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Biomechanics > Spine > Flashcards

Spine Flashcards

1
Q

Attachment of Ligamentum flavum:

A

B/w anterior surface of one lamina and posterior surface of lamina below

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2
Q

Function of Ligamentum flavum:

A

limits flexion

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3
Q

Attachments of supraspinous and interspinous ligaments:

A

B/w adjacent spinous processes from C7 to sacrum

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4
Q

Fuction of supraspinous and interspinous ligaments:

A

limit flexion

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5
Q

Attachment of Intertransverse ligaments:

A

Between adjacent transverse processes

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6
Q

Function of Intertransverse ligaments:

A

Limits contralateral lateral flexion and forward flexion

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7
Q

Attachment of Anterior longitudinal ligament

A

B/w basilar part of occipital bone and entire length of anterior surfaces of all vertebral bodies, including sacrum

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8
Q

Function of Anterior longitudinal ligament

A

Limits extension or excessive lordosis in cervical and lumbar regions. Reinforces anterior sides of intervertebral discs (IVDs)

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9
Q

Attachment of Posterior longitudinal ligament

A

Throughout length of posterior surfaces of all vertebral bodies, b/w axis (C2) and sacrum

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10
Q

Function of Posterior longitudinal ligament

A

Limits flexion.

Reinforces posterior sides of IVDs

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11
Q

Attachment of Capsules of the apophyseal joints

A

Capsules of the apophyseal joints

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12
Q

Function of Capsules of the apophyseal joints

A

Strengthen apophyseal joints

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13
Q

Intervertebral junction has three functional components:

A

(1) transverse (TVP) and spinous processes (SP)
(2) apophyseal joints
(3) an interbody joint

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14
Q

What is primarily responsible for guiding intervertebral motion:

A

apophyseal joints

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15
Q

What increases mechanical leverage of muscles and ligaments?

A

SP and TVPs provide mechanical levers

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16
Q

Plane of movement of flexion and extension of axial skeleton

A

sagittal

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17
Q

Plane of movement of lateral flexion (right or left) of axial skeleton:

A

frontal

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18
Q

Plane of movement of axial rotation (right or left) of axial skeleton

A

horizontal

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19
Q

AOR axial rotation (right or left) of axial skeleton

A

vertical

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20
Q

AOR of flexion and extension of axial skeleton

A

medial-lateral

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21
Q

AOR of lateral flexion (right or left) of axial skeleton

A

anterior-posterior

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22
Q

What strongly influences kinematics at different regions across vertebral column?

A

orientation of plane of facet surfaces within each joint

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23
Q

Horizontal facet surfaces favor:

A

axial rotation

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24
Q

Vertical facet surfaces (either in sagittal or frontal planes) block:

A

axial rotation

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25
Q

Why is axial rotation is far greater in cervical region than lumbar region?

A

plane of facet surfaces

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26
Q

What is the orientation of each collagen fiber?

A

65 degrees from vertical

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27
Q

How are the collagen fibers arranged?

A

concentric layers with fibers in every other layer running in identical directions
-130 degrees relative to each other

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28
Q

ROM atlanto-occipital joint (C0-C1) flexion and extension:

A

Flexion: 5
Extension: 10
Total: 15

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29
Q

ROM atlanto-axial joint complex (C1-C2), flexion and extension:

A

Flexion: 5
Extension: 10
Total: 15

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30
Q

ROM intracervical region (C2-C7), flexion and extension:

A

Flexion: 35-40
Extension: 55-60
Total: 90-100

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31
Q

Total ROM across craniocervical region, flexion and extension:

