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PT 106 > Neck/ Trunk > Flashcards

Neck/ Trunk Flashcards

1
Q

In which axis does the vertebral column reside?

A

Longitudinal

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2
Q

What does the vertebral column help to provide?

A

Upright vertical position of the body
Protects the spinal cord and visceral organs
Provides pivot point for motion and support of the head at the cervical region
Establishes a link b/t the upper and lower extremities
Organizes column segments in an effective formation to provide shock absorption from force transmission placed upon the body
Transmits weight of head, shoulder girdle, UE and trunk through the vertebral column to pelvis
Provides stable base for attachments of bones, ligaments, tendons, muscles of extremities, pelvis and rib cage

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3
Q

How does the vertebral column present?

A

Multi-jointed rod structure
Motions occur due to combine motions of individual vertebrae (provides movement as a unit but each segment has specific motions)

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4
Q

How many vertebral segments are there? How many are found in each segment?

A 
33
Cervical =7
Thoracic= 12
Lumbar = 5
Sacral= 5
Coccygeal = 4
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5
Q

Which vertebra does tucking your chin involve?

A

Flexing on C1
Extending C2-C7
*referred to axial extension or cervical retraction

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6
Q

What is a facet joint?

A

Articulation b/t the superior articular process of the vertebra below w/ the inferior articular process of the vertebra above

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7
Q

In what plane/ axis does flexion/ext/hyperextension occur?

A

Sagittal plane

Frontal axis

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8
Q

In what plane/ axis does lateral bending occur?

A

Frontal plane

Sagittal axis

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9
Q

In what plane/ axis does rotation occur?

A

Transverse plane

Vertical axis

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10
Q

What motions occur at the Atlanto-occipital joint?

A

Flex/ext
Minimal lateral bending
No rotation

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11
Q

What structures make up the Atlanto-occipital joint?

A

C1 and Head

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12
Q

C1 and C2 make up what joint?

A

Atlantoaxial joint

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13
Q

Which vertebra are concave ANTERIORLY and convex POSTERIORLY? What type of curve does this provide?

A

Thoracic and Sacrococcygeal

Kyphosis

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14
Q

Which vertebra are convex ANTERIORLY and concave POSTERIORLY? What type of curve does this provide?

A

Cervical and Lumbar

Lordosis

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15
Q

What is the negative consequence of the natural spinal curve?

A

the existence of shear forces

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16
Q

What are the areas of transition in the axial skeleton?

A

C6,7- T1
T10-T12
L5-S1

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17
Q

By how much does the curve of the spine increase its strength?

A

Up to 10 times

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18
Q

How many intervertebral discs are there?

Where do they begin?

A

23

B/t C2 & C3

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19
Q

What is the function of the intervertebral discs?

A

To absorb and transmit shock and maintain flexibility of the vertebral column

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20
Q

What % of the length of the vertebral column do the discs comprise?

A

25%

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21
Q

Where does the line of gravity pass through the axial skeleton

A

Passes through the mastoid process > anterior to the 2nd sacral vertebra > posterior to the hip > anterior to the knee and ankle

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22
Q

Which structures located on the vertebrae dictate movement of the spine?

A

Facets

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23
Q

What types of bone make up the vertebrae?

A

Trabeculae (resists compressive forces)

Cortical (shell that reinforces the vertebral body)

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24
Q

Where is the Dens located? What does it allow for?

A

C2

Bone protrusion that allows articulation w/ the atlas (C1) to produce head rotation

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25
Q

The atlantoaxial joint allows for which motion to occur?

A

rotation

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26
Q

What happens to the vertebrae from C3-S1? Why?

A

The become progressively larger

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27
Q

What is the function of the pedicle on the vertebrae?

A

Transmits tension and forces from the vertebral bodies

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28
Q

What is the most prominent posterior projection on the vertebrae?

A

Spinous process

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29
Q

What is the opening formed by the joining of the body of the neural arch through which the spinal cord passes?

A

Vertebral foramen

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30
Q

What is the posterior portion of the neural arch that unites from each side in the midline?

A

Lamina

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31
Q

This structure is formed at the union of the lamina and pedicle, the lateral projections of the arch to which muscles and ligaments attach?

