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Kinesio > Cervical Spine Biomechanics > Flashcards

Cervical Spine Biomechanics Flashcards

1
Q

What did Takala determine about neck pain in the population based on gender

A

Men: 16%
Women: 18%

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2
Q

What did Aryanpur determine about the percent of the population that will have neck pain

A

10%

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3
Q

What Dvorak determine was the percent of soft tissue injuries

A

87.5%

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4
Q

What percent of soft tissue injuries were due to MVA

A

53%

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5
Q

What percent of soft tissue injuries were due to falls and sports

A

45%

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6
Q

True or False:

You have to have to have radicular symptoms or referred symptoms with neck pain

A

False

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7
Q

How many cervical vertebrae are there

A

7

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8
Q

What are the atypical cervical vertebrae

A

1 and 2

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9
Q

What are the typical cervical vertebrae

A

3-6

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10
Q

What is C1

A

Cradle/Atlas

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11
Q

What is C2

A

Axis

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12
Q

What is C3

A

The root

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13
Q

What are C4-7

A

Column

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14
Q

What is C7

A

A transitional vertebrae

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15
Q

What is a transitional vertebrae

A

A vertebrae is starting to look like the next set of vertebrae

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16
Q

What is another name for C7

A

Vertebral Prominens

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17
Q

What i transegrity

A

Balance between mobility and stability

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18
Q

What are the size of cervical vertebrae bodies

A

Small

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19
Q

Why are cervical vertebrae bodies small

A

Wolffe’s Law… They don’t support a lot of weight

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20
Q

What are cervical vertebrae made for stability or mobility

A

Mobility

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21
Q

What is the neutral zone

A

The OA AA complex

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22
Q

How much more neutral is the OA AA complex than the lower cervical vertebrae

A

50%

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23
Q

True or False:

Cervical vertebrae have general laxity to capsule and ligaments

A

True

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24
Q

What is looser the upper cervical or lower cervical spine

A

Upper cervical spine

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25
Q

Where are the uncinate processes located

A

Posterolateral superior and inferior surfaces of vertebral bodies

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26
Q

What do the uncinate processes form

A

The uncovertebral joints

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27
Q

What is another name for the uncovertebral joints

A

Joints of VonLuschka

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28
Q

How are the transverse processes oriented in the cervical vertebrae

A

Anterolateral

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29
Q

True or False:

The transverse processes of the cervical vertebrae have lateral grooves

A

True

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30
Q

What do the lateral grooves predispose the vertebrae to

A

Fracture

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31
Q

What is the angle of the facet joints in the typical cervical spine

A

45 degrees

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32
Q

What are housed in the lateral grooves

A

Spinal nerves

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33
Q

What are the transverse processes of C1-4 usually called

A

Lateral masses

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34
Q

What do the bifid processes allow for

A

Greater surface area for attachment of soft tissue

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35
Q

What can cause vertebral artery compromise (3)

A
  1. Skeletal muscle and fascial bands near transverse foramen
  2. Osteophytes adjacent to C4/5 and C5/6 and C6/7
  3. Gliding motion at the AA articulation
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36
Q

What are osteophytes

A

Bone spurs

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37
Q

True or False:

C6 is a level of high mobility

A

True

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38
Q

How does flexion affect the vertebral artery

A

Nothing

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39
Q

How does extension affect the vertebral artery

A

Usually nothing

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40
Q

How does side bending affect the vertebral artery

A

Slight decrease in ipsilateral artery and normal contralateral artery

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41
Q

How does rotation affect the vertebral artey

A

Slight decrease in ipsilateral artery and slight superficial decrease in contralateral artery

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42
Q

How does extension and rotation affect the vertebral artey

A

Bilateral decrease

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43
Q

Where is the exclusion of the artery slightly worse during rotation and extension

A

Contralateral artery

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44
Q

How does flexion and rotation affect the vertebral artery

A

Bilateral decrease

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45
Q

True or False:

Atlas/C1/Cradle has no body or spinous process

A

True

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46
Q

What does atlas have for weight bearing

A

Lateral masses

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47
Q

True or False:

The superior facets of atlas are convex

A

False

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48
Q

What do the superior facets of atlas accept

A

Convex occipital condyles

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49
Q

What type of joint is the OA joint

A

Planar synovial joint

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50
Q

How much flexion does the OA joint account for

A

About 20 degrees

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51
Q

How much extension does the OA joint account for

A

About 20 degrees

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52
Q

How much side bending does the OA joint account for

A

About 5 degrees

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53
Q

How much rotation does the OA joint account for

A

About 1 degree

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54
Q

True or False:

