Spine Flashcards
General function of vertebral column
Support for head and internal organs
Stable attachment for all soft tissues, extremities, rib cage, and pelvis
Protection of internal organs and spinal cord
Attenuates forces from above and below
Components of vertebral column
24 freely movable and 9 fused bones
Cervical variations -
Two atypical (atlas and axis) which allow for increase AROM in rotation without compressing spinal cord
Uncinate processes
Transverse foramen
Cervical variations - uncinate joints - found at
C3 to C7
Limit lateral cervical movement
Thoracic variations - demifacets for articulation with
ribs
Thoracic variations - spinous process
Follow rules of 3
SP of T1-T3 even with TP of same level
SP T4-T6 SP found 1/2 level below TP of same level
SP T7-T9 SP one full level below TP of same level
T10 - full level below
T11 - 1/2 level
T12 - level
Atlanto-occipital joint
Synovial articulation between occiput and C1
YES joint
Atlanto-axial joint
Nonsynovial articulation between dens of C2 and anterior arch of C1
NO joint
Apophyseal or Facet joints
Synovial/diarthordial joints with capsule and synovial membrane
Guide movement of the spine
Intervertebral joints
Between IVD and adjacent sup and inf vert body
Allow mvmnt between bodies and transmits load from one vertebral segment to another
Sacroiliac joint
Diarthrosis/Synarthrosis (syndesmosis) combination
Ilial articulation is convex (covered with fibro)
Sacral articulation is concave (covered with hyaline)
Fibroadipose meniscoid
Composed of ___
Found ___
Function ___
Composed of dense CT and adipose tissue
Found at sup and inf aspects of facet joints
Protects cartilage of facet surface during extremes in motion
Inspiratory muscles
Diaphragm
Levator costarum
External intercostals
Ant internal intercostals
Forced expiratory muscles
Internal oblique External oblique TA Posterior internal intercostals Rectus abdominis
Spinal extension
Erector spinae
Transversospinalis
Interspinalis
Rotatores intertransversarii
Spinal flexion
Rectus abdominis
External obliques
Internal oblique
Psoas major
Spinal lateral flexion
Quadratus lumborum
Spinal rotation
Rotators
Internal/Ext obliques
Intertransversarii
Transversospinalis
Annulus fibrosus
Concentric layers or lamellae composed of type II collagen and fibrocartilage
65% water
Abbulus fibrosus - outer 1/3 innervated by
branches from sinovertebral nerve
Annulus fibrosus - functions to
sustain compressive, torsional, shearing, and distraction loads
Nucleus pulposus
Gel with imbiding capabilities composed of water and proteoglycans with a minimal amount of type 1 collagen
Avascular and aneural structure
70-90% water
Nucleus pulposus - function
to sustain compressive, torsional, shearing, and distraction loads
Makes up 20-33% height of vertebral column
Vertebral endplate
Continuous with annulus and nucles
Sits inside ring apophysis of vertebral body
Vertebral endplate - composed of
proteoglycans, collagen, and water as well as both fibrocartilage (side closest to disc) and hyaline cartilage (side closest to vertebral body)
Vertebral endplate - functions to
provide passive diffusion of nutrients
Capsules - facet joint
Assist ligaments in providing limitation of motion and stability of spine
Strongest in thoracolumbar and cervicothoracic regions
Capsules - sacroiliac
Synovial capsule present in surrounding joint - very prominent ant
Is lost post with posterior interossseous ligament
Thoracolumbar fascia - function
Provides stability of vertebral column when a force is applied
Acts as a corset when tension is created by contraction of abs, glutes, and lumbar mm
Nerves - Dorsal roots transmit
sensory fibers to spinal cord
Nerves - Ventral roots transmit
motor fibers from spinal cord to spinal nerve
Spinal nerves are connected centrally to spinal cord by
a dorsal and ventral root which join to become the spinal nerve in the intervertebral foramen
Spinal nerves divide into dorsal and ventral rami
Dorsal rami innervate structures of the
posterior trunk
Ventral rami
Cervical - form cervical and brachial plexuses
Thoracic - innervate anterior thoracic trunk
Lumbar - form lumbar and lumbosacral plexuses
Cervical plexus
C1 - C4
Brachial plexus
C5 - T1
Spinal nerves - Cervical spinal nerves come out
at the level above its associated vertebrae
Spinal nerves - Thoracic/Lumbar spinal nerves comes out
at level below its associated vertebrae
Spinal cord terminates at about
L1/L2 disc
Biomechanics - Spinal flexion
Upper facets glide anteroproximally and tilt forward
Biomechanics - Spinal extension
Upper facets move downward, slightly posterior, and tilt backward
Biomechanics - Side bending ???
When SB R upper facet moves down and slightly ant. L facet moves upward and slightly post
Both facets move to the left
Biomechanics - Cervical right rotation causes
facets on right to glide down and back
causing approximation of facet joints on the right
Biomechanics - lumbar/thoracic rotation
Very little
But this motion causes separation and approximation of the facet joints
If L3 rotates right, there is separation at R L3-L4 joint and approximation at left L3-L4 joint
Biomechanics - Coupled motions - Cervical
SB and Rot occur in same direction from C2 - C7
REGARDLESS of whether spine is in neutral/extension or flexion
When occiput SB, C1 rotates in opp direction
Biomechanics - Coupled motions - Lumbar/Thoracic - Neutral/Extension
Lumbar segments SB and Rot in OPP directions
SB R results in segment rotating left
Biomechanics - Coupled motions - Lumbar/Thoracic - Flexion
Lumbar segments SB and Rot in SAME direction
Biomechancis - Lumbopelvic rhythm - during flexion
spine (primarily lumbar) - goes through 60-70 of motion and then pelvis will rotate ant to allow more movement, eventually followed by flexion of hips
Biomechanics - Lumbopelvic rhythm - during extension (coming from flexed position)
Hips extend, pelvis rotates post, and then spine begins to extend
Sacroiliac joint osteokinematics - motion at SIJ joint
is limited but during gait movement takes place in multiple planes
Sacroiliac joint osteokinematics - Nutation and Counternutation is what
coupling motion that occurs between sacrum and ilium during gait
Sacroiliac joint osteokinematics - Nutation is what
A movement that involves flexion of sacrum and posterior rotation of ilium
Sacroiliac joint osteokinematics - Counternutation is what
A movement that involves extension of sacrum and anterior rotation of ilium
