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Semester 3 FS Exam 1 > Cervical Biomechanics > Flashcards

Cervical Biomechanics Flashcards

1
Q

Mechanically the spine is

A

Long, slender, flexible, curved beam

Similar segments that can be considered in isolation

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2
Q

Mechanical functions of the spine

A

Structural support for musculoskeletal torso
Flexibility of motion for activities
Protection of the spinal cord

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3
Q

Mechanical stability elements - passive elements

A

vertebrae, disc, facets, ligaments

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4
Q

Mechanical stability elements - active elements

A

muscles

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5
Q

Mechanical stability elements - the stability is obtained through the

A

highly developed dynamic neuromuscular control system

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6
Q

Spine - disturbances

A

Biological factors (degeneration)
Acute or cumulative fatigue injuries
Surgical procedures

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7
Q

Triangular column of support

A

Anterior pillar along vertebral bodies (starts at C2)

Posterior pillars bilaterally along zygopophyseal articulations (starts at occ bone)

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8
Q

Occipital condyles - located on which part of occipital bone

A

inferior surface

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9
Q

Occipital condyles - articulate with

A

superior facets of the atlas

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10
Q

Occipital condyles - shape

A

oval

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11
Q

Occipital condyles - Anterior extremities are

A

forward and medial

closer together anteriorly

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12
Q

Occipital condyles - posterior extremities are

A

extended back to the middle of foramen magnum

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13
Q

Occipital condyles - articular surfaces of the condyles are

A

convex AP and ML

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14
Q

A typical vertebrae has

A 
Body
2 pedicles
2 laminae
2 TP
4 articular processes
1 spinous process
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15
Q

C1 - lateral masses inline with

A

occipital condyles
TP
muscles attach

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16
Q

C1 - superior surface is

A

biconcave AP
Articular surfaces sup and med
Outer margins sup
Double facets - non articular middle section

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17
Q

C1 - inferior surface

A

flat facets
slightly convex AP
Directed inferior and lateral

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18
Q

C1 - arches

A

slender ant and post

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19
Q

C1 - ant arch

A

short and slender, small facet for the dens

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20
Q

C2 - accepts load from

A

atlas (A-A joints)

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21
Q

C2 - transmits load to

A

C3

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22
Q

C2 - 3 IVD is

A

anterior

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23
Q

C2 - 3 Zygopophysial joints are

A

posterior

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24
Q

C2 - dens/odontoid process

A

pivot A-A joint

axial rotation

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25
Q

C2 - superior surface - facets are

A

facets are lateral to dens
Face up and lateral
Sloped inferiorly

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26
Q

C2 - inderior surface - facets are

A

located posteriorly to the superior facets

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27
Q

C2 - lamina

A

broad and robust

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28
Q

C2 - spinous process

A

bifid

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29
Q

Typical cervical vertebrae - exhibit features of

A

load bearing, stability, mobility

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30
Q

Typical C vertebrae - vertebral bodies have the ability to

A

ability to bear and transmit axial loads

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31
Q

Typical cervical vertebrae - vertebral bodies sup surface

A

concave ML

sloped down ant

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32
Q

Typical cervical vertebrae - vertebral bodies inf surface

A

concave AP

Ant lip projects ant - inf

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33
Q

Typical cervical vertebrae - uncinate processes

A

sup post lat border
Not present early in life
prevents above vertebrae from gliding side to side

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34
Q

Typical cervical vertebrae - Facets - function

A

support weight and offer stability
limit glide motion btw consecutive vertebrae
prevent above vertebrae to translate forward
Directed btw the frontal and transverse planes

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35
Q

Typical cervical vertebrae - inf facet

A

face inf ant

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36
Q

Typical cervical vertebrae - sup facet

A

face sup post

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37
Q

Cranio-vertebral joints

A

Two atlanto-occipital joints

Three atlanto-axial joints (2 lateral, 1 median)

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38
Q

Cranio-vertebral joint - OA

A

Superior concave sockets of the atlas
Occipital condyles of the skull
First few degrees of flex and ext occur here

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39
Q

Cranio-vertebral joint - Lateral AA

A

Superior articular process C2
Inferior articular process C1
Covered with hyaline cartilage
Facet surface is flat

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40
Q

Cranio-vertebral joint - Median AA

A

Odontoid process

Osseoligamentous ring

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41
Q

Cranio-vertebral joint ligaments - false ligaments = why called false?

