KNES 360 EXAM 2 Trunk & Spinal Column Flashcards
Vertebral Column
*Complex
24 intricate and complex articulating vertebrae (+ sacrum/coccyx)
Abdominal muscles
several sections linked by fascia and tendinous bands (really important)
do not attach from bone to bone (not designed for movement)
Bones
24 articulating and 9 fused vertebrae: -7 cervical (neck) vertebrae -12 thoracic (chest) vertebrae -5 lumbar (lower back) vertebrae -4 coccyx (tail bone) vertebrae First 2 cervical vertebrae: shapes allow for extensive rotary movements of head to side
Atlantoccipital Joint
First joint
Formed by occipital conduces of skull sitting on articular fossa of the 1st vertebrae
Allows flexion and extension
Atlantoaxial Joint
Atlas (C1) sits on axis (C2)
Most cervical rotation occurs here
Pivot-type joint
Most mobile joint of any two vertebrae
Vertebrae C3 through L5 Architecture
Body-Anterior bony block
Central vertebral foramen for spinal cord
Transverse process projecting out laterally
Spinous process projecting posteriorly
3 Normal Curves within the Spine
-Thoracic spine curves anteriorly (kyphosis)
-Cervical & lumbar spine curve posteriorly (lordosis)
-Spinal curves enable it to absorb blows & spocks
Vertebrae increase in size from cervical to lumbar region due to lower back having to support more weight
Lordosis
increased posterior concavity of lumbar & cervical curves
Kyphosis
increased anterior concavity of thoracic curve
Hypolordosis
reduction of normal lordotic curve, resulting in a flat-back appearance
Scoliosis
lateral curvatures or sideward deviations of spine
Changing lumbar curvature
Lumbar spine is happiest in a neutral lordotic posture. Any constant deviations from the posture puts your spine at risk of injury
Hyperlordosis
Common mechanism of back injury/pain in younger people
Muscular spasm and nerve impingement
Hypolordosis
Common mechanism of back injury/pain in older people
Leads to posterior disc herniation
Joints
Minimal movement between any 2 vertebrae (except atlantoaxial joint)
- Cumulative effect of combined movement from several vertebrae allows for substantial movements
- Vertebral body articulations classified as arthrodial: symposis (slightly moveable)
- Gliding type joints due to limited gliding movements (facet joints)
- Gliding movement between superior and inferior articular processes of facets joints
Intervertebral Discs
Annulus fibrosus: outer rim of dense fibrocartilage
Nucleus pulposus: central gelatinous, pulpy substance
Between vertebral bodies:
-Fibrocartilaginous disc
-Composed of annulus fibrosis and nucleus purposes
-Discs act to absorb shock through spine
Ligaments
Anterior longitudinal ligament (ALL)
Posterior longitudinal ligament (PLL)
Supraspinous ligament
Additional ligaments between adjacent vertebrae
SI joint has strong ligaments to maintain its stable position
Ribs
12 pairs of ribs
-7 pairs of true ribs attach directly to sternum
-5 pairs of false ribs: 3 attach indirectly to sternum, 2 pairs of floating ribs (ends are free)
All ribs attached posteriorly to thoracic vertebrae
Sternum
Manubrium, body of sternum, xiphoid process
Movements
Spinal movements are often preceded by the name given to the region of movement
Ex. flexion of trunk at lumbar spine is known as lumbar flexion, extension of neck is cervical extension
Pelvic girdle rotates as a unit due to movement occurring in hip & lumbar spine (anterior pelvic tilt: paris hilton, posterior pelvic tilt: flat back)
Facet Joints
Part of posterior element, control movement
Angle of facet joint changes at different spinal level to allow certain movements and prevent others
-Thoracic v. lumbar
Spinal flexion
- Anterior movement of spine; in cervical region the head moves toward chest; in lumbar region the thorax moves toward pelvis
- Sagittal plane movement
Spinal extension
return from flexion or posterior movement of spine; in cervical spine, head moves away from the chest and thorax moves away from pelvis
sagittal plane movement
Lateral flexion
left or right
sometimes referred to as side bending; head moves laterally toward the shoulder and thorax moves laterally toward pelvis
frontal plane movement
Spinal rotation
left or right
rotary movement of spine in traverse plane; chin rotates from neutral toward shoulder and thorax rotates to one side
Important landmarks for abdominals
xiphoid process iliac crest anterior superior iliac spine (ASIS) linea alba pubic symphysis inguinal ligament
