Head, Neck, Back, and Spine Flashcards
The specialized joint of the craniovertebral area are formed by one centrally located articulation & two facet whose axis of motion is vertical through the dens, accounting to 50% of rotation in the cervical area:
Atlanto-axial joint
The atlanto-occipital joint is an example of this joint:
Condyloid
The bony landmark corresponding to the superior angle of scapula?
T2
During lumbar flexion, the intervertebral disc:
flattens anteriorly and pushed posteriorly
A cervical facet joint oriented in sagittal plane will allow:
Flexion-extension
The alar ligaments limit _________________________ and play a major role in stabilizing C1 and C2. (2)
Flexion and rotation
A therapist palpates medially along the spine of the scapula. Which spinous process is at the same level as the vertebral end of the spine?
T3
Lumbar lordosis develops during:
10-12 months
Which vertebral body has a bifid spinous process?
Cervical
This structure provides humans the ability to lift heavy weights overhead; it also stabilizes the trunk for throwing objects with high velocities.
Thoracolumbar fascia
The first cervical vertebra (atlas) does not have which anatomic features of typical vertebrae
no vertebral body, no spinous process
Fibrocartilaginous pulp in the IV disc?
Annulus fibrosus
How many total joints do the joints of Von Luschka
12
The most limited motion in the lumbar spine is:
Rotation
Other names for Von Luschka’s joints? (2)
Uncovertebral joints; neurocentral joints
Ligament typically punctured during lumbar puncture/lumbar tap procedures?
Ligamentum flavum
What vertebra is the hyoid bone in line with?
C3
The characteristic feature of the fifth cervical vertebra is its:
Small body
Orientation of lumbar facet joints?
Superior: medial
Inferior: lateral
Orientation of thoracic facet joints?
Superior: posterior, lateral
Inferior: anterior, medial
Orientation of cervical facet joints?
Superior: posterior, superior
Inferior: anterior, inferior
The seventh cervical vertebra is characterized by having:
The longest spinous process
Other name for C7
Vertebral prominence (vertebra prominens)
Components of 3-joint complex?
- IV disc
- paired superior and inferior facets
This median-placed structure connects the apex of the odontoid process to the anterior margin of the foramen magnum?
Apical ligament
Structures that pass through the transverse foramen?
vertebral veins, vertebral arteries, sympathetic nerves
Close-packed position of the vertebral column:
Extension
Transversospinalis is composed of an intermediate oblique running muscles comprising of which of the following (3)
Semispinalis, Multifidus, Rotatores
The bony landmark corresponding to the tubercle of iliac crest?
L5
The adult spine is composed of how many vertebrae?
26
The broadest muscle in the body and is considered a large, flat muscle covering the width of the middle and lower back?
Lats dorsi
It is also known as the “Yellow ligament”?
Ligamentum flavum
The ligament that unites the adjacent spinous process?
Interspinous ligament
The anterior longitudinal ligament if injured due to a sprain may cause the affected spinal segment to:
Move excessively during spinal extension
Asking the patient to perform oblique sit-ups to the left would test which of the following muscle groups:
Left internal oblique & right external oblique
Asking the patient to perform oblique sit-ups to the right would test which of the following muscle groups:
Right internal oblique & left external oblique
Posterior longitudinal ligament is incomplete posteriorly ________.
Below L2
It is the force generated by the annulus fibrosus once it was stretched?
Hoop stretch
The intervertebral disks account for about _____ of the height of the vertebral column.
25%
This cervical ligament prevents the posterior subluxation of dens when fractured?
Transverse ligament
The cervical and lumbar curves are known as ____________________ because they begin to form later, several months after birth.
Secondary curves
The SI joint corresponds with what vertebral level?
S2
The intervertebral discs are the main structures that bind together the vertebral bodies, and they extend:
from C2 to sacrum
The vertebral foramina encloses the spinal cord; the intervertebral foramina provide spaces through which spinal nerves exit the vertebral column.
Which statements are true?
Both statements are true
A typical lumbar vertebra has the following characteristics:
I. The body is large and kidney shaped.
II. The vertebral foramina are triangular.
III. The transverse processes are long and slender.
IV. The spinous processes are short, flat, and quadrangularand project posteriorly.
V. The articular surfaces of the superior articular processes face laterally, and those of the inferior articular processes face medially.
Which statements are correct?
