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Biomechanics Exam 2 > Biomechanics of the Cervical Spine > Flashcards

Biomechanics of the Cervical Spine Flashcards

1
Q

T/F: there are less muscles in the cervical region than any other?

A

False (there are more)

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2
Q

What part of the vertebral column is the most mobile?

A

Cervical

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3
Q

What is the cervical spine’s “job”?

A

maintain head posture while allowing for a great deal of mobility

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4
Q

T/F: Cervical curve is the least distinct of spinal curves?

A

T

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5
Q

The part of the spine is considered to have a secondary (compensatory) curve

A

Cervical

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6
Q

What does the upper cervical spine consist of?

A

Occiput
Atlas
Axis

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7
Q

What is the most complex region of the axial skeleton?

A

Upper cervical spine

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8
Q

What are the 2 articulations of the upper cervical spine?

A

Atlanto-occiptial

Atlanto-axial

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9
Q

T/F: there is no IVD at the articulations of the upper cervical spine?

A

T

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10
Q

What types of motion are the the Occiput -C1 articulation?

A

Combined øx -25 degrees
one sided øz - 5
one sided øy - 5

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11
Q

What types of motion are the C1-C2 articulation?

A

combined øx - 20 degrees
one sided øz -5
one sided øy -40

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12
Q

What are the important muscles in the upper cervicals? (6)

A
  1. rectus capitis post. major
  2. rectus capitis post. minor
  3. rectus capitis lateralis
  4. recuts capitis anterior
  5. sup. oblique
  6. inf. oblique
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13
Q

What are the stabilizing ligaments of the upper cervicals? (7)

A
  1. transverse ligament of atlas
  2. alar lig
  3. PLL
  4. Post. atlanto-occipital membrane
  5. Ant. atlantooccipital membrane
  6. ligamentum nuchae
  7. apical lig
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14
Q

What is the shape of the Superior Articular Process of atlas?

A

peanut shaped

concave

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15
Q

T/F: The “cuplike” structure at C0/C1 in both the sagittal and frontal planes allows for ALOT of rotation.

A

F: this allows for little rotation

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16
Q

The shape of the articulation of C0/C1 favors what axis of rotation?

A

øx (flexion-extension)

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17
Q

X Axis Rotation of the C0/C1:
Flexion is limited by?
Extension is limited by?
What is the Range?

A

F: post. neck muscular tension
E: subocciptial muscle compression against the occiput
Range: mean value b/w 14-35 degrees

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18
Q

Y Axis Rotation of C0/C1:
limited by?
range?

A 
limited by:
- ant. and post. walls of C1 sockets
- joint capsule tension
- alar lig tension
Range: 4-8 degrees (each side)
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19
Q

Lateral flexion under physiological conditions has not been systematically demonstrated and studied of this axis rotation.

A

Z axis rotation

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20
Q

How is Z axis rotation induced at C0/C1?

A

One condyle elevates out of its socket, while the other serves as a pivot. Both condyles slide up their walls.

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21
Q

What is the Range of Z axis rotation at C0/C1?

A

4-11 (induced in cadavers)

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22
Q

What ligament limits z axis rotation of C0/C1?

A

alar lig

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23
Q

The small amount of z axis rotation that occurs at the C0/C1 is typically associated with some small degree of what?

A

coupled rotation in the opposite direction, leading to the rotation of the chin away from the side of lateral flexion

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24
Q

What is the shape of C1 inferior articular process?

A

oval
flat or slightly concave
faces slightly medial

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25
Q

Even though the inferior facets of C1 may be flat or even concave, the configuration of the cartilage creates what type of articulation?

A

biconvex

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26
Q

X Axis Rotation: C1/C2

A

Biconvexity: Combined øx = 20 degrees

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27
Q

Increasing the curvature of the dens does what?

A

increases the amount of øx

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28
Q

What is IAR?

A

Instant Axis of Rotation: a path that identifies where one body will rotate relative to another body at a given instant in time.

