Spine Flashcards
Where does the ligamentum flavum attach?
Between the anterior surface of one lamina and the posterior surface of lamina below
What motion does the ligamentum flavum limit?
flexion
Where do the supraspinous and interspinous ligaments attach?
Between adjacent spinous processes from C7 to sacrum
What motion do the supraspinous and interspinous ligaments limit?
flexion
Where do the intertransverse ligaments attach?
Between adjacent transverse processes
What motions does the intertransverse ligament limit?
Contralateral lateral flexion and forward flexion
Where does the ALL attach?
Between the basilar part of the occipital bone and along the entire length of the anterior surfaces of all vertebral bodies, including the sacrum
What are the 2 functions of the ALL?
- Limits extension or excessive lordosis in cervical and lumbar regions.
- Reinforces anterior sides of IVDs
Where does the PLL attach?
Throughout the length of the posterior surfaces of all vertebral bodies, between axis (C2) and sacrum
What are the 2 functions of the PLL?
- Limits flexion
- Reinforces posterior sides of IVDs
Where do the capsules of the apophyseal joints attach?
Along the margins of each apophyseal joint
What is the function of the apophyseal joint capsules?
To strengthen the apophyseal joints
What are the 3 functional components of the intervertebral unction?
(1) transverse and spinous processes
(2) apophyseal joints
(3) an interbody joint (IVD)
What is the function of spinous processes and transverse processes?
They provide mechanical levers that increase mechanical leverage of muscles and ligaments
What is the main function of the apophyseal joints?
They guide intervertebral motion
Vertebral column flexion/extension occur in what plane? What about lateral flexion to the right or left? And axial rotation to the right or left?
Sagittal
Frontal
Horizontal
Horizontal facet joints favor what movement?
axial rotation
In what vertebral region are horizontal facet joints dominant?
cervical; this is why axial rotation is far greater in the cervical region rather than in the lumbar region
The layers of the annulus fibrosus are oriented about __° from the vertical
65°
How much flexion and extension occur at the atlanto-occipital joint?
Flexion: 5
Extension: 10
How much lateral flexion occurs at the atlanto-occipital joint?
5 degrees
How much flexion and extension occur at the atlanto-axial joint complex?
Flexion: 5
Extension: 10
How much axial rotation occurs at the atlanto-axial joint complex?
35-40 degrees
How much lateral flexion occurs at the atlanto-axial joint complex?
none
How much flexion and extension occur at the intracervical (C2-C7) region?
Flexion: 35-40
Extension: 55-60
How much axial rotation occurs at the intracervical (C2-C7) region?
30-35 degrees
How much lateral flexion occurs at the intracervical (C2-C7) region?
30-35 degrees
How much flexion and extension occur (total) over the craniocervical region?
Flexion: 45-50
Extension: 75-80
How much axial rotation occurs (total) over the craniocervical region?
65-75 degrees
How much lateral flexion occurs (total) over the craniocervical region?
35-40 degrees
Describe the arthrokinematics at the atlanto-occiptal joint, alanto-axial joint, and in the intracervical region during extension
Posterior roll and anterior slide at the alanto-occipital joint
Inferior tilt at alanto-axial complex
Posterior-Inferior slide in the intracervical region
Describe the arthrokinematics at the atlanto-occiptal joint, alanto-axial joint, and in the intracervical region during flexion
Anterior roll and posterior slide at the alanto-occipital joint
Superior tilt at alanto-axial complex
Anterior-Superior slide in the intracervical region
During protraction of the cranium, lower-to-mid cervical spine _____ as upper craniocervical region _____.
flexes
extends
During retraction of the cranium, lower-to-mid cervical spine _____ as upper craniocervical region _____.
extends
flexes
Describe the arthrokinematics at the atlanto-axial joint and in the intracervical region during right rotation
there is a posterior slide on the right side and anterior slide on the left side at all joints
Describe the arthrokinematics at the atlanto-occipital joint during right lateral rotation
There is a roll in the same direction of the movement (right) and slide in the opposite direction (left)
Describe the arthrokinematics in the intracervical region during right lateral rotation
There is a posterior-inferior slide on the right and anterior-superior slide on the left
What is the angle of inclination of the articular facets of C2 - C7?