The inferior facets of atlas are slightly convex

A

True

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55
Q

True or False:

Atlas has a facet on the internal surface of the anterior arch

A

True

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56
Q

What does the internal facet on atlas do

A

Accepts the dens (odontoid process)

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57
Q

Which way is the roll with side bending right

A

Right roll

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58
Q

Which way does the right and left OA move during right lateral flexion

A

Right: Inferomedial
Left: Superolateral

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59
Q

During right rotation what happens to the left and right OA

A

Right: Posterior and superior
Left: Anterior and superior

60
Q

What is the vertical extension of C2

A

Dens/Odontoid process

61
Q

What shape are the superior zygapophyseal joints

A

Convex

62
Q

How are the inferior facets of C2 oriented

A

40 degrees

63
Q

Which way do the inferior facets of C2 face

A

Medial and anterior

64
Q

How many joints compose the AA joint

A

3

65
Q

What are the 3 joints of the AA joint

A

1 Median atlanto-axial joint

2 Lateral atlanto-axial joints

66
Q

What type of joint is the median AA

A

Synovial trochoid (pivot)

67
Q

What type of joint are the lateral AA joints

A

Synovial planar

68
Q

How much rotation does the AA allow

A

40 degrees

69
Q

How much flexion and extension does the AA joint allow

A

0

70
Q

How does the AA joint prevent flexion and extension

A

Ligament restrictions

71
Q

Why does the AA prevent flexion and extension

A

To protect the brainstem/spinal cord

72
Q

What are the arthokienmatics of the median AA joint

A

Spin

73
Q

During right rotation which way do the right and left zygapophyseal joints of C1 and C2 move

A

Right: Posterior Inferior
Left: Anterior Inferior

74
Q

What is Fryette’s Law I

A

Within the spine rotation and sidebending occur in opposite directions

75
Q

So if you had right sidebending and applied Fryette’s Law I which way is the rotation

A

Left

76
Q

Is the rotation noticeable

A

No

77
Q

What is Fryette’s Law II

A

Within the spine rotation and sidebending occur in the same direction

78
Q

So if you had right sidebending and applied Fryette’s Law II which way is the rotation

A

Right

79
Q

Which degree are the superior facets of C3 oriented

A

40 degrees

80
Q

What does neutral or non-neutral refer to

A

The sagittal plane

81
Q

Which one of Fryette’s Law applies at C2/C3 junction

A

Fryette’s Law I

82
Q

What type of joint is between the zygapophyseal joints of C3-C7

A

Plane synovial

83
Q

What is the meniscoid properties of C3-C7

A

Soft tissue structure like menisci in the knee located between the zygapophyseal joints

84
Q

What is the zygapophyseal joints composed of for C3-C7

A

Joint lined by hyaline cartilage surrounded by a capsule with menicsal inclusions

85
Q

What do the meniscal inclusions between the Z-joints do

A

Guide/direct motion (keep train on track)

86
Q

True or False:

You can impinge the menisci in the Z-joints

A

True

87
Q

What are the menisci innervated by

A

Medial branches of cervical posterior rami C2-C8

88
Q

Can the menisci of the Z-joints be a source of referred pain

A

Yes

89
Q

Where does the C6/7 Z-joint refer

A

To the inferior angle of the scapula

90
Q

Do the cervical IV discs have annulus in the back

A

No

91
Q

What is the back of the cervical IV disc called

A

Uncovertebral cleft

92
Q

Do the cervical IV disc have a concentric annulus

A

No

93
Q

How much of the disc does the nucleus pulposus comprise in the cervical IV disc at birth

A

25%

94
Q

How much of the disc does the nucleus pulposus comprise in the lumbar IV discs at birth

A

50%

95
Q

What is the composition of the IV disc of the cervical vertebrae in adults

A

Fibrocartilage with no gelatinous component

96
Q

What does genic mean

A

Produced by or from

97
Q

What are possible sources of disc related pain in the cervical spine (2)