A

Transverse process

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32
Q

What opening is formed by the superior vertebral notch of the vertebra below and the inferior vertebral notch above?

A

Intervertebral foramen

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33
Q

What depressions are located on the superior and inferior surfaces of the pedicle?

A

Vertebral notches

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34
Q

This structure projects superiorly and inferiorly off the posterior surface of each lamina?

A

Articular process

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35
Q

What is the portion of the neural arch just posterior to the body and anterior to the lamina?

A

Pedicle

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36
Q

What is the anterior portion of C1?

A

Anterior arch

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37
Q

Name the structure that is also called the odontoid process?

A

Dens

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38
Q

Which vertebrae has the most prominent spinous process?

A

C7

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39
Q

What holes or openings in the transverse process of each vertebra allow for vertebral arteries to pass?

A

Transverse foramen

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40
Q

Pulpy, gelatinous substance in the center of the disk? At birth, it is comprised of what % water and it decreases to what as we age?

A

Nucleus pulposus
80% at birth
70% by age 60

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41
Q

This vertebra is ring shaped and has no spinous process. The cranium rests upon it?

A

Atlas (C1)

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42
Q

What is the outer portion of the disk consisting of several concentrically arranged fibrocatilaginous rings that serve to contain the nucleus pulposus?

A

Annulus fibrosus

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43
Q

What is a half facet called? Where is it located?

A

Demifacet

Located laterally on the superior and inferior edges of the vertebral body where ribs articulate w/ thoracic vertebrae

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44
Q

What is the small prominence in the center of the occiput?

A

Occipital protuberance

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45
Q

This bone forms the posterior, inferior part of the cranium?

A

Occiput

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46
Q

Forms the base and lateral inferior sides of the cranium?

A

Temporal bone

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47
Q

Refers to the base or inferior portion of the occiput?

A

Basilar area

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48
Q

Ridge that runs horizontally along the back of the head from the occipital protuberance toward the mastoid processes?

A

Nuchal line

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49
Q

Opening in the occipital bone through which the spinal cord enters the cranium?

A

Foramen magnum

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50
Q

Located lateral to the foramen magnum on the occiput, provides articulation w/ the atlas (c1)?

A

Occipital condyles

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51
Q

Bony prominence behind the ear to which the SCM muscles attaches?

A

Mastoid process

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52
Q

Cylindrical mass of cancellous bone, not present in the atlas

A

Body

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53
Q

What type of joint is a facet joint?

A

Synovial joint w/ a synovial membrane and enclosed in a joint capsule ligament

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54
Q

How many facet joints does each vertebra have?

A

2

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55
Q

What is the orientation of the facet joints in the lumbar, thoracic, and cervical segments?

A 
Lumbar = sagittal plane - flex/ext
Thoracic = frontal plane - rotation/ lateral flex
Cervical = triplanar- all motion
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56
Q

What limits motion in the thoracic spine?

A

The ribs, shape of the vertebral bodies and length of the spinous processes

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57
Q

Which ligament extends from the 7th cervical vertebra distally to the sacrum posteriorly along the tips of the spinous processes?

A

Supraspinal ligament

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58
Q

This ligament runs along the vertebral bodies posteriorly, inside the vertebral foramen? Its thick superiorly to support the skull, but thin inferiorly which contributes to instability and disk injury in the lumbar region

A

Posterior longitudinal ligament

59
Q

What does the posterior longitudinal ligament prevent?

A

Excessive flexion

60
Q

Which ligament runs b/t successive spinous processes?

A

Interspinal ligament

61
Q

Which ligament runs down the anterior surface of the vertebral column? It is thin superiorly and thick inferiorly where it fuses to the sacrum. It is located in the thoracic and lumbar regions just deep to the aorta.

A

Anterior longitudinal ligament

62
Q

What does the anterior longitudinal ligament prevent?

A

Excessive hyperextension

63
Q

What ligament takes the place of supraspinal and interspinal ligaments in the cervical region?

A

ligamentum nuchae (nuchal ligament)

64
Q

What ligament connects adjacent lamina anteriorly?

A

Ligamentum flavum

65
Q

What are the 4 anatomical units of the cervical spine?

