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EPHE 450 > Spine > Flashcards

Spine Flashcards

1
Q

function of axial skeleton in terms of forces

A

transfer and absorb forces from upper and lower extremities

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2
Q

what do the ribs protect?

A

internal organs

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3
Q

function of spinal curves

A

to absorb forces

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4
Q

describe development of curves from birth

A

born: single kyphotic curve
infant: develop cervical lordosis
walking: develop lumbar lordosis

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5
Q

what are the four spinal curves

A

two lordotic - cervical and lumbar
two kyphotic - thoracic and sacral

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6
Q

number of vertebrae and how many per region?

A

33 total
7 cervical
12 thoracic
5 lumbar
5 sacral
3-5 coccyx (fused)

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7
Q

parts of the typical vertebrae

A

body
2 pedicles
2 lamina
vertebral foramen
intervertebral foramen
7 processes (1 spinous, 2 transverve, 4 articular)

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8
Q

function of vertebral processes

A

muscular attachements
provide leverage for the muscles
articulations

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9
Q

what are zygopophyseal joints

A

joints between the vertebra above and below via the articular processes

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10
Q

what runs through the vertebral foramen?

A

spinal cord

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11
Q

what is the shape of the cervical vertebral foramen and why is it this way

A

large and triangular
this is the smaller vertebra and needs to still fit the spinal cord through

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12
Q

What is C1 called and describe its shape

A

Atlas
large transverse processes
no body (lateral masses)

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13
Q

what is C2 called and describe important part of its shape

A

Axis first prominent spinous process
dens (odontoid process)
has a body

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14
Q

what is the general shape fo C3-C6

A

typical cervical vertebrae

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15
Q

what is unique about C7

A

vertebral prominence
looks a bit like a thoracic vertebrae because it articulates with the T-spine

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16
Q

main parts of the thoracic vertebrae

A

heart shaped body
transverse processes (long and strong, like armour)
spinous processes (long, slope down and posterior, spine of T7 at level of T8 body)
have articulations for the ribs

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17
Q

thoracic vertebrae shape largely prevents what movement to protect what

A

prevent spinal extension to protect the heart and lungs

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18
Q

how and where to the ribs articulate with the thoracic vertebrae

A

on the costal facets on vertebral body (head of rib)
on costal facets on transverse processes (rib tubercle)

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19
Q

where do the arms connect to the spine

A

sternoclavicular joint

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20
Q

main parts of the thorax

A

sternum (manubrium, body, xyphoid processes)
7 true ribs
3 false ribs
2 floating ribs

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21
Q

what is a floating vs a false rib

A

floating: joint with cartilage of rib 7
false: don’t connect to the cartilage

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22
Q

describe main parts/landmarks of the ribs

A

head (two articular facets)
Neck
tubercle to articulate with TP
Body
Sternal end

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23
Q

which ribs are atypical in shape and what makes them different

A

1: broad and short
2
10 = single articular facet
11-12: no neck or tubercle, single articular facet

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24
Q

Features of the body, spinous processes, transverse processes, and articular processes of the lumber vertebrae

A

Body: wider along transverse vs AP axis
Spinous process: large and horizontal
TP: accessory process at TP root
Articular process: mammilary process on posterior border of superior process

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25
Q

nerve roots off sacrum become what

A

sciatic nerve

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26
Q

what is in the sacral canal

A

cauda equina

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27
Q

what part of teh sacrum to we name the movement of the sacrum off of

A

sacral promotory

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28
Q

what is the sacral hiatus and what passes through

A

opening in the sacrum, allows passage of the cauda equina

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29
Q

three sacral crests made out of what structures

A

lateral = for tips of TPs
median = fused rudimentary SPs
Intermediate = fused articular processes

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30
Q

what is the auricular surface and where is it and what is an important feature

A

lateral surface of the sacrum
SI joint
cross of hyaline and fibrous cartilaginous joint to provide stability and movement

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31
Q

where it the sacral tuberosity and what attaches off of it

A

postural sacroiliac ligament
in angle of the “ear”

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32
Q

what is a motion segment in the vertebrae made of

A

two vertebrae
three intervertebral joints + facet joint capsules
intervertebral disc
longitudinal and intersegmental ligaments
facet joint capsules

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33
Q

what movements do the cervical facet joints allow

A

flex/ex + rotation

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34
Q

what movements do the thoracic facet joints allow

A

side bending

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35
Q

what movements do the lumbar facet joints allow

A

flex/ex, no twist

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36
Q

facets open in what movement and close in what movement

A

Open = flexion
close = extension

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37
Q

what movements test facet irritation

A

flexion and rotation

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38
Q

describe an intervertebral disc and what structures stabilize it

A

made of annulus fibrosis and nucleus pulpous

annulus fibrosis stabilizes the lies, vertebrae stabilize top and bottom, ribs stabilize the sides in thoracic vertebrae.

