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Caroline > LECTURE 3- the vertebral column > Flashcards

LECTURE 3- the vertebral column Flashcards

1
Q

how many intervertebral disk do we have

A

23

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2
Q

how many vertebrae do we have

A

33

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3
Q

what is the “roof” to protect the SC

A

the lamina

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4
Q

what connects with the vertebra above and below

A

articulate process

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5
Q

what does the articulate processes resists

A

shear, compression, tensile and torsional forces

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6
Q

what is spondylolysis

A

where there is a fx to the pars interaticularis

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7
Q

what is spondyloloisthesis

A

when there is a fx and separation of the pars interarticularis

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8
Q

where is spondylosis and spondylolisthesis most common

A

L5-S1

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9
Q

what is the nucleus pulposus made up of

A

80% water

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10
Q

what is the annulus fibrosus made up of

A

60% water

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11
Q

what is the degrees of cervical , thoracic , and lumbar facet joints

A

C- 45
T- 60
L- 90

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12
Q

what does the anterior longitudinal ligament resist

A

extension

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13
Q

where does the anterior longitudinal ligament run

A

anterior surface of vertebra bodies from C2- sacrum

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14
Q

what do the fibers of the ALL blend with

A

annulus fibrosus

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15
Q

where is the ALL the thickest

A

lordotic regions

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16
Q

what does the anterior atlantooccipital and atlantoaxial membranes resist

A

extension

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17
Q

what does the posterior longitudinal ligament resist

A

flexion

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18
Q

where does the PLL run

A

posterior surface of vertebra bodies from C2- sacrum

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19
Q

what does the ligamentum flavum resist

A

flexion

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20
Q

where does the ligamentum flavum run

A

posterior surface of the SC

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21
Q

which ligament is in constant tension even in neutral

A

ligamentum flavum

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22
Q

what does the interspinous ligament resist

A

flexion

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23
Q

what does the interspinous ligament connect

A

SP to adjacent vertebra

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24
Q

what does the supraspinous ligament resist

A

flexion

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25
Q

what does the intertransverse ligament resist

A

lateral flexion

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26
Q

what does the alar ligaments resist

A

rotation

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27
Q

where are the alar ligaments

A

in teh atlas (C0-C2)

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28
Q

what does the alar ligaments limit ips and contra

A

ips- lateral flexion
contra- rotation

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29
Q

what does the facet joints resist

A

forward flexion and rotation

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30
Q

what is determined by the direction of motion pertaining to the vertebrae

A

orientation of the facets

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31
Q

what does the amount of motion available depend on in the spine

A

size of the disc

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32
Q

during flexion where does the vertebral body move

A

anterior

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33
Q

what happens with the facets during flexion

A

inferior facets slide up on superior facets

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34
Q

what happens with the vertebral body during extension

A

posterior tilt

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35
Q

what happens with the facets during extension

A

the inferior facets slides down on the superior facets

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36
Q

what happens during lateral flexion to the vertebral bodies

A

there is a ipsilateral compression and contra lateral opening

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37
Q

what happens with the facets with lateral flexion

A

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

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38
Q

what is flexion limited by

A

posterior outer annulus , facet capsules , post ligaments and mm

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39
Q

what is extension limited by

A

anterior outer annulus , facet capsules, ant lig, SP

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40
Q

what limits axial compression of the spine

A

discs and vertebral bodies

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41
Q

what limits torsional and shear forces on the spine?

A

torsion - resisted by annulus fibrosis and facet joints

shear - resisted by lumbar facets (prevent translation of disks)

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42
Q

what is considers the upper cervical spine

A

C0 - C2

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43
Q

what is considered the lower cervical spine

A

C3-7

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44
Q

what is the OA joint

A

C0 on C1

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45
Q

what is the function of the OA joint

A

nodding of the head

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46
Q

what is the AA joint

A

C1 - C2

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47
Q

what is the function of the AA joint

A

rotation and saying NO

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48
Q

what is the dens held in place by

A

the transverse ligament

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49
Q

what will get damage first the dens or the ligament

A

dens fx

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50
Q

what are the cruciate ligaments of the neck

A

alar ligaments

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51
Q

what type of joint is C0 on C1

A

convex on concave

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52
Q

during flexion of the OA joint what happens and what happens during extension

A

FLX: convex on concave , roll ant slide post
EXT: roll post , slide ant

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53
Q

what % is AA joint for cervical rotation

A

50

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54
Q

what type of joint is teh AA joint

A

convex on convex ( C1 inferior factions on C2)

55
Q

what happens with upper cervical lateral flexion

A

coupled with contralateral rotation

56
Q

what happens with upper cervical rotation

A

coupled with contralateral lateral flexion

57
Q

so if you are laterally flexing your head to the right what is happening in the upper cervical region?

