Axial Skeleton Muscle and Joint Interactions Flashcards

1
Q

What happens once the spinal nerve exits the foramen?

A

Divides into ventral and dorsal ramus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the dorsal ramus form?

A

Nerves that innervate muscles / joints /skin of the posterior trunk and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the ventral ramus form?

A

Nerves to innervate muscles/joints/skin of anterior/lateral trunk, neck, and extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the ventral ramus become?

A

AN individual nerve or a plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the dorsal ramus dermatome?

A

Across most of the posterior trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where does the dorsal ramus branch from? (generally)

A

Every spinal nerve root

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 4 major plexi?

A

Cervical - C1-4
Thoracic- C5-T1
Lumbar - T12-L4
Sacral - L4-S4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What ligaments does the dorsal ramus innervate?

A

ligaments posterior side of vertebrae; capsule of facets; dorsal ligaments of SIJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the individual nerve branches from the ventral plexus?

A

Intercostal and recurrent meningeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is torque?

A

A measure of the force that causes an object to rotate around an axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can torque also be defined as?

A

The rotational equivalent of linear force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What kind of quantity is torque?

A

Vector quantity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the internal torque equal to?

A

The product of the muscle force and its internal moment arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the strength of a muscle action equal to?

A

The distance and spatial orientation of the muscle’s line of force relative to the axis of rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What muscles are in the superficial layers of the back?

A
  • trapezius
  • latissimus dorsi
  • rhomboids
  • levator scapula
  • serratus anterior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What muscles are in the intermediate layer of the back?

A
  • serratus posterior superior
  • serratus posteiror inferior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the three groups of the deep layer?

A
  1. Erector spinae group (spinalis, longissimus, iliocostalis)
  2. Transversospinal group (semispinalis muscles, multifidi, rotatores)
  3. Short segments group (interspinalis muscles, intertransversarius muscles)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the innervation of the deep layer of the back?

A

Dorsal rami innervation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What do the muscles of the back do as they get deeper?

A

Become progressively shorter/more angulated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is the erector spinae group?

A

ill-defined one hands width from the SP
- deep to thoracolumbar fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What torque is large at the erector spinae group?

A

Extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Where are the attachments of the common tendon of the erector spinae?

A
  • spinal tubercles of the sacrum
  • spinous processes and supraspinous ligaments in the lower thoracic and entire lumbar region
  • iliac crests
  • sacrotuberous and sacroiliac ligaments
  • Glut max
  • multifidi
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where is the multifidi?

A
  • posterior sacrum to C2
  • TP to SP one or 2-4 vertebrae above
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is the multifidi thickest?

A

In the lumbar region, 2/3 of muscular stabilizing capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What space is filled by the multifidi?

A

Between TP/SP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What should be know about rotatores?

A
  • deepest
  • most well developed in T/STP - lamina/base of SP 1-2 above
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The short segments group crosses what?

A

1 intervertebral junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

The short segments group is most developed where?

A

In the cervical region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What ligament does the short segments group blend with?

A

Interspinous ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the short segment group rich in?

A

Muscle spindles and sensory feedback

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Where does the multifidi attach inferiorly?

A
  • mammillary process of lumbar vertebrae
  • lumbosacral ligaments
  • deeper part of the common tendon of the erector spinae
  • posterior surface of the sacrum
  • posterior-superior iliac spine of pelvis
  • Capsule of apophyseal joints
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What do the muscles of the anterior-lateral trunk do?

A

Support and protect viscera, increase intrathoracic and intrabdominal pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What forms the linea alba?

A

Anterior and posterior rectus sheaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the two types of diastasis recti?

A

protruding and not protruding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the rectus abdominus intersected by?

A
  • 3 transverse fibrous bands; tendinous insertions
34
Q

Where does the rectus abdominus attach and insert?

A
  • Attaches: xiphoid, 5-7 cartilaginous portion of the ribs
  • Inserts: crest of pubis (can blend with adductor longus)
35
Q

What does the rectus abdominus do?

A

Flexes the thorax and upper lumbar spine - and or tilts the pelvis posterior

36
Q

Rectus abdominus has the longest ________ _______ and the smallest ________ _________ area

A

longest fascicle length, smallest cross sectional area

37
Q

What does the external oblique do?

A

Lateral flexor and contralateral rotator
- bilateral trunk flexor, posterior tilt of pelvis

38
Q

What direction does the external oblique run?

A

inferior and medial (pocket direction)

39
Q

What muscle has the largest cross sectional area of the abs?

A

the internal oblique

40
Q

What direction does the interal oblique run?

A

Cranially and medially

41
Q

What does the internal oblique do?

A
  • Ipsilateral rotator and lateral flexion
  • bilateral flexion of trunk, posterior pelvic tilt and increased tension in TL fascia
42
Q

What is the internal oblique a synergist with? (for ipsilateral rotation)

A

opposite external oblique via the linea alba

43
Q

Which abdominal muscle is the deepest?

