Cervical & Thoracic Spine (Posture) Flashcards
How is posture described?
Position of the joints and body segments
Balance between the muscles crossing the joints
What can bad posture create?
Impairments in joints, muscles, or connective tissues
can work the other way too, Impairments can cause bad posture
What are the 3 key components of proprioception that influence posture?
Foot
SI Joint
Cervical Spine
What are 2 postural reflexes in infants?
ATNR (Asymmetrical Tonic Neck Reflex)
STNR (Symmetrical Tonic Neck Reflex)
What’s the evolution of posture
Start in supine > Prone -> Sitting -> Quadriped -> Half Kneeling -> Kneeling & squat position -> Standing
What are the primary curves
Kyphosis
Present in the infant
What are the compensatory curves?
Lordosis
What are the compensatory curves important for?
Withstanding effects of gravity and other external forces.
What does proper posture do for you?
Allows normal joint ranges.
Positions limbs in appropriate positions for functional activities
Protects musculoskeletal system from excessive forces
How big is the average standing sway of a person?
4 cm
What’s the most common position to assess a patients posture?
Position that causes the most of the patient’s pain.
Standing or sitting
What are the 3 views to assess a patient’s posture?
Lateral
Posterior
Anterior
Where’s the line of gravity in the ankle?
Anterior to joint
Where is the stability provided in the ankle for posture?
Soleus (PF muscles)
Where is the line of gravity in the knee?
Anterior to the knee joint.
keeps knee in extension
Where’s the stability provided in the knee?
ACL, Posterior capsule, and tension in the gastroc-soleus & hamstrings
What muscles are needed for support to maintain upright posture in the knee when it’s extended?
None
What helps stabilize the knee when it is slightly flexed?
Quadriceps contract to prevent knee buckling
Where’s the line of gravity in the hip?
Varies with swaying of the body. Goes through hip joint.
What ligament provides passive stability in the hip joint.
Iliofemoral ligament (at equilibrium no external support is necessary)
What happens if the line of gravity shifts posterior?
Some post pelvic rotation
Hip flexor tension
What happens if the line of gravity shifts anterior?
Hip extensors kick in
Where’s the normal line of gravity in the Trunk?
Through lumbar and cervical bodies.
curves in back balance each other out
What muscles work to keep stability as the trunk shifts?
Contralateral muscles contract (lean forward, back muscles work, visa versa)
Where’s the line of gravity in the head?
Anterior to the atlanto-occipital joints
Which muscles contract to keep head balanced?
Posterior cervical muscles
For every inch the head is forward, how many pounds is added to the spine?
10lbs
What are the 3 subsystems used for postural stability in the spine?
Inert Structures (osseous & ligamentous) Active Structures (muscles) Neural control)
What happens if the Inert Structures are injured?
decreases joint position sense
What happens if the active structures are damaged?
Atrophy & decreased function.
Decreased joint position sense
What role do inert structures play in neural control?
Sensory receptors sense position and report to the CNS
What happens without the dynamic stabilizers (muscles)?
Spine would collapse in upright position
What are global muscles?
Larger muscles
More Superficial
(erector spinea, SCM, Scalenes, Levator, Traps)
What are segmental muscles?
Smaller muscles
Deep
(Rectus Capitis Anterior, Lateralis, longus colli, longus capitis)
What do the global muscles contribute too?
Control spinal orientation
Responds to external loads that shift center of mass
What do segmental muscles do?
Prevents inert tissues from being stressed at the limits of their motion.
Maintain each segment in stable position.
Which muscles are under utilized in patients with neck pain?
Segmental Muscles
