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PT Kines > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Which thoracic spine vertebrae are transitional?

A

T1 and T12

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2
Q

do thoracic or cervical vertebrae have larger bodies?

A

thoracic

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3
Q

Vertebral bodies have?

A

transverse and anterior-posterior diameters

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4
Q

Why dont thoracic vertebrae have transverse foramen?

A

There is no vertebral a. to protect

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5
Q

Transverse processes are more ____ than cervical?

A

posterior

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6
Q

Inferior facets of superior verebrae face?

A

inferior and anterior

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7
Q

Superior facets of the inferior vertebrae face?

A

superior and posterior

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8
Q

Decreased Weight bearing occurs on the facet joints compared to C-spine due to?

A

Facet articulations are 60* from horizontal place

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9
Q

what is responsible for resisting compression in verterbral body?

A

vertical, oblique and horizontal trabeculae in spongy bone

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10
Q

What is the zone of weakness?

A

Decreased trabeculae bone. Can lead to ant comp fractures,

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11
Q

with age kyphosis?

A

increases, more anterior pressure in thoracic spine

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12
Q

vertical trabeculae fibers resist?

A

compression

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13
Q

Horizontal trabeculae fibers resist?

A

tension/shear

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14
Q

Does the vertebral arch have a lot or less trabeculae?

A

multiple, making it more supported for weight bearing

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15
Q

Difference between spondylysis v.s spondylolythesis?

A

spondylolysis is just fracture
spondylolythesis

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16
Q

Ribs

A

restrict ROM

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17
Q

Upper thoracic ROM?

A

rotation and sidebending

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18
Q

Lower thoracic ROM?

A

flexion and extension

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19
Q

Middle thoracic ROM?

A

little bit of everything

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20
Q

Freyette’s law upper thoracic spine?

A

SB and rotation occur in the same direction in neutral and non-neutral biomechanics

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21
Q

Freyette’s law lower thoracic spine?

A

SB and rotation occur in opposite directions

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22
Q

Degrees of freedom in the thoracic spine?

A

3* (flexion/extension, Sb, rotation)

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23
Q

Why does upper thoracic have decreased flexion/extension?

A

facets lie in frontal plane
60* from horizontal plane

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24
Q

Why does lower thoracic have increased flexion/extension?

A

2* from sagittal plane

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25
Q

What does rule of 3s help to determine?

A

SP and TP orientation

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26
Q

Orientation of T1-T3 SPs?

A

Level with respective Tps

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27
Q

Orientation of T4-T6 SPs?

A

1/2 level below respective TPs

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28
Q

Orientation of T7-T9 SPs?

A

SP 1 full level below respective TPs

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29
Q

Orientation of T10 SPs?

A

SP 1 full level below

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30
Q

Orientation of T11 and T12?

A

Sp 1/2 level below, SP in line with TP

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31
Q

What structures provide check rein to flexion?

A

PLL, ligamentum flavum, erector spinae, Spinal cord
Anterior vertebral body + IV disc

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32
Q

What structures check rein to extension?

A

ALL, rectus abdominus,
Post vertebral body + disc, spinous process

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33
Q

What structures check rein to side bending?

A

Contralateral musculature Intratransverse compression
Ribs

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34
Q

What happens to facets and IV foramen with sidebending?

A

closing of facets and IV foramen
Posterior inferior motion

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35
Q

Distortion of rib pair?

A

this happens during rotation
One rib goes posterior the other goes anterior
magnitude dependent on CV and CT joint motion

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36
Q

Check rein for rotation?

A

winding of the disc
ribs

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37
Q

Scoliosis is named according to?

A

direction of convexity and region

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38
Q

what is a type I scoliotic dysfunction?

A

rib hump evident

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39
Q

Primary curve v.s secondary curve?

A

primary: congenital
secondary: compensatory

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40
Q

Describe normal Thoracic LOG?

A

LOG anterior to thoracic (flexion moment)
PLL counteracts

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41
Q

Describe LOG action due to a moderate kyphosis?

