Lecture 16: Kinesiology of the Spine Flashcards
What are the 4 main regions of the spine?
cervical
thoracic
lumbar
sacroiliac and symphesis pubis
What part of the intervertebral disc is innervated and perfused?
The outer third
What is an intervertebral disc composed of?
nucleus pulposus
peripheral annulus
What type of joints are facet joints of the spine and ribs?
non-axial plane synovial
Intervertebral discs are what type of joint?
amphiarthroidial sympheses
What does the anterior longitudinal ligament (ALL) limit?
limits extension and reinforces anterior annulus fibrosis and facet joints
Where does the ALL begin and end?
orginates as the anterior atlanto-occipital (C0-1) membrane and extends to the sacrum
What does the posterior longitudinal ligament (PLL) limit?
limits flexion and reinforces poserior annulus fibrosus
Which is thinner and weaker, the ALL or PLL?
the PLL
Where does the PLL begin and end?
originates at the tectoral membrane (C0-2) and extends to sacrum
Intervertebral discs are between which vertebrae?
from C2-C3 to L5-S1
What does the ligamentum flavum limit?
Flexion, especially in the lumbar region
What does the ligamentum flavum limit?
Flexion, especially in the lumbar region
What do the interspinous ligaments limit?
The primary limiter of flexion
What does the supraspinous ligament limit?
flexion
What is the first ligament to be injured in a hyperflexion injury?
the supraspinous ligament
What does the intertransverse ligament limit?
lateral flexion
Lateral flexion creates what forces
Compression ipsiliaterally and tensile force contralaterally
Where does torsional stiffness increase?
mid thoracic spine inferiorly
Flexion of the spine is primarily limited by ligaments. Which ligaments?
interspinous ligaments
supraspinous ligaments
ligamentum nuchae
PLL
Extension narrows the IVFs and is limited by what?
Bony contact
ALL
Lateral flexion is maximized with facets in what plane?
Frontal plane
Lateral flexion is greatest where?
cervical then thoracic spine (thoracic is limited by ribs)
Lateral flexion causes rotation in the VB. Which vertebra rotate ipsilaterally and which are contralateral?
ipsilateral C2-T6
contralateral T6-L5
What is the CPP of the cervical spine
full extension
What is the capsular pattern of the cervial spine?
Lateral flexion, rotation, extension
Which vertebra have bifid SPs?
C2-C6
Uncinate processes are on which vertebra?
C3-T1
What ligament connects the occiput to C2?
Apical ligament
What is the orientation of cervical facets?
45 degrees to horizontal plane
Flex/Ex is maximized where in the cervical spine?
Flex C5/6
Ex C4/5
In cervical spine, lateral flexion is coupled with VB rotation in what direction?
Ipsilateral
Atlanto-occipital is what type of jt?
Biaxial condyloid synovial
What are the articulating surfaces of the atlanto-occiputal jt?
convex occipital condyles of the occiput
concave superior facets of C1
What are the arthrokinematics of the atlanto-occipital jt?
Convex on concave, thus roll & glide in opposite directions.
What is unique about the atlanto-occipital jt capsule?
There are 2, one the left, one on the right
What does the atlanto-occipital membrane contain?
The anterior and posterior bands
What are the movements of the atlanto-occipital jt?
Predominantly flex/ex
some lateral flexion and rotation, limited by bones
How does the occiput move during flexion and extension?
Posterior/superior during flexion
Anterior/inferior during extension
What are the arthrokinematics of the medial atlanto-axial jt?
Concave atlas moves around convex dens, so same direction
Ribs articulate posteriorly with?
It’s own Vb and the one above, except for ribs 1, 11 and 12 which only articulate with their own VB
Which ribs don’t articulate with their TVP?
Ribs 11 and 12
Costovertebral and costotransverse jts are classified as what type?
non-axial plane synovial. Slight gliding movements
Costovertebral and costotransverse jts are classified as what type?
non-axial plane synovial. Slight gliding movements
What does the radiate ligament limit?
Posterior displacement of the the head of the rib
The facets of thoracic vertebra are oriented how?
60 degrees to the horizontal plane
Which way to thoracic vertebra rotate in lateral flexion?
T1-T6 ipsilateral rotation
T7-T12 contralateral rotation
What are the true, false, and floating ribs?
1-7 true ribs
8-10 false ribs
11-12 floating ribs
Rib humping occurs on which side of the scoliotic curve?
the convex side
What is the CPP of the lumbar spine?
full extension
What is the capsular pattern of the lumbar spine?
lateral rotation, rotation, extension
What is the capsular pattern of the lumbar spine?
lateral rotation, rotation, extension
What is the orientation of the facets in the lumbar spine?
L1 directly in the true sagittal plane
L2-L4 semi-sagittal plane
L5 is in the frontal plane to limit movement on the sacrum
What are the movements of the lumbar spine?
Flex/ex - increases inferiorly
Lateral flexion and rotation - mostly from intervertebral discs.
What is sacral counternutation?
Posterior tilt of the sacral promontory
