Thoracic, Rib Cage, Lumbar and Pelvis Flashcards
what makes ribs T1, T10-12 atypical?
- T1 spinous process is long and prominent
- T12 → thoracic-like superior facet, inferior facets are more lumbar-like
- have full costal facets rather than demifacets
what is the significance of thoracic vertebral pedicles having a different orientation?
they face posteriorly not laterally
results in narrowing of vertebrae canal
what are the available osteokinematic motions at the thoracic spine?
- flexion/extension
- lateral flexion
- rotation
what limits flexion in the thoracic spine?
tension in several ligaments including:
- posterior longitudinal ligament
- ligamentum flavum
- interspinous ligaments
- joint capsule of facets
what limits extension in the thoracic spine?
contact of spinous processes, laminae, facet joints and tension from anterior longitduinal ligament, facet joint capsules and abdominal muscles
what limits lateral flexion in the thoracic spine?
facets and ribs
what limits rotation at the thoracic spine?
rib cage
describe the arthrokinematics for flexion in the thoracic spine at the intervertebral and facet joints
- facet joint
- anterior and superior glide bilaterally
- intervertebral
- anterior tilting of superior vertebrae
describe the arthrokinematics for extension in thoracic spine at the intervertebral and facet joints
- facets
- posterior and inferior glide
- intervertebral
- posterior tilting of superior vertebrae
T/F: flexion and extension are more limited in the lower T-spine than in the upper T-spine
FALSE
more limited in upper T-spin (T1-T6) due to rib cage rigidity and facet orientation
describe the arthrokinematics for L sidebending in the thoracic spine at the facet and intervertebral body joints
- facets
- contralateral facet → superior glide
- ipsilateral facet → inferior glide
- intervertebral body
- lateral tilt to the L
describe the arthrokinematics for R rotation in the upper thoracic spine at the facet and intervertebral body joints
- facet
- contralateral side → anterior slide with superio glide
- ipsilateral side → posterior slide with inferior glide
- interbody
- R rotation
describe the arthrokinematics for L rotation in the lower thoracic spine at the facet and interbody joints
- facets
- contralateral → anterior glide with inferior glide
- ipsilateral → posterior glide with superior glide
- interbody
- rotate to the L
In the upper Thoracic spine how is rotation and side bending coupled?
same direction
R rotation = R side bending
during L rotation in T3-T4, which facet will be gapping and which will be approximating?
- gapping → contralateral
- anterior with superior glide
- approximation → ipsilateral side
- posterior with inferior glide
during L rotation in T8-T9, which facet will be gapping and which will be approximating?
- gapping → ipsilateral side
- posterior with superior glide (side bending to R)
- approximating → contralateral side
- anterior with inferior glide (side bending to R)
what can cause hyperkyphosis?
- trauma
- abnormal growth/development of vertebrae
- severe DDD
- marked osteoporosis
what kind of joints make up the sacroiliac joint?
overall it is a compound joint
- anterior portion → synovial planar
- posterior portion → syndesmosis
what muscles help reinforce the anterior portion of the pubic symphysis?
- transversus abdominis
- rectus abdominis
- internal oblique
- adductor longus
describe the arthrokinematics for flexion in the lumbar spine at the facet and interbody joints
- facets
- anterior and superior gliding (gapping)
- interbody
- anterior tilting
describe the arthrokinematics during extension of the lumbar spine at the facet and interbody joints
- facets
- posterior and inferior glide (approximating)
- interbody
- posterior tilt
where does the greatest amount of motion occur in the lumbar spine?
inferior segments for all sagittal plane motions
describe the arthrokinematics during L3-L4 R sidebending at the facet and interbody joints
- facet
- contralateral side → superior glide
- ipsilateral side → inferior glide
- interbody
- R tilt
how is rotation and side-bending coupled in the lumbar spine?
it is inconsistent in research
BUT
we know that if you start in a neutral spine, then side-bending and rotation are coupled in the OPPOSITE direction
if you are starting with a neutral Lumbar spine
where would facet gapping occur during L sidebending?
- gapping → ipsilateral side (L)
- approximation → contralateral side (R)
describe the arthrokinematics during L rotation of the L2-L3 at the facets and interbody joints
- facets
- contralateral side → anterior slide (approximate if started in neutral)
- ipsilateral side → posterior slide (gap if started in neutral)
- interbody
- L rotation
where does the greatest amount of motion occur for the Lumbar spine with side bending and rotation?
superior lumbar segments
what is lumbo-pelvic rhythm?
the relationship of the lumbar spine and the hip joints that occurs with flexion and extension
what is the normal lumbo-pelvic rhythm for flexion?
initially lumbar flexion followed by anterior tilting of the pelvis
what is lumbo-pelvic rhythm for extension?
posterior tilting of the pelvis followed by lumbar extension
what is a consequence of imparied lumbo-pelvic rhythm?
reduced ROM
what are the 2 phases typical to a situp?
Trunk flexion phase
hip flexion phase
what is an altered pattern that can occur during a situp?
weak abdominals result in early hip flexion due to hip flexors dominance of the activity
what are 3 strategies that should be applied to have better lifting mechanics?
- reduce velocity of lift
- reduce magnitude of external load
- reduce length of extensor moment arm
what terms are used to describe the movement of the pelvis (innominate bones)?
- anterior pelvic tilt → ASIS and pubic move inferiorly
- posterior pelvic tilt → ASIS and pubic move superiorly
what terms describe the movement of the sacrum on the pelvis?
- nutation
- counternutation
what is nutation?
sacral promontory → moves anteriorly and inferiorly
sacral apex → moves posteriorly and superiorly
what is counternutation?
sacral promontory → moves posteriorly and superiorly
sacral apex → moves anteriorly
how does nutation provide stability?
it will result in increased compression of the SI joint making it more stable
how does utilizing a lumbar role during sitting postively impact the lumbar spine?
without one our lumbar spine flexes more which increase the pressure on the anterior disc causing it shift disc material posteriorly