A

Increased anterior (increased flexion moment)
PLL and erector spinae

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42
Q

Describe Severe kyphosis affect on LOG?

A

Even greater anterior (larger flexion moment)
erector spina and PLL
Upper cervical spine will go into extension to counteract

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43
Q

Where do ribs 1-7 attach?

A

true ribs
attach directly to cartilage to sternum

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44
Q

Where do ribs 8-10 attach

A

false ribs
attach to costal cartilage above attaching to sternum

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45
Q

Where do ribs 11-12 attach?

A

floating ribs (no attachment to sternum)

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46
Q

what type of joint are the costovertebral joints?

A

planar synovial

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47
Q

head of rib is?

A

convex

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48
Q

T2-T8 facets are?

A

formed by 2 concave demifacets on inferior and superior body of vertebrae

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49
Q

T1, T11, T12 articulate with?

A

only 1 vertebrae

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50
Q

The vertebral facets of T9-T12 are?

A

posterior to the pedicles

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51
Q

Ribs 2-10 also articulate with?

A

intervertebral discs

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52
Q

Which costovertebral joints have more mobility?

A

those that articulate with only one vertebrae

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53
Q

How does rotation and gliding occur in CV joint?

A

Rib springing

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54
Q

Where does Functional internal rotation lie to spinous process?

A

T5

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55
Q

Where does Functional external rotation lie to spinous process?

A

T3

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56
Q

What is the total degrees of ROM for Horizontal Abduction
Horizontal Adduction

A

120-140’ AB
40-60’ ADD

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57
Q

What is the total degree of ROM for extension or hyperextension?

A

60-80’

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58
Q

What are the four joints that make up the shoulder complex?

A

Glenohumeral
scapulothoracic
acromioclavicular
sternoclavicular

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59
Q

What are the four joints that make up the shoulder complex?

A

Glenohumeral
scapulothoracic
acromioclavicular
sternoclavicular

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60
Q

Where does the superior angle of the scapular in respects to spinous process?

A

T2

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61
Q

Where does the inferior angle of the scapular in respects to spinous process?

A

T7

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62
Q

What angle of upward rotation does the scapula lie in?

A

3-5 degrees

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63
Q

Why does the scapular have upward rotation at rest?

A

Because it creates a shelf for humeral head to stop dislocation

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64
Q

When the scapula elevates it causes more anterior tilting which can lead to

A

AC impingement

upper cross syndrome

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65
Q

Upward rotation promotes ______stability. With what contribution?

A

inferior
Glenoid contribution
CH & SGH ligament contribution

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66
Q

What is scapular dumping?

A

When there is relaxation (adaptive stretch) of coracohumeral ligament and superior glenohumeral ligament
downward rotation means no shelf
inferior translation/ dislocation

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67
Q

What is the typical posture for scapular dumping?

A

Rounded Shoulder
inferior translation
increase kyphosis

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68
Q

What is the normal range for anterior tilting of the scapula?

A

9’-20’

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69
Q

What are you to likely see with anterior tilting greater than 20 degrees?

A

Subacromial impingement
w/ inc. kyphosis
osteoporosis
menopausal women

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70
Q

What is the scapulo-clavicular angle?

A

50 degrees
POS 30’ anterior to frontal plane
Clavicular retraction angle is 20’

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71
Q

What is the purpose of scapulothoracic motion?

A

appropriately position the glenoid to allow optimal motion

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72
Q

Scapulothroacic motion has _____translation and _____rotary motion? What are they?

A

Translation
-elevation/depression
-protraction/retraction
Rotary
-upward/downward rotation
-anterior/posterior tilting or tipping
-medial/lateral rotation

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73
Q

What motion is coupled with protraction of the scapula?

A

Medial rotation = protraction

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74
Q

What motion is coupled with retraction of the scapula?

A

Lateral rotation = retraction

75
Q

What is the pathology that reveals the entire medial border of the scapula?

