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Anatomy > spinal bio 2 test 1 > Flashcards

spinal bio 2 test 1 Flashcards

1
Q

2 main functions of the functional spine

A

rigidity

flexibility

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2
Q

what % of body weight does the spine hold

load bearing?

A

50% body weight

100% load bearing (picked up items)

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3
Q

flexibility ensures ________ & _______

A

mobility and plasticity

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4
Q

what is involved in proprioception

A

muscle spindal fibers
vestibular apparatus
righting reflex

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5
Q

what is the righting reflex

A

keeps eyes perpendicular to horizen

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6
Q

cervical spine has what mobility and stability

A

increased

decreased

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7
Q

thoracic spine has what mobility and stability

A

low mobility

increased stability

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8
Q

lumbar spine has what mobility and stability

A

increased mobility

increased stability

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9
Q

where is the center of gravity

A

anterior 1/3 of sella turcica

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10
Q

is the cranial curve anatomical

A

no

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11
Q

explain the lever system in the cranial curve

A

center mass of skull is the load
the condyles are the fulcrum
the posterior extensor muscles are the effort

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12
Q

where does the cervical curve end

A

inferior epiphysis of T1

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13
Q

what is the apex of the cervical curve

A

C4-C5 IVD

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14
Q

where does the thoracic curve begin and end

A

sup. epiph of T2——>inf epiph of T11

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15
Q

where is the apex of thoracic curve

A

T6-T7 IVD

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16
Q

Where is the apex of the thoracic curve in relation to the back of the trunk?

A

1/4 anterior

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17
Q

Is the cervical curve anatomical and functional?

A

yes

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18
Q

how does the cervical curve develop?

A

breastfeeding

curiosity

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19
Q

how does the lumbar curve develop?

A

crawling

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20
Q

where does the lumbar curve begin and end?

A

sup. epiph of T12—–>inf. epiph of S1

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21
Q

what is the apex of the lumbar curve?

A

L3 body

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22
Q

SC curve is anatomical not functional. T or F

A

T

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23
Q

In the fetus the occiput to L5 is kyphotic. T or F

A

T

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24
Q

When does the cervical curve develop?

A

birth —-> 5 months

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25
Q

When does the ALL begin to get stretched?

A

birth—–>5 months

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26
Q

when does convexity of the lumbar spine start?

A

5 months—->3 years

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27
Q

when should there be an obvious curve?

A

8 y/o

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28
Q

where should the GWL go in a radiograph?

A
  1. ant 1/3 of sella
  2. C5-6 IVD
  3. Body L3
  4. Femur head
  5. Lat. maleolus
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29
Q

What is the visual A-P GWL?

A
  1. Eop
  2. Scaoula
  3. Buttocks
  4. heels
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30
Q

What is the lateral visual GWL?

A
  1. tragus
  2. shoulder
  3. acetabulum
  4. knee
  5. lat maleolus
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31
Q

Why is there a slight physiological curve in the thoracic spine to the right?

A

heart

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32
Q

A lever gives _________

A

a mechanical advantage

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33
Q

forces are ______ or _______

A

parallel or perpindicular

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34
Q

a curve takes a vertical force and

A

transfers it to a horizontal

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35
Q

stress is _______ distributed among a curve

A

evenly

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36
Q

what is the bending moment?

A

force on the apex of a curve

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37
Q

what is an example of a class 2 lever?

A

wheelbarrow

foot

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38
Q

what is an example of a class 3 lever

A

arms

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39
Q

what is the goal of a curve?

A

to have the lowest bending moment with the highest flexibility

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40
Q

the force on the apex _____ at first then increases ________

A

slow at first

increases very quikly

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41
Q

wolfe’s law

A

the body will add bone to areas of stress

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42
Q

the mechanical advantage _______ quickly as the curve increases but _______ off

A

increases

levels

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43
Q

how many curves in the human spine?

A

4

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44
Q

what is the resistance to axial compression

A

R=(n)2 + 1

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45
Q

how much do the curves in the human spine increase resistance to axial compression?

A

8 1/2 times stronger

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46
Q

what does the delmas index measure?

