Lecture 16: Kinesiology of the Spine

Question 1

What are the 4 main regions of the spine?

Answer 1

cervical
thoracic
lumbar
sacroiliac and symphesis pubis

Question 2

What part of the intervertebral disc is innervated and perfused?

Answer 2

The outer third

Question 3

What is an intervertebral disc composed of?

Answer 3

nucleus pulposus
peripheral annulus

Question 4

What type of joints are facet joints of the spine and ribs?

Answer 4

non-axial plane synovial

Question 5

Intervertebral discs are what type of joint?

Answer 5

amphiarthroidial sympheses

Question 6

What does the anterior longitudinal ligament (ALL) limit?

Answer 6

limits extension and reinforces anterior annulus fibrosis and facet joints

Question 7

Where does the ALL begin and end?

Answer 7

orginates as the anterior atlanto-occipital (C0-1) membrane and extends to the sacrum

Question 8

What does the posterior longitudinal ligament (PLL) limit?

Answer 8

limits flexion and reinforces poserior annulus fibrosus

Question 9

Which is thinner and weaker, the ALL or PLL?

Answer 9

the PLL

Question 10

Where does the PLL begin and end?

Answer 10

originates at the tectoral membrane (C0-2) and extends to sacrum

Question 11

Intervertebral discs are between which vertebrae?

Answer 11

from C2-C3 to L5-S1

Question 12

What does the ligamentum flavum limit?

Answer 12

Flexion, especially in the lumbar region

Question 13

What does the ligamentum flavum limit?

Answer 13

Flexion, especially in the lumbar region

Question 14

What do the interspinous ligaments limit?

Answer 14

The primary limiter of flexion

Question 15

What does the supraspinous ligament limit?

Answer 15

flexion

Question 16

What is the first ligament to be injured in a hyperflexion injury?

Answer 16

the supraspinous ligament

Question 17

What does the intertransverse ligament limit?

Answer 17

lateral flexion

Question 18

Lateral flexion creates what forces

Answer 18

Compression ipsiliaterally and tensile force contralaterally

Question 19

Where does torsional stiffness increase?

Answer 19

mid thoracic spine inferiorly

Question 20

Flexion of the spine is primarily limited by ligaments. Which ligaments?

Answer 20

interspinous ligaments
supraspinous ligaments
ligamentum nuchae
PLL

Question 21

Extension narrows the IVFs and is limited by what?

Answer 21

Bony contact
ALL

Question 22

Lateral flexion is maximized with facets in what plane?

Answer 22

Frontal plane

Question 23

Lateral flexion is greatest where?

Answer 23

cervical then thoracic spine (thoracic is limited by ribs)

Question 24

Lateral flexion causes rotation in the VB. Which vertebra rotate ipsilaterally and which are contralateral?

Answer 24

ipsilateral C2-T6
contralateral T6-L5

Question 25

What is the CPP of the cervical spine

Answer 25

full extension

Question 26

What is the capsular pattern of the cervial spine?

Answer 26

Lateral flexion, rotation, extension

Question 27

Which vertebra have bifid SPs?

Answer 27

C2-C6

Question 28

Uncinate processes are on which vertebra?

Answer 28

C3-T1

Question 29

What ligament connects the occiput to C2?

Answer 29

Apical ligament

Question 30

What is the orientation of cervical facets?

Answer 30

45 degrees to horizontal plane

Question 31

Flex/Ex is maximized where in the cervical spine?

Answer 31

Flex C5/6 Ex C4/5

Question 32

In cervical spine, lateral flexion is coupled with VB rotation in what direction?

Answer 32

Ipsilateral

Question 33

Atlanto-occipital is what type of jt?

Answer 33

Biaxial condyloid synovial

Question 34

What are the articulating surfaces of the atlanto-occiputal jt?

Answer 34

convex occipital condyles of the occiput concave superior facets of C1

Question 35

What are the arthrokinematics of the atlanto-occipital jt?

Answer 35

Convex on concave, thus roll & glide in opposite directions.

Question 36

What is unique about the atlanto-occipital jt capsule?

Answer 36

There are 2, one the left, one on the right

Question 37

What does the atlanto-occipital membrane contain?

Answer 37

The anterior and posterior bands

Question 38

What are the movements of the atlanto-occipital jt?

Answer 38

Predominantly flex/ex some lateral flexion and rotation, limited by bones

Question 39

How does the occiput move during flexion and extension?

Answer 39

Posterior/superior during flexion Anterior/inferior during extension

Question 40

What are the arthrokinematics of the medial atlanto-axial jt?

Answer 40

Concave atlas moves around convex dens, so same direction

Question 41

Ribs articulate posteriorly with?

Answer 41

It's own Vb and the one above, except for ribs 1, 11 and 12 which only articulate with their own VB

Question 42

Which ribs don't articulate with their TVP?

Answer 42

Ribs 11 and 12

Question 43

Costovertebral and costotransverse jts are classified as what type?

Answer 43

non-axial plane synovial. Slight gliding movements

Question 44

Costovertebral and costotransverse jts are classified as what type?

Answer 44

non-axial plane synovial. Slight gliding movements

Question 45

What does the radiate ligament limit?

Answer 45

Posterior displacement of the the head of the rib

Question 46

The facets of thoracic vertebra are oriented how?

Answer 46

60 degrees to the horizontal plane

Question 47

Which way to thoracic vertebra rotate in lateral flexion?

Answer 47

T1-T6 ipsilateral rotation T7-T12 contralateral rotation

Question 48

What are the true, false, and floating ribs?

Answer 48

1-7 true ribs 8-10 false ribs 11-12 floating ribs

Question 49

Rib humping occurs on which side of the scoliotic curve?

Answer 49

the convex side

Question 50

What is the CPP of the lumbar spine?

Answer 50

full extension

Question 51

What is the capsular pattern of the lumbar spine?

Answer 51

lateral rotation, rotation, extension

Question 52

What is the capsular pattern of the lumbar spine?

Answer 52

lateral rotation, rotation, extension

Question 53

What is the orientation of the facets in the lumbar spine?

Answer 53

L1 directly in the true sagittal plane L2-L4 semi-sagittal plane L5 is in the frontal plane to limit movement on the sacrum

Question 54

What are the movements of the lumbar spine?

Answer 54

Flex/ex - increases inferiorly Lateral flexion and rotation - mostly from intervertebral discs.

Question 55

What is sacral counternutation?

Answer 55

Posterior tilt of the sacral promontory