A

scapular winging

76
Q

What causes scapular winging?

A

neuropathy of the long thoracic n.
adaptive shortening of serratus anterior

77
Q

What is the pathology that reveals the inferior angle?

A

Excessive anterior tipping

78
Q

What causes excessive anterior tipping?

A

adaptive shortening of pec minor

79
Q

At neutral where is the instanenous center of rotation

A

at the spine of the scapula

80
Q

What is the concavity of the AC joint?

A

Convex lateral clavical
concave acromion

81
Q

What type of joint is the AC joint?

A

Synovial joint with an fibrocartilaginous disc

82
Q

What ligaments stabilize the AC joint

A

Conoid, trapezoid and AC ligamentts

83
Q

What ligament is responsible for posterior tilting of the scap

A

Conoid ligament

84
Q

What type of joint is the costotransverse joint?

A

planar, synovial between ribs and TP

85
Q

Which thoracic vertebrae have costotransverse jiont?

A

T-T10

86
Q

Convexity of the costal facet? costal tubercle?

A

costal facet: concave
costal tubercle: convex

87
Q

Some rotation is allowed at which costotransverse joint?

A

T1-T6

88
Q

Which costotransverse joint is flat?

A

T7-T8

89
Q

What type of joint is the costosternal joint?

A

Planar, synovial
except rib 1: cartilagenous

90
Q

Where do costosternal joint ribs 1-7 articulate with?

A

sternum

91
Q

what do costosternal joint ribs 8-10 articulate with?

A

costocartilage

92
Q

what do costosternal joint ribs 11 and 12 articulate with?

A

nothing babe

93
Q

Rib 1 kinematics?

A

Costosternal joint is stiff
Elevates with inspiration
costovertebral joint: superior and posterior

94
Q

axis for Costovertebral and costosternal joint?

A

2* to CKC,
CS moves vertically but no rotation

95
Q

around what axis does rib 1-6 motion occur?

A

M-L axis
Nearly in the fronal plane

96
Q

around what axis does rib 7-10 motion occur?

A

A-P axis
Nearly sagittal plane

97
Q

Ribs 1-6 motion can be described as ?

A

pump handle
increased A-P dimension

98
Q

Rib 7- 10 motion can be described as?

A

Bucket handle
increased lateral dimention

99
Q

Rib 7- 10 motion can be described as?

A

Bucket handle
increased lateral dimension
up and out

100
Q

Rib 11-12 motion can be described as?

A

caliper
lateral dimension

101
Q

Welcome to the shoulder :)

A
102
Q

From base position how many degrees of UE ER do we have? what plane of motion is this happening in?

A

40-60*, transverse plane

103
Q

At 90* abduction how many degrees of UE ER do we have? what plane of motion

A

90-100, sagittal plane

104
Q

At 90* abduction how many degree of UE IR do we have?

A

45-60*

105
Q

What is the ideal level of functional internal rotation and functional er?

A

FIR: spinous process of T5
FER: Spinous process of T3

106
Q

Ideal degrees of horizontal abduction?

A

120-140

107
Q

ideal degrees of horizontal adduction?

A

40-60*

108
Q

Ideal degrees of extension?

A

60-80*

109
Q

What are the 4 joints of the UE?

A

glenohumeral
scapulothoracic
acromioclavicular
sternoclavicular

110
Q

What are the main movements in the scapulothoracic joint?

A

rotary: upward/downward rotation, tilt, medial-lateral rotation
translatory:protraction/retraction + elevation, depression

111
Q

how much scapular upward rotation do we have at rest?

A

3-5*

112
Q

Upward rotation of scapula promotes?

A

inferior stability

113
Q

What contributes to upward rotation of scapula?

A

Glenoid
Coracohumeral ligament
SGH ligament (superior glenohumeral ligament)

114
Q

What capsuloligamentous scapular dumping?

A

relaxation of Coracohumeral and SGH ligament
Will produce false sulcus test

115
Q

Scapulathoracic joint is slightly anterior tilted in neutral. to what degree?