I, II, III and IV
Pedicles are considered widest at:
L5
Pedicles are considered narrowest at:
T5
Flexion-extension from lumbar vertebrae totals how much?
65deg
This ligament connects the tip of spinous process from C7 to sacrum?
Supraspinous ligament
The most superficial muscle in the posterior trunk:
Longissimus
Thyroid cartilage is at the level of:
C4-C5
An atypical cervical vertebra known as the epistropeus?
C2 (Atlas)
A typical thoracic vertebra has the following characteristics:
I. The body is medium size and heart shaped.
II. The vertebral foramen is small and circular.
III. The spines are long and inclined downward.
IV. Costal facets are present on the sides of the bodies for articulation with the heads of the ribs.
V. The superior articular processes bear facets that face posteriorly and laterally, whereas the facets on the inferior articular processes face anteriorly and medially.
Which statements are correct?
All statements are correct
Leaning the trunk forward when standing from a sitting position is better accomplished because of: (in relation to COG)
Forward shifting of the center of gravity
At the point where a lamina and pedicle join, a _______________ extends laterally on each side.
Transverse process
Also known as the “ Coronal Plane”; divides the body into anterior and posterior parts
Frontal plane
Plane where pronation and supination occur
horizontal plane
Joint that provides almost all of four joint mobility
Diarthrodial joints
COG of head, neck, and trunk
anterior to T11
Types of muscles which passively elongates to allow agonist to move
Antagonist
Lever where resistance is applied between the force and the axis
Second class lever
This type of suture connects occipital to parietal lobes
lambdoidal suture
What lobes does the squamosal suture separate?
parietal-temporal
Dome-shaped bump at the posterior base of the skull
Inion
Which landmark is between the supercilliary ridges?
Glabella
Landmark is a depression at the root of the nose
Nasion
Muscle that brings the eye downward and outward
Superior oblique
Muscle that brings the eye upward and outward
inferior oblique
Which muscles are responsible when looking upward? (L & R)
R: SR & IO
L: SR & IO
Which muscles are responsible when looking downward to the left? (L & R)
R: SO
L: IR
Foramen where the sensory branch of vestibulocochlear nerve passes through
Internal acoustic meatus
What artery passes through the foramen lacerum?
internal carotid artery
Medulla oblongata, spinal cord, and vertebral arteries pas through this foramen
Foramen magnum
What nerves pass through the jugular foramen?
CN9, 10, 11
Part of the vertebra connects transverse process to spinous process?
Laminae
Angle of inclination of lumbar vertebra?
90deg
C7 has which features not found in typical vertebra?
long non-bifid spinous process; no or small foramen transversarium
Which atypical vertebrae has costal facets located on the outer aspect of pedicles?
T11-T12
Gel-like material part of IV disc which primarily absorbs compression forces?
Nucleus pulposus
What landmark is in line with C6 vertebra?
Cricoid
A patient comes to you with a pain on the posterior part of his neck, neurologic findings, and LOM of the cervical region. Upon checking, your patient has (+) Spurling’s & (+) Lhermitte’s sign. Pt. also has an x-ray finding of C5-C6 affectation. Identify which spine condition is most likely present
Spondylosis
What spine condition is a fracture of the parts interarticularis?
Spondylolysis
Landmark in line with T7 vertebra?
inferior angle of the scapula
superior continuation of the tectorial membrane? this ligament is taut during spinal flexion
PLL
What spine condition is an anterior slippage of the pars?
Spondylolisthesis
What spine condition is an posterior slippage of the pars?
Retrolisthesis
What’s the other name for Tietze’s syndrome? What happens in this condition? When is it painful?
Costal chondritis
Painful inflammation of costo-chondral junction – happens in the AM
What happens during Marie-Strumpell disease?
A. increased lumbar lordosis
B. (-) back pain
C. Increased thoracic kyphosis
D. (+) barrel chest
What’re other names for this condition?
C. Increased thoracic kyphosis
Ankylosing Spondylitis / Von Beckterev’s disease
Most common muscle affected by Torticollis
SCM
Source of back pain is d/t organ disease?
Viscerogenic
Source of back pain is d/t a nerve root compression/impingement?
Neurogenic
Source of back pain is d/t faulty posture and/or biomechanics?
Mechanical/postural
Most common source of back pain?
mechanical/postural back pain
Source of back pain is d/t obstruction of blood vessels?
Vasculogenic
Source of back pain is d/t malingering or hysterical pt.?
