Unit 1 Flashcards
What makes up the axial skeleton?
Head, neck and trunk
The apendicular skeleton consists of
Limbs that are attached to the body’s axis
Spinal column consists of: _____, ________, _____
Spine, sacrum, coccyx
A child has 33 individual segments
- ______ in the spine
- _____ in the sacrum
- _____ in the coccyx
24
5
4
The adult has 26 segments
- _______ in the spine
- ______ in the sacrum
- ______ in the coccyx
24
1
1
___________ are considered freely moveable in the adult and consists of 24 segments of the spine
True segments
________ those segments that are NOT freely moveable
False segments
What are examples of false segments
Sacrum and coccyx
What are the 6 ranges of movement of the spine?
Flexion/extension
Right and left rotation
Right and left lateral flexion
What are the 3 distinct regions of the spine?
Cervical, thoracic and lumbar
What is the most variable region as to the number if segments in it?
Lumbar
Typical spine vertebrae are divided into 2 basic parts
Anterior and posterior
The vertebral arch has an anterior and posterior part. What is the anterior arch comprised of?
The vertebral body
What is the posterior arch of the vertebral arch comprised of?
Pedicles, lamina, processes
What forms the vertebral foramen?
Pedicles, vertebral body and the lamina
What forms the neural/vertebral canal?
Several vertebral (spinal) foramen
________ is the hole that the spinal cord goes through
Vertebral foramen
______ is the largest part of the vertebrae who’s typical shape is cylindrical or square
Vertebral body
The transverse diameter of the vertebral bodies increases from _______ to_______
C-2 to L-3
The _________ of the vertebral body is slightly concave as to help form the ___________
Posterior margin
Vertebral foramen
The epiphyseal plate fuses to the vertebral body between the ages of ________ and _______
16 and 20
_________ a ring of hard compact bone that surrounds the superior and inferior surfaces of the vertebral body
Epiphyseal plate
on top of epiphyseal plate is 3 mm thick Hyaline cartilage AKA __________
End plate
The _________ is really part of the intervertebral disc
End plate
Describe the pedicles
Anterior part of the vertebral arch
2 short thick round attachments of bone that fuse to the lateral aspect of the vertebral bodies between the ages of 3 and 6
The ________ are lateral to the neural foramen
Pedicles
The ____________ is through which the spinal nerve roots leave the spinal cord
Intervertebral foramen (IVF)
The superior pedicles notch of the vertebra ________ becomes the ________ of the Intervertebral Foramen
Below; floor
The inferior pedicle notch of the vertebra _______ forms the ______ of the intervertebral foramen
Above; roof
What is pedicogenic stenosis?
Congenital shortening of on or both of the pedicles
Common in males and in the lumbar spine
___________ are angled posteriorly and medial. The close off the back of the spinal canal
Laminae
_________ is posterior and lateral to the neural foramen
Laminae
When do the laminae fuse together?
Laminae fuse together in the back during the first year of life
What is the result when the lamina do not fuse?
Spina bifida
There are three different forms of spina bifida. How does one describe meningocele?
A protrusion of the meninges through the gap where the laminae failed to fuse
What is the most severe form of spina bifida, where the meninges and the spinal cord protrude where the laminae failed to close properly?
Meningomyelocele
Explain spina bifida occulta
The mildest form of spina bifida
Results in a small separation or gap in one or more of the bones of the spine.
Can go unrecognized until X-ray
What is the least reliable area of palpation when trying to ascertain subluxation?
Spinous process
Why’s the spinous process the least reliable area of palpation ?
Because it may deviate or bed either left or right of the midline due to trauma during the cartilaginous stage of development
The tip of the spinous process fuses with the rest of the spinous process around the age of ______
16
_________ project laterally from the lamina pedicle junction and serve as attachments for muscles and ligaments
Transverse process
Muscles that attach to the __________ are mainly for maintaining posture and to induce rotation and lateral bending (lateral flexion)
Transverse process
_____________ is the true transverse process part (________ part)
Diapophysis; posterior
__________ is a costal element part of the TVP (_______ part)
Pleurapophysis; anterior
The tips of the transverse processes fuse to the rest of the TVP about age _____
16
There are _______ articular processes AKA the zygapophysis
4
There are 2 ___________ (prezygapophysis)
There are 2_____________ (postzygaphophysis)
2 superior articular processes
2 inferior articular processes
The the cervical facet of the articular processes are oriented in the __________ plane
Coronal
The thoracic facet of the articular processes are oriented in a _______ plane
Coronal
The lumbar facet of the articular process is ortiented in a _______ plane
Sagittal
What is an articular joint?
