1- Vertebral Column Flashcards
What does the vertebral column describe?
The entire set of vertebra (excluding ribs, sternum, and ilium)
How many vertebra in each section are there? How many total?
7 cervical 12 thoracic 5 lumbar 5 sacral 4 coccygeal (29 spinal vertebra total)
What are the 3 separate joints in the vertebral motion system?
1 joint between the 2 vertebral bodies and the IVD
2 articular process joints (zygoapophyseal joints/facet joints)
How many pairs of facet joints are there?
24
What type of joint is the facet joint?
planar
How are the C-spine facets oriented?
There are horizontal in the upper segments and move to more vertical (about 45 deg) in the lower segments
What are the articular surfaces of the facet joints covered in?
hyaline cartilage
What do the articular surfaces of the facet joints have and what does it do?
They have small fibrous synovial meniscoid-lik e fringes that project between the joint surfaces
- space fillers during displacement
- actively assist in the dispersal of synovial fluid
Horizontal articular surfaces favor ____, while vertical articular surfaces act to block ______.
Axial rotation
How are the cervical facet joints oriented?
relatively horizontal, especially upper (lower are about 45 degrees)
How are the thoracic facet joints oriented?
almost vertical direction (facilitates rotation and resists anterior displacement)
How are the lumbar facet joints oriented?
vertical with a J-shaped surface (restricts rotation and anterior shear)
Where are the intervertebral joints thicker in front?
Cervical and lumbar vertebra (contributes to lordosis)
How are the intervertebral discs attached to the vertebra?
through end plates and annular fibers
What are the 3 main parts of the disk?
Nucleus pulposus
Annulus fibrosus
Cartilage end plates
What are some major stresses that can be placed on the intervertebral disks?
Axial compression
Shearing
Bending
Twisting
What is a state of equilibrium/zero velocity called?
Static
What implies a change over time with constant velocity?
Dynamic
What are the 3 sub-systems that contribute to stability?
Passive system
Active system
Central Nervous system
What is the passive system?
Anatomical structures contributing to stability
What is the active system?
Muscles, sources of active stiffness
How does the central nervous system contribute to stability?
feedforward (anticipatory) and feedback (reflex) control
What is the region of laxity around the neutral resting position of a spinal segment?
Neutral Zone (Panjabi)
What is happened in the neutral zone?
- minimal loading occuring in passive and active structures
- spinal motion produces with minimal internal resistance
What do agonistic and synergisting muscles do?
Initiate and perform movements
What do antagonistic muscles do?`
Control and modify the movements
What is type of motion governed by?
- shape and orientation of articulations
- ligaments and muscles in segment
- size and location of articulating processes
How much flexion/extension does the upper cervical spine have?
Minimal
How much axial rotation for the upper cervical spine have?
about 30-40 degrees
How much flexion/extension does C2-3 have?
about 10 degrees
How much flexion/extension does C5-7 have?
about 20 degrees
How much axial rotation does the lower cervical spine have?
about 5-6 degrees
What is it called when two or more individual motions are coupled when one motion is always accompanied by another?
Coupling
All motions of a segment are defined by motion of the _____ vertebra on the ______ vertebra.
Upper on the lower
Rotation is to the side the ______ aspect of the vertebra is facing.
Anterior
What is Fryette’s First Law?
When lumbar or thoracic spine is in neutral, sidebending is opposite of rotation
What is Fryette’s Second Law?
When spine is in flexion or hyperextension, sidebending is same side as rotation
What is Fryette’s Third Law?
When the spine is placed in any directional plane, motion in another plane is restricted
What is a closing restriction? What does it cause?
Restriction of Ext/SB/Rot to the same side of pain
Compression
What is an opening restriction? What does it cause?
restriction of flex/SB/rot to the opposite side of pain
Stretch
Which system involves classifying symptoms into syndromes? What does it help with
Osteopathic
Patient response
What is the order of testing for the osteopathic model?
Extension, flexion, neutral
Where are neuromuscular impairments usually found?
spinal junctions (TL, CT)
Which system is based on providing a mechanical diagnosis?
McKenzie System
What is the order of testing for the McKenzie model?
Dynamic, then static
What are the results of tests classified into according to the McKenzie System?
- Postural
- Dysfunction
- Derangement
What do postural syndromes result from?
sustained loading of the tissues during end range positions
What do dysfunction syndromes result from?
adaptive shortening of some soft tissues and an overstretching of others
What do derangement syndromes result from?
displacement in the position of joint structures (IVD)…posterior or anterior
What are the treatment classifications for the McKenzie System?
- Mobilization
- Stabilization
- Specific Exercise
- Traction
Which system is based on an eclectic approach founded on an amalgam of doctrines and techniques that incorporate biomechanical concepts of the Norwegians?
Canadian Biomechanical Model
What are the testing procedures for the Canadian biomechanical model?
- Cyriax upper and lower quarter scanning
- Plane and combined movement testing
- Passive physiological intervertebral mobility (PPIVM) testing
- Passive accessory intervertebral motion (PAIVM) testing
- Segmental stability tests
What is ACDF?
Anterior Cervical Discectomy and Fusion
What is IDET?
Intradiscal Electrothermy Annuloplasty