A

Transversus abdominus

44
Q

How does the transversus abdominus stabilize?

A

via the thoracolumbar fascia

45
Q

Where does the transverse abdominis have the most extensive attachments?

A

Into the thoracolumbar fascia

46
Q

Where does the transversus abdominis run?

A

Ribs to iliac crest to inguinal ligament to the TL fascia

47
Q

What is the role of the transverus abdominis?

A

Stabilization for other abdominal muscles; increases tension on the TL fascia; compression of abdominal cavity

48
Q

A diagonal sit up incorporates what muscle groups?

A

trunk flexion and axial rotation to the left/right

49
Q

With a diagonal sit up, there is bilateral activation of which muscles?

A
  • rectus abdominis and transverse abdominus
50
Q

With a standard sit up, the opposing axial rotation and lateral flexion torques are _________

A

neutralized

51
Q

With a diagonal sit up to the left, which muscles are working on the left?

A
  • external oblique, rectus abdominus, internal oblique
52
Q

With a diagonal sit up to the left, which muscles are working on the right?

A
  • SCM
  • Pec major
  • Serratus anterior
  • External oblique
  • transversus abdominis
53
Q

Lateral flexion involves both _____ and ______ (muscle groups)

A

flexors and extensors

54
Q

What is a stabilizer during rotation of the trunk?

A

Transversus abdominis

55
Q

Which muscle group has a long lever arm?

A

Obliques

56
Q

Which muscle group has more torque, flexors or extensors?

A

Extensors

57
Q

Which muscle group has a larger moment arm?

A

Flexors

58
Q

Which muscle group has more mass and overall more vertically aligned fibers (posture role)

A

Extensors

59
Q

Where does the QL attach?

A

To the IC and iliolumbar ligament

60
Q

With bilateral contraction, what does the QL do?

A

Extension and vertical stabilization

61
Q

With unilateral contraction, what does the QL do?

A

Lateral flexion

62
Q

What is the QL also known as?

A

‘Hip-hiker’

63
Q

What can happen to the QL in LBP patients?

A

Can be hypertonic

64
Q

The iliopsoas is a combination of what two muscles?

A

iliacus and psoas

65
Q

What does the iliopsoas do? Innervation?

A

Hip flexor
- femoral nerve

66
Q

What does the iliopsoas do to the pelvis and back?

A

Anterior tilt of pelvis and lumbar extenson (lateral flexion of trunk as well)

67
Q

How does flexion primarily change the spine?

A

Through pelvic tilt

68
Q

What do the QL and ilipsoas do together?

A

Run nearly vertical on both sides of the lumbar spine - strong bilateral contraction provides stability

69
Q

What do we consider when looking at core stability>

A
  • 3 subsystems of control
  • global or regional
  • intrinsic or extrinsic
70
Q

What is the role of the neural subsystem?

A

Manage spinal stability

71
Q

What do short deep local muscles do?

A
  • control precise alignment and stiffness
  • high density muscle spindles
  • varying angles act as guidewires
  • sail boat analogy
72
Q

What do global or extrinsic muscles do?

A
  • longer muscles
  • important torque generators
  • provide strong links between regions
73
Q

Why is it important for the transversus abdominis to be the first muscle active?

A
  • it is not influenced by movement direction, supporting the hypothesized role of this muscle in spinal stiffness generation
74
Q

What type of patient was shown to have delayed contraction of the transversus abdominis?

A

LBP patients

75
Q

What does the contraction of the transversus abdominius significantly decrease?

A
  • the laxity of the SIJ
76
Q

What happens with the lumbar multifidus following a low back injury?

A
  • segmental atrophy which develops at the level of pathology (quickly as 24 hours after injury), which can persist beyond the resolution of symptoms
77
Q

What are the two phases of the full sit up?

A

a.) trunk flexion phase, activation of abs esp rectus abdominus
b.) hip flexion phase

78
Q

A curl up puts less demand on what?

A

hip flexors

79
Q

A full sit up puts more pressure on what?

A

discs

80
Q

When is there the greatest injury risk during the sit up?

A

During hip flexion without the trunk curl - can cause anterior shear forces

81
Q

What should we NOT do during a sit up with our patients?

A

DO NOT hold the feet down, focus on TA and IO

82
Q

What can lifting do that may lead to injury?

A
  • generate large compression, shear, and tension forces
  • may exceed structural tolerance
83
Q

What can stooping do to the body?

A
  • long external moment arm of load
  • greater forces of trunk extensors needed
  • compression and shear forces larger
  • spine flexion = risk to discs
84
Q

What can a squat do to the body?

A
  • lumbar spine may stay extended
  • reduced moment arm of load, less trunk extensor torque
  • larger demand on knees
  • greater work metabolically