Principles 2 Flashcards
Why might maintaining a healthy nervous system be important?
possibly to deal with stress and diseases of adaptation
At what point do we manipulate a joint?
paraphysiologic space
What are the different parts of movement?
neutral position
physiologic barrier (active ROM)
elastic barrier of resistance (crack) (mobilization)
paraphysiologic space (manipulation
limit of anatomic integrity (joint sprain)
hypermobility
Planes of movement
sagittal
coronal
transverse
body planes of movement axis
coronal (x)
sagittal (z)
longitudinal (y)
flexion and extension
sagittal plane coronal axis (x)
abduction/adduction, lateral flexion
coronal
sagittal (z)
medial/lateral flexion (axial rotation)
transverse longitudinal (y)
IVFs ___ in flexion and ___in extension
opens in flexion
decreases in extension
boundaries of an IVF
anterior: body, IVD
superior: pedicle
posterior: zygopophyseal joints (facets)
inferior: pedicle
anatomic contents of IVF
spinal nerve nerve roots recurrent meningeal nerves blood vessels lymphatics connective tissue DRG
order of compression in the IVF
adipose
veins
arteries
nerve
what is the most sensitive to compression from the IVF?
DRG
IVDs are found?
between the bodies of C2-3 all the way down to the lumbosacral junction
how much of the height of the vertebral column are discs responsible for?
1/4 the height
what is the function of discs?
weight bearing an dissipating shock
what are the 3 components of IVD?
annulus fibrosis
nucleus pulposus
cartilaginous endplates
cartilaginous endplates
composed of hyaline cartilage that separates but also helps attach the disc to the vertebral bodies
function of the cartilaginous endplates
anchor disc
form the growth zone for immature vertebral body
provide a permeable barrier between the disc and the body
the roll of the cartilaginous endplates is to?
allow avascular disc to receive nutrients and repair products
annulus fibrosis
fibrocartilaginous ring that encloses and retains the nucleus pulposus
function of annulus
enclosing and retaining the nucleus pulposus, absorbing compressive shocks, forming a structural unit between vertebral bodies and restricting motion
limits amount of torsion allowed on the disc and amount of rotation on the vertebra
allows disc to adapt to stress
what reinforces the annulus?
ALL
PLL
why is the PLL clinically significant for the annulus
as it descends its width narrows until covering only about 50% of the central portion of the lower lumbar discs
this makes the posterolateral aspect to most likely be injured
describe how the annulus gets nutrients
outer portion has a blood supply innervated by the sinuvertebral/recurrent meningeal nerve
the lateral aspect is innervated by grey rami communicantes
nucleus pulposus
central portion of the disc and is embryological derivative of the notochord
it account for about 40% of the disc and is semifluid gel that will deform easily but is considered impressionable
responsible for high water content of the disc
during the aging process, the water gradually disappears
when is the most common time to injure a disc?
30-50 years
pressure changes in the disc
recumbent standing sitting sitting leaning forward jumping
what can compressive loads do to the disc?
can cause fracture to the endplate or anterior vertebral body will collapse, but not herniation
nutrition to the disc is by way of?
imbibition (motion)
transverse ligament
holds dens in fovea dentalis of atlas
cruciate ligament
occiput to body of C2, cross shaped
alar ligament
limits rotation of C2
sides of dens to occipital condyles (AKA check ligament)
apical dental ligament
limits flexion/extension of C2, apex of dens to anterior aspect of the foramen
dentate ligaments
21 ligaments connecting pia to dura along the spinal cord (dural torque theory)
anterior longitudinal ligament
limits extension
front of vertebral bodies from sacrum to C2
anterior atlanto-occipital ligament
continuation of PLL from C2 to occiput
anterior atlanto-axial ligament
continuation of ALL from C2 to atlas
posterior longitudinal ligament
limits flexion. back of vertebral bodies (anterior portion of canal)
wider in cervicals, thinner in lumbars and thinnest at L5
tectorial memebrane
continuation of PLL from C2 to occiput
ligamentum flavum
most important of the posterior ligaments in limiting flexion
lamina to lamina (posterior portion of canal)
high elastic content
under constant tension as a result of its elastic properties
posterior atlanto-axial
continuation of ligamentum flavum from C2 to C1
posterior atlanto-occipital
ligamentum flavum from C1 to occiput
arcuate foramen if ossified
capsular ligament
between articular processes
intertransverse ligament
between TVP
interspinous ligament
between spinous process
supraspinous ligament
from spinous to spinous
ligamentum nuchae
continuation of supraspinous ligament from C7 to occiput
transforaminal ligament
traverse the foramina and diminsh space available for passage of NRs
meninges
CT coverings arranged in 3 distinct layers that cover and protect the spinal cord from excessive movement and damage
3 layers of meninges
dura
arachnoid
pia
(dentate)
dura mater
thick and tough CT
continuous from cranial cavity to sacrum
covers individual NR and nerves as they exit spinal canal
sleeves of dura follow nerves to the IVF and surround a swelling, which represents the location of the DRG
arachnoid mater
more delicate and VASCULAR and is attached to the inner surface of the dura
thin weblike projections extend from arachnoid to pia
pia mster
single cell CT layer that adheres directly to the surface the neural tissue, including the individual cranial and spinal rootlets
dentate ligament
series of pial porjections, located primarily in the thoracic region, which project from lateral surface of the spinal cord penetrate the arachnoid and anchor to the dura
gives us the dural torque theory
