LECTURE 3- the vertebral column Flashcards
how many intervertebral disk do we have
23
how many vertebrae do we have
33
what is the “roof” to protect the SC
the lamina
what connects with the vertebra above and below
articulate process
what does the articulate processes resists
shear, compression, tensile and torsional forces
what is spondylolysis
where there is a fx to the pars interaticularis
what is spondyloloisthesis
when there is a fx and separation of the pars interarticularis
where is spondylosis and spondylolisthesis most common
L5-S1
what is the nucleus pulposus made up of
80% water
what is the annulus fibrosus made up of
60% water
what is the degrees of cervical , thoracic , and lumbar facet joints
C- 45
T- 60
L- 90
what does the anterior longitudinal ligament resist
extension
where does the anterior longitudinal ligament run
anterior surface of vertebra bodies from C2- sacrum
what do the fibers of the ALL blend with
annulus fibrosus
where is the ALL the thickest
lordotic regions
what does the anterior atlantooccipital and atlantoaxial membranes resist
extension
what does the posterior longitudinal ligament resist
flexion
where does the PLL run
posterior surface of vertebra bodies from C2- sacrum
what does the ligamentum flavum resist
flexion
where does the ligamentum flavum run
posterior surface of the SC
which ligament is in constant tension even in neutral
ligamentum flavum
what does the interspinous ligament resist
flexion
what does the interspinous ligament connect
SP to adjacent vertebra
what does the supraspinous ligament resist
flexion
what does the intertransverse ligament resist
lateral flexion
what does the alar ligaments resist
rotation
where are the alar ligaments
in teh atlas (C0-C2)
what does the alar ligaments limit ips and contra
ips- lateral flexion
contra- rotation
what does the facet joints resist
forward flexion and rotation
what is determined by the direction of motion pertaining to the vertebrae
orientation of the facets
what does the amount of motion available depend on in the spine
size of the disc
during flexion where does the vertebral body move
anterior
what happens with the facets during flexion
inferior facets slide up on superior facets
what happens with the vertebral body during extension
posterior tilt
what happens with the facets during extension
the inferior facets slides down on the superior facets
what happens during lateral flexion to the vertebral bodies
there is a ipsilateral compression and contra lateral opening
what happens with the facets with lateral flexion
the inferior facet on the ipslaterla side slides down on the superior facets and on the contralateral side the inferior facet slides up on the superior facet
what is flexion limited by
posterior outer annulus , facet capsules , post ligaments and mm
what is extension limited by
anterior outer annulus , facet capsules, ant lig, SP
what is considers the upper cervical spine
C0 - C2
what is considered the lower cervical spine
C3-7
what is the OA joint
C0 on C1
what is the function of the OA joint
nodding of the head
what is the AA joint
C1 - C2
what is the function of the AA joint
rotation and saying NO
what is the dens held in place by
the transverse ligament
what will get damage first the dens or the ligament
dens fx
what are the cruciate ligaments of the neck
alar ligaments
what type of joint is C0 on C1
convex on concave
during flexion of the OA joint what happens and what happens during extension
FLX: convex on concave , roll ant slide post
EXT: roll post , slide ant
what % is AA joint for cervical rotation
50
what type of joint is teh AA joint
convex on convex ( C1 inferior factions on C2)
what happens with upper cervical lateral flexion
coupled with contralateral rotation
what happens with upper cervical rotation
coupled with contralateral lateral flexion
so if you are laterally flexing your head to the right what is happening in the upper cervical region?
R lateral flexion with L rotation
where is the greatest range of flexion and extension in the cervical region
C5/6
what happens in the lower cervical region if there is lateral flexion
coupled with ipslateral rotation
what happens if there is rotation in the lower cervical region
ipsilateral lateral flexion
what articulates with the heads of ribs
demifacets
what are transitional vertebrae
t1 and t12
what is there an increase of in the thoracic spine
lateral flexion and rotation
where is the smallest intervertebral disc ratio
thoracic
what does it mean if there is a small intervebral disc ratio
increase stability over mobility
what is lateral rotation coupled with in the thoracic region
axial rotation
what does rotation of the thoracic region cause the ribs to do
shift
posterior ipsilateral rib( more concave) and anterior contralateral rib (less concave )
what ways do the ribs move if there is a right rotation of the thoracic region
the right ribs shift posteriorly and the left rights shift anteriorly
which region has the largest vertebral bodies
lumbar
what does the lumbar region support
body weight
gravity
muscle contraction
where are there mammillary processes at the superior facet for the multifidus to attach
facet joins of L 1- L4
in the lumbar region the discs are arranged in sheets called
lamellae
where does the supraspinous ligament terminate
L4
the supraspinous ligament blends with what
thoracolumbar fascia
what does the iliolumbar ligament do
prevents anterior displacement of L5 due to shear forces
what is the role for the thoracolumbar fascia
acts as mm attachment site
rentinaculum
accessory lig
what happens in lumbar region during flx/ext
tilt and slide occur in same direction
what happens in the lumbar region during rotation
body tilts and slides ipsilaterally
ipsilateral facet distracts
contralateral facet compresses
what happens in the lumbar region with lateral flexion
body tilts and slides ipsilaterally
ipsilaterally - infeior facet joint slides down on sup
contra- inferior facet joint slides up on sup
with forward bending lumbar flexion is followed by
anterior pelvic tilt
from forward bending to standing waht happens
posterior pelvic tilt is followed by lumber extension
what bears 65% of shear forces at facet joints
L4-5
how many fused vertebrae are there at the sacrum
5
what is the base of the sacrum and apex
base - S1
apex - S5
what is the symphysis pubis
pubic bones with articulate cartilage and fibrocartilage disc
what ligaments is a major bonds between sacrum and ilia which creates a fibrous union
interosseous
what ligament is ischial tuberosity to posterior spine at ilia and lateral sacrum and coccyx
sacrotuberous
what ligament is ischial spine to lateral sacrum/ coccyx
sacrospinous
what is it called when sacral base rotates anteriorly on fixed innominates
nutation
what is it called when sacral base rotates posteriorly on the fixed innominates
counternutation
in the sacrum stability is key support of what
body weight and transmission of forces
what is nutation resisted by
sacrotuberous , sacrospinous ,and anterior sacroiliac ligaments
what is nutation associated with
hip flexion and anterior pelvic til it
what is counternutaition resisted by
long posterior sacroiliac ligaments
what does the pelvic floor provide
stability to lumbopelvic ring
what are the levator ani muscles
iliococcygeus and pubococcygeus
what does the levator ani muscles do
lift pelvic floor and constrict openings
where does the ribs superior facet fit into
the inferior vertebral facet above
for example what does rib 6 articulate with
inferior facet of T5 and superior facet of T6
which ribs are considered to be “true”, “false”, and “ floating”
t- 1-7
f- 8-10
floating - 11-12
what happens to the ribs during inspiration
elevate
ribs 2-7 do what action
pump handle
ribs 8-10 do what actions
buckle handle action
primary ventilation muscles
diaphragm , intercostals , scalenes
accessory breathing muscles
SCM & traps
pec major and minor
subclavius
serratus post and inf
abdominals
how are the ribs and diaphragm in infants compared to adults
horizontal
how many degrees of flexion and extension is at the OA joint
15-25
