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Analysis of Movement > Axial Skeleton > Flashcards

Axial Skeleton Flashcards

1
Q

Why do different areas of the spine favor different motions?

A

the orientation of the facets allow for different motions in each area of the body (cervical, thoracic, etc)

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2
Q

What 4 things does the axial skeleton do?

A

1) transmission of forces to the lower extremity during walking
2) supports body weight
3) protects
4) shock absorption from disks

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3
Q

Why are the curves in our spine so important?

A

they help us absorb the compressive forces we endure; we’re 25% less effective at absorbing those forces without them

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4
Q

Why are the transitional areas in the spine (ex: C to T, T to L) likely to break down easier for pts?

A
  • those areas are more subject to sheer forces and can develop bone spurs more quickly
  • these areas are more likely for patients to have pain
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5
Q

T/F: Cervical and lumbar curves are primary curves.

A

false, secondary

- primary are thoracic and sacral

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6
Q

What creates the lumbar lordosis in a developing child?

A

the psoas tilts pelvis forward during walking, creating the lumbar lordosis

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7
Q

How are the curves physiologically able to form in a growing baby?

A
  • their vertebral bodies are half bone and half cartilage, they haven’t ossified yet
  • to get them to ossify, the babies need to weight bear
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8
Q

At what age is the spine at adult proportions?

A

10 y/o

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9
Q

Describe the line of gravity throughout the head to feet.

A

1) head: through mastoid/ext. acoustic meatus
2) thoracic: anterior to thoracic curve
3) hip: slightly posterior to hip, causing extension moment
4) knee: slightly anterior to knee: extension moment
5) ankle: anterior to ankle, dorsiflexion moment

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10
Q

How does the spine change when we age?

A
  • decreased lumbar lordosis
  • increased thoracic kyphosis
  • increased cervical lordosis
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11
Q

How can osteoporosis change the curves of the spine for women?

A

can cause an increased thoracic kyphosis, which can be compensated by a lumbar lordosis

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12
Q

T/F: The long SPs on thoracic vertebrae limit flexion.

A

false, extension

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13
Q

How are the thoracic vertebrae limited in motion? (by what bony anatomy?)

A

1) costal facets limit motion due to the articulation with the ribs
2) long SPs limit extension

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14
Q

What spinous ligament resists excessive side bend on the contralateral side?

A

intertransverse ligament

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15
Q

What ligaments resist excessive trunk flexion?

A
  • ligamentum flavum
  • interspinous ligaments
  • supraspinous ligaments
  • PLL
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16
Q

What motion does the ALL resist?

A

hyperextension

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17
Q

Describe the two parts of the IVD and their purpose.

A
  • nucleus pulposa = gel-like inner portion of disk, filled with H20, proteoglycans, and type II collagen
  • annulus fibrosis = rings of fibrous cartilage that contain the nucleus pulposa, helps distribute compressive forces
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18
Q

At what time of the day is the disk most hydrated?

A

Right in the morning, since it regains water overnight and swells up

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19
Q

What happens to the disk as we age? What is the “vicious cycle” that occurs?

A
  • nucleus pulposa dehydrates
  • this causes the disk to breakdown and vertebral bodies begin to touch, resulting in degeneration of the vertebral end plate
    • b/c the vertebral end plate is broken down, now the disk won’t get its nutrients, so it breaks down even more - vicious cycle
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20
Q

How do we prevent the degeneration of our disks as we age?

A
  • stay active
  • get lots of calcium
  • don’t smoke (prolongs healing time for disks, bad)
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21
Q

T/F: Creams can help prevent disk degeneration.

A

false, but certain injections can

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22
Q

How do intervertebral disks get nutrients?

A
  • end plates get peripheral blood flow, and then diffuse these nutrients into the disk
  • diffusion occurs from annulus fibrosis to nucleus pulposa
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23
Q

What are the two nutrient sources for the disk?

A

1) blood vessels in the superficial annulus

2) blood in adjacent vertebral bodies

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24
Q

What does a spinal motion segment consist of?

A

adjacent halves of two vertebrae, the disk in between, the related spinal canal and foramen

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25
Q

Which is stronger, ALL or PLL?

A

ALL

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26
Q

What motion occurs in the frontal plane, and about what axis?

A

side bend, about the AP axis

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27
Q

What motion occurs about the ML axis?

A

flexion/extension, in the sagittal plane

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28
Q

What plane and axis does rotation occur in?

A 
plane = horizontal
axis = vertical
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29
Q

T/F: Facets are smaller in the cervical region and larger in the lumbar region.

A

true

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30
Q

If the facet orientation is parallel to the horizontal plane, what motion is favored?

A

rotation (like the C-spine orientation)

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31
Q

The cervical facets are at what angle with the horizontal plane?

A

45 degrees

32
Q

What plane are the cervical facets parallel to, and what motion does this make them good for?

A

frontal, so really good for side bend

33
Q

T/F: Cervical facets are equally as good at flexion/extension as they are at side bending.

A

false

- best at side bend, then equally good at rotation and flex/extend (since 45 deg from both horizontal and vertical axes)

34
Q

In what direction do the cervical IAPs and SAPs lie?

A 
IAP = inferior and anterior direction
SAP = superior and posterior direction
35
Q

What motion do thoracic vertebrae favor?

A

side bend, b/c they’re so close (20 deg) to the frontal plane

36
Q

Which way do the IAPs and SAPs face in the thoracic region?

