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OCS Studying > Spine Anatomy > Flashcards

Spine Anatomy Flashcards

1
Q

Uncovertebral joints

A

AKA Joints of Luschka; ucinated processes C3-T1

  • lateral/superior surface of inferior vertebrae and inferolateral surface of superior vertebrae
  • Develop w/in first 12 years life, fully developed by 33
  • Guides cervical F/E, reduces SB of c-spine, prevents posterior translation of neighboring vertebrae, reinforces posterolateral aspect of IVD
  • *Impairments of uncovertebral joints unaffected by F/E
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2
Q

Tectorial Membrane:

A
  • Connects occipital bone to C2
  • superior continuation of PLL
  • Important limiter in upper cervical flexion; holds occiput to atlas
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3
Q

Alar Ligament:

A
  • dens to medial occipital condyles
  • resists flexion, C/L SB, and C/L OA rotation
  • *Insufficiency increases OA instability
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4
Q

Cervical spine Transverse Ligament:

A
  • part of cruciform ligament
  • connects C1 to Dens
  • limits flexion b/t C1 and C2
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5
Q

ALL

A

C-spine: Narrower in upper c-spine, wider in lower c-spine; firmly attached to inferior end plates but NOT to IVD; restricts extension

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6
Q

PLL

A

C-Spine: up to C2 where it is continuous with tectorial membrane; prevents disk protrusions, restrains segmental flexion

*Broader and thicker in c-spine than thoracic/lumbar

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7
Q

Ligamentum Nuchae:

A

External occipital protuberance fo C7 SP
-When OA joint flexed, tightens and pulls on deep laminae and muscular attachments AKA limits anterior translation in flexion

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8
Q

Dysfunction with shortened Rectus Capitus Anterior muscle on R

A

Decreased L translation in extension at OA

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9
Q

Suboccipital muscles:

A 
RCP Major, RCP minor, Obliques inferior, Obliques superior
-Innervated by posterior ramus C1
Strongly linked to trigeminal nerve
b-supply from vertebral artery
-RCP Major and OCI: I/L rotate head
-RCP Major and Minor: extend head
-OCS: I/L SB
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10
Q

Scalenes:

A

Anterior: C3-C6 TPs–>1st rib
Middle: C2-C7 TPs–> 1st rib
Posterior: C4-C6 TPs–>2nd rib

Ant & Middle: if neck fixed elevates first rib; if rib fixed I/L SB and C/L rotation
Post: if neck fixed elevates 2nd rib; if rib fixed I/L SBs

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11
Q

What muscle does the greater occipital nerve (C2) pierce through?

A

Semispinalis Cervicis

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12
Q

Where do nerves exit?

A

C-spine: ABOVE level (C1-2) = C2

t-spine: BELOW level (T1-T2)= T1

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13
Q

OA joint motion:

A

F/E

*Hypermobility considered if axial rotation >8 deg here

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14
Q

AA joint motion

A

rotation
–To decrease compression of vert A as rotating, I/L C1 facet moves posteriorly while C/L facet moves anteriorly (each move inferiorly)

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15
Q

C-spine Arthrokinematics for F/E, rotation, SB

A

Flexion: Superior lateral glide of IAP of superior vertebra
Ext: inferior medial glide of IAP of superior vertebra
Rotation: I/L extension (closing), C/L flexion
SB: I/L extension (closing), C/L flexion (opening)

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16
Q

C-spine flexion: 3 sequential phases

A

Initially at C4-7 (most at C6-7)
2nd at C0-2
last at C2-3, C3-4

17
Q

C-spine facet orientation, innervation, and % load bearing

A

45 deg to sagittal

  • innervated by dorsal rami
  • bear 9-25% load; if spine arthritic facets may bear 50% of load
18
Q

C spine motions at upper, middle, and lower segments

A

C0-1: 10-15 deg F/E, 8 deg SB; minimal rotation
C1-2: 10 deg F/E; 45 deg rotation; minimal/no SB
C3-7: 64 deg F 24 deg E; 40 deg SB and rotation