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39
Q

number of joints at each vertebrae and what type of joint they are

A

2 cartilage joints above and below (intervertebral discs)
4 articular joints between processes (synovial)

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40
Q

O, I, A of anterior longitudinal ligament

A

O: pelvis surface of sacrum
I: anterior tubercle of C1 and anterior foramen magnum
A: prevent vertebral hyperextension

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41
Q

posterior longitudinal ligament OIA and where it runs

A

Run within vertebral canal along posterior bodies
O: C2
I: sacrum
A: prevent posterior herniation of nucleus pulpous; resister hyperflexion; proprioceptor

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42
Q

Where does the ligamentous flavum run and function and why is it yellow

A

has more elastin = yellow
vertical ligaments extended from lamina to lamina and extend lateral to IV foramen
Helps to assist with straightening teh spine after flexion (elastic band) and helps preserve curvature

43
Q

O, I of interspinous ligament; what does it turn into at C7, and what is it made out of, strong or weak?

A

Membranous, weak
O: root of spinous process
I: apex of adjoining spinous processes
turns into the ligament nuchae, reinforces the vertical area and is an area of muscle attachment

44
Q

Supraspinous ligament
Strong or weak?
Make out of?
Runs from were to where?
Continuous with what?

A

Strong fibrous cord
Connects to tips of SP’s from C7 to sacrum
Continuous with interspinous ligament

45
Q

inter transverse ligaments
connect what?
What are they like in the C spine vs T spine

A

connect adjacent transverse processes
C spine: a few scattered irregular fibres
T spine: rounds cords closely connected with deep muscles of the back

46
Q

what is coupling why does it occurs

A

vertebral motion rarely happens in one plane; combined motion = coupling

due to facet orientation: limited by disc, ligaments, fascia and muscles

47
Q

motion at Atlanta occipital joint

A

nodding (not neck flexion)

48
Q

motion at atlanto-axis joint

A

rotation

49
Q

what percent of neck rotation occurs at the Atlanto axis joint

A

50%

50
Q

articulations from C2-C7:
what is the facet joint angle between transverse and frontal place
what process provides most of bony stability
stable or mobile?

A

45 degree
uncinate processes
mobile rather than stable

51
Q

cervical ROM (flex, ex, side flex, rotation)

A

Flex: 50 degrees
Ex: 60 degrees
Side flex: 45 degrees
Rotation: 80

52
Q

T spine
facet joint orientation? optimal for what?
What structures limit movement

A

Facets: oriented to the frontal plane, optimal for side bending

movements limited by ribs, sternum and spinous processes

53
Q

T spine ROM

A

Flex: 20-45 degrees
Ex: 25 to 40
Side flex: 25-40
rotation: 30-50

54
Q

L spine ROM

A

Flex: 40-60 degrees
Ex: 25 to 40
Side flex: 15-20
rotation: 5-20

55
Q

where does the ribs articulate with the t spine vertebrae

A

costal facets on vertebral body and facet on rib head
transverse costal facets + rib tubercle

56
Q

functions of the thoracic region

A

protection for cardiorespiratory system and internal organs Breathing

57
Q

Three motions that make breathing

A

pump handle (AP increase)
Bucket handle (increase horizontal width)
calliper (posterior, protect kidneys)

58
Q

L- spine
Facet orientation // facilitates what
what movement is very limited
what lumber vertebrae has the most movement

A

saggital facet orientation facilitates flex and ex
rotation limited
most movement occurs at L4/L5

59
Q

L5/S1 facet orientation and function of that orientation

A

frontal orientation
prohibits rotation and anterior shear

60
Q

name all ligaments of the spine

A

ALL
PLL
supraspinous
interspinous
ligamentum flavum
intertransverse iliolumbar

61
Q

function of iliolumbar ligament
orientation/location

A

stabilize L4 and L5 on sacrum
help to resist anterior shear of L5 on S1 (spondylolisthesis)
posterolateral orientation from TP to L4 and L5 to the crest of the ilium

62
Q

weak point in the spine

A

L5/S1 junction

63
Q

ligamentous support of the lumbosacral junction

A

iliolumbar
sacrolumbar

64
Q

position of L5 on S1

A

anterior and anterior tilt

65
Q

how much motion is allowed at the sacroiliac joint

A

1-3 mm

66
Q

what type of joint is the SI joint and what does this allow

A

diarthrodial
sacrum: hyaline (mobility)
Iliac: fibrocartilage (stability)

67
Q

what is nutation and counternutation

A

special name for flexion (nutation) and extension (counternutation) at the SI joint

68
Q

describe nutation

A

sacral locking
posterior rotation of ilium on the sacrum
when moving from supine to standing, ilia move closer together and ischial tuber-sixties move apart

69
Q

what does is pathological nutation and what does it cause

A

when nutation only occurs on one side, and ASIS is higher and PSIS is lower on one side, gives appearance of a shorter leg