A

9-20*

116
Q

A pathologically elevated scap will lead to more?

A

anterior tilting
potential for impingement

117
Q

Anterior tilt of scap does what to muscles?

A

adaptively shortening elevators
Adaptively lengthens depressor
increases impingement of subacromial structures

118
Q

What is the plane of the scapula?

A

30* anterior to frontal plane

119
Q

What is the scapulo-clavicular angle?

A

50*

120
Q

what is the clavicular retraction angle?

A

20*

121
Q

Main function of the scapulothoracic joint?

A

appropriate position glenoid

122
Q

Do scapulothoracic motions occur independently?

A

no

123
Q

Elevation of scapula does what to the clavicule?

A

elevation

124
Q

Elevation and depression is coupled with which two motions?

A

anterior and posterior tilt

125
Q

What is protraction and retraction coupled with?

A

medial and lateral rotation

126
Q

Anterior tilting involves what movement of the superior/inferior angles?

A

anterior displacement of superior angle
posterior displacement of inferior angle

127
Q

Posterior tilting involves what movement of the superior/ inferior angles?

A

posterior displacement of superior angle
anterior displacement of inferior angle

128
Q

Tilting is coupled with?

A

retraction/protraction
Upward/downward rotation

129
Q

Rotary motions of the scapulothoracic joint occur around?

A

vertical axis of AC joint

130
Q

medial rotation of the scapula does what to the glenoid fossa?
lateral rotation?

A

faces more anteriorly
Faces more posteriorly

131
Q

What motion is affected with scapular winging?

A

medial/lateral rotation
medial rotation is excessive

132
Q

upward rotation of scapula, does what to the glenoid? clavicle? inferior angle?

A

upward of glenoid
elevation of clavicle
superolateral displacement

133
Q

What are the 3 rotary motions of the acromioclavicular joint?

A

anterior/posterior tipping
medial/lateral rotation
upward/downward rotation

134
Q

What type of mechanism would injure AC joint?

A

Lateral FOOSH
Lateral force

135
Q

Convexity of the acromial end of the clavicle?

A

convex

136
Q

Convexity of the acromion?

A

Concave

137
Q

What type of joint is the AC joint?

A

Fibrocartilagenouw

138
Q

The AC joint is stabilized by?

A

Conoid, trapezoid, AC ligaments

139
Q

What is the benefit of a fibrocartilagenous joint?

A

Healing properties

140
Q

What type of joint is the sternoelavicular joint?

A

Synovial w/ articular disc

141
Q

SC motions are linked with which snap motion?

A

Elevation depression, protraction, retraction, post/ant rotation

142
Q

Convexity of sternal end of clavicle?

A

Convex

143
Q

Convexity of sternum

A

Concave

144
Q

Transverse plane convexities of clavicle and sternum?

A

Opposite of frontal plane. Concave clavicle, convex sternum

145
Q

Post rotation of Sc joint is coupled with what scap motion

A

Upward rotation after 30° clavicle elevation

146
Q

Max rotation at Sc joint?

A

30-55°

147
Q

Anterior rotation at sc joint?

A

No ant. Rotation (from neutral)

148
Q

The glenoid cavity has-more concavity in which direction?

A

Superior → inferior

149
Q

What is angle of humeral head?

A

130°150°

150
Q

Which directions does the humeral head face?

A

Medial, superior, posterior

151
Q

Issue with glenoid + humerus orientation?

A

Humerus is superior, glenoid is inferior

152
Q

ER at gh joint? At base? @ 90°?

A

40-60° 90-100°

153
Q

IR at GH joint at 90°?

A

45-60°

154
Q

Elevation @GH joint?

A

0-120°, informal!

155
Q

Full elevation of the UE requires___ to prevent impingement and provide greater humeral articulation.

A

External rotation

156
Q

Mechanical purpose of scapulohumeral rhythm?

A

Increase ROM of elevation
Increases inferior stability of GH
Maintains optimal length tension relationship

157
Q

Describe phase 1A of UE elevation.

