Cervical & Thoracic Spine

Question 1

A primary curve that is present in newborns and remains throughout our development in the thoracic & sacral regions.

Kyphotic or Lordotic curve?

Answer 1

Kyphotic curve

Question 2

A secondary curve that develops in the cervical and lumbar region.
Cervical: infant starts demonstrating head control against gravity.
Lumbar: develops as infant begins to sit upright, stand, walk.

Lordotic or Kyphotic curve?

Answer 2

Lordotic curve

Question 3

(Lordosis/Kyphosis) – Normal inward curvatures in the cervical and lumbar regions

Answer 3

Lordosis

Question 4

(Kyphosis/Lordosis) - normal outward curvature specifically in the thoracic region

Answer 4

Kyphosis

Question 5

Curve convex anteriorly and concave posteriorly. “Secondary” curve, develops with maturation and secondary to muscle pull and upright posture.

Lordosis or Kyphosis?

Answer 5

Lordosis

Question 6

Curve concave anteriorly and convex posteriorly. Space for major organs in the thoracic and pelvic cavities.

Kyphosis or Lordosis?

Answer 6

Kyphosis

Question 7

Extension (increases/decreases) the cervical and lumbar lordosis and (reduces/increases) the thoracic khyphosis

Answer 7

increases; reduces

Question 8

Flexion (decreases/increases) cervical and lumbar lordosis but (increases/decreases) thoracic khyphosis

Answer 8

decreases; increases

Question 9

There is an external torque that is being created by gravity so the line of gravity will fall posterior to the lordosis at the neck creating an (extension/flexion) torque, but then it falls anterior to the thoracic curve creating a (flexion/extension) torque, and then posterior to the lordotic curve of the lumbar spine creating an (extension/flexion) torque. So this alternation at different regions of the spine allows there to be balance in the overall net torque experienced at the spine as close to zero as possible. With that being the case there is less muscle activation required to stand and the netting out of torques mean I do not have to use my internal force generators to negate the external.

Answer 9

extension; flexion; extension

Question 10

The (thoracic/cervical/lumbar) spine is the best spine for limiting anterior shear force because of the 60 degree orientation of the facet joints is almost in the frontal plane.

Answer 10

Thoracic

Question 11

As we move into the lumbar spine we start to shift more to the (sagittal/frontal) plane because the facet joints are aligned differently.

Answer 11

Sagittal

Question 12

Intervertebral discs are (fibrocartilaginous/fibrous) .

Answer 12

Fibrocartilaginous

Question 13

The (taller/shorter) the height of the disc and the more (thicker/thinner) the intervertebral disc is, the more motion it permits

Answer 13

taller; thicker

Question 14

If the vertebral segment moves into (flexion/extension), the annulus compresses anteriorly and is stretched posteriorly. The nucleus pulposus will move posteriorly.

Answer 14

flexion

Question 15

Cervical rotation at C1/C2 is very (large/small)

Answer 15

Large

Question 16

In the cervical spine, C1-C2 is responsible for about ___% of the cervical rotation.

Answer 16

50

Question 17

In the thoracic spine, (flexion and extension/rotation) is limited

Answer 17

Flexion and extension

Question 18

The facet joints would be under the most compression/load in the trunk during (extension/flexion) . In (flexion/extension) there is little to no load because you are pulling the facet joints apart.

Answer 18

Extension; flexion

Question 19

The facet joints on the right side would open up if I (left/right) side bend and the (left/right) ones would be compressed. This is something we can use as PTs because we know if you side bend and you have pain and you bend the opposite way and you do not have pain maybe it has something to do with the closing and opening up of the facet joints.

Answer 19

left; left

Question 20

A facet joints load would be (increased/decreased) if the disc was degenerated because the disc would not be dispersing forces as well and the load has to go on the facet joints. If the disc is degenerated/shrunk the vertebral bodies would move closer together and now the facet joints would be more in contact with each other.

Answer 20

increased

Question 21

If an individual is lifting something heavy and all the movement is coming from the lumbar spine and now you have increased force through your spinal erectors having to compensate for the large moment arm. The large moment arm of the weight being way out in front of a person is causing the spinal erectors to work really hard to lift that weight. If the spinal erectors compress the spine and they have to increase their internal force in order to lift the weight, the disc is being compressed in flexion and now you have the potential to drive the disc backwards. So when you tell someone to bend their knees it is with the hope of making the lumbar extensors work (less/more) and sparing the disc of the extra pressure.

Answer 21

less

Question 22

The collagen fibers running in (multiple/one) direction(s) on the annulus fibrosus allows the intervertebral disc to resist forces in a multitude of directions.

Answer 22

multiple

Question 23

In (flexion/extension) the intervertebral foramen increase in size.

