Podcast
Questions and Answers
According to Fryette's Laws, what happens to spinal motion in one direction?
According to Fryette's Laws, what happens to spinal motion in one direction?
Which movement combination occurs in non-neutral mechanics according to Fryette's Laws?
Which movement combination occurs in non-neutral mechanics according to Fryette's Laws?
What is the implication of understanding normal lumbopelvic anatomy in a clinical setting?
What is the implication of understanding normal lumbopelvic anatomy in a clinical setting?
Which anatomical landmark corresponds to the L4 spinous process?
Which anatomical landmark corresponds to the L4 spinous process?
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In what spinal condition are side bending and rotation in opposite directions as per Fryette's Laws?
In what spinal condition are side bending and rotation in opposite directions as per Fryette's Laws?
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Which ligament is primarily involved in preventing hyperextension in the lumbar spine?
Which ligament is primarily involved in preventing hyperextension in the lumbar spine?
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What type of motion is primarily restricted by the orientation of facet joints in the lumbar spine?
What type of motion is primarily restricted by the orientation of facet joints in the lumbar spine?
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What is the term used to describe an anterior and posterior rotation of the innominate bones?
What is the term used to describe an anterior and posterior rotation of the innominate bones?
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Which motion occurs when there is 'closing' of the facet joints?
Which motion occurs when there is 'closing' of the facet joints?
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In Fryette's laws, which type of spinal motion occurs in the thoracic and lumbar regions when the spine is in a flexed or extended position without load?
In Fryette's laws, which type of spinal motion occurs in the thoracic and lumbar regions when the spine is in a flexed or extended position without load?
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Which bones are involved during the process of nutation and counternutation?
Which bones are involved during the process of nutation and counternutation?
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Which term describes an innominate dysfunction where the anterior iliac bone moves outward?
Which term describes an innominate dysfunction where the anterior iliac bone moves outward?
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What is a common arthrokinematic feature of intervertebral joints?
What is a common arthrokinematic feature of intervertebral joints?
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What is a facet anomaly found at the L5–S1 level known as?
What is a facet anomaly found at the L5–S1 level known as?
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During which movement does the sacral articular surface glide inferoposteriorly?
During which movement does the sacral articular surface glide inferoposteriorly?
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Study Notes
Lumbopelvic Anatomy and Kinematics
- Objectives: Understand lumbopelvic region anatomy and arthrokinematics; learn Fryette's laws of coupled motion; demonstrate ability to palpate structures in the lumbopelvic region.
Lumbopelvic Region Anatomy
- Lumbar Spine: Contains 5 lumbar vertebrae.
- Ligaments: Includes anterior longitudinal ligament, posterior longitudinal ligament, ligamentum flavum, and interspinal ligament.
- Facet Joints: Facet joint orientation varies significantly; common shapes include half-moon (2%), flat (normal 57%), and asymmetric half-moon/flat (31%).
- Intervertebral Disc: Includes the endplate.
- Sacrum/Coccyx: 5 fused vertebrae form the sacrum, another fused group of vertebrae forms the coccyx (tailbone).
Sacrum and Pelvis
- Sacrum: 5 fused vertebrae. Features include sacral canal, anterior and dorsal sacral foramina, sacral hiatus, and the sacral base/apex.
- Coccyx: 3-5 fused vertebrae; often described as the tail bone.
- Pelvis: Components include ilium, ischium, pubis, and the pelvic inlet/outlet. The study also includes descriptions of specific bony landmarks (superior/inferior articular facets, sacral base, PSIS, and other bony landmarks to aid in palpation).
Muscles (Sacral/Pelvic Area)
- Superficial Muscles: Gluteus medius, gluteus maximus, piriformis.
- Deep Muscles: Gemellus superior/inferior, obturator internus/externus, quadratus femoris.
Muscles (Lumbar Spine Area)
- Superficial Muscles: Semispinalis capitis, semispinalis cervicis; sternocleidomastoid, trapezius, splenius capitis, Levator scapulae, rhomboideus minor/major, supraspinatus, infraspinatus, teres minor/major, latissimus dorsi, serratus anterior/posterior, external oblique, internal oblique.
- Deep Muscles: Multifidus, rotator brevis, rotator longus, interspinales, erector spinae, short rotator.
- Related Muscles: Iliopsoas, tensor fasciae latae, sartorius, rectus femoris, adductor longus, vastus lateralis, vastus medialis, vastus intermedius, pectineus, gracilis, adductor brevis.
Nerves
- Lumbar Plexus: Important nerve supply.
- Sacral Plexus: Important nerve supply
Lumbopelvic Osteokinematics
- General Ranges of Motion: Flexion (40–60°), extension (20–35°), lateral flexion (15–20°), rotation (3–18°).
- Rotation Limited: by facet joint orientation.
- Nutation and Counternutation: describe sacral movement.
- Innominate Dysfunctions: Inflare/outflare, anterior/posterior rotation, upslip/downslip, and sacral torsions.
Lumbopelvic Arthrokinematics
- Facet Joint Sliding: Slide without roll.
- Intervertebral Joints: Pivot and glide.
- Ball Bearing Action: How vertebrae interface.
- Closing/Opening of facets: The mechanism of movement relates to flexion, extension, lateral flexion, and rotation (ipsilateral/contralateral).
- Sacral Nutation/Counternutation: Describes sacral movement along its articulation with the pelvis.
Fryette's Laws
- Law 1: Sidebending and rotation occur in opposite directions when spine is neutral.
- Law 2: Sidebending and rotation occur in the same direction when spine is flexed or extended.
- Law 3: Motion in one direction can limit or decrease motion in other directions.
Palpation
- Bony Landmarks: Top of iliac crest = L4 spinous process; PSIS, sacral base, s2 spinous process, inferior lateral angle of sacrum, ischial tuberosity, ASIS, AIIS, pubic symphysis.
- Soft Tissues: Erector spinae, hip abductors,hip extensors/rotators, hip flexors, hip adductors.
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Description
This quiz focuses on the anatomy and kinematics of the lumbopelvic region. Participants will explore key components such as lumbar spine structures, ligaments, facet joints, and the sacrum. Gain insights into Fryette's laws of motion as well as palpation techniques for relevant anatomical structures.