Exam 3 Flashcards by Katie Carrico

Ligaments of cervical spine (7)

Posterior atlantoaxial 
Anterior atlantoaxial 
Tectorial membrane 
Ligamentum nuchae 
Transverse atlantal 
Alar 
Apical

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Posterior atlantoaxial continuation of

Ligamentum flavum

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Anterior atlantoaxial continuation of

ALL

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Tectorial membrane continuation of

PLL

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Ligamentum nuchae continuation of

Supraspinous

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Functions of transverse atlantal ligament

Holds dens against atlas and prevents anterior displacement of atlas on axis

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Function of alar ligament

Prevent distraction of occiput on atlas and limit SB

Becomes tight in rotation

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Attachments of transverse ligament

One side of atlas to the other

To occiput superiorly and to axis inferiorly

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Attachments of alar ligaments

From side of dens to medial occipital condyles

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Attachments of apical ligaments

Apex of dens to anterior margin of foramen magnum in occiput

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Function of apical ligament

Aligns dens and keeps it straight up

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Direction of cervical pedicles

Posterolateral

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Direction of cervical lamaniae

Posteromedial

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Cervical vertebral foramen

Triangular and largest because it houses all branches of spinal cord

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Characteristics of cervical vertebral body

M/L larger than A/P

Uncinate process on superior body to give concave shape and stability

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Direction of superior facet of cervical vertebrae

Superior and posterior

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Direction of inferior facet of cervical vertebrae

Inferior and anterior

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Angle of superior articular facet of cervical vertebrae

45 degrees between horizontal and vertical axis

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Function of cervical spine

Stability of head on occiput and rest of cervical spine

House the spinal cord

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Mobility of A/O joint

Primarily nodding
Roll and glide in opposite direction
SB and rotation in CL direction (limited)

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Mobility of A/A joint

Primarily rotation

55% of rotation of c spine

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Mobility of C2-C7

Lateral flexion, rotation, flexion

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Limitations to mobility of C2-C7

Ligaments, annulus fibrosus, and facet orientation

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Roll and glide of cervical spine (C2-C7) flexion and extension

Flexion - anterior rotation and ant/sup glide to open up joint
Extension - posterior rotation and post/inf glide to close joint

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Most flex/ext of cervical spine occurs at what level

C5/C6

Protraction of cervical spine

Lower to mid c spine flexes as upper craniocervical spine extends

Retraction of cervical spine

Lower to mid c spine extends as upper craniocervical spine flexes

Characteristics of the body of the lumbar vertebrae

Transverse greater than AP and height

Supraspinous ligament ends at

L3 or L 4

Intertransverse ligament replaced by

Iliolumbar ligament

Characteristics of iliolumbar ligament

Transverse process to iliac crest Primary function is to prevent anterior shear and resist movement of L5 on Si Loaded more in flexion

Mobility of lumbar area limited by

Orientation of facets

Greatest amount of flexion in lumbar area

Greatest amount of SB and rotation in lumbar area

L2-L3

Orientation of (anterior) facet of lumbar vertebrae

Frontal plane

Orientation of (posterior) facet of lumbar vertebrae

Sagittal plane - allows a lot of flex/ext

Coupled movements of lateral flexion/rotation in lumbar area

Lateral flex with CL rotation

Pattern of lumbar-pelvic rhythm as you FB

Lumbosacral flexion (flattening of lumbar spine) and then anterior tilt of pelvis

Pattern of lumbar-pelvic rhythm as you go from flex to ext

Posterior tilt then extension of spine (can assess hip extensor activity)

Function of lumbar vertebrae

Stability from body weight, ground rxn forces, and muscles | Support body weight

Amount of force going through bodies/facets for compression in lumbar area

80% through disc | 20% through facet

Shear in lumbar vertebrae resisted by

Facets and the amount of frontal plane movement

Function of SI joint

WB joint that tries to distribute weight equally to LE Transmits ground rxn forces up equally through vertebral body Provides absorption to relieve stress on ring

Most important ligament for SI stability

Interosseous SI ligament

Sacrospinous ligament

Sacrum to ischial spine | Provides good inferior stability

Ligaments of pubic symphysis

Superior and inferior Pelvic | Posterior pelvic

Structures that resist nutation of sacrum

Sacrotuberous, sacrospinous, anterior SI, and interosseous ligament

Structures that resist counternutation

Long post SI ligament and iliolumbar ligaments

Characteristics of body of thoracic vertebra

Larger than cervical, smaller than thoracic A/P and M/L about equal Wedge shaped (Higher posteriorly)

How many demifacets on thoracic vertebrae

Orientation of pedicles of thoracic vertebrae

Almost purely posterior (not lateral because foramen not large)

Orientation of articular processes and what motion does this allow?