A

clinical measurement of degree of overall curve in a spine

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47
Q

the # of curves in a spine determines what

A

resistance to axial compression

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48
Q

According to the delmas index, what is optimal curve?

A

95 %

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49
Q

According to the delmas index, what is regional hyper-curvature?

A

less than 94%

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50
Q

According to the delmas index, what is regional hypocurvature?

A

more than 96%

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51
Q

The leading theory is that the spinal curves are what?

A

arcs of circles

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52
Q

What is the basic spinal unit?

A

2 vertebra and all associated muscles and structures

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53
Q

Where does the ALL begin and end?

A

Basion—->skips ant. tubercle of C1—->sacral promentory

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54
Q

What does pre-loaded mean?

A

tension artificially induced in the structural elements in addition to any self-weight or imposed loads they may carry. It is used to ensure that the normally very flexible structural elements remain stiff under all possible loads.

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55
Q

The ALL limits what movement?

A

extension

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56
Q

The ALL is a wide ____ band

A

elastic

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57
Q

The ALL naturally wants _______

A

kyphosis

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58
Q

Where does the PLL begin and end?

A

Foreamen magnum——>skips C1—–>posterior C2 body—–>post. S1

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59
Q

The PLL is ________ attached

A

loosely

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60
Q

The PLL narrows between the

A

pedicles

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61
Q

The ligamentum flava begins and ends where?

A

C2-3—–>L5,S1

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62
Q

What is the most elastic ligament in the human body?

A

yellow ligament

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63
Q

The intertransverse ligaments limit what movement?

A

contralateral lateral flexion

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64
Q

The intertrasverse ligament go from where to where?

A

proximal tp to the tp below

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65
Q

What is the anterior column?

A

vertebral bodies + IVDs

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66
Q

what is the posterior column?

A

Z column + vertebral arch

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67
Q

What is the function of the anterior column?

A

weight bearing

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68
Q

The load on the anterior is passed where?

A

posteriorly

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69
Q

The anterior column is purely ______

A

anatomical

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70
Q

The anterior column is _______ adapted

A

passive

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71
Q

The main function of the posterior column is

A

mobility and motion guidance

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72
Q

the posterior column is not passive due to

A

muscles——mainly interspinalis

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73
Q

Internal trabeculation patterns

vertical fibers resist

A

resist axial compression

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74
Q

Internal trabeculation patterns

A–P fibers run from

A

sup. epiph—–>spinous

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75
Q

Internal trabeculation patterns

A—P fibers part 2 run from

A

inf. epiph—->post zyg—->spinous

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76
Q

Internal trabeculation patterns

horizontal fibers resist

A

inward thrust (reenforce side walls)

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77
Q

Internal trabeculation patterns

oblique fibers run from

A

inf. epiph—–>side wall

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78
Q

the least stress is on what part of the vertebral body?

A

anterior

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79
Q

Where is the most dense bone?

A

pedicle

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80
Q

What are the most common clinical causes of compression fracture?

A

`oteoporosis
Forward head posture
kyphosis

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81
Q

what is loose packed position

A

where the joint is most open and capsule + ligaments are most relaxed

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82
Q

what is joint play

A

assesment of resitance from neutral and/or loose packed joint position

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83
Q

what is capsular feel?

A

some spongy give but increase in pain

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84
Q

pain is normally due to an

A

enlarged capsule

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85
Q

what is the end play zone?

A

end of passive ROM at the elastic barrier

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86
Q

What is ligamentous creep?

A

deformation of ligaments under continous load

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87
Q

what is the main functions of synovial fluid?

A

lubrication

bring in nutrients and evacuate waste

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88
Q

what is the articular cartilage composed of?

A

hylaronic acid
proteoglycans
type 2 collagen

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89
Q

what is an adhesion?

A

scar tissue

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90
Q

when is fluid film lubrication prevalent?

A

happens during light load
primary lubricant
increases movement

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91
Q

what is boundry lubricant?

A

is used when cartilage is heavily loaded

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92
Q

what are the properties of the zyg joints?

