Spine Kinesiology Flashcards

1
Q

Rib articulations

A

Costovertebral (radiate ligament),
Costotransverse (costotransverse ligament)
Costosternal ( 2 articulations: costochondral as well as chondrosternal, calcify as we age; ribs 8,9,10 share cartilage)

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2
Q

Limitations of Thoracic Motion

A

Ribs, larger vertebral bodies, spinous processes, ligamentous network,, orientation of zygapophyseal joints

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3
Q

Most Flex/Ext in thoracic spine found in….

A

Lower thoracic spine, T9-T12

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4
Q

Most rotation in thoracic spine

A

upper thoracic T1-T8

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5
Q

Most lateral flexion in thoracic spine

A

throughout but moreso in upper, linked with rotation (ex: if you laterally flex to R, vertebra rotate to L to make room for spinous processes)

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6
Q

Lumbar Kinematics

A

Flexion/Ext predominate

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7
Q

motion at L4-S1

A

mostly flex/ext

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8
Q

motion in upper lumbar L1-L3

A

rotation

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9
Q

lateral flexion in lumbar…

A

limited, but linked to rotation ie upper lumbar

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10
Q

Sacral Angle

A

S1, angle formed by line that goes across S1 and another that is parallel to floor, usually 30’, if larger, more likely to have spondylolysthesis

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11
Q

Effect that pelvic tilting (ant/post) has on sacral angle

A

Anterior tilt=increase angle, posterior tilt= decrease angle

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12
Q

Ilium articulates with

A

S1, S2, S3 (S4 down is synarthrodial), creating the Sacroiliac joint

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13
Q

nutation/ counternutation

A

nutation= sacral flexion (S1 forward, S5 back), counternutation= sacral extension (S1 backwards, S5 forward)`

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14
Q

Ligaments of SI Joint

A

Ant & Post SI joints, Sacrospinous (sacrum to posterior iliac spine), sacrotuberous (sacrum to ischial tuberosity), iliolumbar (lumbar to ilium)

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15
Q

Which ligament creates the greater sciatic foramen and what passes through it?

A

sacrospinous ligament, the piriformis and sciatic nerve pass through the greater sciatic foramen

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16
Q

Which ligament creates the lesser sciatic foramen?

A

sacrospinous superiorly and sacrotuberous inferiorly

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17
Q

Anterior Longitudinal Ligament (ALL)

A

runs along the anterior portion of the vertebral body from C2-sacrum, prevents hyperextension of spine (shortens with flexion, lengthens with extension)

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18
Q

Posterior Longitudinal Ligament (PLL)

A

runs along the posterior portion of vertebral bodies with the lamina, prevents hyperflexion (shortens with extension, lengthens with flexion), not as extensive as ALL which is why posterior disc herniations are more common than ant

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19
Q

Ligamentum Flavium

A

ligament within the spinal canal, posteriorly located from C2-sacrum, runs along the L and R lamina, checks hyperflexion (shortens with extension, lengthens with flexion)

20
Q

Interspinous Ligaments

A

btw spinous processes, segmental btw vertebrae, shorten with extension, lengthen with flexion, from cervial to lumbar vertebrae

21
Q

Intertransverse Ligaments

A

Segmental, btw transverse processes (each vertebra has 2, L and R), prevent lateral hyperflexion, in C, T, L, most developed un Lumbar region

22
Q

Supraspinous Ligament

A

C7-sacrum (cont with nuchal ligament form Occiput-C7), continuous, prevents hyperflexion

23
Q

Atlantocruciform Ligament

A

C1-C2, odontoid process of C2>Arch of C1, stabilizes AA joint

24
Q

Alar ligament

A

BTW Odontoid process to occiput, stabilizes AO & AA Joints

25
Q

Abdominal Function

A

Spinal Motion: Flexion, isometric: stabilization, protect viscera, forced expiration/coughing

26
Q

Abdominal layers: superficial to deep

A

rectus abdominis, external obliques, internal obliques, transverse abdominals

27
Q

Rectus abdominis (orientation, attachments, action)

A

straight sup/inf orientation, from costals 5-7 & zyphoid process to pubic symphysis, R/Lsides separated by linea alba, also has 3/4 tendinous inscriptions which help bind the muscle down& generate more tension, Acts as spinal flexor and lateral flexor, posterior pelvic tilt when stabilizing upper abs

28
Q

External Obliques (orientation, attachments, actions)

A

“hand in pocket orientation”, from pubic bone, linea alba & ant iliac crest to inferior surface od inferior 8 ribs,
Act: flex laterally, rotates contralaterally when stabilize pelvis, ipsilateral rotation when stabilize trunk & rotate pelvis, good stabilizers

29
Q

Internal Obliques (orientation, attachments, actions)

A

Perpendicular to External Obliques, from lat 2/3 of inguinal ligament, iliac crest, lumbo-dorsal fascia, and lower 3 ribs to linea alba,
Act as flexor, lateral flexion, ipsilateral trunk rotation when pelvis stabilized, contralateral when trunk stabilized

30
Q

Transverse Abndominis (orientation, attachments, action)