Answer 23

Flexion

Question 24

In (flexion/extension) the annulus bulges anteriorly and the nucleus pulposus migrates posteriorly.

Answer 24

Flexion

Question 25

In (flexion/extension), the posterior longitudinal ligament is on tension because it has to resist that movement.

Answer 25

Flexion

Question 26

If a ligament sits (anterior/posterior) to the axis of rotation of the spine then you know in extension the ligament will be on tension and in flexion it will be slacking.

Answer 26

anterior

Question 27

If I lateral side bend to the left, the inter transverse ligament on the left will be on (slack/tensed) and the inter transverse ligament on the right would be on tension.

Answer 27

slack

Question 28

Spinal ligaments tend to have a very (large/small) elastic range

Answer 28

large

Question 29

In full extension you have very (little/large) stress on your spinal ligaments. In the neutral position you still have very (little/large) stress so this would be the neutral zone. When you get to full flexion (think of bending your toes all the way) of the spine there is __% strain on the ligaments and failure occurs at ___ %. So it gets injured because of its elasticity well past the normal ROM. We are talking trauma, a car accident, etc for a ligament to reach its failure point. In the neutral zone, the amount of room that I have to move my spine before something starts to stop it from moving is much bigger if you have more elastin (more ligamentous elasticity).

Answer 29

little; little; 50; 70

Question 30

In extension of the vertebral column the intervertebral foramen closes down and gets (smaller/larger)

Answer 30

smaller

Question 31

In extension of the vertebral column, the intervertebral disc the annulus bulges (posterior/anterior) and the nucleus migrates (anterior/posterior)

Answer 31

posterior; anterior

Question 32

In extension of the vertebral column, the anterior ligaments are on (tension/slacked) and the posterior ligaments are (slacked/ on tension).

Answer 32

tension; slacked

Question 33

If you laterally bend to the left, the intervertebral foramen on the left (closes down/opens up) while the intervertebral foramen on the right (opens up/closes down).

Answer 33

closes down; opens up

Question 34

If you laterally bend to the left, the intervertebral disc rocks to the left, the annulus bulges (left/right) and the nucleus migrates to the (right/left)

Answer 34

left; right

Question 35

If you laterally bend to the left, ligaments on the left will be (slacked/ on tension) while the ligaments on the right will be (on tension/slacked)

Answer 35

slacked; on tension

Question 36

What region is the most mobile section of the spine?

Answer 36

Cervical

Question 37

What are the typical cervical vertebrae?

Answer 37

C3-C6

Question 38

What are the atypical cervical vertebrae?

Answer 38

C1, C2, C7

Question 39

__ is the largest cervical vertebrae

Answer 39

C7

Question 40

What are the osteokinematic motions that occur at the atlantoccipital (OA) joint?

Answer 40

Flexion/extension and maybe lateral flexion

Question 41

In regard to flexion/extension in the cervical spine, __ to ___% of total motion happens at the OA joint

Answer 41

20 to 25

Question 42

For the OA joint in flexion, it is an ______ roll and posterior _____

Answer 42

anterior; slide

Question 43

For the OA joint in extension , it is an ______ roll and _____ slide

Answer 43

posterior; anterior

Question 44

What is the osteokinematic motion that occurs at the atlantoaxial joint?

Answer 44

Cervical rotation

Question 45

For the AA joint with right rotation, the flat right inferior facet of the atlas slides ____ on the flat superior facet of the axis

Answer 45

posterior

Question 46

What are the osteokinematic motions that occur in the lower cervical spine?

Answer 46

Flexion/extension, cervical rotation, and lateral flexion/side bending

Question 47

For flexion in the cervical vertebrae, the inferior articular facet of the superior vertebrae slide ________ and _______

Answer 47

superior; anterior

Question 48

For extension in the cervical vertebrae, the inferior articular facet of the superior vertebrae slide ______ and _____

Answer 48

inferior; posterior

Question 49

Rotation to the right increases the intervertebral foramen space on the (left/right).

Answer 49

left

Question 50

Right cervical rotation means that the inferior facet slides posterior and slightly inferior on the (right/left), along with anterior and slightly superior on the (left/right).

Answer 50

right; left

Question 51

In cervical lateral flexion to the right, the inferior articular facet of the superior vertebrae slides (inferiorly and posteriorly/superiorly and anteriorly) and the left slide slides (superiorly and anteriorly/ inferiorly and posteriorly) .

Answer 51

inferiorly and posteriorly ; superiorly and anteriorly

Question 52

What plane of motion does cervical protraction and retraction happen in?