Frontal Plane (mostly SB and rot)

Upper thoracic spine movements

Moves like cervical spine | IL SB and rotation

Lower thoracic spine movements

Moves like lumbar spoine | CL SB and rotation

Limits to flexion in thoracic spine

PLL, ligamentum flavum, interspinous, capsule, and post disc

Limits to extension in thoracic spine

SP, anterior disc, facets, ALL, abdominal muscles

Limits to lateral flexion in thoracic spine

Rib cage and facets

Limits to rotation in thoracic spine

Rib cage

LOG of spine

Anterior to thoracic spine Creates a flexion moment that is resisted by muscles and posterior structures Greatest at peak of kyphosis (T7)

Function of thorax

Attachment of muscles Protection of viscera Ventilation

How many articulations are there for ribs on a thoracic vertebrae? Where are they?

4 on vertebral body | 2 on transverse process

Vertebrae that have articulations with just one rib

T1, T11, T12

Radiate ligament attachments

Superior - to body above Inferior - to body below Intermediate - to IV disc

Intra-articular ligament

From ridge of rib to IV disc

Intra-articular ligament

From ridge of rib to IV disc

Costovertebral joint is what kind of jont

Plane

Costotransverse joint is what kind of joint

Syovial

Superior transverse ligament

Crest of rib below to tp of vertebrae above | Prevents too much elevation

Costochondral joint at which ribs

1-10

Pump handle movement m

Occurs in upper ribs | Increases AP diameter

Bucket handle movement

Occurs in lower ribs | Ribs move laterally

Bucket handle movement

Occurs in lower ribs | Ribs move laterally

Curvature angle of cervical spine

30-35

Curvature angle of thoracic spine

Curvature angle of lumbar spine

Pedicles transmit...

bending forces from spinous process to body

Vertical trabecular systems resist

Compressive forces

Oblique trabecular system resists

Oblique forces

Function of intervertebral disk

Separate vertebral bodies to allow movement to occur Transmits forces Dissipates forces

What kind of cartilage is in a young disc

Hyaline cartilage

What kind of cartilage is in an older disc

Fibrocartilage

What part of disc is innervated

Outer 1/3 to 1/2 of annulus

What part of disc is innervated

Outer 1/3 to 1/2 of annulus

Circulation of disc

Most by diffusion, small amount of circulation to end plate and annulus

Where do most disc hernations occur

L4/L5 and L5/S1

Characteristics of zygapophyseal joints

Synovial Meniscoid structures that are part of capsule Capsule resists flexion Joints resist shear in lumbar area because of facets in frontal plane

Facet joint orientation of cervical spine and associated movements

Triplanar | All motions

Facet joint orientation of thoracic spine and associated movements

Frontal | Rotation and lateral flexion

Facet joint orientation of lumbar spine and associated movements

Sagittal plane | Flexion/extension

Facet joint orientation of lumbar spine and associated movements

Sagittal plane | Flexion/extension

ALL is well developed in...

Lordotic areas (cervical and lumbar)

Special characteristics of ligamentum flavum

Made of elastic fibers (yellow in nature) | Under constant tension(increases compression of disc and intradiscal pressure and prevents compression of spinal cord)

Ligamentum flavum strongest in? Weakest in?

Lower thoracic | Mid cervical

First ligaments injured with hyperflexion

Interspinous and supraspinous

Characteristics of supraspinous ligament

``` On top of SP Merge in lumbar area with Thorac. fascia Stops at L3 or L4 Becomes ligamentum nuchae at C7 Has mechanoreceptors to stabilize spine ```

Ligamentum nuchae

Takes place of supraspinal and interspinal ligaments

Amount of mobility determined by...

Ratio of disc to body

Direction of movement determined by...

Orientation of facets

Extension of spine limited by

``` ALL Spinous process Ant. trunk muscles Ant. annulus Joint capsule ```

Lateral flexion limited by

CL side of annulus, CL intertransverse ligament, and CL trunk muscles

Axial compression resisted by

Disc Vertebral bodies Neural arches

Axial rotation limited by

Annulus and facet joints