Spine Flashcards
Synarthrosis
immovable fibrous joint which can attenuate force but permits little to no movement (sutures-skull syndesmosis-distal tibiofibular )
amphiarthrosis
slightly movable cartilaginous joint which can attenuate force and permit more motion than a synarthrosis
(synchondrosis, symphysis-vertebral joints and pubis symphysis)
Diarthrosis
synovial-freely movable joint with articular cartilage, joint capusle and synovial fluid
types of joints
- Gliding
- Hinge
- pivot
- Condyloid
- Saddle
- Ball and Socket
Gliding joint
plane, arthrodial
the articulating surfaces are nearly flat and the motion allowed is NON_AXIAL or gliding
in the foot: intermetatarsal joint
Hinge (ginglymus)
one articular surface is concave and the other one is convex-the motion allowed is planar, hinge-like
in the foot: interphalangeal joints
pivot ( screw, trochoid)
motion occurs around one axis~ like atlanoaxial joint
Condyloid (ovoid, ellipsoid)
one articular surface is ovular convex and the other one is reciprocally shaped concave. Allowing for flexion/extension, adduction/abduction as well as circumduction
in the foot: the lesser metatarsophalangeal joints
Saddle (Sellar)
The articular surfaces are reciprocally concavoconvex (saddle shaped) allowing for motion similar to but greater than condyloid joint (the elbow)
Ball and Socket (spheroidal)
The articular surfaces are reciprocally concave and convex allowing for motion in all 3 planes
intermetatarsal joints are what type of joints?
Gliding
interphalangeal joints are what type of joints?
Hinge
atlantoaxial joint is what type of joint?
Pivot
lesser metatarsophalangeal joints are what type of joints?
Condyloid
Spine is composed of
7 cervical 12 thoracic 5 Lumbar 5 Sacral 4 Coccygeal
all of the vertebrae in the spine are separated by discs with the exception of
C1 and C2
cervical and lumbar curves on the spin are
Convex
thoracic curve on the spine is
concave
convex curves are AKA
secondary
concave curve is AKA
primary
sometimes Sacral curve can also be
anterior , concave, primary curve
kyphotic curves
anterior concavity/posterior convexity ( primary)
Lordotic curves
anterior convexity/posterior concavity ( secondary)
pregnancy increases
lordosis
scoliosis is ——plane change
Frontal
the type of vertebra determine the type of
motion
what is the motion that the thoracic spine is responsible for?
Lateral bending and axial rotation
what is the motion that the lumbar spine is responsible for?
flexion and extension with some axial rotation
the location of the axis of a joint changes as it undergoes
range of motion
instantaneous center or instantaneous axis of rotation
position of the axis at a single point along the range of motion
i.e., the instantaneous axis at the knee when the knee is fully extended will be different than then instantaneous axis when the knee is fully flexed
where does the instantaneous center of rotation lie in the spine?
within the intervertebral disc.
the disc is composed of
- nucleus pulposus
2. annulus fibrosus
what is the effect of bending and torsional stresses on the IV disc?
bending and torsional stresses increase the load on the disc which may lead to deformation and loss of function over time.
what does the Young’s law of stretch say?
if you stretch something beyond its flexibility , it will no longer return to its original shape
True/ False
IV disc has its own blood supply
True
until age 8..after which they rely on intermitent changes of pressure to provide a pumping action of fluids carrying nutrient in and wastes out .
a typical geriatric patients has approximately ——-less fluid content
35%
A young , healthy nucleus pulposes is composed of ———-water
90%
over time the disc creeps which means
it loses its ability to return back to its original shape
as the disc becomes less effective in providing shock absorption and motion
the facets have to take on more and more stress
extension gives what kind of stress
Anterior stress
Flexion gives what kind of stress
Posterior Stress
What is coupling?
