Fryette's Laws and Lumbar Spine Anatomy Quiz

Lumbopelvic Anatomy and Kinematics

• The presentation covers lumbopelvic anatomy and kinematics.
• Objectives include understanding the normal anatomy and arthrokinematics of this region.
• Also, learning Fryette's laws of coupled motion in the spine.
• Demonstrating the ability to palpate specific structures in the lumbopelvic region is another objective.

Lumbar Spine

• The lumbar spine contains 5 lumbar vertebrae.
• Key ligaments include the anterior longitudinal ligament, posterior longitudinal ligament, ligamentum flavum, and interspinal ligament.
• Facet joint orientation varies significantly, with common types including half-moon, flat (normal), and asymmetric half-moon/flat shapes.
• L5-S1 facet anomalies (tropisms) are also discussed.
• Important structures include the intervertebral disc and endplate.

Sacrum/Pelvis

• The sacrum comprises 5 fused vertebrae.
• The coccyx is also a part of this region , composed of 5 fused vertebrae (tailbone).
• Key ligaments include the anterior longitudinal ligament, iliolumbar ligament, and various sacroiliac ligaments (anterior sacroiliac, sacrotuberous, sacrospinous).
• Pelvic anatomy includes the ilium, pubis, and ischium.
• The presentation covers variations in pelvic shape (gynecoid and android).

Lumbopelvic Muscles

• Superficial and deep muscles are included.
• Examples include the Erector spinae, Hip abductors, hip extensors/rotators, hip flexors, and hip adductors.
• The presentation outlines muscles of the sacrum/pelvis.

Lumbopelvic Nerves

• The lumbar and sacral plexuses are discussed.
• The presentation details the nerve structures and their roles.
• The sciatic nerve may also be involved.

Osteokinematics

• Lumbopelvic flexion ranges from 40-60 degrees.
• Extension ranges from 20-35 degrees.
• Lateral flexion ranges from 15-20 degrees.
• Rotation ranges from 3-18 degrees.
• Rotation is limited by facet joint orientation.
• Nutation and counternutation are also key concepts.
• Innominate dysfunctions (inflare, outflare, anterior/posterior rotation, upslip/downslip) are presented.
• Sacral torsions are another topic in the osteokinematic section.

Arthrokinematics

• Facet joint sliding without rotation.
• Intervertebral joint pivoting and gliding are key aspects.
• Ball-bearing action is discussed in the material.
• "Closing" and "opening" of facet joints are noted.
• Key movements: Sacral nutation and counternutation.

Fryette's Laws

• Fryette's Laws, two basic laws, are discussed in relation to spine mechanics.
• Law #1: When the spine is in a neutral position, side bending will occur in a direction opposite to the axis of rotation.
• Law #2: When the spine is in a non-neutral position (flexed or extended), side bending and rotation will occur in the same direction.
• Law #3: Motion in one direction limits motion in other directions, particularly when considering high-velocity, low-amplitude manipulation techniques for the spine.

Palpation

• Bony landmarks for palpation include spinous processes, iliac crests, posterior superior iliac spines, sacral base, S2 spinous processes, inferior lateral angle of sacrum, ischial tuberosities, ASIS, AIIS, and pubic symphysis.
• Soft tissue landmarks also include erector spinae, hip abductors, hip extensors/rotators, hip flexors, and hip adductors.