2 adjacent articular processes come together to form a joint called the articular joint
Where is the facet located on the articular process?
On the articular portion of the AP is a smooth surface called the facet
What is the articular joint surrounded by?
The articular capsule
What are the 3 parts of an articular capsule?
Inner, central layer, outer
Explain the inner part of the articular capsules
Called the synovial membrane that is filled with synovial fluid
explain the central layer of the articular capsule
Vascular and composed of loose connective tissue
Explain the outerpart of the articular capsule
Made up of connective tissue which connects to the articular processes
Rich in sensory nerve supply
(Facet joint capsule)
The articular joint is covered on the _______ _______ side by the ligamentum flavum
The articular joint is covered on the ______ _____ side by the articular capsule
Anterior medial
Posterior lateral
Why is the Z joint of added interest to chiropractors?
Because loss of motion or any abberant motion may be the primary cause of pain in this multilevel innervation
The superior articular process is considered the ______________ of the IVF
The posterior boundary or the posterior wall
The superior articular process projects _________ and ______
The inferior articular process projects
______ and _________
Superior and posterior
Inferior and anterior
How many active ranges of motion does the spine have?
6
Motion reveal ens around the 3 axes (X,Y.Z)
What are the 6 ranges of motion the spine has?
Flexion and extension (around the X- axis)
Left and right rotation (around the y axis)
Left and right lateral flexion (around the z axis
What us subluxation: spinal manipulation?
Joint manipulation comprises a high velocity, low amplitude, end range thrust maneuver
Explain mobilization
Involves manual techniques without thrust or sudden movement
Articular processes of the cervical region:
The superior articular process faces ______ and ________ and is angled at _______ degrees to the _________ plane
Posterior and superior
Angled at 45 degrees to the horizontal plane
The inferior articular process of the cervical region faces _____ and ________ and is angled at ______ degrees
Inferior and anterior at 45 degrees
Where does the overal greatest range of motion in the spine take place?
Mid cervical spine (C4,C5,C6)
Overall greatest amount of flexion and extension of a facet joint in the cervical region take place at ________
C5-C6
The articular processes of the thoracic region:
The superior articular facets face ______ and ______ and are angled at _______ degrees and rotated ______ degrees laterally
Superior and posterior
60 degrees
Rotated 20 degrees medially
Articular processes of the thoracic region:
The inferior articular facets face _______ and _______ and are at a ______ degree angle and rotated _______ degrees ______
Inferior and posterior and are at a 60 degree angle
Rotated 20 degrees medially
The articular processes of the thoracic region allow for what ranges of motion?
Allows for rotation and some flexion very very little extension
The articular processes of the Lumbar spine are considered shaped like a what letters?
C or J
Articular processes in the lumbar spine:
The superior articular facets faces _____ mainly and are ________ and rotated at _______ degrees ______
Posterior
Concaved
45 degrees medially
Articular Processes in the Lumbar Spine:
The inferior articular facets face ______ mainly and are ________ and face ______ degrees ______
Anterior
Convexed
Face 45 degrees laterally
The articular processes in the lumbar spine allow for what ranges of motion?
Flexion and extension but very little bending and very little to No rotation
The greatest amount of overall range of motion in the lumbar spine take place at ______
L-5/ S-1
The most lateral flexion in the lumbar spine occurs at
T-12/L-1
The facet joints are made up of what?
Superior and inferior articular processes
Superior articulate facet faces _______
Inferior articulate facet faces ______
Posteriorly
Anteriorly
What is the tripod theory of weight bearing?
States that the axial compression on any vertebra is bore by the vertebral BODY and the TWO Superior Articular processes
_______ support most of the weight placed on the vertebra
Vertebral bodies
Articular processes average _____ percent of the total compressive load (weight)
18%
What are the typical spinal vertebra parts?
1 body; 2 pedicles; 2 laminae; 1 spinous process; 2 transverse processes; 4 articular processes
If any of the typical spinal vertebra parts are missing, the vertebra is considered _______ to the spine
Peculiar
________ is the site of attachment that is relatively fixed
Origin
________ is the site of attachment that is normally displaced by contraction of the muscle
Insertion
What are the superficial back muscles?