A 
IAP = anterior
SAP = posterior
37
Q

T/F: Thoracic vertebrae are better at rotation than flexion/extension.

A

true?

38
Q

What areas of the spine are good for rotation?

A

cervical -> thoracic -> lumbar

39
Q

Why is thoracic extension limited?

A

by the thoracic SPs and ribs

40
Q

What directions do the IAPs and SAPs of the lumbar spine point to?

A 
IAP = anteriolateral
SAP = posteriolateral
41
Q

What motion does the lumbar spine favor?

A

flexion/extension due to being nearly parallel to the sagittal plane

42
Q

T/F: Lumbar facets are oriented 90 degrees from the horizontal plane.

A

true, making them not good for rotation at all

43
Q

What kind of forces cause herniated disks?

A

shear and torque forces

44
Q

What is spondylothesis?

A

when two vertebral bodies shear off

45
Q

What structure helps control the compressive forces that the disk endures?

A

the annulus fibrosis evenly distributes the force about the disk so as to not have it

46
Q

Where does a common spondylysis occur?

A

at L5 and S1, lots of shear forces here due to angle of lumbosacral joint

47
Q

Do the facets gap or approximate in trunk flexion?

A

gap; they approximate in extension

48
Q

What’s the normal angle for the lumbosacral joint? How much body weight does this joint hold?

A
  • 40 deg

- takes 64% of body weight; will do more if angle is increased

49
Q

What structures are taut in flexion?

A

ligamentum flavum, interspinous lig, supraspinous lig, ligamentum nuchae at neck, PLL, posterior disk

50
Q

What happens at the facets and joint capsules on both sides for L side bend?

A

L side: facet closes down, capsule compressed

R side: facet gaps, capsule stretched

51
Q

T/F: When side-bending, the disk protrudes contralaterally towards the convex side.

A

true

52
Q

Pressure loss in the nucleus of a disk can cause what?

A

disk collapse: delaminating stressing can pull annulus apart

- commonly found in older spines

53
Q

What does the transverse ligament do?

A

holds down the dens

54
Q

What ligament in the neck is the big ligament preventing excessive rotation?

A

alar ligament

55
Q

What does the cruciate ligament do?

A

limit side bend and flex/extend, stabilize AA joint

56
Q

What does the tectorial membrane do?

A

limits rotation and flexion (extension of PLL), stabilizes low C-spine

57
Q

T/F: There is radial bulging both outwards and inwards during disc collapse.

A

true

58
Q

What arthrokinematics are occuring at the AO joint during flexion? AA joint?

A
  • AO = anterior roll and posterior slide of occipital condyles on their facets
  • AA = tilts forward
59
Q

What arthrokinematics occur at the C2-C7 level during flexion?

A

IAPs slide superior and anterior on the SAPs

60
Q

Which joint in the neck doesn’t move much during motion?

A

AA joint

61
Q

What arthrokinematic motions occur at each neck joint during side bend?

A
  • AO = condyles roll toward side of bend and away on contralateral side
  • AA = minimal motion
  • C2-7 = ipsilateral IAPs slide inferior and some posterior, while contralateral IAPs slide superior and a little anterior
62
Q

In what movement does the AO not do much?

A

rotation

63
Q

What c-spine arthrokinematics occur with rotation?

A
  • AO = not much
  • AA = ipsilateral IAPs slide posterior, contralateral slide anterior
  • C2-7 = ipsilateral IAPs slide mostly posterior, some inferior; contralateral IAPs slide mostly anterior, some superior
64
Q

What happens with craniocervical spinal coupling?

A
  • when low c-spine rotates R, it will also R side bend

- upper c-spine will also R side bend, but rotate L

65
Q

Where does the AA joint have the most motion?

A

during rotation

66
Q

T/F: The C-spine is naturally slightly protracted

A

true (flexed lower c-spine, extended upper c-spine)

67
Q

What bony structures in the c-spine facilitate flexion and extension, but limit side bend?

A

uncinate processes

68
Q

What motion opens up the IVFs?

A

flexion

69
Q

The patient doesn’t want to turn their head to the right because it’s painful. What bony issue could be causing this?

A

stenosis on the right side: ipsilateral IVFs close down during rotation, so if it’s painful to rotate to the right, it may be because of those IVFs

70
Q

T/F: T-spine and L-spine move the same.

A

true THANK GOD

71
Q

What arthrokinematics occur during extension at the t-spine?

A

same as C-spine: IAPs slide posterior and inferior to SAPs

72
Q

What arthrokinematics occur during t-spine side bending?

A

ipsilateral IAP slides inferior, contralateral slides superior

73
Q

What do the facets do in the t-spine during right rotation?

A

both right and left IAPs slide left (contralateral slide)

74
Q

When rotating left, which facet gaps and which approximates in the L-spine?

A

ipsilateral side gaps, so L gap, R approximate

75
Q

In rotation, what is the difference in arthrokinematics between L-spine and T-spine?

A

T-spine slides inferiorly and superiorly, while L-spine just gaps and approximates

76
Q

In what motion does the coccyx tilt posteriorly?

A

nutation

77
Q

How are the sacroiliac joints stabilized?

A

1) form closure = good bony articulation btwn joint, occurs with age (increased integrity of ligaments, bones have grown together)
2) force closure = comes from the erector spinae, multifidus, thoracolumbar fascia

Analysis of Movement (14 decks)

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