A

Not organized dense areolar tissue - their ability to restrict motion is low due to the lack of organization

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42
Q

Names of false ligaments

A

Posterior and anterior OA membranes (ant and post arches of C1 to foramen magnum)
Posterior, anterior AA membranes - very flimsy
Membrane tectoria
Apical ligament

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43
Q

Cranio-vertebral joint ligaments - membrane tectoria

A

Wide sheet of collagen fibers invested in dense irregular connective tissue
Converting AA ligament complex
Continuation of Post long ligament
Connects body of C2 to internal surface of occipital bone

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44
Q

Which ligament is a continuation of the post long ligament

A

membrane tectoria

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45
Q

Cranio-vertebral joint ligaments - apical ligament

A

Tricial in size, thin, from odontoid process to the ant rim of the foramen magnum

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46
Q

Cranio-vertebral joint ligaments - proper ligaments

A

Alar ligaments
Transverse ligament
Cruciform ligament

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47
Q

Cranio-vertebral joint ligaments - proper ligaments - alar

A

Sides of dens to lateral margins of foramen magnum - connects dens to occ bone
Controls rotation and side to side movement
Restricts contralateral rot

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48
Q

Cranio-vertebral joint ligaments - proper ligaments - transverse

A

Occipital tubercles to lateral mass of C1
Holds dens against ant arch of C1
Holds the dens inside

49
Q

Cranio-vertebral joint ligaments - proper ligaments - cruciform ligament

A

Transverse ligament is part of it

It is a reinforcement of the post structures

50
Q

Joints of the lower cervical spine

A

IVDs btw vertebral bodies below C2

Zygapophyseal (facet) joints

51
Q

Cervical IVD are thicker where?

A

thicker ant - contributes to lordotic curve

52
Q

Cervical IVD - nucleus

A

fibrocartilaginous core - no gelatinous component
Has ability to regenerate
Nerve endings - pain
No nucleus polpusus

53
Q

Cervical IVD - Annulus Ant

A

Thick crescent of oblique fibers connecting the bodies like an interosseous membrane

54
Q

Cervical IVD - Annulus post

A

thin, narrow vertically oriented joining the bodies

55
Q

Cervical IVD - Annulus lat

A

flimsy fascial tissue cont. periosteum

56
Q

Cervical IVD - function

A

accommodate motion and are strong enough to transfer loads

57
Q

Cervical facet joints - location

A

Inferior articular process of one vertebrae with the ipsilateral superior articular process of the vertebrae below

58
Q

Cervical facet joints - description

A

typical synovial joints
articular facets round or oval
often right/left symmetry

59
Q

Cervical facet joints - joint capsule thick and thin

A

Thick - med ant lat

Thin - post

60
Q

Cervical facet joints - in neutral position the capsules are

A

lax - allow a large ROM

61
Q

Cervical facet joints - at the extreme ranges the capsules

A

are taut and function as stabilizers

62
Q

Orientation of the facets contribute to

A

the segmental function btw vertebrae

63
Q

Orientation of the facet - C3 sup process

A

Facets face sup and post (about 45 deg) and med

Form a socket to enclose the inf ant processes of C2

64
Q

Orientation of the facet - Changes in facet orientation

A

From medial C2/C3 to lateral C7/T1

Transition from med to lat occurs at C5/C6

65
Q

Orientation of the facet - Facets sit ___ relative to the body of the vertebra

A

Higher

66
Q

Height and inclination of the facets is higher as you what

A

descend

As you go down the facet inclination is higher

67
Q

C7-T1 = cantilevered

A

where the neck is cantilevered off - the more rigid the thoracic spine

68
Q

Ligaments of lower cervical spine - Anterior long ligament

A

Attaches to skull superior
Loose attachment to discs
Attached to vertebral bodies
Limits extension

69
Q

Ligaments of lower cervical spine - Posterior long ligament

A

Attached to disc and body

Limits translations

70
Q

Ligaments of lower cervical spine - Ligamentum nuchae

A

Occipital protuberance to SP of all 7 vertebrae
Dense irregular connective tissue
Continuation of supraspinous ligament - major limiting structure with flexion

71
Q

Ligaments of lower cervical spine - ligamenta flava

A

Terminate at lamina of C1-C2

Limit flexion bilaterally and rotation in opp directions

72
Q

Atypical vertebrae - kinematics - OA

A

First for flex/ext
15-30 degrees in total of flex/ext (nodding motion)
LF and rot are possible but limited

73
Q

Atypical vertebrae - kinematics - OA - flexion

A

convex occipital condyles glide posterior on concave atlas

74
Q

Atypical vertebrae - kinematics - OA - extension

A

Occipital condyles glide anterior on atlas

75
Q

Atypical vertebrae - kinematics - AA

A

The first for rotation
axial rotation mainly 30-43 degrees on each side
50% of the rotation of cervical spine - occurs here first and then rest of cervical spine

76
Q

Typical vertebrae - kinematics - DOF

A

6 DOF
Translation - ML, up/down, A/P
Rotation - AP axis, Long axis, ML axis

77
Q

Segmental movements of the spine - Flex/Ext

A

A lot at OA and then limited at AA and then begins to inc a bit but then is limited again
Change at C5/6 when facet orientation changes from med to lateral

78
Q

Segmental movements of the spine - lateral flex

A

Non btw C1 and C2 and then dec as move down cervical region

79
Q

Segmental movements of the spine - rotation

A

Limited/none at OA

Most rotation at AA then pretty flat after that

80
Q

Typical vertebrae - kinematics - entire cervical spine moves

A

as a unit

Facets guide the movement

81
Q

Tyical vertebrae - kinematics - flex/ext is

A

uncoupled - horizontal translation is limited
Flex - sup vertebrae will move ant and sup
Ext - sup vertebrae will move post and inf
SP limit motion