45°
What 2 motions occur simultaneously in the upper vertebrae?
lateral flexion and axial rotation
With lateral flexion to the right at the mid-and-low cervical regions slight axial rotation to the ___ also occurs
right (ipsilateral)
Why is this compensatory action of atlanto-axial joint important?
It minimizes the overall rotation of the head, which helps the eyes fixate on a stationary object during lateral flexion of neck
How much movement occurs in the sagittal plane (flexion/extension) in the thoracic region?
50-65 degrees
How much movement occurs in the sagittal plane (flexion/extension) in the lumbar region?
55-70 degrees
How much movement occurs in the horizontal plane (axial rotation) in the lumbar region?
5-7 degrees
How much movement occurs in the frontal plane (lateral flexion) in the lumbar region?
20 degrees
Describes the arthrokinematics at the thoracic and lumbar regions during flexion
There is an anterior-superior slide of the facet joints
Describes the arthrokinematics at the thoracic and lumbar regions during extension
There is a posterior-inferior slide of the facet joints
Describes the arthrokinematics at the thoracic region during axial rotation
Slide occurs in the same direction as the movement
Describes the arthrokinematics at the lumbar region during axial rotation
The ipsilateral and contralateral facet joints approximate in the lumbar region
(not much movement therefore there is no slide)
Describes the arthrokinematics at the thoracic and lumbar regions during lateral flexion
Inferior slide on the ipsilateral side and superior slide on the contralateral slide
What are the 4 components of the pelvic ring
- sacrum
- 2 SIJs
- 3 bones of each hemipelvis (ilium, pubis, and ischium)
- pubic symphysis joint
What is the purpose of the pelvic ring?
It transfers body weight bidirectionally between the trunk and femurs
What does the strength of the pelvic ring depend on?
The tight fit of the sacrum wedged between the two halves of the pelvis
What is the keystone of the pelvic ring?
The sacrum
During anterior pelvic tilt the sacrum ____ and the lumbar spine _____.
counternutates
extends
During posterior pelvic tilt the sacrum ____ and the lumbar spine _____.
nutates
flexes
The cancellous bone within the vertebral body has a trabecular design. Describe the orientation of this design
There is one vertical and two oblique lines that interweave
What is the primary shock absorber in the lumbar spine?
Cancellous bone (not the IVDs)
Describe how the cancellous bone can be a shock absorber when compressed
The nucleus pulposus pressurizes and causes the cartilaginous end plates of vertebrae to bulge inward, thus compressing the cancellous bone
Which trabeculae are crucial in determining compressive strength?
Transverse trabeculae
With extreme compressive loading the end plates begin to bulge into the vertebral bodies and cause what?
Fractures or cracks in the end plate sometimes large enough to permit liquid NP to squirt through end plate into the vertebral body
What is a Schmorl’s node?
Protrusion of the cartilage of the IVDs through the vertebral body endplate and into the adjacent vertebra, however the annulus fibrosis remains intact
A Schmorl’s node is developed how?
By spinal compression when spine is in neutral ROM (i.e., not flexed, bent or twisted)
How are the posterior elements of the vertebrae damaged?
Repeated, cyclic full spine flexion and extension
3 components of the IVDs
nucleus pulposus
annulus fibrosis
end plates
4 conclusions about disc lesions
- disc must be bent to full ROM in order to herniate
- the mechanism of injury is fatigue
- found more in those with sedentary occupations and sitting posture
- occurs more often is younger spines
Disc herniation is due to what?
fully flexing the spine for repeated or prolonged period of time
What is the function of rotatores and intertransversarii muscles?
Vertebral position sensors at every thoracic and lumbar joint
What are the 3 back extensors (1 group)?
Erector Spinae Group
- Longissimus - Iliocostalis - Spinalis
What are the 3 layers of the abdominal wall?
- external oblique
- internal oblique
- transverse abdominis