Lumbopelvic Anatomy and Kinematics
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Questions and Answers

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.

False (B)

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.

<p>False (B)</p> Signup and view all the answers

The obturator nerve, part of the lumbar plexus, primarily innervates the anterior thigh muscles.

<p>False (B)</p> Signup and view all the answers

Normal lumbar flexion range of motion is typically between 65-85 degrees.

<p>False (B)</p> Signup and view all the answers

Rotation in the lumbopelvic region is primarily limited by the intervertebral discs.

<p>False (B)</p> Signup and view all the answers

Nutation of the sacrum involves the sacral base rotating anteriorly and inferiorly, while the coccyx moves posteriorly.

<p>True (A)</p> Signup and view all the answers

An upslip of the innominate bone refers to a superior shear force causing the ilium to shift upwards relative to the sacrum.

<p>True (A)</p> Signup and view all the answers

During lumbar extension, the facet joints 'open,' allowing for increased space and reduced compression.

<p>False (B)</p> Signup and view all the answers

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.

<p>True (A)</p> Signup and view all the answers

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.

<p>False (B)</p> Signup and view all the answers

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.

<p>False (B)</p> Signup and view all the answers

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.

<p>False (B)</p> Signup and view all the answers

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.

<p>False (B)</p> Signup and view all the answers

Flashcards

Lumbar Vertebrae

Five vertebrae in the lower back region of the spine.

Osteokinematics

The movement of bones at joints, including flexion, extension, rotation.

Facet Joints

Joints between the vertebrae that allow for movement and stability.

Nutation

The tilting forward of the sacrum with movement of the pelvis.

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Counternutation

The backward tilting of the sacrum; opposite of nutation.

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Innominate Dysfunctions

Pelvic misalignments affecting motion patterns.

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Lumbar Spine Muscles

Muscles supporting and moving the lumbar spine.

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Arthrokinematics

The movement between joint surfaces during motion.

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Lateral Flexion

Bending the trunk sideways; movement in the frontal plane.

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Sacral Torsions

Twisting of the sacrum around its axes affecting posture.

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Fryette's Law #1

In neutral spine, side bending and rotation occur in opposite directions.

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Fryette's Law #2

In flexed or extended spine, side bending and rotation occur in the same direction.

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Fryette's Law #3

Motion in one direction decreases motion in all other directions.

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Palpation

The process of examining by touch to assess structures in the body.

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Bony Landmarks in Palpation

Key anatomical points include spinous processes and iliac crest landmarks.

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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.

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