direction?
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Horizontally
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What are the main bony landmarks of the ilium?
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Iliac tuberosity
Auricular surface Iliac Crest Iliac fossa Posterior Superior Iliac Spine (PSIS) Anterior Superior Iliac Spine (ASIS) |
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What are the main bony landmarks of the ischium?
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Ischialbody
Ischialspine Ischialtuberosity Ramus |
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What are the main bony landmarks of the sacrum and coccyx?
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Base
Superior articularprocess Ala Foramina Auricular Surface Pelvic Surface |
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What are main ligaments of the pelvis?
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Anterior/ventral sacroiliac ligament
Posterior/dorsal sacroiliac ligament InterosseousSI ligament Sacrotuberousligament Sacrospinousligament Iliolumbarligament 2-3 bands (lower band “lumbosacralligament”) |
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What is the lumbosacral angle?
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What influences the lumbosacral angle?
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Anterior pelvic tilt increases the angle
Posterior pelvic tilt decreases the angle |
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What are the two parts of the SI joint?
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Synovial L-shaped
Fibrous Synarthrosis |
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What are the key ligaments of the SI joint?
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Ventral/dorsal SI
Interosseous SI |
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What motions occur at the SI joint?
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Nutation
Counternutation |
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What are the arthrokinematics of the of the SI joint?
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Rotation of either the sacrum on the ilium or vice versa
Base moves in opposite direction of apex Some translation accompanies rotation |
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What are the two main ligaments of the pubic symphysis?
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Superior pubic
Inferior pubic |
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Why is the pubic symphysis important?
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Balance of stability/mobility critical to the stability/mobility of the pelvis
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Which muscles assist in anterior pelvic tilt?
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Hip flexors
Back extensors |
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Which muscles assist in posterior pelvic tilt?
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Trunk flexors
Hip extensors |
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Which muscles assist in lateral pelvic tilt?
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Hip abductors
Lateral trunk flexors |
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What are functions of the pelvic muscles?
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Support for pelvic organs
Keep urogenitalorifices closed Unload other pelvic connective tissue Routine postural adjustments Support during increased intraabdominalpressure Control of functions such as micturition, defacation, sexual function, parturition |
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What is the relative direction of the superior articular facet of the lumbar spine?
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Facing medial like it would rotate around a cylinder
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What are the extrasegmental ligaments of the lumbar spine?
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Anterior Longitudinal
Posterior Longitudinal Supraspinal |
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What are the intersegmental ligaments of the lumbar spine?
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Ligamentum Flavum
Interspinal Intertransverse |
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What motion does the iliolumbar ligament resist?
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Most motions
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What are implications of viscoelastic ligaments?
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If I impart forces more quickly, the resistance is more stiff.
The time to return to original resting tension is usually slower than when it was stretched. |
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What are implications to having a highly elastic ligamentum flavum?
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It limits all sorts of motion, but still allows us to move and to be stable.
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What are characteristics of the thoracolumbar fascia?
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3 layers
Connect with abdominal fascia Multiple bony and muscle attachments |
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What is the guideline to palpating L4-L5?
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Iliac Crest
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What is the guideline to palpating S2?
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PSIS
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What is the orientation of the fibers of the IVD in the lumbar spine?
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Oblique orientation
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What are characteristics of the IVD nucleus pulposus in the lumbar spine?
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Mucopolysaccarideapprox 70-90% water
The rest is collagen, elastic fibers and proteins Important for nutrition Compression tolerance in conjunction with annulus |
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What is the effect of hydration on the IVD?
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Hydration can change the shape of the disc throughout the day-Change in height
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What is a hoop stress?
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The compression force on the disc actually creates a tension force
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How is the lumbar IVD able to resist rotation?
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Only a portion of oblique fibers under tension-thus reduced ability to resist torsion
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What is the normal lordotic pressure in the lumbar disc?
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400 N
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What increases pressure in the lumbar disc?
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Flexion
Increased muscle activity Lifting Sitting unsupported |
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What is the innermost abdominal muscle?
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Transverse Abdominis
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What structure do the abs attach to that has an effect on the lumbar spine?
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Thoracolumbar fascia
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What motion does the rectus abdominis perform?
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Trunk flexion
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What does the quadratus lumborum perform?
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Hiking the hip
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Rotating to the right, was does the right facet joint do?
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Gapping
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How much load distribution is there in the lumbar spine in a neutral position?
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400N
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How much load distribution is there in the lumbar spine under max pressure?
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10kN compression
1000 N shear |
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What can assist the lumbar spine in stability?
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Appropriately distributing loads
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During flexion, what are the magnitudes of shear and compression forces in the lumbar spine?
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1000 N shear
3000 N compression |