A
  1. change with volume of fluid; fluid excursion under pressure into hyaline cartilage w/i 3 min
  2. hyaline cartiladge can go under massive pressure and keep shape (plyable)
  3. As joint loaded and unloaded, the cartilage and joint exchange nutrients & waste
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93
Q

What are the four main biomechanical characteristics of ligaments and tendons?

A
  1. passive structures that are important to stability
  2. get stiffer with increased strain
  3. ligaments in joint capsules act as static restraints
  4. tendons transmit tensile loads from muscle to bone
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94
Q

elastic: collagen ration in ligamentum flava

A

2:1

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95
Q

Both tendons and ligaments have

A

mechano/proprioceptors

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96
Q

Damage to ligaments is due to

A

rate of impact

amount of load

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97
Q

what is hysteresis?

A

energy lost due to deformation

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98
Q

What is the weakest point of a ligament/tendon?

A

insertion point

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99
Q

T or F

corticosteriods inhibit collagen synthesis?

A

T

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100
Q

What is George’s line?

A

a line down the posterior vertebral bodies on a x-ray

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101
Q

Henri gillete’s fixation theory

A
  1. muscles
  2. ligamentous
  3. articular

primary—–>secondary

102
Q

Henri gillete’s fixation theory

muscles

A

secondary; minor fixation, palpated tender, taut muscle fibers, hyperaestetic, little end play

103
Q

Henri gillete’s fixation theory

ligamentous

A

ligaments shorten slowly & lose stretch ability. abrubt block w/ no give; improvement is partial and takes time to acheive

104
Q

Henri gillete’s fixation theory

articular

A

total fixation, palpates as a full blockage
pathology-ankylosis (fusion)
(not-always adjustable)

105
Q

Henri gillete’s fixation theory

primary leads to

A

secondary

106
Q

Henri gillete’s fixation theory

secondary fixations are

A

compensatory

107
Q

Henri gillete’s fixation theory

adjusting the secondary alone will

A

never change the primary

108
Q

Lumbar facet syndrome

A
  1. localized pain sometimes radiates to butt and thighs
  2. often sudden onset
  3. decrease weight bearing
109
Q

What is dynamic coupling?

A

two or more motions that necessarily occur simultaniously

110
Q

What 2 factors are involved with dynamic coupling?

A
  1. coupling mech. joint surface structure

2. ligamentous factors

111
Q

Thoracic lumbar coupling

2 mechanisms

A
  1. lateral flexion/ contralateral rotation are strongly coupled
  2. rotation/contralateral lat. flexion are not coupled
112
Q

mechanisms of coupling

anterior mech.

A

IVD

Lat. flex—contralateral wedge opening/ipsilateral annulus

113
Q

mechanisms of coupling

posterior mechanisms

A
  1. lat. flex—> contralateral streched ligaments
    effect maximized on intertransverse, capsule, & yellow lig.
  2. pull arch ipsilaterally to shorten arc
114
Q

T or F coupling must happen both ways

A

F

115
Q

Rotation is defined by

A

the vertebral body

116
Q

Cervical coupling

A

lateral flexion is coupled with ipsilateral roation

117
Q

IVD structure

nucleus pulposis

A
  1. yellowish-white, translucent gel
  2. hydrophilic muco-polysaccharide matrix w/ CT cells and mature chondrocytes
  3. up to 88% H2O from surrounding tissues mostly through cartilage of epiphysis
  4. imbibation decreases with aging (fibrosis is common)
  5. avascular, no nerve supply
  6. derived from the notochord
118
Q

IVD structure

Annulus fibrosis

A
  1. 95% collagen
  2. 12-20 lamina
  3. multiple orientations
  4. more oblique —->closer to nucleus
    5 attached to VB by Sharpe’s fibers
119
Q

IVD structure

annulus/nucleus boundry

A
  1. no distinct boundry
  2. only volume-no shape- amorpous
  3. forced into roughly spherical shape
120
Q

active joint movement

A

requires muscular contraction

121
Q

active joint movement

factors determining active ROM

A
  1. articular design

2. inherent tension or resiliency of the associated muscle

122
Q

passive joint movement

A
  1. when dr. must bring joint through ROM
  2. passive joint movement has greater ROM than active joint movement
  3. takes muscle resistance out of play
123
Q

passive joint movement

factors determining ROM

A
  1. articular design

2. flexibility of soft tissue

124
Q

restriction

A

can occur anywhere along the ROM

125
Q

Active ROM restriction

A

1.myofascial shortening (splinting, aging)