Trunk and Spinal Column Muscles
Abdominal wall muscles do not go from bone to bone but attach into aponeurosis (fascia) around rectus abdomens area
-external oblique abdominal, internal oblique abdominal, and transversus abdominis
Rectus Abdominis
Marked weakness permits an anterior pelvic tilt and a lordotic posture from erect position
O: pubic crest and pubic symphysis
I: cartilage of 5th-7th and xiphoid process
A: flexes trunk and compresses abdomen
IN: intercostal nerves 7-12
External Oblique
O: Infeior 8 ribs
I: Anterior portion of iliac crest; abdominal aponeurosis to linea alba
A: Together- Compress abdomen and flex vertebral column
Singulary- Laterally flex and rotate vertebral column to opposite side
IN: Intercostal nerves 8-12, iliohypogatric and ilioinguinal nerves
Internal Oblique
O: Iliac crest, lateral half of inguinal ligament, and thoracolumbar fascia
I: cartilage of lower 3-4 ribs; abdominal aponeurosis to linea alba
A: Together- Compress abdomen and flex vertebral column
Singularly- laterally flex and rotate vertebral column to the same side
IN: Intercostal nerves 8-12, iliohypogastric, and ilioinguinal nerves
Transversus Abdominis
Acts like a girdle to flatten the abdominal wall and compress the viscera
Weakness permits a bulging of anterior abdominal wall
O: Iliac crest, lateral potion of inguinal ligament, thoracolumbar fascia and carriages of inferior six ribs
I: abdominal aponeurosis to linea alba
A: Compress abdoment
IN: Intercostal nerves 7-12, iliohypogastric, ilioninguinal nerves
Abdominal Cross-Section
- Skin
- Superficial fascia:
- fatty layer (of camper)
- membranous layer (of scarpa) - External oblique
- Internal oblique
- Transversus
- Fascia transversalis
- Extraperitoneal fatty areolar tissue
- Peritoneum
Erector Spinae
largest muscle
extends on each side of spinal column from pelvic region to cranium
divided into 3 muscles:
-Spinalis, longissimus, and iliocostalis
-From medial to lateral side, has attachments in lumbar, thoracic, and cervical regions
-actually made up of 9 muscles
Erector Spine (O, I, A, IN)
O: Spinous processes of T9-T12
I: Spinous process of T1 and T2 and cervical vertebrae
A: extension of vertebral column
IN: posterior branch of spinal nerve
Muscles of the Thorax
*For respiration Diaphragm (quiet breathing) Intercostals (forced breathing) -External intercostals (inspiration) -Internal intercostals (expiration)
Diaphragm
Involved almost entirely in respiration
Responsible for breathing during quiet rest
As it contracts and flattens, thoracic volume is increased and air is inspired to equalize the pressure
When larger amounts of air are needed, as in exercise, other thoracic muscles have a more significant role in inspiration
External intercostals
further expand the chest volume when they contract
Internal intercostals
contract to decrease the chest volume
Quadratus Lumborum
Stabilizes pelvis and lumbar spine O: Iliac crest, iliolumbar ligament I: last rib and transverse processes A: Unilateral- lateral flexion Bilateral- depression of rib cage IN: 12th thoracic and first through 4th of lumbar nerves
Triangle of Auscultation
Borders:
-Latissimus dorsi
-Trapezius
-Rhomboid major
The triangle enlarges when the arm is drawn across the body
Location for stethoscope placement for respiratory sound examination
Quadratus Lumborum Dysfunction
Heavily implicated in low back pain (LBP)
- Connects pelvis to spine -> can extend the lower back when contracting bilaterally
- -When the erector spinae muscles are weak (in basically everyone who sits all day), the QL picks up the slack and extends the lower back
- However, QL is at a mechanical disadvantage (short moment arm) and thus has to perform substantial work to extend the back, causing muscles fatigue -> overuse -> injury
Quadratus Lumborum Hip
also assists hip abduction when the gluteal muscles are weak (medias and minimus) -> results in hip hiking during the swing phase in gate
-Raise the pelvis on the unsupported side
Disc Herniation
Generally a flexion mechanism
Causes posterior herniation
Upper back posture is important
Extensions as exercises can help
Spondylosis
Cause: degeneration of vertebrae or defect in the articular process
-Occurs as a stress fracture in vertebrae
-Repetitive hyperextension of spine (swimming, gymnastics, serving, lifting weights, etc.)
Signs: persistent aching pain across the low back, pain after physical activity
Care: bracing, rest, strengthen core and trunk stabilizers