Answer 52

Sagittal

Question 53

ROM of cervical protraction is typically a lot (smaller/larger) than retraction

Answer 53

Larger

Question 54

Protraction flexes the (lower/upper) cervical spine and extends the (upper/lower) cervical spine

Answer 54

lower; upper

Question 55

Retraction extends the (lower/upper) cervical spine and flexes the (upper/lower) cervical spine

Answer 55

lower; upper

Question 56

Prolonged protraction may lead to chronic forward head posture, causing increased strain on the craniocervical (extensor/flexor) muscles

Answer 56

extensor

Question 57

Let’s say I have a piece of that fibrocartilage disk that is sticking out of my lower cervical spine and I want to nudge it back in, the motion that I need to perform is (retraction/protraction) to extend the lower cervical spine because I know based on disk mechanics that if I go into flexion of the cervical spine it pinches the front and pushes the forces to the back.

Answer 57

retraction

Question 58

If the cervical spine is anterior to the axis of rotation you will get pulled into (extension/flexion), whereas if the cervical spine is posterior to the axis of rotation you will get pulled into (flexion/extension). That is why the SCM bilaterally flexes the lower cervical spine and extends the upper cervical spine.

Answer 58

extension; flexion

Question 59

The scalenes have a very limited moment arm and the reason is because the overall average vector of that is almost (in line/ out of line) with the axis of rotation. So if you add up all of those different pulls the overall vector is not that big which also results in the scalenes being weak cervical flexors bilaterally and limited cervical rotators ipsilaterally.

Answer 59

in line

Question 60

The longus colli is a dynamic anterior longitudinal ligament because one of its’ main goals is to provide vertical (stability/mobility) to the front of the cervical spine because of its’ attachments.

Answer 60

stability

Question 61

What is the only muscle that attaches entirely to the anterior spine?

Answer 61

Longus colli

Question 62

The longus colli has a (small/large) cross sectional area

Answer 62

small

Question 63

The longus colli acts to (flex/extend) the cervical spine and reduce its lordosis

Answer 63

flex

Question 64

Longus colli - unilateral activation acts as a (weak/strong) lateral flexor

Answer 64

weak

Question 65

Which muscle group has an important role in providing neural feedback regarding the position and rate of head movement and indirectly contributes to balance, equilibrium and eye hand coordination ?

Answer 65

The suboccipital muscles

Question 66

In the thoracic spine, flexion/extension (increases/decreases) in the cranial-caudal direction: There is not going to be a ton of room for flexion and extension due to the orientation of the facet joints in the thoracic spine. However, as the orientation of the facets lower in the thoracic vertebrae become more and more like the lumbar vertebrae and now flexion and extension are going to be the predominant motion.

Answer 66

increases

Question 67

In the thoracic spine (extension/flexion) is limited by contact of the spinous processes

Answer 67

extension

Question 68

In the thoracic spine thoracic rotation (decreases/increases) in the cranial-caudal direction because the mid-Lower T spine has more vertical oriented facets that tend to block rotation

Answer 68

decreases

Question 69

The facet orientation in the thoracic spine would indicate that (lateral flexion/ flexion and extension/ rotation) would be the predominant motion, however only about __ degrees to each side.

Answer 69

lateral flexion and extension; 25

Question 70

Lateral flexion is limited by what in the thoracic spine ?

Answer 70

The rib cage

Question 71

What are the osteokinematic motions the clavicle can perform ?

Answer 71

Elevation/Depression, Protraction/Retraction, and axial (longitudinal) rotation

Question 72

Elevation/Depression of the clavicle happens in the ___ plane

Answer 72

frontal

Question 73

The clavicle gets more degrees of (elevation/depression) than (depression/elevation)

Answer 73

Elevation than depression

Question 74

In elevation/depression the clavicle is (convex/concave) and the sternum is (concave/convex)

Answer 74

convex; concave

Question 75

In elevation of the clavicle, the roll is (superior/inferior) and the slide is (inferior/superior)

Answer 75

superior; inferior

Question 76

In elevation of the clavicle what ligament is being stretched?

Answer 76

The costoclavicular ligament

Question 77

In depression of the clavicle, the roll is (inferior/superior) and the slide is (superior/inferior)

Answer 77

inferior; superior

Question 78

In depression of the clavicle what ligament is being stretched?