126
Q

passive ROM restriction

A
  1. due to shortening of joint capsule, ligaments
127
Q

close packed position

A
  1. joint surface = compressed

2. joint capsule and ligaments are at tightest

128
Q

adjustments

A
  1. correct subluxations

2. neurological component

129
Q

manipulative therapy

A
  1. often applied along planes of resistance to increase ROM
  2. decrease pain
  3. occurs in para-physiological space
130
Q

end play zone

A
  1. must go beyond active ROM

2. movement at end of passive ROM right before elastic barrier

131
Q

end play

A

qualitative assessment of resistance at end of passive joint movement

132
Q

abrupt & extreme pain

A

bone on bone contact

133
Q

global ROM

A

between regions

134
Q

segmental ROM

A

between two vertebra

135
Q

physiological barrier

A

end of active ROM

136
Q

elastic barrier

A
  1. end of passive ROM

2. adjustment set up just prior to elastic barrier

137
Q

anatomical limit

A
  1. joint trauma or pathology

2. strains and sprains

138
Q

para-physiological space

A
  1. place where manipulation takes place
  2. some adjustments take place here (diversified)
  3. where cavitation comes from (nitrogen release
139
Q

IVD function

hydrophilic nucleus

A
  1. incompressible but flexible

2. acts as ball-bearing between two plates=swivel joint

140
Q

6 degrees of freedom

three rotations

A
  1. F/E (sagittal)
  2. L/R Lateral Flexion (Coronal Rot)
  3. L/R rotation (Axial rot)
141
Q

6 degrees of freedom

three translations

A
  1. anterior—>posterior gliding
  2. L/R gliding
  3. Compression and Traction
142
Q

rotation definition

A

movement around a point

143
Q

translation definition

A

movement in a straight line

144
Q

Water Imbibition

nucleus communicates with ______ bone via _________ in cartilage

A
  1. spongy

2. micropores

145
Q

Water Imbibition

what absorbs water

A

resting disk

146
Q

Water Imbibition

what happens to the pressurized disk?

A
  1. water is squeezed out

quickly at first then levels off

147
Q

Water Imbibition

how much height can be lost over the course of a day due to pressure?

A

3/4 of inch

148
Q

When one ages what happens to the nucleus?

A
  1. more fibrotic

2. decreases hydrophilic properties

149
Q

How does aging directly cause subluxation?

A

loss of IVF space=pressure on nerves

150
Q

What is the goal of pre-loading?

A

gives greater resistance to forces of compression and lateral flexion

151
Q

What are two factors that maximize pre-load?

A
  1. nucleus has a set volume

2. water imbibition

152
Q

T or F

pressure on the nucleus can be zero

A

F

due to water imbibition

153
Q

T or F

the nucleus translates radial load to axial load

A

F

axial to radial

154
Q

T or F

An increased load will make the annulus stiffer

A

T

155
Q

How much axial load is on the nucleus?

A

75%

156
Q

How much axial load is on annulus fibrosis?

A

25%

157
Q

What is the self-stabiliztion mechanism in the IVD?

A

the IVD returning to its neutral state

158
Q

What is the neutral state of the IVD?

A
  1. maximum thickness
  2. minimum stress on annulus
  3. level end plates
159
Q

What is the IVD response to axial load?

A
  1. IVD gets stiffer
160
Q

Why does the IVD stiffen under axial load?

A
  1. Nucleus bulges against annulus

2. annulus must increase resistance to prevent prolapse

161
Q

Dampening oscillation happens within _ sec

A

1

162
Q

What is the nucleus’ response to asymetrical load?

A

compresses ipsilaterally/ depressurizes contralaterally

163
Q

What is the annulus’ response to asymmetrical load?

A

compresses ipsilaterally/ tensioned contralaterally

164
Q

The nucleus under asymetrical load wil press against the contralateral side and _______
the annulus?