A

oriented transversely, from thoracolumbar fascia, iliac crest, ribs 7-12, lateral 1/3 inguinal ligament to linea alba Act: pulls umbilicus in, “corset”, stabilization, coughing, forced expiration

31
Q

Spinal extensors (erector spinae)

A

extension, lateral flexsion, and ipsilateral rotation, attach central-inferior to superolaterally, stabilizers, anti-gravity
Spinalis: most central, Capitis (AO), cervicis, thoracic
Longissimus: in between, capitis (AO), cervicis, thoracis
Iliocostalis: most lateral, (cervicis, thoracic, lumborum

32
Q

Deep Spinal Extensors (Transversospinalis)

A

deep so more stabilizers than anything, attached inferolaterally and superocentrally, contralateral rotation, extension, and lateral flexion
Semispinalis: Capitis (AO), cervicis, thoracis trans>spinous process (sup)
Multifidis: Sacrum to C4, very deep, like semispin.
Rotatores: inf lamina to sup spin process, cervial and thoracis, dont cross AO
Interspinalis: paired on each side of spin proc, can extend but mostly stabilize
Intertransversari: mainly stabilize but can flex laterally, cerv, thorac, and lumb

33
Q

Cervical Flexion (ROM & Goniometer placement)

A

0-45’-60’, pivot @ external acoustic meatus, static arm perp to ceiling (or floor), moving arm at nose level, if gravity goniometer then on superior aspect of cranium, tape measure chin to suprasternal notch

34
Q

Cervical rotation (ROM & goniometric placement)

A

0-60-80’, for goniometry, stand above pt, pivot in center of cranium, static arm in line w/acromions(0’), moving atm in line w/nose, tape measure chin to acromion, gravity gonionemeter: pt lies supine and goniometer on forehead)

35
Q

Cervical Lateral Flexion (ROM & Goniometric placement)

A

0-45’, pivot @C7, static arm perpendicular to floor (line w/spinous processes), moving arm lines up w/top of occiput, gravity goniometer on top of head, tape measure from mastoid process to acromion

36
Q

Cervical Extension

A

0-60’-70’, pivot@ External acoustic meatus, static arm perpendicular to floor, moving arm in line w/nose, gravity goniometer at top of head, tape measure chin to suprasternal notch

37
Q

Sternocleidomasteoid MMT

A

CN11, (C2,C3), supine, head rotated to side testing, ask to rotate to opposite side and lift, light resistance on temple, substitution: trunk rotation& flex

38
Q

Cervial Flexors MMT (RCA, RCL, Long. Cap, Long Cerv)

A

C1-C8, chin to chest (AO Flex) and lift off table, gentle pressure on forehead (make sure tuck chin), Grav Elim: sidelying, difference btw 3-2 is ROM

39
Q

Cervical Extension (RCP Maj, RCP Min, Splenius Cap, Splenius Colli ,Erector Spinae Cap/Cerv, Transversospinals (Cerv/Cap)

A

Pt prone w/head off table in a little flexion, extend neck up, apply light flexion on occiput, if very weak dont have them lie off table just see if they can lift forehead off table when supproted (MMT=2)

40
Q

Thoracolumbar Lateral Flexion (ROM, Goniometric Placement)

A

0-25-35, standing, feet shoulder width, pivit @SI Joint, Static Arm @ gluteal cleft or perpendicular to floor, moving arm in line w/C7,
measuring tape: finger tips to floot
Gravity Goniometer: @ spinous process of C7

41
Q

Thoracolumbar Rotation (ROM, Goniometric placement)

A

0-35-45’, Pt is seated, pivot @ center of cranium, static arm in line w/ASISs, Moving arm in line w/Acromions, Gravity goniometer: spinal flexion and rotation

42
Q

Thoracolumbar Flexion & Extension

A

Flex: 0-60’, Ext: 0-20, Best w/gravity goniometer placed between C7/T1 in frontal plane, STABILIZE PELVIS and flex/extend
linear measurement: measure distance between C7 and S1

43
Q

Spinal Flexion MMT

A

Rect Ab + obliques: pt is supine, legs extended, hands behind head, “curl up and lift shoulder blades off table”=5, w/arms across chest=4, w/arms @ side=3, 2=arms at side w/o lifting scapulae or post pelvic tilt, 1=palpable contraction w/cough

44
Q

Kendall’s Test

A

higher level MMT for abs, pt is supine, lift legs to 80’ w/post pelvic tilt then slowly lower legs, MMT3=75’, 3+=60’, 4-=45’, 4=30’, 4+=15’, 5

45
Q

Spinal Flexion & Rotation MMT

A

Int & Ext Obliques, same criteria as flexion (5=hands behind head, 4=cross chest, 3=at side, etc) but only one shoulder and elbow that are twisting near to clear table

46
Q

Spinal Extension MMT

A

Spinal Extensors, pt is prone, hands behind head, lift & clear chest from table, add pressure between scapulae & if held=5, break w/push=4, arms @ side=3, for only thoracic, then have neck & top of chest off table& have pt clear table

47
Q

Quadratus Lumborum MMT

A

Pt is lying supine, have them hike ipsilateral hip towards rib and try to pull down @ med/lateral maleolli, probably also recruiting obliques