A

Atlas, Axis, C2-C3 junctions, and remainder of the vertebral spine

66
Q

The anterior atlanto-occipital membrane is an extension of which ligament?

A

Anterior longitudinal ligament

67
Q

The tectorial membrane is an extension of which ligament?

A

Posterior longitudinal ligament

68
Q

Concave-Convex relationship of Atlanto-occipital condyles

A

The convex Atlanto-occipital condyles of the occipital base are in a posterolateral direction, these articulate w/ the anteriomedial orientation of the concave superior processes of the Atlas

69
Q

How many joints compose the cervical spine?

A

36

70
Q

What is the function of the Atlas?

A

Cradles the occiput
Transmits forces from the head to the cervical spine
Attachment for ligaments and muscles
Has a posterior tubercle/ no spinous process
Smooth, small internal facet articulates w/ the Dens
No bony process b/t C1 & C2
C1 inferior facets articulate w/ superior facets of C2

71
Q

What is the function of the Axis?

A

Transitional vertebrae
Located b/t craniovertebral region and traditional cervical vertebrae
Includes Dens (odontoid process)
Functions as a pivot for upper cervical joints
Provides center of rotation for the atlantoaxial joint

72
Q

Atlanto-occipital joint

A

C1-C2, Synovial, pivot joint
Formed by the condyles of the occiput that articulate w/ the superior articular processes of the atlas
Very strong and supports weight of the head
Anterior atlanto-occipital membrane is an extension of the anterior longitudinal ligament

73
Q

Tectorial ligament

A

Sling shaped
Supports the spinal cord as it enters the vertebral column
Continuation of the posterior longitudinal ligament

74
Q

Median atlantoaxial joint

A

Synovial articulation b/t the Dens (odontoid process) of the axis and the anterior arch of the atlas anteriorly and the transverse ligament posteriorly

75
Q

Lateral atlantoaxial joint

A

Located b/t the articular processes of the vertebrae

76
Q

Functions of the Lower cervical spine (C3-C7)

A

Carry load bearing structures- head, stability, and mobility
Vertebral bodies have inferior and superior end plates- greater transverse diameter
Superior surface is concave, in frontal plane, slopes in a forward and downward direction
Inferior vertebrae is convex
Superior and inferior surfaces of the transverse processes have grooves for spinal nerves exiting the spinal cord
Transverse process contains anterior tubercle and posterior tubercle

77
Q

What muscles attach to the anterior tubercle?

A

Anterior Scalenes, Longus capitis, Longus colli

78
Q

What muscles attach to the posterior tubercle?

A

Illiocostalis cervicals, mid and post scalenes, and levator scap

79
Q

Anterior longitudinal ligament

A

Runs along anterior surface of vertebral bodies
Prevents excessive hyperextension
Thin superiorly/ thick inferiorly
Fuses w/ the sacrum
Found in deep thoracic and lumbar/ deep to the aorta

80
Q

Posterior longitudinal ligament

A

Run along posterior surface of vertebral bodies
Prevents excessive flexion
Thick superiorly/ thin inferiorly which contributes to instability of the lumbar spine, increasing the risk of disk injury

81
Q

Location of Supraspinal ligament

A

From C7 to sacrum posteriorly

Along tips of spinous processes

82
Q

Features of Cervical vertebrae

A

Smallest body
Largest vertebral foramen
Short spinous process

83
Q

Features of Thoracic vertebrae

A

Intermediate body
Smallest vertebral foramen
Long spinous process

84
Q

Features of Lumbar vertebrae

A

Largest body
Intermediate foramen
Thick spinous process

85
Q

Where are the apophyseal joints oriented?

A

In the frontal and sagittal planes

86
Q

This ligament limits flexion and serves as an attachment point for trapezius, splenius capitis and cervicus?

A

Ligamentum nuchae

87
Q

This segment of the spine is the most injured and absorbs the majority of the body’s weight?

A

Lumbar

88
Q

At which lumbar spinal segment does the majority of movement occur?

A

L4-L5 and L5-S1

89
Q

What muscles cause lateral flexion of the cervical spine?