A

Flexion: 45-50
Extension: 75-80
Total: 120-130

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32
Q

ROM atlanto-occipital joint (C0-C1) axial rotaiton

A

negligible

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33
Q

ROM atlanto-occipital joint (C0-C1), lateral flexion

A

about 5

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34
Q

ROM Atlanto-axial joint complex (C1-C2) axial rotation

A

35-40

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35
Q

Atlanto-axial joint complex (C1-C2) lateral flexion

A

negligible

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36
Q

ROM Intracervical region (C2-C7) axial rotation

A

30-35

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37
Q

ROM Intracervical region (C2-C7) lateral flexion

A

30-35

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38
Q

ROM Total across craniocervical region axial rotaiton

A

65-75

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39
Q

ROM Total across craniocervical region lateral flexion

A

35-40

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40
Q

Protraction of cranium, lower-to-mid cervical spine:

A

flexes as upper craniocervical region extends

41
Q

Retraction of cranium, lower to mid cervical spine:

A

extends as upper cranicervical region flexes

42
Q

Kinematics of craniocervical axial rotation C2-C7:

A

inferior facets slide posteriorly and slightly inferiorly on the same side as rotation and anteriorly and superiorly on the side opposite rotation.

43
Q

What does the 45° inclination of articular facets of C2 to C7 dictate?

A

mechanical spinal coupling b/w movements in frontal and horizontal planes

44
Q

Because upper vertebra follows plane of articular facet of lower vertebra:

A

lateral flexion and axial rotation occur simultaneously

45
Q

Lateral flexion and axial rotation in mid-and-low cervical region area:

A

coupled in ipsilateral fashion

-lateral flexion to right occurs with slight axial rotation to right and vice versa

46
Q

Approximate ROM for Thoracic Region, flexion and extension:

A

flexion: 30-40
extension: 20-25
total: 50-65

47
Q

Approximate ROM for Thoracic Region axial rotation

A

30-35

48
Q

Approximate ROM for Thoracic Region lateral flexion

A

25-30

49
Q

Approximate ROM
 for Lumbar Region, flexion and extension:

A

flexion: 40-50
extension: 15-20
total: 55-70

50
Q

Approximate ROM
 for Lumbar Region axial rotation

A

5-7

51
Q

Approximate ROM 
for Lumbar Region lateral flexion

A

20

52
Q

Total flexion between thoracic and lumbar regions:

A

85 degrees (35 thoracic, 50 of lumbar)

53
Q

Total extension between thoracic and lumbar regions:

A

35-40 degrees (20-25 thoracic extension, 15 lumbar extension)

54
Q

Total axial rotation between thoracic and lumbar region

A

-40 degree arc: sum of about 35° of thoracic rotation and 5° of lumbar rotation

55
Q

Total lateral flexion of thoracic and lumbar region:

A

-45 degrees, sum of 25° of thoracic lateral flexion and 20° of lumbar lateral flexion

56
Q

Large amount of motion in cervical spine and why:

A

large motion in all three planes, highest is axial rotation permitted at atlanto-axial joint

57
Q

Thoracic spine permits:

A

constant amount of lateral flexion: reflects general frontal plane orientation of apophyseal joints combined w/stabilzing effect of ribs

58
Q

Thoracolumbar spine, from crainial-to caudal direction permits:

A

increasing amounts of flexion and extension at expense of axial rotation

59
Q

Orientation of apophyseal joints in cervical-thoracis junction:

A

horizontal and frontal planes

60
Q

Orientation of apophyseal joints in lumbar region

A

near sagittal plane and vertical orientation

61
Q

Prevailing near-sagittal plane and vertical orientation of lumbar region naturally favor :

A

flexion and extension but restrict axial rotation

62
Q

Lumbar spine, in combination with flexion and extension of ribs:

A

forms primary pivot point for sagittal plane motion of entire trunk

63
Q

SI joints mark transition between…

A

caudal end of axial skeleton and lower appendicular skeleton

64
Q

What are the components of the pelvic ring?

A

sacrum, pair of SI joints, three bones of each hemipelvis (ilium, pubis and ischium) and pubic symphysis

65
Q

What does the pelvic ring do?

A

transfers body weight bidirectionally b/w trunk and femurs

66
Q

What does the strength of the pelvic ring depend on?