70
Q

what is counternutation

A

sacral unlocking
anterior rotation of the ilium on the sacrum
ilia move further apart and ischial tuberosities approximate
limited by posterior SI ligaments

71
Q

what does pathological counternutation cause

A

ASIS is lower and PSIS is higher on one side

72
Q

direction of forces through the body when sitting and standing

A

standing: HAT –> L5 –> sacrum –> pelvis –> pubis symphysis and femoral heads –> floor
sitting: pubis symphysis to ischial tuberosities to chair

73
Q

what direction is the sacrum pushed and what direction is teh iliac pushed when standing and sitting

A

sacrum –> anteriorly
ilia –> posteriorly

74
Q

long posterior sacroiliac ligament
- location
- connects to
- function

A

caudal to PSIS
most superficial
connects to S3 and S4
resist sacral counternutation

75
Q

what ligament resists nutation and what does it connect to

A

sacrotuberous
connects to ILA, coccyx to ischial tuberosity

76
Q

anterior ligaments of the pelvis

A

anterior SI ligament
inguinal ligament

77
Q

location of inguinal ligament and function

A

from ASIS to pubic tubercle
contains spermatic cord or broad ligaments and ilioinguinal nerve

78
Q

what ligament creates the sciatic notch

A

sacrospinous ligament

79
Q

O and I of the sacrospinous ligament

A

O: ischial spine
I: lower lateral sacrum S4 and S5 and coccyx

80
Q

what does the thoracolumbar fascia connect (two bigger ideas)

A

connect ilum to skull and opposite glute to opposite late

81
Q

function of thoracolumbar fascia

A

spinal stabilization, enhances ability to lift heavy loads

82
Q

pre vertebral neck flexor main muslce

A

longus colli

83
Q

what muscle is a big neck proprioceptor

A

longus colli

84
Q

what muscle is a big issue in whiplash

A

longus colli

85
Q

what to the anterior, middle and posterior scalenes connect to

A

ant: rib 1
middle: rib 1
post: rib 2

86
Q

what muscle can cause numbness in the arm

A

the scalenes
pull up on ribs, and pinch brachial plexus

87
Q

posterior cervical muscles (which group is deep and which is superficial)

A

Deep: erector spinae, below upper trapezius levator scapulae
Superficial: splenius group

88
Q

what muscles run between the SP and TP (group name and individual muscles) + what is their orientation + O and I

A

transversospinalis group
semispinalis, multifidus, rotatores

O: TP of inferior vertebrae
I: SP of superior vertebrae

oblique orientation

89
Q

name muscles of the erector spinae group

A

iliocostalis
longissimus (both)
spinalis

90
Q

main function of erector spinae muscles

A

anti-gravity, hold you upright

91
Q

name the two splenius muscle
- what is is the function
- O and I (general)

A

splenius cervicis
splenius captius

Function: thick and got, wrap the vertical muscles and hold them in place

O: SP + ligamentum nuchae
I: TPs and skull

92
Q

what are the four deep muslces of the back

A

intertranversarii
interspinalis
multifidus
rotatores

93
Q

name the intermediate muscles of the back (2 groups, name four from one of the groups)

A

transverospinalis
erector spinae (longissimus thoracic, iliocostalis lumborum and thoracic, quadrates lumborum

94
Q

O, I A of quadratus lumborum

A

O: iliolumbar ligament, posterior iliac crest
I: inferior border of the last rib and TP of L1-4
A: elevate ipsilateral pelves, side flex ipsilaterally, assist in spine extension of lower lumber spine, anterior tilt of pelvis

95
Q

anterior trunk and lateral mucles (5)

A

Rectus abdominis
External and internal oblique
transverse abdominis
external adn interval intercostals
diaphragm

96
Q

primary inspiratory muslces

A

diaphragm, levator costarum, internal (anterior) and external intercostals

97
Q

primary expiratory muscles

A

abdominal muscles
internal intercostals (posterior)
transverse thoracic

98
Q

name the three hiatus in the diaphragm and what cases through each structures pass through the diaphragm

A

vena caval foramen (inferior vena cava and phrenic verve)
Esophageal hiatus (esophagus and vagus nerve)
aortic hiatus - formed by median arcuate ligament –> does not pierce diaphragm

99
Q

diaphragm origins and insertion

A

Sternal: dorsal of typhoid process
Costal: inner surfaces of lower 6 costal cartilages
Lumber: by crura from bodies of upper lumber vertebrae to 12th rib

insertion: central tendon

100
Q

main function of the head neck adn trunk msucles

A

provide a solid platform the limbs can move on

101
Q

TMJ joints are what type and made between what two structures

A

bilateral synovial joints
convex mandibular condyles + concise glenoid fossa

102
Q

motion for opening and closing at the TMJ joint

A

rotation and translation

103
Q

three movements of the TMJ joint

A

open/close
lateral shift
protrusion/retrusion

104
Q

three main muscles of closing the jaw

A

temporalis
masseter
medial pterygoid

EPHE 450 (2 decks)

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