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Spine & Hip Kines > Spine Kinesiology > Flashcards

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
Abdominal Function
Spinal Motion: Flexion, isometric: stabilization, protect viscera, forced expiration/coughing
26
Abdominal layers: superficial to deep
rectus abdominis, external obliques, internal obliques, transverse abdominals
27
Rectus abdominis (orientation, attachments, action)
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
External Obliques (orientation, attachments, actions)
"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
Internal Obliques (orientation, attachments, actions)
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
Transverse Abndominis (orientation, attachments, action)
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
Spinal extensors (erector spinae)
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
Deep Spinal Extensors (Transversospinalis)
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
Cervical Flexion (ROM & Goniometer placement)
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
Cervical rotation (ROM & goniometric placement)
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
Cervical Lateral Flexion (ROM & Goniometric placement)
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
Cervical Extension
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
Sternocleidomasteoid MMT
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
Cervial Flexors MMT (RCA, RCL, Long. Cap, Long Cerv)
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
Cervical Extension (RCP Maj, RCP Min, Splenius Cap, Splenius Colli ,Erector Spinae Cap/Cerv, Transversospinals (Cerv/Cap)
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
Thoracolumbar Lateral Flexion (ROM, Goniometric Placement)
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
Thoracolumbar Rotation (ROM, Goniometric placement)
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
Thoracolumbar Flexion & Extension
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
Spinal Flexion MMT
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
Kendall's Test
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
Spinal Flexion & Rotation MMT
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
Spinal Extension MMT
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
Quadratus Lumborum MMT
Pt is lying supine, have them hike ipsilateral hip towards rib and try to pull down @ med/lateral maleolli, probably also recruiting obliques

Spine & Hip Kines (2 decks)

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