82
Q

Cervical vertebrae - coupled motions - lateral flexion is coupled with

A

ipsilateral rotation
Contralateral inf facet moves ant and sup
Ipsilateral inf facet moves post and inf

83
Q

Cervical vertebrae - coupled motions - rotation is coupled with

A

ipsilateral flexion
Contralateral inf facet glides sup
Ipsilateral inf facet glides inf

84
Q

Cervical vertebrae - coupled motions - to bend to the R you also

A

rotate to the R

85
Q

Cervical vertebrae - coupled motions - to rotation to the R you also

A

lat flex to the R

86
Q

Ligaments that strain flexion

A 
Ligamentum nuchae
Ligamentum flavum
Post AO membrane
Post long lig
Tectorial membrane
87
Q

Ligaments that strain extension

A

Ant long ligament

Anterior AO membrane

88
Q

Ligaments that strain rotation

A

Alar ligaments (def contralateral rot but some say both)

89
Q

Suboccipital muscles - action

A

Deep plane
4 on each side
Bilaterally extend head
Unilaterally rot and laterally flex in ipsilateral direction

90
Q

Suboccipital muscles - Rectus Capitis Posterior Minor

A

Deeper, btw atlas and occ bone
Closer to midline
Controls/limits motion at OA

91
Q

Suboccipital muscles - Rectus Capitis Posterior Major

A

More sup btw axis and occ bone
Controls/limits motion at OA and AA
More lateral

92
Q

Suboccipital muscles - Oblique capitis superior and inferior

A

More lateral so will have greater effect on lat flex

93
Q

Semispinalis plane

A

Large group of muscle fibers that originate from transverse processes of the thoracic vertebrae
Semispinalis Capitis and Cervicis

94
Q

Semispinalis plane - Capitis

A

TP to occipital bone

Will act on OA

95
Q

Semispinalis plane - Cervicis

A

TP to SP of cervical region
Will not act on OA
Helps rotate contralaterally

96
Q

Semispinalis plane mm action

A

bilaterally extend the head and inc lordosis of cervical region
unilateral ipsilateral LF

97
Q

Splenius and levator plane

A 
large flat group on sup and med aspect fo post neck
Splenius capitis
Splenius cervicis 
Levator scap
Longissimus capitis
98
Q

Splenius capitis

A

Finishes on skull

Very lat and post attachment

99
Q

Splenius cervicis

A

Finsihes on cervical region (SP to TP)

100
Q

Levator scap

A

Contributes into ext, ipsilateral flex and rot

101
Q

Longissimus capitis

A

bilateral ext

unilateral ipsilateral flex

102
Q

Splenius muscles action

A

bilateraly ext, control flex, inc lordosis, ipsilateral flex and rot

103
Q

Superficial plane

A

Trap

104
Q

Trap attachments

A

Lig nuchae, occ bone, and distally at scapula

Has effect on skull and cervical region

105
Q

Trap action cervical

A

Bilaterally ext cervical region
Unilaterally ipsi flexion and cont rot
also elevate scap and up rotation of it

106
Q

Flexors of head and neck

A 
Anterolaterally around the neck
SCM
Scalenes 
Longus capitis
Longus colli
107
Q

SCM

A

Ipsilateral flex and contralateral rot
Attached on mastoid process (post to OA so bring chin up)
Can also pull cervical region forward (flex)
Ext at OA and flex at lower cervical

108
Q

Scalenes

A

Post attaches at second rib
Help into flexion bilaterally
Unilaterally - Ipsilateral flex and if any rot would be contralateral

109
Q

Longus Capitis

A

Attach at TP

Stability of upper joints

110
Q

Longus Colli

A

Attached to bodies of cervical region, stabilizing cervical region

111
Q

Cervical spine - neutral zone

A

Rot 35 in each direction
flex/ext and LR 10 in each direction
Motion here is no restricted - things that resist come into play after this

112
Q

Cervical spine - muscle interactions

A

More muscles than motions
Multiple muscles doing same action
Single muscle contributes to multiple actions

113
Q

Cervical spine - muscle interactions - muscle synergy

A

activation of multiple muscles to produce a desired movement

114
Q

Least stress on the spine occurs when

A

the head is basically centered over the spinal column below so there is minimal muscle tension necessary to hold head up - biomechanical normal good posture

115
Q

Forward head posture - every 2-3cm the head is held forward requires exertion of

A

70-140N of extra muscle tension wich means there is less muscle strength available to support outside loads

116
Q

Cervical spine proper posture

A

Shoulders are held back and down
Thoracic spine curves forward only slightly
Scapulae are flat and dont wing out
Chest curves out forward but shoulder tips wouldnt touch yardstick
Collar bones are level or only slope slightly upwards
From front chin is at least 5cm if not 8-10 above clavicular notch

117
Q

JRF at AA joint

A

1.5 times the weight

118
Q

JRF at typical

A

3 times the weight

119
Q

Acceleration injuries

A

whiplash - head gets left behind - maintains its inertia - whether motionless or in motion it will keep its velocity and position

Semester 3 FS Exam 1 (2 decks)

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