Answer 78

The interclavicular ligament

Question 79

Protraction/Retraction of the clavicle occurs in the ___ plane

Answer 79

Horizontal

Question 80

In protraction and retraction the clavicle is (concave/convex) and the sternum is (convex/concave)

Answer 80

concave; convex

Question 81

In protraction of the clavicle, there is an (anterior/posterior) roll and an (anterior/posterior) slide

Answer 81

anterior; anterior

Question 82

In protraction of the clavicle, there is an elongation of the ____ ligament and (posterior/anterior) capsule ligaments of the SC joint

Answer 82

costoclavicular; posterior

Question 83

In retraction of the clavicle, there is a (posterior/anterior) roll and (posterior/anterior) slide

Answer 83

posterior; anterior

Question 84

In retraction of the clavicle, there is an elongation of the _____ ligament and (anterior/posterior) capsule ligaments of the SC joint

Answer 84

costoclavicular; anterior

Question 85

Axial rotation of the clavicle occurs with raising the arm (overhead/to 45 degrees)

Answer 85

overhead

Question 86

Axial rotation of the clavicle (can't/can) occur with your arm at rest by your side

Answer 86

can't

Question 87

Throughout arm elevation, the clavicle rotates (posteriorly/anteriorly)

Answer 87

Posteriorly

Question 88

What are the arthrokinematics that occur in an axial rotation of the clavicle?

Answer 88

A spin

Question 89

The ____ joint is an articulation between lateral end of the clavicle and acromion of scapula

Answer 89

Acromioclavicular

Question 90

The AC joint is a (flat/round) joint

Answer 90

flat

Question 91

If two flat edges meet for a joint (there aren’t/there are) going to be any arthrokinematics present.

Answer 91

there aren't

Question 92

The AC joint is surrounded by capsule which are reinforced by superior and inferior ligaments. The superior ligaments are reinforced by attachments of what two muscles?

Answer 92

The deltoid and the trapezius

Question 93

The coracoclavicular ligament is an extrinsic source of stability to the AC joint because it is not actually attached to the joint, it is pulling the clavicle down to the coracoid process, which is another part of the scapula. What two ligaments are a part of the coracoclavicular ligament?

Answer 93

The trapezoid and conoid ligament

Question 94

Coracoclavicular ligament (plays/does not play) a role in holding everything up in the the scapula (thereby the whole arm) from the clavicle

Answer 94

plays

Question 95

What are the kinematic motions that occur at the AC joint?

Answer 95

Upward/Downward rotation, internal/external rotation, & anterior/posterior tilting

Question 96

Out of the kinematic motions that occur at the AC joint, which motions are actually adjustments at the AC joint?

Answer 96

Internal/External rotation & Anterior/Posterior tilting

Question 97

Upward rotation at the AC joint is a natural component of what two motions?

Answer 97

Abduction or flexion

Question 98

Downward rotation of the AC joint returns the scapula back to anatomic position and is associated with what two motions?

Answer 98

Adduction and extension

Question 99

Internal/External rotation & Anterior/Posterior tilting of the AC joint are defined by the motion of the __ ___

Answer 99

glenoid fossa

Question 100

During protraction of the scapulothoracic joint , the AC joint (internally/externally) rotates slightly in the horizontal plane. This allows for the scapula to maintain contact with the curved thorax.

Answer 100

internally

Question 101

With the elevation of the scapulothoracic joint (shoulder shrug) (anterior/posterior) tilting is needed in order to maintain contact with the curved thorax

Answer 101

anterior

Question 102

The clavicle and the scapula are very closely linked, the clavicle and scapula do almost the same exact thing but the little bit of ___ ____ allows for the scapula to adjust slightly and not have to follow the EXACT path of the clavicle for each motion.

Answer 102

AC adjustments

Question 103

What are the osteokinematics of the scapulothoracic joint?

Answer 103

Elevation/depression, upward/downward rotation, & protraction/retraction

Question 104

Elevation of the scapula is a composite motion from ___ joint and ___ joint rotations

Answer 104

SC and AC

Question 105

In elevation of the scapula, the scapula follows the exact path of the clavicle around the ___ joint

Answer 105

SC

Question 106

Combined downward rotation at the (AC/SC) joint allows the scapula to remain nearly vertical throughout the elevation

Answer 106

AC

Question 107

Protraction/Retraction of the scapula are a summation of horizontal plane rotations at both the __ and __ joints

Answer 107

SC and AC

Question 108

Protraction at the SC joint is accompanied by slight internal rotation at the ___ joint

Answer 108

AC

Question 109

The __ joint and ___ joint can compensate at each joint to make up for lack of motion at the other

Answer 109

SC; AC

Question 110

(Upward/downward) rotation is an integral part of overhead reaching. It is necessary to place the glenoid fossa in a position to support and stabilize the head of the abducted humerus.

Answer 110

Upward

Question 111

Complete upward rotation occurs as a summation of clavicular elevation at the ___ joint and scapular upward rotation at the ___ joint. It is essential for full 60 degrees of upward rotation at the _____ joint

Answer 111

SC; AC; scapulothoracic

Question 112

(Downward/Upward) rotation occurs as the arm is returned to the side from a raised position (clavicular depression and downward rotation at AC joint)

Answer 112

Downward

Question 113

In the thoracic spine there is more (flexion/extension) than (extension/flexion)

Answer 113

Flexion than extension