A 
Traps (upper fibers)
Levator Scapula 
SCM
Scalenes group
Splenius capitis and cervicis
Longus capitis, longus colli
Oblique capitis superior, intertransversarii
90
Q

Muscles that perform cervical extension

A 
Traps (upper fibers)
Levator scapula
Splenius capitis and cervicis
Rectus capitis posterior major and minor
Oblique capitis superior and inferior
Semispinalis capitis
Interspinalis
Multifidi
Rotatores
Intertransversarii
Longissimus cervicis, capitis, and iliocostalis cervicis (assist)
91
Q

Muscle that perform cervical flexion

A

SCM
Anterior scalene
Longus capitis and longus colli

92
Q

What is the origin and insertion of the Anterior scalenes

A 
O= Transverse process of C3-C6
I = 1st rib
93
Q

What is the origin and insertion of the middle scalenes

A 
O= transverse process of C2-C7
I= 1st rib
94
Q

What is the origin and insertion of the post scalenes

A 
O= transverse process of C5-C7
I= 2nd rib
95
Q

What is the origin and insertion of the splenius capitis

A 
O= Spinous process of C7-T3
I= Mastoid process
96
Q

What is the origin and insertion of the splenius cervicis

A 
O= Spinous process of T3- T6
I= Transverse process of C1-C3
97
Q

Muscle that perform cervical rotation

A 
Levator scapula
Splenius capitis and cervicis
Rectus capitis posterior major
Oblique capitis inferior
Longus colli and capitis
SCM and scalenes group
Traps (upper fibers) and iliocostalis cervicis
Multifidi
Rotatores
Longissimus capitis and cervicis
98
Q

What separates the two sides of the rectus abdominis?

A

Linea alba

99
Q

Origin and insertion of rectus abdominis

A 
O= pubis
I= xiphoid process and coastal cartilages of 5th, 6th, and 7th ribs
100
Q

Action of the rectus abdominis

A

Trunk flexion and compression of the abdomen

101
Q

Origin and insertion of the External oblique

A 
O= Lateral on the lower 8 ribs
I= Iliac crest and linea alba
102
Q

Action of the external oblique

A

Bilaterally- trunk flexion, compression of abdomen

Unilaterally- lateral bending and rotation to OPPOSITE side

103
Q

Origin and insertion of internal oblique

A 
O= inguinal ligament, iliac crest, thoracolumbar fascia
I= 10th-12th ribs and abdominal aponeurosis
104
Q

Action of the internal oblique

A

Bilaterally- trunk flexion, compression of abdomen

Unilaterally- lateral bending and rotation to SAME side

105
Q

Origin and insertion of transverse abdominis

A 
O= inguinal ligament , iliac crest, thoracolumbar fascia, and last 6 ribs
I= Abdominal aponeurosis and linea alba
106
Q

Action of transverse abdominis

A

Compresses abdomen

107
Q

During trunk rotation the right external oblique and left internal oblique function as ________.

A

Agonists- rotating to the same side

108
Q

A muscle that attaches spinous process to spinous process will perform what action? Which muscles are being activated?

A

Extension

Spinalis and Interspinales

109
Q

A muscle that attaches transverse process to transverse process will perform what action? Which muscles are being activated?

A

Extension and lateral bending

Longissimus and intertransversarii

110
Q

A muscle that attaches spinous process to transverse process will perform what action? Which muscles are being activated?

A

Extension and Rotation

Splenius cervicis

111
Q

A muscle that attaches transverse process to spinous process will perform what action? Which muscles are being activated?

A

Extension and rotation

Semispinalis, multifidus, rotatores

112
Q

A muscle that attaches transverse process to rib or rib to rib will perform what action? Which muscles are being activated?

A

Extension and lateral bending

Iliocostalis

113
Q

Shorter muscles are better at ________. Longer muscles are better at ______.

A

Rotation

Extension

114
Q

What line of pull occurs in a muscle that attaches from spinous process to spinous process?

A

Vertical line of pull

They extend

115
Q

What line of pull occurs in a muscle that attaches from transverse process to transverse process?