A

tension

165
Q

How many disks in the spine are level to the ground?

A

4

166
Q

What is the annulus response to torqueing load?

A

50 % becomes stiffened due to concentric alternating pattern

167
Q

What fibers are tightened in torqueing load?

A

oblique fibers in the direction of motion

168
Q

Why is rotation a compromising position?

A

The annulus is only 50% stiffened

169
Q

What effect happens during torquing load?

A

screw down effect

170
Q

Direction of sheer is direction of

A

inferior tilt

171
Q

sheer increases as you move ______ from the disk

A

away

172
Q

T or F neutral disks have sheering force?

A

F

173
Q

What are the four IVDs that are level to the ground?

A
  1. C4/C5
  2. T6/T7
  3. L2/L3
  4. L3/L4
174
Q

What disks are extended?

A
  1. C2/C3
  2. C3/C4
  3. T7-L1
175
Q

What disks are flexed?

A
  1. C5-T5

2. L4/L5

176
Q

What happens to extended disks during flexion?

A

neutralizes sheering force

177
Q

What happens to flexed disks during flexion?

A

increase sheering force

178
Q

Which disks have the most problems over lifespan?

A

flexed

179
Q

What is the most common injured disk in the body?

A

L5/S1

180
Q

What type of sheer comes from left lateral flexion?

A

anterior and left sheer

181
Q

Where is herniation of the disk most common?

A

posterolateral

182
Q

What is the weakest part of the annulus?

A

lateral

183
Q

Where is the maximum vulnerablity of the annulus?

A
  1. contralateral to rotation in flexed disks

2. ipsilateral to rotation in extended disks

184
Q

During right rotation where are flexed disks most commonly injured?

A

left side

185
Q

During right rotation where are extended disks most commonly injured?

A

right side

186
Q

traction =

A

axial tension

187
Q

What does traction do?

A

seperates end plates (brings fluid into disks)

188
Q

What happens to the nucleus during traction?

A

consolidated inward & upward

189
Q

What happens during extreme traction?

A

damage to the annulus

190
Q

What determines the amount of mobility in a region?

A

Amount of soft tissue associated

191
Q

Where is the cervical apex in relation to back of neck?

A

1/3 anterior

192
Q

Where is the thoracic apex in relation to the back?

A

1/4 anterior

193
Q

Where is the Lumbar apex in relation to the back?

A

1/2 anterior

194
Q

What is the average thickness of an IVD in the cervical region?

A

3 mm

195
Q

What is the average thickness of an IVD in the thoracic region?

A

5 mm

196
Q

What is the thickness of an IVD in the lumbar region?

A

9 mm

197
Q

T or F

Disk thickness is more important to mobility than overall percentage of soft tissue?

A

F

198
Q

What is the percentage of soft tissue in the cervical region?

A

28%

199
Q

What is the percentage of soft tissue in the thoracic region?

A

16%

200
Q

What is the percentage of soft tissue in the lumbar region?

A

25%

201
Q

The lumbar region has a high percentage and very thick IVDs which indicates ________ _______ and ________

A

high mobility and stability

202
Q

In the cervical spine the nucleus is what percentage of disk width?

A

30%

203
Q

In the cervical spine the nucleus is in what relation to center?

A

slightly posterior

204
Q

In the cervical region the nucleus is where in relation to the axis of motion?

A

directly under

205
Q

In the thoracic region the nucleus is what percentage of disk width?

A

30%

206
Q

In the thoracic region where is the nucleus located in relation to center?

A

slightly posterior

207
Q

In the thoracic region where is the nucleus located in relation to the axis of motion?

A

very posterior (low mobility)

208
Q

In the lumbar spine the nucleus is what percentage of disk width?

A

40%

209
Q

In the lumbar spine the nucleus is located where in relation to center?

A

posterior (more than cervical and thoracic)

210
Q

In the lumbar region how much of an increase (over the other regions) in surface area does the nucleus have?

A

80%

211
Q

In the lumbar region where is the nucleus located in relation to the axis of motion?

A

directly under (good mobility)

212
Q

The interspinous ligaments limit what movement?

A

flexion

213
Q

What region has the most defined intertransverse ligaments?