Psychogenic
Source of back pain is d/t bony disease?
spondylogenic
special test for psychogenic back pain?
Hoover’s test
Disc herniation stage where nucleus pulposus herniates posteriorly through complete tear of the annulus fibrosis
Extrusion
Disc herniation stage where nucleus pulposus herniates posteriorly through incomplete tear of the annulus fibrosus
Prolapse
Disc herniation stage where nucleus pulposus herniates outside the completely torn annulus fibrosus
Sequestration
Disc herniation stage where nucleus pulposus bulges to intact annulus fibrosis
Bulging
Structural kyphosis that is d/t single collapsed vertebra
Gibbus deformity
Type of osteoporosis d/t immobility, endocrine disorder, and prolonged corticosteroid use
Type III
A kyphosis where there’s a wedging at least 5 degrees of 3 consecutive vertebrae
Scheuermann’s disease
In upper crossed syndrome, which muscles are tight and which are weak/stretched?
tight pecs major/minor; upper trap, lev scap
weak deep neck flexors; SA, rhomboid lower traps
In lower crossed syndrome, which muscles are tight and which are weak/stretched?
tight erector spinae; hip flexors (iliopsoas)
weak abs; hip extensors (GMax, hams)
Type of posture with excessive anterior pelvic shift?
Swayback
Posture also known as roundback?
postural kyphosis
Posture also known as slouched posture?
Swayback
Other names for Scheuermann’s disease? (3)
juvenile discogenic disease (JDD), juvenile kyphosis, adolescent kyphosis
A TMJ condition where there is pain upon mouth opening and contralateral lateral excursion
TMJ capsulitis
A TMJ condition where there is swelling and contralateral LOM of lateral deviation
TMJ synovitis
When conducting Weber Test, pt. says sound is better on the unaffected ear. Which condition might she have?
Sensorineural hearing loss
When conducting Weber Test, pt. says sound is better on the affected ear. Which condition might she have?
Conductive hearing loss
Which test should be used to compare bone conduction and air conduction?
Rinne’s test
Which test should be used to test for CN 7 pathology ?
Chvostek test
Indications for (+) Chvostek test
hypokalcemia, Bell’s palsy
Which test should be used to test for conductive VS. sensorineural hearing loss ?
Weber test
Which test should be used to test for meningeal irritation ?
Brudzinski-Kernig test
You performed a special test to your patient in long sitting position. You passively flex his head and flex his hip then, your patient felt a sharp, electric shock-like pain on his low back. Your pt. is positive in which test?
Lhermitte’s sign
Other name and procedure for Bakody’s sign? (+) ?
Shoulder abduction test; active shoulder abduction until arm rests on top of his head
(+) pain decreases throughout the procedure or disappears before reaching end position
indication for (+) scalene cramp test? (2) differentiate
(+) localized pain = trigger points
(+) radicular pain = plexopathy
Nerve bias of upper limb tension test 3
Radial
Nerve bias of upper limb tension test 4
Ulnar
Nerve bias of upper limb tension test 2
Median
Axillary
Musculocutaneous
Nerve bias of upper limb tension test 1
Median
Anterior Interosseous nerve
Nerve bias of Slump Test 1
SC, Cervical, Lumbar, sciatic
Nerve bias of Slump Test 4
SC, Cervical, Lumbar, sciatic
Nerve bias of Slump Test 2
obturator
Nerve bias of Slump Test 2
femoral
this type of special test is when you instruct your pt. to stand on 1 leg then extend the trunk with rotation
Stork standing test
The weight arm is longer than the force arm (lever)
third-class lever
COG is located at what of % of the body’s height?
55% of the body’s height
where is the body’s COG located?
slightly anterior to S2
tongue muscle actions (4)
palatoglossus - elevates tongue
genioglossus - protrudes tongue
hyoglossus - depresses tongue
styloglossus - retrudes tongue
value for functional mouth opening VS. normal mouth opening (with mm measurement)
fxnal: 2 finger breadths
normal: 3 finger breadths (35-55mm)
OPP, CPP, and capsular pattern of TMJ
OPP: slightly ajar
CPP: clenched teeth
capsular pattern: limited mouth opening
TMJ is what kind of jt.? what are the arthrokinematic motions?
ginglymoarthrodial/modified hinge
STIR (superior - translation; inferior - rotation)
arthrokinematic motion during TMJ depression
B anterior rotation followed by B anterior translation