A

R lateral flexion with L rotation

58
Q

where is the greatest range of flexion and extension in the cervical region

A

C5/6

59
Q

what happens in the lower cervical region if there is lateral flexion

A

coupled with ipslateral rotation

60
Q

what happens if there is rotation in the lower cervical region

A

ipsilateral lateral flexion

61
Q

what articulates with the heads of ribs

A

demifacets

62
Q

what are transitional vertebrae

A

t1 and t12

63
Q

what is there an increase of in the thoracic spine

A

lateral flexion and rotation

64
Q

where is the smallest intervertebral disc ratio

A

thoracic

65
Q

what does it mean if there is a small intervebral disc ratio

A

increase stability over mobility

66
Q

what is lateral rotation coupled with in the thoracic region

A

axial rotation

67
Q

what does rotation of the thoracic region cause the ribs to do

A

shift
posterior ipsilateral rib( more concave) and anterior contralateral rib (less concave )

68
Q

what ways do the ribs move if there is a right rotation of the thoracic region

A

the right ribs shift posteriorly and the left rights shift anteriorly

69
Q

which region has the largest vertebral bodies

A

lumbar

70
Q

what does the lumbar region support

A

body weight
gravity
muscle contraction

71
Q

where are there mammillary processes at the superior facet for the multifidus to attach

A

facet joins of L 1- L4

72
Q

in the lumbar region the discs are arranged in sheets called

A

lamellae

73
Q

where does the supraspinous ligament terminate

A

L4

74
Q

the supraspinous ligament blends with what

A

thoracolumbar fascia

75
Q

what does the iliolumbar ligament do

A

prevents anterior displacement of L5 due to shear forces

76
Q

what is the role for the thoracolumbar fascia

A

acts as mm attachment site
rentinaculum
accessory lig

77
Q

what motions happen with the bodies in lumbar region during flx/ext

A

tilt and slide occur in same direction

78
Q

what happens in the lumbar region during rotation

A

body tilts and slides ipsilaterally
ipsilateral facet distracts
contralateral facet compresses

79
Q

what happens in the lumbar region with lateral flexion

A

body tilts and slides ipsilaterally
ipsilaterally - infeior facet joint slides down on sup
contra- inferior facet joint slides up on sup

80
Q

with forward bending lumbar flexion is followed by

A

anterior pelvic tilt

81
Q

from forward bending to standing what happens

A

posterior pelvic tilt is followed by lumber extension

82
Q

what vertebrae levels bears 65% of shear forces at facet joints

A

L4-5

83
Q

how many fused vertebrae are there at the sacrum

A

5

84
Q

what is the base of the sacrum and apex

A

base - S1
apex - S5

85
Q

what is the symphysis pubis

A

pubic bones with articulate cartilage and fibrocartilage disc

86
Q

what ligaments is a major bonds between sacrum and ilia which creates a fibrous union

A

interosseous

87
Q

what ligament is ischial tuberosity to posterior spine at ilia and lateral sacrum and coccyx

A

sacrotuberous

88
Q

what ligament is ischial spine to lateral sacrum/ coccyx

A

sacrospinous

89
Q

what is it called when sacral base rotates anteriorly on fixed innominates

A

nutation

90
Q

what is it called when sacral base rotates posteriorly on the fixed innominates

A

counternutation

91
Q

in the sacrum stability is key support of what

A

body weight and transmission of forces

92
Q

what is nutation resisted by

A

sacrotuberous , sacrospinous ,and anterior sacroiliac ligaments

93
Q

what is nutation associated with

A

hip flexion and anterior pelvic til it

94
Q

what is counternutaition resisted by

A

long posterior sacroiliac ligaments

95
Q

what does the pelvic floor provide

A

stability to lumbopelvic ring

96
Q

what are the levator ani muscles

A

iliococcygeus and pubococcygeus

97
Q

what does the levator ani muscles do

A

lift pelvic floor and constrict openings

98
Q

where does the ribs superior facet fit into

A

the inferior vertebral facet above

99
Q

for example what does rib 6 articulate with

A

inferior facet of T5 and superior facet of T6

100
Q

which ribs are considered to be “true”, “false”, and “ floating”