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29
Q

What is the role of C2?

A

transmit the axial load of the head to the cervical spine and permits lots of Y axis rotation

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30
Q

T/F: at the limits of rotation, the lateral atlanto-axial joints are almost subluxated?

A

T

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31
Q

What lig restrains Y axis rotation at C1/C2?

A

Alar lig

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32
Q

What is the Range of y axis rotation at C1/C2?

A

43 degrees + or - 5.5 degrees

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33
Q

What articulation produces over 50% of the rotation of the neck?

A

Y axis rotation of C1/C2

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34
Q

Where are intraarticular meniscoid found?

A

With in the spaces where the surfaces of the articular cartilage diverge anteriorly and posteriorly of C1/C2.

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35
Q

These serve to keep a film of synovial fluid applied to surfaces of the articular cartilage that are not in contact with one another of C1/C2.

A

intraairticular meniscoids

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36
Q

When are intraarticular meniscoids of C1/C2 displaced?

A

They are displaced with Y axis rotation and passively return when neutral position is resumed

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37
Q

øy is coupled with y translation at what articulation?

A

C1/C2

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38
Q

Why is C1/C2 øz limited to 5 degrees?

A

alar lig and bony anatomy

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39
Q

Why is there little Z axis translation of C1/C2?

A

tight articulation of C1 ring around the dens

40
Q

This axis of translation of C1/C2 is controversial and some claim that is doesn’t exist.

A

X axis translation

41
Q

C1 lateral bending has what effect on C2 motion?

A

it results in the rotation of the spinous process of C2 toward the convexity of the lateral bend (rotates to the opposite side)

42
Q

Look at Tables of Cervical Flexion/Extension, Cervical Axial Rotation, & Cervical Lateral Bending (slide 59 -61)

43
Q

coupled motion

A

Axial rotation about a longitudinal axis and lateral rotation about a sagittal axis are not natural or pure movement of the cervical spine. For this reason, they are always coupled with one another

44
Q

During Flexion/Extension, there is associated translation in what plane?

45
Q

What is the total “normal” translation in mm?

46
Q

Lateral bending causes spinous processes to move toward the convexity or concavity of the curve?

47
Q

øx Arc of Curvature

A

The steepness of the arch while a vertebra moves from flexion to extension varies from vertebra to vertebra

48
Q

What is the øx Arch at C2?

49
Q

What is the øx arch at C6 and C7?

A

Steepest arches *

50
Q

T/F: The acuity of the arch increases with degeneration

A

F: it decreases

51
Q

Motion limited by ALL

A

(-) øx [extension]

52
Q

Motion limited by PLL

A

(+) øx [flexion]

53
Q

Motion limited by Ligamenta Flava

A

slows the last few degrees of (+) øx [flexion]

54
Q

Motion limited by Interspinous lig

A

(+) øx [flexion]

55
Q

Motion limited by Ligamentum Nuchea

A

(+) øx [flexion}

56
Q

Motion limited by Intertransverse lig

A

contralateral lateral flexion (øz)

57
Q

What is the shape of the vertebral bodies of the cervical spine?

A

rectangular

58
Q

What are the shape of the superior and inferior surfaces of the cervical vertebral bodies?

A

seller or saddle-shapped

59
Q

In the cervical spine, X axis translation is ________, while X axis rotation is _________.

A

reduced; promoted

60
Q

What limits pure lateral flexion to only a few degrees in the cervical spine?

A

uncinate processes; they serve as guides to couple lateral flexion with axial rotation

61
Q

Possible synovial joint (synovial membrane w/ synovial fluid but no joint capsule) forming between the uncinate process and the superior vertebral body.

A

Uncovertebral joints

62
Q

Degeneration of these joints is due to underlying DDD results in bony outgrowth (osteophytosis).

A

Uncovertebral joints

63
Q

Degeneration of Uncovertebral joints my impinge what adjacent anatomy with disc bulge/herniation?