A

Vertical line of pull lateral to the middle line
Bilaterally: extend
Unilaterally: laterally bend
*same for muscles that attach rib to rib

116
Q

What line of pull occurs in a muscle that attaches from spinous process to transverse process and vice versa?

A

Oblique line of pull
Bilaterally: extend
Unilaterally: rotate

117
Q

What muscles comprise the erector spinae group (ES)?

A

Spinalis
Longissimus
Iliocostalis

118
Q

What do the erector spinae group connect?

A

Run parallel to the vertebral column and connect spinous processes (spinalis) , transverse processes (longissimus), and ribs (iliocostalis)

119
Q

The ES group are prime movers in what motion?

A

Trunk extension

120
Q

What muscles comprise the transversospinalis group (TS)

A

Semispinalis
Multifidus
Rotatores

121
Q

What line of pull does the TS group have? Where do they attach?

A

Oblique

From a transverse process to the spinous process of the vertebrae above

122
Q

Motions of the TS group?

A

Extension and rotation

123
Q

Origin and insertion of the quadratus lumborum

A 
O= iliac crest
I= 12th rib, transverse process of all 5 lumbar vertebrae
124
Q

What action is perform by the quadratus lumborum and what line of pull does it have?

A

Trunk lateral bending

Vertical line of pull

125
Q

What is the reversal of muscle action for the quadratus lumborum?

A

Hip hiking or hip elevation in the pelvis

126
Q

Thoracic Outlet Syndrome

A

Compression of the neurovascular structures (brachial plexus and subclavian artery and vein)

127
Q

Where is the thoracic outlet located?

A

B/t the 1st rib, clavicle, and the scalene muscles

128
Q

Torticollis

A

deformity of the neck in which the person’s head is laterally bent to one side and rotated toward the other side.
Aka- wry neck

129
Q

Cervical sprains

A

Occurs when the head suddenly and violently hyperextends then flexes

130
Q

Sciatica

A

Pain that runs down posterior thigh and leg.
Caused by pressure on the sciatic nerve roots
Symptomatic of an underlying pathology such as a herniated disk

131
Q

Lordosis

A

an abnormally increased curve of the lumbar spine

aka- sway back

132
Q

Flat back

A

abnormally decreased lumbar curve

133
Q

Kyphosis

A

Abnormally increased thoracic curve

134
Q

Scoliosis

A

Any amount of lateral curve in the spine

135
Q

Spondylosis

A

Spinal osteoarthritis, degenerative disorder that may result in bone spurs, thickening of ligaments, decreased disk height that results from reduced water content of the nucleus pulposus
May lead to nerve root and spinal cord compression

136
Q

Spinal stenosis

A

narrowing of the vertebral canal that houses the spinal cord.
Its also possible to have stenosis of the intervertebral foramen through which the nerve roots pass

137
Q

Herniated disks

A

weakness or degeneration of the annulus fibrosus, allowing the nucleus pulposus to bulge or herniate through the annulus
L4-L5 most common sites for disk lesions

138
Q

Ankylosing spondylitis

A

chronic inflammation of the vertebral column and sacroiliac joints, leads to fusion
Progressive rheumatic disease that can lead to total loss of spinal mobility

139
Q

Spondylolysis

A

a vertebral defect of the pars interarticularis, most commonly seen in L5

140
Q

Spondylolisthesis

A

usually results from a fracture or giving away of the defective pars interarticularis. One vertebra slips forward in relation to the adjacent vertebra, usually L5 slips anterior on S1

141
Q

Osteoporosis

A

disease in which bone is removed faster than it can be laid down results in decreased bone mass and density.
Commonly seen in hip, thoracic vertebra, and the wrist

142
Q

Compression fractures

A

results in the collapse of the anterior portion of the vertebra usually caused by trauma in the lumbar region or osteoporosis in the thoracic region.
Does not usually cause spinal cord damage or paralysis b/c this is a stable fracture.
A stable fracture does not have progressive displacement or dislocation

143
Q

Fractures w/ dislocations

A

usually result in spinal cord injury and paralysis.

144
Q

Hangman’s fracture

A

fracture involving C2, typically occurs when there is a forceful, sudden hyperextension of the head.
Striking the head against a windshield in a MVA is often the cause

PT 106 (2 decks)

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