A

t- 1-7
f- 8-10
floating - 11-12

101
Q

what happens to the ribs during inspiration

A

elevate

102
Q

ribs 2-7 do what action

A

pump handle

103
Q

ribs 8-10 do what actions

A

buckle handle action

104
Q

primary ventilation muscles

A

diaphragm , intercostals , scalenes

105
Q

accessory breathing muscles

A

SCM & traps
pec major and minor
subclavius
serratus post and inf
abdominals

106
Q

how are the ribs and diaphragm in infants compared to adults

A

horizontal

107
Q

how many degrees of flexion and extension is at the OA joint

A

15-25

108
Q

List the joint types for AO, AA and lower cervicle

A

AO - convex on concave
AA - plane joint
lower cervical - saddle joint

109
Q

In the lower cervical region, the discs are thicker (anterioly/posteriorly)

A

Anterior

110
Q

When you flex your OA joint what are the kinematics? What about extension

A

Flexion - roll anterior and slide posterior

Extension- roll posterior slide anterior

111
Q

What are the kinematics at the lower cervical spine?

A

Flexion - anterior tilt and slide (couples up slide of ZAJ)

Extension: posterior tilt and slide (down slide of ZAJ)

112
Q

Lower cervical kinematics with later flexion vs upper cervical

A

Lower : lateral flex with ipsi rotations

Upper: lateral flex with contra rotation

113
Q

What part of the spine has the smallest intervertebral disc ratio

A

Thoracic

114
Q

What vertebrate experiences the most shear stress?

A

L5 - more with anterior pelvic tilt

115
Q

The lamellae in the discs of lumbar region resist what motion

A

Torsional

116
Q

What does the iliolumbar ligament resist??

A

Prevents anterior displacement on L5 due to shear forces

And all movements of L5 on S1

117
Q

How does the thoracolumbar fascia translate forces

A

It attaches to glute max and contralateral lat, when contracted, it does transmission of forces between pelvis and trunk

118
Q

In regards to lumbopelvic rythm, forward bending causes lumbar ____ and ___ pelvic tilt
While returning to erect stance causes …. ( what motions in what ORDER?)

A

Forward bending - lumbar flexion and anterior pelvic tilt
Returning - posterior pelvic tilt FIRST then lumbar extension

119
Q

The lumbar interbody joints typically bear more weight than the facet joints. What would cause this to change? What would cause the facet joints to take on more load?

A

increased lumbar lordosis or internal disc distraction

120
Q

The lordotic position of the lumbar spine face what forces?

A

Shear forces

so think tighter hip flexors = more lordosis, more shear forces

121
Q

Lumbar region: increased shear loads = ___ plays a more significant role

A

disc

122
Q

Base of sacrum at S_ and apex at S_

A

1

5

123
Q

irregular joint surfaces (of sacrum) increase ____ but decrease ____

A

increase stability
decrease mobility

124
Q

LoG passes ___ to the head/cervical regions, so the ___ muscles resist _____

A

anterior
posterior
flexion

125
Q

The levator ___ the lordoditc postion of the cervical spine while the semispinalis and cervicis ___ it

A

resists

maintains

126
Q

List the lateral and anterior muscles of the cervical region

A

lateral - scalenes, SCM

anterior - longus capitis and longus coli, rectus capitis anterior and lateral

127
Q

Tightness in your psoas major can lead to what postural adjustment and what forces?

A

anterior pelvic tilt = increase compression and anterior shear forces

128
Q

How does your erector spinae come into play with lifting principles

A

with a squat lift, the erector spinae can offset anterior shear forces
in a stoop lift, they can not, there is a shorter moment arm

129
Q

what decreases the amount of load that vertebrae can hold with aging?

A

decrease in horizontal and vertical trabeculae

loss of proteoglycans and water content

vertebral endplates cant diffuse as well

130
Q

schmorls node

A

nuclear material of discs prolapses into bone

131
Q

Which ribs only articulate with one vertebrae

A

1, 10, 11 and 12

132
Q

describe the movements of the upper thorax ribs vs the lower thorax and their plane of motion

A

pump handle action AP diameter

bucket handle action - lateral diametere

133
Q

why are babies more susceptible to dying with RSV?

A

diagrams are less fatigue resistant (20%), failure can occur with infection

and they cant use their accessory muscles yet

134
Q

the elderly have (earlier/later) recruitment of accessory muscles?

A

earlier

Caroline (20 decks)

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