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Questions and Answers
The anterior longitudinal ligament is located posterior to the vertebral bodies in the lumbar spine.
The anterior longitudinal ligament is located posterior to the vertebral bodies in the lumbar spine.
False (B)
Facet joint orientation is uniform throughout the lumbar spine, providing consistent rotational stability at each level.
Facet joint orientation is uniform throughout the lumbar spine, providing consistent rotational stability at each level.
False (B)
The intervertebral disc is composed of the nucleus pulposus, annulus fibrosus and the spinous process.
The intervertebral disc is composed of the nucleus pulposus, annulus fibrosus and the spinous process.
False (B)
The sacrum is comprised of 3 fused vertebrae, providing a stable base for the spine.
The sacrum is comprised of 3 fused vertebrae, providing a stable base for the spine.
The obturator nerve, part of the lumbar plexus, primarily innervates the anterior thigh muscles.
The obturator nerve, part of the lumbar plexus, primarily innervates the anterior thigh muscles.
Normal lumbar flexion range of motion is typically between 65-85 degrees.
Normal lumbar flexion range of motion is typically between 65-85 degrees.
Rotation in the lumbopelvic region is primarily limited by the intervertebral discs.
Rotation in the lumbopelvic region is primarily limited by the intervertebral discs.
Nutation of the sacrum involves the sacral base rotating anteriorly and inferiorly, while the coccyx moves posteriorly.
Nutation of the sacrum involves the sacral base rotating anteriorly and inferiorly, while the coccyx moves posteriorly.
An upslip of the innominate bone refers to a superior shear force causing the ilium to shift upwards relative to the sacrum.
An upslip of the innominate bone refers to a superior shear force causing the ilium to shift upwards relative to the sacrum.
During lumbar extension, the facet joints 'open,' allowing for increased space and reduced compression.
During lumbar extension, the facet joints 'open,' allowing for increased space and reduced compression.
According to Fryette’s Law #1, if the spine is in a neutral position, side bending to the right will result in rotation to the left of the same vertebral segment.
According to Fryette’s Law #1, if the spine is in a neutral position, side bending to the right will result in rotation to the left of the same vertebral segment.
In a non-neutral spinal position such as flexion, if side bending occurs to the left, Fryette's Law #2 indicates that rotation will occur to the right at the same vertebral level.
In a non-neutral spinal position such as flexion, if side bending occurs to the left, Fryette's Law #2 indicates that rotation will occur to the right at the same vertebral level.
Fryette’s Law #3 implies that if motion is enhanced in one plane of the spine, motion in all other planes will consequently also be enhanced.
Fryette’s Law #3 implies that if motion is enhanced in one plane of the spine, motion in all other planes will consequently also be enhanced.
When palpating bony landmarks of the lumbar spine, the spinous process of the L3 vertebra is typically located at the level of the top of the iliac crest.
When palpating bony landmarks of the lumbar spine, the spinous process of the L3 vertebra is typically located at the level of the top of the iliac crest.
The hip adductors, such as the adductor magnus and adductor longus, are classified as soft tissues of the posterior lumbopelvic region and are not typically considered in palpation assessments of this area.
The hip adductors, such as the adductor magnus and adductor longus, are classified as soft tissues of the posterior lumbopelvic region and are not typically considered in palpation assessments of this area.
Flashcards
Lumbar Vertebrae
Lumbar Vertebrae
Five vertebrae in the lower back region of the spine.
Osteokinematics
Osteokinematics
The movement of bones at joints, including flexion, extension, rotation.
Facet Joints
Facet Joints
Joints between the vertebrae that allow for movement and stability.