A

vertebral artery & cervical spinal nerves

64
Q

What part of the IVD is thick and strong, binds to the anterior vertebral body, and acts like an interosseous ligament?

A

Anterior annulus

65
Q

What part of the IVD is minimal if even present?

A

lateral annulus

66
Q

What part of the IVD is only a concentrated central bunch of fibers?

A

posterior annulus

67
Q

What is the cervical facet orientation?

A

teardrop-shaped synovial joints, angled at 45 degrees between coronal and transverse planes

68
Q

What are the superior facet orientations of the cervical spine?

A

Posterior
Superior
Medial

69
Q

What are the inferior facet orientations of the cervical spine?

A

Anterior
Inferior
Lateral

70
Q

How mm thick is the articular cartilage of the “Z” joint prior to 20 years of age?

71
Q

What happens to the “Z” joint with age?

A

Thins the articular cartilage
Thickens the subarticular bone
Osteophyte formation occurs

72
Q

Sensory perception of movement or position within the body

A

proprioception

73
Q

The IVD is innervated with what arrangement for proprioception?

A

circumferential arrangement

superficial to deep

74
Q

What does the IVD likely sense (proprioception)?

A

peripheral compression/tension, deformation and alignment

75
Q

Facet Mechanoreceptors reponde to _______ rather than mid-range of joint motion.

76
Q

There are small or large numbers of mechanoreceptors found in the cervical facet capsules?

A

small ; but each receptor is likely responsible for a large receptive field

77
Q

Sensory receptors within the belly of a muscle that primarily detect changes in the length of the muscle

A

Muscle Spindles

78
Q

Muscles in the cervical region contain a high density of muscle spindles, especially in what muscles?

A

subocciptial muscles

79
Q

What is the likely reason that the head and neck muscles have high spindle count?

A

head-eye coordination demands complex proprioceptive inputs form the neck muscles

80
Q

The very high proprioceptive content makes the suboccupital musculature ideal for what?

A

ideal sensors of joint position and movements of craniovertebral joints

81
Q

What suboccipital muscles has the most muscle spindles?

A

Rectus Capitis Posterior Minor (RCPMI)

36 spindles/g

82
Q

What is the “gate theory”?

A

Proprioceptive input flowing into the dorsal horn serves to disallow or modulate nociceptive input into the CNS
- the more open the “gates”, the more pain messages pass through. Therefore, the person experiences high levels of pain and vice versa.

83
Q

This is a change in the stimulus-response profile of dorsal horn neurons so that they respond to mechanoreceptive afferents as if they were nociceptors
(hurt may not equal harm)

A

Sensitization

84
Q

Adjustments to decrease nociceptor input into the spinal cord seem to be an effective way to decrease what?

A

the hyper excitable central state

85
Q

What are the muscular differences found in MRIs of individuals with chronic neck pain?

A

atrophy & fatty infiltration/degeneration

86
Q

When does the cervical curvature develop?

A

prior to birth

87
Q

What angle should the cervical lordosis be?

A

aprox 30-45 degrees

when measured between the lines drawn through C1 and C7

88
Q

What does the Upper Cervical Curve consist of?

A
  1. Occiput to Axis

2. Concave anteriorly (aka Kyphotic)

89
Q

What does the Lower Cervical Curve consist of?

A
  1. C2-C7

2. Classical Lordosis

90
Q

Is kyphosis a normal varient?

A

Not according to Deep Harrison (CBP)

91
Q

What is the primary load on the cervical spine?

A

compression; shear component is only 10% of compression

92
Q

What load is increased during flexion or extension in the cervical spine?

A

Compressive loads

93
Q

Under what load does the spine remain tangential to the spinal curve, minimizing bending moments and shearing, while allowing the cervical spine to bear larger loads?

A

Follower Load

94
Q

What load induces bending and shearing due to the formation of movement arms (levers)?

A

Vertical Load

95
Q

The co-activation of the cervical muscles produces what?

A

follower load (NOT vertical load)

Biomechanics Exam 2 (8 decks)

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