Spine Flashcards

1
Q

Functions of the spine?

A

Structural support – head shoulders chest, connects upper and lower body, provides balance and weight distribution

Protection – spinal cord and nerve roots, internal organs

Base for attachment – ligaments, tendons, muscle

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2
Q

Describe the Cervical vertebrae

A

7 cervical vertebrae are the smallest vertebrae (C1-C7)
Extend from skull to thorax
Support only the weight of the head(can be small and light)
Small muscles can produce effects by tipping balance one way or the other
sudden fall - these arent strong enough to stabilise (Whiplash)

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3
Q

Describe the thorax verterbrae

A

Mid-back or dorsal region
Twelve vertebrae - T1-T12
Ribs attached to these
Allows change in volume of thoracic cavity
Immobile

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4
Q

Describe the lumbar vertebrae

A

Lower back
Five vertebrae: L1-L5
Carries weight of upper body
Larger broader (stress = F/A)

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5
Q

Describe the sacrum of the sacral

A

➢ Triangular structure
➢ Base of the spine
➢ Connects spine to pelvis
➢ Nerves to pelvic organs
➢ Initially unfused – fuses @ 16-18 yrs, completely fused aged 34

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6
Q

Describe the coccyx of the sacral

A

➢ Few small bones
➢ Remnant of tail
➢ Attachment of various muscles and
ligaments
➢ Takes weight of person sitting

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7
Q

What does the vertebrae consist of?

A

Body, neural arch and processes

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8
Q

Describe the verterbal bone

A

designed to bear mainly compressive loads
Larger caudally as superimposed weight of upper body incr
Bone remodels: Wolffs law - adapts to physical sorrounding(creates more/less bone depending on force applied)
80% of bone cancellous (first to be affected by osteoporosis)

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9
Q

Describe the structue of the vertebra

A

body transfers weight along the axis of the vertebral column. bodies of adjacent vertebrae are interconnected by ligaments, separated by intervertebral disc
vertebral arch forms the posterior margin of each vertebral foramen. Foramen and successive vertebrae form vertebral canal enclosing spinal chord.
superior articular process articulates with the inferior articular process of a more superior vertebra.

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10
Q

What is the motion unit of the spine?

A

twovertebrae and their intervening soft tissues

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11
Q

Describe the intervertebral disc

A

Nucleus Pulposus: Gelatinous mass, rich in hydrophilic (water binding) glycosaminoglycans in young adults.
Annulus fibrous: outer layer composed of fibrocartilage. Withstand high bending and torsional loads due to crisscross arrangement of coarse collagen fibre bundles.

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12
Q

Describe the longitudinal ligaments of the motioning segment

A

Provide stability to the spine during rest and movement
Resists excessive movements – hyper extension/flexion
Prevents movements in some directions
High % elastin - highly elastic

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13
Q

Describe the facet joints of the motioning segment

A
  • Articulation between superior and inferior facets
  • Hinge structure - link vertebrae together
  • Synovial joints: surrounded by a capsule of connective tissue - produces a fluid lubricate the joint.
  • Jt surfaes coated with cartilage - jts move/glide smoothly against eachother
  • Guide intervertebral motion through their
    orientation in the transverse and frontal planes
    limits motion (determined by orientation of fcts)
  • Strongest in thoracolumbar and cervicothoracic regions where the curvatures change
  • Resist flexion & undertake tensile loading in
    the superior portion with axial loading or
    extension
  • Resists rotation in lumbar region
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14
Q

Describe the spinal muscles of the motioning segment

A

Muscles & ligaments support spine,hold upright,control movement
Muscle attachments on spinous and transverse processes
Skeletal muscles is innervated and under voluntary control – no control over cardiac muscle

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15
Q

Describe the intervertebral disc of the motioning segment

A

Disc loaded in complex manner - combo of compressive,tensile and shear loads
In comp - pressure in NP 1.5 times the applied load per unit area
Comp load makes disc bulge radially and circumferential stress developed in annular fibres (As NP only slightly compressible)

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16
Q

What are the regional differences of the Vertebrae

A
17
Q

What do the agonsitic and antagonistic muscles do?

A

agonistic: initiate and carry movement
Antagonistic: control and modify movement

18
Q

What are the different motions of the spine

A
  1. Flexion, or bending anteriorly
  2. Extension, or bending posteriorly
  3. Lateral flexion, or bending laterally
  4. rotation
19
Q

Describe flexion of the spine

A

First 50-60% of spine flexion occurs in the lumbar spine. - lower motion segments, tilting pelvis allows further flexion
Flexion initiated by abdominal and psoas muscles
Weight of body produces further flexion (controlled by incr activity of erector spinae- - antagonistic muscle)

20
Q

Describe loading during standing

A

line of g passes ventral to transverese axis of motion
motion segment subjected to forward bending mom
Balanced by ligament and erector spinae muscle forces
Displacement of line of gravity alters magnitude and direction of moment of spine
Pelvis titl changes angle of inclination at base of sacrum
Pelvist tilt backward decreases sacral angle and luumbar lordosis flattens = spine extends changing COG

21
Q

Describe the loading of the spine during different sitting positions

A

sitting position- pelvis backward tilt, lumbar lordosis straightened out, shifting COG creating longer lever arm
Erect sitting - forward tilt of pelvis & incr in lumbar lordosis reduce loads on lumbar spine - exceed those prodcued during standing
Loads on lumbar spine lower during supported seating = weight supported by back rest

22
Q

What does disc degeneration do?

A

Reduces the proteoglycan content and thus its hydrophilic (water binding) capacity.
Healthy - gelatinous nucleus pulposus is 80-88% water, easy to distinguish from AF
Late stage - NP has become dehydrated and has lost its gel-like character
Boundary between NP and AF hard to distinguish

23
Q

Effects of disc degeneration

A
  1. Disk integrity decreases with age
  2. Loses ability to retain water in disk so disks
    “dry out”
  3. Ability to distribute load across disk changes
  4. Annular rings become softened,
    overstretched and torn
  5. Normal viscoelasticity is exceeded
  6. Annulus fibrosus cannot stabilize or limit
    motion
24
Q

What are the creep characteristics of disc degeneration?

A

➢ Grade 0 – Non-degenerative disc ( more
viscoelastic)
➢ Grade 2 – Mild degenerative disc (less
sustenance)
➢ Grade 3 – Severe degenerative disc ( more
deformation)
creep: 1.5-2mm in 10 mins
Plateaus at 90 mins

25
Q

What are the treatment and repair strategies for disc degeneration?

A

-Spinal fusion - join two or more vertebrae - bone graft to immobilise vertebrae
-Implants: rods, hooks, plates, cages