consisitent association of one motion about an axis with another motion about a different axis
coupling patterns /types of motions are dependent upon
the anatomy, spinal curvature, IV disc and soft tissues
“couple” in spine means
motion patterns
“couple” in gait means
forces
a moment created by 2 equal forces parallel to each other but acting in opposite directions
Spinal movements always involve a number of
motion segments ( 2 vertebrae and soft tissues in between)
The range of motion for flexion/extension is greatest in the
cervical and lumbar segments
The range of motion for flexion/extension is highest at
L5-S1
lateral flexion is
frontal plane movement of the spine
lateral flexion is least at
L5-S1
Transverse plane rotation of the spine is minimal in
the lumbar region
lateral flexion and transverse plane rotations are ————
coupled motions-one doesnt occur without the other
Sacroiliac joint is located
just anterior to the posterior superior iliac spine of the ilium
sacroiliac joint is exposed to large stresses from the
lower extremity to axial skeleton and vice-versa
Sacroiliac joint changes in childhood
synovial joint with mobility and a pliable joint capsule
Sacroiliac joint changes in young adulthood
the joint changes from a diarthrodial to a modified amphiarthodial joint with transition from a smooth to a rough joint surface
Sacroiliac joint changes in adulthood
numerous reciprocally contoured elevations and depressions
Sacroiliac joint changes in aging
joint capsule becomes increasingly fibrosed , with less motion available and osteophyte formation is common
when a joint fuses
sacrolosis, anklosis
ligaments of sacroiliac joint …3 primary ligaments
anterior sacroiliac joint
interosseous ligament
short and long posterior sacroiliac ligaments
ligaments of sacroiliac joint- 2 secondary ligamnets
sacrotuberous ligamnet
sacrospinous lifament
sacroiliac joint motion
relatively small primarily sagittal plane motion ( rotational and translational)
0.2 to 2 degrees for rotation
1-2 mm for translation
7-8 degrees in extremes of bilateral hip motions
sacroiliac joint motion-Nutation
anterior sacral tilt with posterior iliac tilt
sacroiliac joint motion-counternutation
posterior sacral tilt with anterior iliac tilt
nutation and counternutation are ——–plane motion
Sagittal
motion can occur as
sacral on iliac rotation
iliac on sacral rotation
or both
sacral angle
the angle of superior surface of the sacrum to the transverse plane
Normal sacral angle in adult
30º
as the sacral angle increases
lordosis increases
as the sacral angle increases
the shear force also increases
gravity will try to pull off the one vertebrae inferior to it
what is structural limb length discrepancy?
a true difference between the length of one or more of the bones in one lower extremity as compared to the other lower extremity.
What is Functional(apparent, False) limb length discrepancy?
A spinal , pelvis or pedal condition causing one lower extremity to act as if it were shorter than the other lower extremity
scoliosis can be as a result of
limb length discrepancy
differences of more than 1cm ( one hip 1 cm higher than the other ) can cause
lateral flexion of the upper border of the sacral plane of 4º ( changes in 4 º which is a lot!!!)
what is compensation?
the body will attempt to correct itself for the discrepancy by posteriorly rotating the inominate bone (transverse plane) and pronating more at the subtalar joint on the longer side to produce a functional shorter limb
in other words compensation is
pronation on the longer side
supination on the shorter side
compensation ~ the more you pronate
the more you flex the knee
limb length discrepancy short side
- chronic low back pain
- anterior rotation of the inominate (hip bone)
- reduced facet angle
- tensor fascia Lata tightness and trochanteric bursitis
- subtalar joint supination
limb length discrepancy long side
- Drooping shoulder with an elevated iliac crest on the long side
- posterior rotation of the nominate
- reduced sacral angle and increased lumbar lordosis-eventual sciatica
- ilipsoas and priformis tightness
- superolateral hip joint degeneration
- subtalar joint pronation
unilaterally plantar fasciatis can be associated with
limb length discrepancy
measurement of actual limb
measure from ASIS to medial malleolus
measurement of functional limb
measure from umbilicus to medial malleolus
