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GM Biomechanics > Exam 2: Cervical Spine/whiplash > Flashcards

Exam 2: Cervical Spine/whiplash Flashcards

1
Q

What region has more muscles associated with it than anywhere else

A

Cervical

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2
Q

What is the cervical spines job

A

Maintain head posture, great deal of mobility

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3
Q

Cervical curve is the ___ distinct of all the spinal curves

A

Least

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4
Q

What is the most complex region of the axial skeleton

A

Occiput atlas axis

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5
Q

What is the orientation of superior articular process of atlas

A

Concave and medial

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6
Q

What is the anatomical structure of C0/C1 inn saggital and frontal planes

A

Cuplike

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7
Q

Why is there little rotation of occiput-atlas

A

Lat mass of C1 is shaped like a peanut

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8
Q

If occiput=atlas doesnt translate P-A or A-P how does it create flexion extension

A

Rotating post and sup and rotating ant sup

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9
Q

Flexion of occiput - atlas is limited by what

A

Posterior neck muscular tension

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10
Q

What is extension of the occiput - atlas limited by

A

Suboccipital muscle compression against the occiput

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11
Q

What is the range of x axis rotation in the occiput - atlas

A

Mean value between 14-35 degrees

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12
Q

Y axis rotation of occiput - atlas limited by

A

Elastic range, ant/post walls of C1 socket, joint capusle tension, mostly alar ligament tension

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13
Q

What is the range of y axis ratoation of occiput - atlas

A

4-8 degrees

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14
Q

Z axis of occiput-atlas is not physiological accomplished but can be what

A

Induced by elevating out of one socket while other is pivot

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15
Q

What is the range of z axis roation occiput - atlas

A

4-11 degrees (in cadavers)

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16
Q

What limits z axis rotation of occiput - atlas

A

Alar ligament attachement

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17
Q

Z rotation of occiput - atlas is coupled by what

A

Rotation in opposite direction leading of chin away from side of lateral flexion

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18
Q

What are the C1 inferior articular processes shaped

A

Flat, slightly convave, medial

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19
Q

The configuration of the cartilage of atlas axis creates what type of articulation

A

Biconvex

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20
Q

The x axis rotation c1-c2 biconvexity combined has a theta x of what

A

20 degreese

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21
Q

Increasing the anterior curvature of the dens increases what

A

X axis rotation

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22
Q

What is a path that identifies where one body will rotate relative to another body at a given instant in time

A

Instant axis of rotation (IAR)

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23
Q

What is the major role of C2

A

Permit lots of Y axis rotation

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24
Q

What limits the rotation of C1-C2

A

Alar ligaments

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25
Q

What is the range of C1-c2 y axis rotation

A

43-50

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26
Q

Where does over 50% of the rotation of the neck take place

A

Y axis rotation C1-c2

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27
Q

What is the role of the intra articular meniscoids

A

Keep film of synovil fluid applied to articular cartilages not in contact with one another

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28
Q

What happens to intra articular meniscoids in y axis rotations

A

They are displaced and passively return

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29
Q

What is y axis rotation at c1-c2 coupled with

A

Y translation

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30
Q

Why is lateral bending limited at c1-c2

A

Alar ligaments and bony anatomy

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31
Q

Does c1-c2 have x axis translation

A

No, only apparent

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32
Q

As the head is laterally flexed to one side at c1-c2 what happens to the ipsilateral articular process

A

Takes on a greater loade

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33
Q

How does the c2 inferior articular surface act during lateral flexion

A

Slopes inferiorly

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34
Q

How does the spinous rotate during lateral ben of c2

A

Rotates toward convexity of lateral bend - the opposite side

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35
Q

During flexion/extension what is the coupled motion

A

Translaton in sagittal plane

36
Q

Where does more translation occur

A

In the upper c/s

37
Q

Where are the steepest arches at for x axis rotation

A

At C6/C7

38
Q

What happens to the acuity of the arc with degeneration

A

Are decreases

39
Q

What is the shape of the vertebral body at superior/inferior surfaces

A

Sellar or saddle shaped

40
Q

In lower c/s x axis translation is ____ and rotation is _____

A

Reduced, promoted

41
Q

What limits pure lateral flexion in lower c/s

A

Uncinate process

42
Q

What are the uncinate processes a guide to

A

Couple lateral flexion with axial rotation

43
Q

Degeneration at uncovertebral joints is due to DDD resulting in what

A

Body outgrowth (osteophytosis)