A

primarily on tight fit of sacrum wedged b/w two halves of pelvis

67
Q

What are the movements at the SI joints?

A

nutation and countermutation

68
Q

Nutation:

A

anterior sacral tilt
posterior iliac tilt
forward movement of sacral apex/anterior pelvic tilt

69
Q

Countermutation:

A

posterior sacral tilt

anterior iliac tilt

70
Q

Nutation is couped with

A

lumbar extension

71
Q

Countermutation is coupled with

A

lumbar flexion

72
Q

Mechanisms of injury for low back

A

trauma

fatigue

73
Q

What are the orientations of the trabecular design within cancellous bone?

A

one vertical

two oblique

74
Q

What compresses cancellous bone?

A

NP pressurizes & causes cartilaginous end plates of vertebra to bulge inward

75
Q

What plays the role of shock absorbers?

A

vertebral bodies

76
Q

How do end plates bulge into seemingly rigid bone?

A

design of cancellous bone

77
Q

Vertebral cancellous bone structure dominated by system of columns of bone that run…

A

vertically from end plate to end plate

78
Q

Vertical columns tied together with what?

A

smaller transverse trabeculae

79
Q

Under axial compression, as end plates bulge into vertebral bodies….

A

these columns experience compression and appear to bend

80
Q

Under extreme compressive load…

A

bending columns will buckle as smaller bony transverse trabeculae fracture

81
Q

How much of cancellous bone can rebound back to original shape?

A

95% of original unloaded shape

82
Q

What causes microdamage to trabeculae?

A

highly repetitive loads, even at low magnitudes

83
Q

What is lost in osteoporotic vertebrae?

A

transverse trabeculae are far fewer in number and smaller in diameter then longitudinal trabeculae

84
Q

When does osteporotic vertebrae begin to collapse?

A

gradually when exposed to excessive load, with serial buckling or failure of columns of bone

85
Q

Transverse trabeculae were thick and dense from…

A

weightlifters

86
Q

Schmori’s node:

A

local area of bone collapses under end plate to create a pit or crater that gradually forms

87
Q

What injury is associated with spinal compression when spine is in neutral ROM?

A

schmori’s node/end plate fracture

88
Q

What remains intact with end plate fracture?

A

AF of disc

89
Q

In an end plate fracture, if there is substantial loss of nucleus from disc, what results?

A

immediate loss of disc height & compromise of nerve root

-mimics symptoms of true herniation

90
Q

Why is end plate fracture misdiagnosed as a herniated or degnerated disc?

A

b/c in films loss of disc nucleus results in flattened interdiscal space

91
Q

What has a shell of cortical bone?

A

posterior elements of vertebrae (pedicles, laminae, spinous processes and facet joints)

92
Q

What can lead to spondylolisthesis?

A

failure of posterior elements in conjunction with facet damage

93
Q

What appears to be somewhat flexible during flexion/extension movements?

A

neural arch in general (pedicles and lamina)

94
Q

Damage to posterior elements mar be associated with what?

A

full ROM

95
Q

Repeated, cyclic full spine flexion and extension leads to fatigue within arch (repeated stress reversals) can lead to what?

A

a pars fracture- spondylolisthesis

96
Q

Patients with pars fractures do not do well with what?

A

therapeutic exercises that take spine through ROM, stability objective maybe better

97
Q

During craniocervical extension, the atlanto-occipital joint demostrates a ______ roll and ______ slide, while atlanto-axial joint demonstrates a ______tilt.

A

posterior, anterior, posterior

98
Q

During craniocervical flexion, the atlanto-occipital joint demostrates a ______ roll and ______ slide, while atlanto-axial joint demonstrates a ______tilt.

A

anterior, posterior, anterior

99
Q

C2-C7 lateral flexion, inferior articular facets on side opposite side lateral flexion slide______ and; ________.

A

superior anteriorly

Biomechanics (13 decks)

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