A
  1. Strains or tears of annulus fibrosous

2. Strains of the lateral parts of PLL

98
Q

What Fryette’s Law refers to the typical vertebrae

A

Fryette’s Law II

99
Q

Can we sidebend left and rotate right in the cervical spine

A

Yes

100
Q

How can we sidebend left and rotate right in the cervical spine

A

Rotation at AA and side bending left in colum

101
Q

Which way do the facet joints move during flexion

A

Superior and anterior

102
Q

Do the facet joints have a roll

A

No

103
Q

Why don’t the facet joints have roll

A

They are planar joints

104
Q

What happen to IV foramen during flexion

A

Open or gapping

105
Q

Which way do the facet joints move during extension

A

Inferior and posterior

106
Q

What happens to the IV foramen during extension

A

Approximation or closing

107
Q

Which way do the facet joints move during right side bending

A

Right: Posterior inferior
Left: Anterior superior

108
Q

What happens to the IV foramen during right side bending

A

Right: Close
Left: Open

109
Q

During right sidebending what do the facet joints move like

A

Right: Extension
Left: Flexion

110
Q

During right rotation what happens to the facet joints

A

Right: Posterior inferior
Left: Anterior superior

111
Q

Where does the most flexion and extension occur in the C-spine

A

The lower C-spine

112
Q

When is the alar ligament taught ad slack

A

Taught: Flexion
Slack: Extension

113
Q

During right rotation what happens to the alar ligaments

A

Right: Slack
Left: Taught

114
Q

At what point does the alar ligament get sprained

A

Greater than 20 degrees

115
Q

What is the sequence of whiplash for a rear end accident (5)

A
  1. Body rises
  2. Head goes into extension and mouth opens
  3. Body descends
  4. Head goes into flexion and mouth closes
  5. Back to normal position
116
Q

What way does the head move first

A

The direction the force is applied

117
Q

What happens to the articular processes during a whiplash injury

A

The tip of the inferior articular process of superior vertebra chisels into the surface of the superior articular facet of inferior vertebra

118
Q

Why does the articular process chisel into the articular facet

A

Compression during whiplash move the IAR causing it to be in the vertebral body causing a greater inferior component

119
Q

What does IAR mean

A

Instantaneous axis of rotation

120
Q

True or False:

The IAR can change at any moment

A

True

121
Q

What happens to the facet joints with extension

A

They come together

122
Q

What happens to the annular fibers with a disc protrusion

A

The annular fibers are still intact

123
Q

What are the 2 types of disc protrusion

A
  1. Localized annular bulge

2. Diffuse annular bulge

124
Q

What direction is a localized annular bulge

A

Usually lateral

125
Q

What direction is a diffuse annular bridge

A

Usually posterior

126
Q

What happens to the annular fibers with a disc prolapse

A

Annular fibers disrupted (tiny hole)

127
Q

What has occurred with a disc prolapse

A

The nucleus has migrated through the inner laminar layers, but is still contained

128
Q

What happens to the annular fibers with a disc extrusion

A

Annular fibers are disrupted

129
Q

What has occurred with a disc extrusion

A

Nucleus has broken through the outer most layer

130
Q

What happens to the annular fibers with a disc sequestration

A

Annular fibers disrupted

131
Q

What has occurred with a disc sequestration

A

Nucleus separate from disc and now is in the spinal or IV canal

132
Q

When do disc sequestrations require surgery

A

When the disc is irritating the spinal cord

133
Q

What happens if no surgery is needed to fix a disc sequestration

A

The body sees it as a foreign object and gets rid of it

134
Q

What part of the disc is innervated

A

Outer 1/3

135
Q

What percent of people 40 and older have a herniation

A

60%

136
Q

What type of repeated movement does an upper cervical posterior derangement respond to

A

Protrusion because the upper cervical spine extends

137
Q

What do the suboccipital ghost muscles do

A

Put compression on the suboccipital nerve

138
Q

What does compression of the suboccipital nerve cause

A

Headaches overtime

139
Q

What are guy wires

A

Wires on cellular towers that support the tower

140
Q

What is there a balance of with guy wires

A

Tension, length, and strength

141
Q

True or False:

Guy wires don’t need to be in balance

A

False

142
Q

What can a forward head cause overtime

A

Retrusion and depression of the mandible

143
Q

What happens because of the depression to the muscles

A

Adaptive lengthening of elevators and adaptive shortening of depressors

144
Q

What happens because of the retrusion to the TMJ

A

Compression overload of the TMJ articular cartilage

145
Q

What are the 4 types of disc herniation

A
  1. Disc protrusion
  2. Disc prolapse
  3. Disc extrusion
  4. Disc sequestration
146
Q

Motivation

A

IT’S ALMOST TIME TO BALL HARD

Kinesio (11 decks)

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