44
Q

What does DDD osteophytosis impinge

A

Adjacent anatomy, can create stenosis in conjunction with disc bulge/herniation

45
Q

What can osteophytosis create stenosis with

A

Vertebral artery or cervical spinal nerves

46
Q

What is the facet orientation of lower cs

A

Tear drop shape, Angled 45 degrees b/w coronal/transverse planes

47
Q

What is the superior facet orientation of lower cs

A

Post, sup, medial

48
Q

What is the inferior facet orientation of lower cs

A

Ant, lateral, inferior

49
Q

Prior to what age is the thickness of articular cartilage 1-1.3 mm

A

20years

50
Q

What does age do to z joint

A

Thins articular cartilage, thickens subarticular bone, ostophyte formation

51
Q

Sensory proprioception of cs is from what in order

A

1) IVD
2) facet joints
3) cervical musclulature

52
Q

What is the arrangement of innervation of IVD

A

Circumferential, superficial to deep

53
Q

What does the IVD sense

A

Peripheral compression/tension, deformation/alignment

54
Q

What is responsive to extremes rather than mid range joint motions

A

Facet mechanoreceptors

55
Q

Each facet mechanoreceptor is responsible for what size receptive field

A

Large

56
Q

What muscle group contain high density of spindles

A

Suboccipital muscles

57
Q

Why is there higher spindle content in suboccipitals

A

Head eye coordination, comlex proprioceptive inputs

58
Q

What theory is that the more open gates the more pain messages pass through and hgiher level of pain and more closed gates = fewer messages = less pain

A

The gate theory

59
Q

Chronic neck pain affects muscle how?

A

Atrophy and fatty infiltration/degeneration

60
Q

When does cervical curvature begin to develop

A

Prior to birth

61
Q

What aids in absorbing spinal loads in c/s

A

Lordosis

62
Q

What is the degree of cervical lordosis

A

About 30-45 degrees

63
Q

What part of the c/s is kyphotic

A

Occiput to axis

64
Q

What can kyphosis of the c/s create

A

Ischemia and dysfunx, possible demyelinating disease

65
Q

What is the primary load on the cervical spine

A

Compression

66
Q

Compressive loads increase during what

A

Flexion/extension

67
Q

What is the max isometric action on the spine

A

1200N

68
Q

What type of load is best on c/s

A

Compressive follower load

69
Q

What does the follower load minimize

A

Bending moments and shear

70
Q

What produces a follower load in c/s

A

Coactivation of muscles

71
Q

What is a mechanism whereby the neck is whipped in one direction and recoils in the opposite direction

A

Whiplash

72
Q

Who is most likley to get injured in car acciden

A

Females 20-24

73
Q

How do we determine mechanism of energy in whiplash injuries

A

Direction of force, patient position, relationship of head/spine, state of tension in neck muscles

74
Q

What end of the neck will move with greater velocity

A

Distal end compared to proximal end

75
Q

What are the 2 mechanisms of injury to the joint in a whiplash injury

A

Pinching of synovial fold, strain of capsule

76
Q

Capsular strain in c/s. Can result in what response

A

Inflammatory response involving spinal cord

77
Q

With aging what happens to bones mass

A

25% reduction in bone mass and 50% in strength

78
Q

What is the first structure to fail when subject to compressive loads

A

The endplate

79
Q

When are injuries more severe at alar and transverse ligaments in whiplash injury

A

When head is turned

80
Q

What discs are most vulnerable when rear impacts happens

A

C5-c6

81
Q

When are discs especially vulnerable during rear impacts

A

At lower speeds (<38 mph)

82
Q

What disks are most at risk during front impacts

A

C2/c3 - c7/t1, c5/c6 most vulnerable

83
Q

What grade of the WAD grating system of whiplash has no symptoms

A

WAD 0

84
Q

What grade of the WAD grating system of whiplash has pain, stiffness, but no physical signs

A

WAD 1

85
Q

What grade of the WAD grating system of whiplash neck complains, decreased ROM, point tenderness

A

WAD 2

86
Q

What grade of the WAD grating system of whiplash neck complaints plus neuro signs

A

WAD 3

87
Q

What grade of the WAD grating system of whiplash have a fracture/dislocation or cord injjury

A

WAD 4

GM Biomechanics (5 decks)

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