Nutation
Nutation
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Counternutation
Counternutation
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Innominate Dysfunctions
Innominate Dysfunctions
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Lumbar Spine Muscles
Lumbar Spine Muscles
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Arthrokinematics
Arthrokinematics
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Lateral Flexion
Lateral Flexion
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Sacral Torsions
Sacral Torsions
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Fryette's Law #1
Fryette's Law #1
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Fryette's Law #2
Fryette's Law #2
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Fryette's Law #3
Fryette's Law #3
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Palpation
Palpation
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Bony Landmarks in Palpation
Bony Landmarks in Palpation
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Study Notes
Lumbopelvic Anatomy and Kinematics
- Objectives: understand the normal anatomy of the lumbopelvic region, understand the osteokinematics and arthrokinematics of the lumbopelvic region, become familiar with Fryette's laws of coupled motion in the spine, demonstrate ability to palpate selected structures in the lumbopelvic region
Lumbar Spine
- Five lumbar vertebrae
- Anterior longitudinal ligament
- Posterior longitudinal ligament
- Ligamentum flavum
- Interspinous ligament
- Facet joints: orientation varies significantly (half-moon, flat, asymmetric half-moon, half-flat)
- Intervertebral Disc: endplate
Lumbar Spine Muscles
- Detailed diagram of superficial and deep muscles, including (but not limited to)
- Semispinalis capitis
- Iliocostalis cervicis
- Longissimus cervicis
- Iliocostalis thoracis
- Longissimus thoracis
- Multifidus
- Rotator brevis
- Rotator longus
- Interspinales
- Erector spinae
Sacrum/Pelvis
- Five fused vertebrae (coccyx)
- Ligaments: anterior longitudinal, iliolumbar, lumbosacral, posterior sacroiliac, sacrospinous, sacrotuberous
- Sacrum: superior and inferior articular facets, ala, sacral canal, base, apex, dorsal and anterior sacral foramina, sacral hiatus
Pelvis
- Bones: ilium, ischium, pubis
- Pelvic brim, inlet, outlet
- Anterior superior/inferior iliac spines, ASIS, AIIS
- Ischial spines and tuberosities
- Greater/lesser sciatic notch, pubic crest, superior/inferior pubic rami
Innominate Dysfunctions
- Inflare/outflare
- Anterior/posterior rotation
- Upslip/downslip
- PSIS (posterior superior iliac spine), ASIS (anterior superior iliac spine), ischial tuberosity
Sacral Torsions
- Oblique axes
- Transverse axes
- Forward/backward sacral torsion
- Right/left sacral torsion
Lumbopelvic Nerves
- Lumbar plexus
- Sacral plexus
Osteokinematics
- Lumbopelvic motion: Flexion (40-60 degrees), Extension (20-35 degrees), Lateral Flexion (15-20 degrees), Rotation (3-18 degrees)
- Rotation limited by facet joint orientation
- Nutation vs Counternutation (sacrum and ilium movement)
Arthrokinematics
- Facet joint slide without roll
- Intervertebral joints pivot and glide (ball-bearing)
- “Closing” of facet joints - extension, ipsilateral lateral flexion, contralateral rotation
- “Opening” of facet joints - flexion, contralateral lateral flexion, ipsilateral rotation
- Sacral nutation and counternutation: inferoposterior glide, anterosuperior glide
Fryette's Laws
- Law #1: Neutral Mechanics: sidebending & rotation occur in opposite directions
- Law #2: Non-neutral Mechanics: sidebending & rotation occur in the same direction
- Law #3: direction of motion in one direction decreases in other directions
Palpation
- Bony Landmarks: spinous processes, top of iliac crest = L4 spinous process, PSIS, sacral base, S2 spinous process, Inferior Lateral Angle of sacrum (ILA), ischial tuberosity, ASIS, AIIS, pubic symphysis
- Soft Tissues: erector spinae, hip abductors, hip extensors/rotators, hip flexors, hip adductors
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Description
Explore the anatomy and movements of the lumbopelvic region, encompassing the lumbar spine, sacrum, and pelvis. Understand Fryette's laws and learn to palpate key structures. Review ligaments, facet joint orientation, and superficial and deep muscles.