A

0-30* scaption/ 0-60* flexion
predominantly glenohumeral
scapula seeks a position of stability

158
Q

Describe Phase 1B of UE elevation?

A

30-90* scaption/60-90* elevation
Consistent upward scapula motion
Acromion elevation, elevates clavicle
IC @ root of spine and SC joint

159
Q

Describe phase 2A of UE elevation?

A

90-120 of elevation
claviclar elevation tension loads costoclavicular ligaments
Costoclavicular ligaments limit elevation
IC shifts to AC joint

160
Q

Describe phase 2B of UE elevation?

A

120-end ROM elevation
ICR @ AC joint
Scapular upward rotation combined with corocoid depression
Depression of corocoid tension loads coraclavicular ligaments

161
Q

What causes posterior clavicular rotation?

A

Coracoclavicular tension from phase 2B impacts downward force on posterior clavicle through conoid ligament

162
Q

The “Crank” shape of the clavicle allows for what?

A

30* further clavicular elevation of outer clavicle during 2B
posterior clavicle able to aid scapular tilting

163
Q

Describe phase 1B scapular rotation?

A

Upper trap creates upward rotation via superomedial force on acromion
Lower serratus creates upward force via inferolateral force
Rhomboid and mid trap provide stabilization
lower trap tries to do downward rotation but it cant do to MA

164
Q

Describe phase 2B scapular rotation?

A

lower trap does upward rotation
Upper trap moment arm decreases
Lower serratus (large MA) upward rotation (inferolateral force)
Rhomboid and mid trap stabilizat

165
Q

During abduction describe the roles of the serratus and trapezius?

A

trap is more important
trap paralysis ROM would only be 75*
serratus paralysis: full ROM possible

166
Q

During flexion describe the roles of the serratus and trapezius?

A

serratus most important
Serratus paralysis: limited flexion
Trap paralysis: full flexion

167
Q

If the trapezius was working alone how much flexion could it create?

A

20* upward rotation during flexion

168
Q

Describe the synergist action between deltoid and supraspinatus?

A

deltoid only will produce superior humeral translation
Supraspinatusreduces this by compressing head into gloid

169
Q

Factors involved in glenohumeral stability?

A

negative intra articular pressure
labral concavity compression
capsular constraint mechanism
Scapulohumeral muscles
Capsuloligamentous restraint

170
Q

What is negative intra-articular pressure?

A

venting produces inferior subluxation
less force needed to translate humeral head in other directions

171
Q

Stability ratio equation related to labrum concavity?

A

stability ratio= translation force/compressive load x100

172
Q

With intact labrum the glenohumeral joint resists dislocation force up to____% of the compressive loads?

A

64%

173
Q

Which muscles compress the humeral head into the glenoid allowing for stability?

A

deltoid, supraspinatus, infraspinatus, teres minor

174
Q

Most increase in which translation (direction) with decreased muscle contractility?

A

anterior translation (46%increase)

175
Q

Least increase in translation (direction) with decreased RC muscle contractility?

A

inferior translation (0% increase)

176
Q

RC muscles act as a buttress by_____?

A

centering the humeral head in the glenoid

177
Q

How do capsuloligamentous structures add to GH stability?

A

GH ligaments restrain motion
motion will take the “slack: out of the ligaments

178
Q

What is the capsular constraint mechanism?

A

End ROM motion takes slack out of ligament
Contribute to obligate humeral head translation

179
Q

Anterior humeral capsule check rein for?

A

ER

180
Q

The pec minor muscle attaches to the coracoid at what clock position?

A

4 oclock

181
Q

What muscles attach to the coracoid at 7 oclock?

A

coracobrachialis
biceps brachii

182
Q

what attaches to the coracoid at 10 oclock?

A

coracoacromial ligament

183
Q

What position on the clock do the coracoclavicular ligaments attach to the coracoid?

A

11 oclock + midnight

PT Kines (4 decks)

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