A

lumbar

214
Q

What limits contralateral lateral flexion?

A

intertransverse ligaments

215
Q

What region is most prone to compression fracture?

A

thoracic

216
Q

What vertebra are most commonly injured due to compression fracture?

A

T7/T8

T12/L1

217
Q

What factors impact biomechanical properties?

A
  1. aging
  2. pregnancy (relaxin)
  3. corticosteriods
  4. NSAIDs
218
Q

Hyperesthetic definition

A

increased sensitivity to touch

219
Q

ankylosis definition

A

joint fusion

220
Q

Protrusion/bulging definition

A

position of nucleus shifted within annulus

but still contained

221
Q

2 types of protrusion/bulging

A

concentric

radial

222
Q

concentric protrusion

4 points

A
  1. the protrusion is 360 degrees
  2. nucleus is seeping into the outside of the annulus
  3. delamination is a precursor to concentric protrusion
  4. unlikely to reconsolidate/ rupture
223
Q

the disk is not usually the cause of the problem, but a __________

A

symptom

224
Q

What is the best way to evaluate a disk?

A

MRI

225
Q

delamination definition

A

the annulus fibrosis fibers have slight rips due to microtraumas

226
Q

radial protrusion

4 points

A
  1. nucleus cuts across annulus layers
  2. usually posterolateral
  3. better chance of reconsolidation
  4. more likely to rupture
227
Q

a straight posterior radial protrusion is the ______ type of protrusion and the ______ most common

A

worst

2nd

228
Q

An anterior protrusion is _______

A

rare

229
Q

what is a prolapse/rupture/herniation/extrusion?

A

nucleus is free of annular containment

230
Q

A subligamentous prolapse may be reconsolidated if it is ___________

A

non-sequestered

231
Q

What happens during a subligamentous prolapse?

A
  1. nucleus is under the PLL
  2. the nucleus may move up or down
  3. the nucleus may be sequestered or non-sequestered
232
Q

what does sequestered mean?

A

fragmented outside of annulus to where part of the nucleus becomes isolated

233
Q

What does frank prolapsed mean?

A
  1. nucleus breaks through PLL
  2. nucleus is in the neural canal
  3. may be sequestered or non-sequestered
234
Q

Frank prolapses increase ________ ________

A

nerve entrapment

235
Q

What is cauda equina syndrome?

A
  1. massive directly posterior prolapse
  2. entire nucleus is expelled
  3. can cause total paralysis of legs and complete loss of bladder control
236
Q

Which has a better possibility of naturally healing, protrusion or prolapse?

A

prolapse

237
Q

T or F

During a protrusion disk function remains intact.

A

T

238
Q

T or F

during a prolapse ankylosis will occur within 1-3 years.

A

T

239
Q

T or F

protrusion rarely has repeated occurences.

A

F

240
Q

T or F

protrusion has a low possibility of long term healing

A

T

241
Q

The spinal cord ends at

A

T12-L3

242
Q

What are some conservative ways to treat disk issues?

A
  1. traction
  2. bed rest
  3. muscle relaxors + pain killers
  4. bracing
243
Q

What are some preventative measures for disk issues?

A
  1. H20
  2. posture
  3. proper weight
  4. lifting properly
  5. chiropractic care for subluxations
244
Q

What are two conditions that lead to disk trauma?

A
  1. delamination of Annulus Fibrosis

2. precipitating event

245
Q

Most disk trauma happens after the age of

A

40

246
Q

T or F

disk trauma is more common in women

A

F

247
Q

A precipitating event most likely happens because of two factors.

A
  1. sudden excessive disk loading

2. most likely flexion sheer

248
Q

During disk trauma pain results from

2 factors

A
  1. ligament trauma (dull, achy)

2. nerve root entrapment (sharp, can radiate)

249
Q

What is the Val Salva reaction?

A

a diagnostic tool for disk trauma consisting of

  1. bearing down
  2. closes all sphincters in abdominal area and thorax
  3. happens during bowel movement naturally
250
Q

What are two surgical options for disk trauma?

A
  1. decompression (laminectomy)

2. excise the disk

Anatomy (22 decks)

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