Movement Flashcards
What are the movements of the spine
- Flexion
- Extension
- Lateral flexion
- Rotation
- Circumduction - combination of the above
- Protraction and retraction (cervical spine)
Although the movement between any two vertebrae is limited, the summation of movement among all vertebrae results in a large range of movement by the vertebral column.
Movements by vertebrae in a specific region (cervical, thoracic, and lumbar) are determined by the shape and orientation of joint surfaces on the articular processes and on the vertebral bodies
Explain movement in cervical spine in relation to the atlas and axis
C1 (atlas), C2 (axis) and associated muscles are specifically modified to support and position the head.
Head flexes/extends, in the nodding motion, on CI (atlas)
Rotation of the head occurs as CI (atlas) moves on C2 (axis)
50% cervical rotation = C1 and C2
Describe lumbar flexion and give normal ROM
Greater than the range of extension
More movement in lower segments: L4/5, L5/S1 because upper lumbar orientation of facets more towards vertical orientation of thoracic vertebrae; from thoracolumbar junction there is sequential morphing of thoracic characteristics into lumbar - stable and fixed thoracic vertebrae becomes more mobile as it morphs into upper lumbar to lower lumbar
Should see a reverse in lumbar lordosis
Approx 50-60 degrees
Describe lumbar extension and give normal ROM
Approx 30 degrees (large variation also between studies)
Describe lumbar rotation and give normal ROM
1º at each segmental level with less rotation available at L5-S1
Mean rotation of 8- 12 º in each direction
Rotation is limited by the vertical (wrapped) orientation of the facet joints
Describe lumbar lateral side flexion and give normal ROM
Approx 25 degrees
Difficult to measure
Coupled with rotation
Describe thoracic flexion and give normal ROM
Thoracic spine relatively less mobile than cervical or lumbar spines
Flexion/extension and lateral flexion more restricted due to vertical “AP sloped” facet joint orientation
Flexion also limited by CC on closing ribs anteriorly
50°–70° combined flexion
Describe thoracic extension and give normal ROM
Thoracic spine relatively less mobile than cervical or lumbar spines
Flexion/extension and lateral flexion more restricted due to vertical “AP sloped” facet joint orientation
Extension also limited by CC on closing ribs posteriorly
50°–70° combined extension
Describe thoracic side flexion and give normal ROM
Thoracic spine relatively less mobile than cervical or lumbar spines
Flexion/extension and lateral flexion more restricted due to vertical “AP sloped” facet joint orientation
Side flexion also limited by ribs closing together and abut; intercostal space becomes taught on contralateral side
20°–25° to each side
Describe thoracic rotation and give normal ROM
Rotation greatest range due to vertical “AP sloped” facet joint orientation
35° axial rotation to each side
Normal Cervical flexion/extension ranges
Flexion = 70-80 degrees. chin to sternum or chin to within 2 fingers width of sternum for full range to be achieved
Extension = ~ 60˚-70˚. On visual estimation, patient should be able to get forehead parallel to ceiling for full range to be achieved
Approx 50% occurs at occiput (C0)-C1 = 20˚ (total) then C3-7 sequentially to 80˚ flex or 70˚ ext.
Normal ranges of cervical side flexion
~ 45˚. Half way to GHJ
C0-C1 to 8˚
C3-7 sequentially to 20˚-45˚
Give normal ranges of cervical rotation
~ 90˚. On visual estimation, patient should be able to get nose over acromion process
Approx 50% occurs at C1-C2 = 15˚ then C3-7 sequentially to 70˚-90˚
Explain cervical spine Protraction and retraction
Protraction = Upper Cx extension coupled with lower Cx flexion
Retraction = Upper Cx flexion coupled with lower Cx extension
Predominantly CO-C1
