thoracic spine/ abs Flashcards
4 factors that limit mobility in thoracic spine
- ribs (limit rotation and lat flexion)
- larger bodies and spinous processes (joint surfaces approximating during extension)
- ligamentous network and joint capsules
- orientation of zyagopophyseal joints- when facets articulate with eachother sliding and gliding occurs is less
movement of thoracic spine (3)
(axis and plane)
- flex/extend = x axis in saggital plane
- rotation = y axis in transverse plane
- lat flexion = z axis in frontal plane
3 ribs articulations
ribs articulating with thoracic vertebrae
- costovertebral = head of rib articulating with side of vertebral bodies, on demi/hemi facet
- costotransverse = tubercle of rib articulating with costal facet on TP
ribs articulating with sternum
3. costosternal articulations
costovertebral and costotransverse articulations (3)
both articulations are:
- diarthrodial joints
- when our ribs elevate it increases med -> lat diameter and up and down
- uniaxial joint = ribs rotates on long axis (because of costotransverse articulation)
costosternal articulations (3)
- in 2 portions: costochondral - rib to cartilage
chondrosternal- cartilage to sternum - amphiarthrodial- some movement/ give in cartilage
- 8,9,10 have shared cartilage
Thoracic spine kinematics
where does flex/extension occur in thoracic spine?
where does rotation occur in thoracic spine?
- most flexion/extension occurs T9-T12
2. more rotation in upper thoracic spine
Lumbar spine kinematics
what movement dominates and why (2)
where does extension take place vs. lat flex/rotation (2)
- flex/ext predominates because:
- the way zyagopophyseal joints are orientated
- L4-S1 is where more extension takes place
- lat flex/rotation is in upper lumbar spine
rhythm of laterally bending thoracic spine (5)
linked movement and what happens during bending
- lateral flexion is linked with rotation
- upper thoracic spine bend to right, ribs bend to right
- spinous process moves to left
- RIGHT ribs will be prominent posterior LEFT ribs will be prominent anterior
- kyphosis/lordosis are the reason for coupled rotation
Sacral angle
What bones are involved?
What is the angle
and what happens if its tooo large?
- L5-S1
- sacral angle is 30 degrees- formed by a line from top of S1 and a line that is parallel to floor
- people with congenitally larger angle (S1 has greater slope) can cause spondylolisthesis - vertebrae sheer each other and vertebrae is dislpaced.
linked motions in lumbar spine (3)
lat flexion (2)
rotation (1)
- lat flexion/ rotation in upper lumber spine is linked with lower thoracic spine
- laterial flexion linked with flexion (subtle)
- rotation linked with contralateral flexion
SI joint basics (4)
sacral flexion/ extension (2)
- posterior portion of ilium connection to S1, S2, S3
- common area of pathology
- diarthrodial
- uniaxial motion of nutation and counter-nutation
- nutation (sacral flexion) - S1 moves forward while S5 moves back = anatomic standing posture
- counter nutation - sacral extension, S1 moves back while S5 moves forward
pelivc tilting:
point of reference
what happens to PSIS, pubis symphysis and sacral angle?