19
Q

T Spine AROM

A

Flexion: 6 deg
Extension: 20 deg
SB: 20-24 deg each direction

20
Q

T spine facet orientation

A

60 deg inclination from sagittal and 20 deg from frontal planes

21
Q

Disc ratios in cervical vs thoracic vs lumbar spine

A

Cervical: 2:5
thoracic: 1:5
Lumbar 1:3

22
Q

Rib TP connections vs v.body connections

A

Ribs 1-10 attach corresponding TP
Ribs 11-12 no costotransverse joints
Ribs 1, 10, 11, 12 attach to corresponding v. body only
Rib 2 attaches t T1-2, manubrium and sternum
Ribs 3-9 have superior and inferior facets that attach to superior and inferior T-spine bodies

23
Q

thoracic biomechanics: SB, with UE elevation

A

–SB: I/L translation of superior segment on inferior

With UE elevation, T-spine extends, rotates, and SB to I/L side

24
Q

Thoracic biomechanics: rotation

A

Greatest at upper T-spine, decreases with lower t-spine

  • Slight C/L glide of superior segment
  • Ribs: posterior rotation of I/L, anterior rotation of C/L
25
Q

Inspiration/expiration ribs movements

A
  • Ribs 1-10 inspiration: lateral and superior glide (pump handle) sagittal plane elevation
  • Ribs 11-12 caliper motion (bucket handle) frontal plane flaring
26
Q

Serratus Anterior influence on ribs when scapula fixed

A

Will pull ribs posteriorly

27
Q

Pec major action on ribs when humerus fixed and flexed

A

pulls rib cage anteriorly, superiorly and laterally

28
Q

What happens with shortening/hypertonicity of pec minor

A

protraction and anterior tipping of scapula

29
Q

External intercostals vs internal intercostals

A

EI: direction superoposterior–>inferoanterior; pulls lower rib towards upper rib (results in inspiration)

II: inferoposterior–>superoanterior; deep to and runs obliquely to EI; during forced expiration pulls upper rib down on lower rib

30
Q

Muscles of forced expiration

A 
-Primary:
Internal and external obliques
RA
TrA
internal intercostals (posterior)
transversus thoracics
transversus intercostals
-Secondary: Lats, Serr Post, QL, iliocostalis lumborum
31
Q

Muscles of inspiration

A 
-Primary:
Diaphragm, 
levator costorum
external intercostals
internal intercostals (anterior)
-Accessory: Scalenes, SCM, traps, SA, SP, pec major and minor, lats, subclavius
32
Q

Where does subcostal nerve supply sensory innervation to ? What can happen and cause pain?

A

Supplies abdominal wall skin, lateral hip region, and over iliac crest

Dysfunction of TL junction can cause pain in hip region

33
Q

T-spine biomechanics: flexion

A

F: IAP of superior vert glides superior and anterior on SAP of inferior

  • *Results in concomitant forward rotation of rib head at costovertebral joint
  • *Concave rib tubercle glides superiorly on convex facet on TP at costotransverse joint
  • Initiated by abdominals and continued by gravity (if unresisted) with e-spinae eccentrically controlling
  • Can also occur due to (B) scapular protraction
34
Q

t-spine biomechanics: extension

A

IAP of superior vert glides inferior and posterior on SAP of inferior vert

  • *Concomitant posterior rotation of rib head at costovertebral joint
  • *Concave rib tubercle glides inferiorly on convex facet on TP at costotransverse joint
35
Q

t-spine biomechanics: Side bending

A
  • I/L IAP of superior vert glides inferolaterally and C/L IAP glides superomedially
  • I/L ribs approximate
  • C/L ribs seperate
  • -Gradually increases from T1-T12
36
Q

Lumbar neurodynamics

A

with forward being, movement at L1-L3 roots only

-With SLR greater lumbar nerve movement at lower levels

37
Q

positions for optimal disc nutrition

A

80% disc nutrition absorbed during 1st hr

  • Sidelying or supine optimizes nutrition
  • prone not recommended unless pillow under abdomen
38
Q

lumbar disc innervation:

A

Sinuvertebral nerve and gray ramus communicans from sympathetic chain

OCS Studying (10 decks)

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