Cervical & Thoracic Spine (Posture)

Question 1

How is posture described?

Answer 1

Position of the joints and body segments

Balance between the muscles crossing the joints

Question 2

What can bad posture create?

Answer 2

Impairments in joints, muscles, or connective tissues

can work the other way too, Impairments can cause bad posture

Question 3

What are the 3 key components of proprioception that influence posture?

Answer 3

Foot
SI Joint
Cervical Spine

Question 4

What are 2 postural reflexes in infants?

Answer 4

ATNR (Asymmetrical Tonic Neck Reflex)

STNR (Symmetrical Tonic Neck Reflex)

Question 5

What’s the evolution of posture

Answer 5

Start in supine > 
Prone -> 
Sitting -> 
Quadriped -> 
Half Kneeling -> 
Kneeling & squat position -> 
Standing

Question 6

What are the primary curves

Answer 6

Kyphosis

Present in the infant

Question 7

What are the compensatory curves?

Answer 7

Lordosis

Question 8

What are the compensatory curves important for?

Answer 8

Withstanding effects of gravity and other external forces.

Question 9

What does proper posture do for you?

Answer 9

Allows normal joint ranges.
Positions limbs in appropriate positions for functional activities
Protects musculoskeletal system from excessive forces

Question 10

How big is the average standing sway of a person?

Answer 10

4 cm

Question 11

What’s the most common position to assess a patients posture?

Answer 11

Position that causes the most of the patient’s pain.

Standing or sitting

Question 12

What are the 3 views to assess a patient’s posture?

Answer 12

Lateral
Posterior
Anterior

Question 13

Where’s the line of gravity in the ankle?

Answer 13

Anterior to joint

Question 14

Where is the stability provided in the ankle for posture?

Answer 14

Soleus (PF muscles)

Question 15

Where is the line of gravity in the knee?

Answer 15

Anterior to the knee joint.

keeps knee in extension

Question 16

Where’s the stability provided in the knee?

Answer 16

ACL, Posterior capsule, and tension in the gastroc-soleus & hamstrings

Question 17

What muscles are needed for support to maintain upright posture in the knee when it’s extended?

Answer 17

None

Question 18

What helps stabilize the knee when it is slightly flexed?

Answer 18

Quadriceps contract to prevent knee buckling

Question 19

Where’s the line of gravity in the hip?

Answer 19

Varies with swaying of the body. Goes through hip joint.

Question 20

What ligament provides passive stability in the hip joint.

Answer 20

Iliofemoral ligament (at equilibrium no external support is necessary)

Question 21

What happens if the line of gravity shifts posterior?

Answer 21

Some post pelvic rotation

Hip flexor tension

Question 22

What happens if the line of gravity shifts anterior?

Answer 22

Hip extensors kick in

Question 23

Where’s the normal line of gravity in the Trunk?

Answer 23

Through lumbar and cervical bodies.

curves in back balance each other out

Question 24

What muscles work to keep stability as the trunk shifts?

Answer 24

Contralateral muscles contract (lean forward, back muscles work, visa versa)

Question 25

Where's the line of gravity in the head?

Answer 25

Anterior to the atlanto-occipital joints

Question 26

Which muscles contract to keep head balanced?

Answer 26

Posterior cervical muscles

Question 27

For every inch the head is forward, how many pounds is added to the spine?

Answer 27

10lbs

Question 28

What are the 3 subsystems used for postural stability in the spine?

Answer 28

``` Inert Structures (osseous & ligamentous) Active Structures (muscles) Neural control) ```

Question 29

What happens if the Inert Structures are injured?

Answer 29

decreases joint position sense

Question 30

What happens if the active structures are damaged?

Answer 30

Atrophy & decreased function. | Decreased joint position sense

Question 31

What role do inert structures play in neural control?

Answer 31

Sensory receptors sense position and report to the CNS

Question 32

What happens without the dynamic stabilizers (muscles)?

Answer 32

Spine would collapse in upright position

Question 33

What are global muscles?

Answer 33

Larger muscles More Superficial (erector spinea, SCM, Scalenes, Levator, Traps)

Question 34

What are segmental muscles?

Answer 34

Smaller muscles Deep (Rectus Capitis Anterior, Lateralis, longus colli, longus capitis)

Question 35

What do the global muscles contribute too?

Answer 35

Control spinal orientation | Responds to external loads that shift center of mass

Question 36

What do segmental muscles do?

Answer 36

Prevents inert tissues from being stressed at the limits of their motion. Maintain each segment in stable position.

Question 37

Which muscles are under utilized in patients with neck pain?

Answer 37

Segmental Muscles