- ASIS is point of reference
- bringing pelvis forward = anterior pelvic tilt
PSIS goes up
pubis symphysis goes back
sacral angle increases - posterior pelvis tilt
S1 slope will be more horizontal (sacral angle decreases)
pelvic ligaments (4)
- anterior and posterior sacral ligament
- sacrospinous ligament- from sacrum to iliac spine
- sacrotuberous ligament - binds sacrum to pelvis
- iliolumbar ligament - from lumbar vertebrae to insert on back of ilium
fused sacral vertebrae (2)
type of joint and function
- synarthrodial
2. transfer weight bearing from lower extremity and spine
sacrotuberous ligament (2)
- binds sacrum to pelvis (ilium and ischium)
2. creates lesser sciatic foramen
sacrospinous ligament (3)
- between sacrum and isichal spine
- creates greater siatic foramen
- sciatic nerve and BV go thru there
7 Spinal ligaments
- anterior longitudinal ligament (all)
- posterior longitudinal ligament (pll)
- ligamentum flavum
- interspinous ligament
- supraspinous ligament
- intertransverse ligaments
- radial ligament
iliolumbar ligament
- gives stability to where lumbar spine is connected to sacral spine
posterior longitudinal ligament (4)
- C2 -> sacrum
- posterior, runs continous- but not as much as ALL ** which is why herniations are posterior or lateral*
- flexion will lengthen, extension will shorten
- prevents hyperflexion
anterior longitudinal ligament (4)
- C2 -> sacrum
- runs continually on ant portion of vertebral bodies
- flexion shortens (extension lengthens)
- prevents hyperextension
interspinous ligament (3)
- C,T,L
- interrupted ligament, not continous- segmentally thru each level of spinous process
- lengthens in flexion, shortens in extension
ligamentum flavum (2)
- runs continuously inside the lamina on the L and R sides
2. lengthens with flexion => prevents hyperflexion
intertransverse ligaments (5)
- interrupted
- laterally and posterior situated
- lengthens in flexion
- main function is to add stability btwn vertebrae
- most developed in lumbar spine
supraspinous ligament (4)
- C7- sacrum
- nuchal ligament is the extension of supraspinous ligament cephaly
- runs continuously down the spinous processes
- lengthens in flexion (prevents hyperflexion)
2 Cervical ligaments
- atlanto cruciform ligament
2. alar ligament
radial ligament
- stabilized costovertebral
alar ligament (2)
- runs btwn odontiod process and occiput
2. stabilizes AA and AO
atlantocruciform ligament (2)
- runs btwn C2 and C1 (from odontoid process and inserts into arch of atlas
- stabilizes AA joint
4 layers of abdominal muscles (superficial -> deepest)
superficial -> deepest
- external obliques
- internal obliques (perpendicular too external)
- rectus abdominis
- transverse abdominis (horizontal)
3 functions of abdominals
- spinal motion = flexion
- stabilize spine (isometrically contract when lifting)
- protect viscera (organs)
external obliques
basics (3)
movements (4)
- “hand in pocket” orientation
- attachment = linea alba, public bone and ant portion of iliac crest -> back of ribs (inferior surface of lower 8 ribs)
- good stabilizers
movements: - flexion
- lateral flexion
- rotators - contralateral rotation = trunk on pelvis
ipsilateral = pelvis on trunk - hike pelvis up (with quadratum lumborum)
rectus abdominis
basics (3)
movements (3)
- straight orientation
- attachment = costal cartilage of ribs 5-7, xyphoid process -> pubic symphysis
- horizontal tendons bind them down - linea alba down the middle. this stomps them from shortening excessively when u contract them
movements: - flexion
- lateral flexion
- attachment on pelvis stabilizes upper portion and does posterior pelvic tilt
transverse abdominals (4)
- important for stabilization, coughing, forced expiration
- attachments = throacolumbar fascia, iliac crest, lower ribs 7-12, lateral/ upper 1/3 inguinal ligament -> linea alba
- forced expiration excerices recruit it
- engage when lifting, help keep spine aligned
internal obliques
basics (3)
movements (3)
- perpendicular to external obliques
- attacment= come from lateral/ upper 2/3 inguinal ligament, iliac crest, lower 3 ribs -> up to linea alba
- good stabilizers
movements: - flexion
- lateral flexion
- rotation = contralateral = pelvis on trunk
ipsilateral = trunk on pelvisd
transverseospinalis
basics (2)
movements (3)
- deeper than erector spinae => more stabilizers than mobilizers
- orientation - lateral inferior and move up and central
movements: - affect rotation
- contralateral rotation
- extension
erector spinae
basics (3)
movements (3)
- superficial stabilizers, and anti-gravity (especially in t-spine)
- multi-joint
- orientation- interior centrally attached, up lateral movements:
- ipsilateral rotation
- lateral flexion
- extension
3 sections of erector spinae
- spinalis (medial)
- longissumus (central)
- illiocostalis (lateral)- don’t cross AO
transverseospinalis muscle groups (5)
- semispinalis - run from TP below to spinous process above (thoracis, cervicis and capitis)
- multifidus- between sacrum and C4 (deep)
- rotatores - cervical and thoracis (not cross AO joint)
- interspinalis (vervical, thoracis, lumbar)
- intertransverserii (cervical, thoracic, lumbar)
What two muscles do hip hiking
- Quadratus lumborum
2. External obliques