Trapezius and Latissimus Dorsi
What are the middle back muscles?
splenius muscles Spinal extensors (spinalis, longissimus, Iliocostalis)
What are the deep muscles in the back that interconnect and stabilize the vertebrae?
transversospinalis group; semispinalis; multifidus, rotatores; interspinalis; intertransversari
What are extrinsic muscles associated with?
The upper extremity and shoulder movement
What are intrinsic muscles associated with?
Deal with movement of the vertebral column
__________ _______ _____ connect upper extremities to the trunk and form the V-shaped musculature associated with the middle and upper trunk
Superficial extrinsic muscles
What are the 5 superficial extrinsic muscles of the back?
Trapezius; Lat dorsi; levator scapulae; Rhomboids (major and minor)
_________ _______ _______ include 2 muscles that are associated with respiration
Intermediate extrinsic muscles
What are the two intermediate extrinsic muscles?
Serratus posterior superior and inferior
What are the 3 muscles in the second layer of extrinsic muscles?
Rhomboid major and minor and levator scapulae
The rhomboid major, minor and levator scapulae inserts into the __________ ______ ______
Scapula’s medial border
What are the elevators of the scapula?
Levator scapulae
Trapezius (upper)
Rhomboideus minor and major
What are the retractors of the scapula?
Rhomboid minor and major and trapezius (middle)
What are the upward rotators of the scapula?
Trapezius (upper and lower)
What are the downward rotators of the scapula?
Rhomboid major and minor
Levator scapulae
What are the intermediate extrinsic muscles of the back?
Serratus posterior superior and inferior
Intrinsic muscles will stretch all the way from the _______ to the ________
Pelvis to the cranium
__________ _______ help maintain posture and move the vertebral column
Intrinsic muscles
What are the 3 groups of the intrinsic muscles of the back?
Superficial layer
Intermediate layer
Deep layer
All layers of the intrinsic muscles of the back are innervated by _______
Posterior rami of the spinal nerves
What muscles are part of the superficial layer of the intrinsic muscles of the back?
Splenius capitis and splenius cervicis
Where are the superficial; layer of intrinsic back muscles located?
On lateral and posterior portions of the neck, laterally flex, rotate and extend the head and neck
What muscles are potent sources of head aches?
Splenius capitis and cervicis
Semispinalis capitis is deep to splenius capitis and is often the cause of neck pain and headaches if pain is just ______ to the __________
Lateral to the spinous process
________ _______ massive extensor consisting of 3 groups that are found from the4 sacrum to the skull
Erector spinae
_______ ______ work to extend the spine or if only one side contracts to bring about lateral flexion
Erector spinae
___________ _______ lay on either side of the vertebral column
Erector spinae
What is the job of the erector spinae group?
To extend the vertebral column and maintain the normal curvature (posture) of the spine
All of the erector spinae originate from where?
The posterior sacrum
Sacroiliac ligaments
Sacral and lumbar spinous processes
Iliac crest
The ______ ______ group are the strongest muscles in the back and take on most of the work
Erector spinae
What are the three columns of the erector spinae group?
Iliocostalis
Longissimus
Spinalis
What is the primary cause of lower back pain?
Quadratus lumborum
What is the action of the quadratus lumborum?
Lifts ilium up and its important for balance.
AKA kip hiker muscle
Where does the quadratus lumborum refer pain to?
Refers pain into the sacroiliac joint
Quadratus lumborum causes ________ ________ of the trunk and depresses rib 12
Lateral flexion
What is the largest muscle that crosses the lumbosacral joint?
Quadratus lumborum
What is the function of deep layer intrinsic back?
Help to support posture and assist intermediate muscles in moving the spine
Deep layer intrinsic back muscles includes 3 muscles known as the ________ group
Transversospinal group
What are the 3 groups of the transversospinal group of the deep layer of intrinsic back muscles?
Semispinalis group
Multifidus
Rotatores
_________ are short triangular muscles that are most prominent in lumbar. Always angle superiorly and medially for 2-4 segments
Multifidus
What is part of the deep muscles of the spine/neck more lateral than spinalis?
Semispinalis
What is the thickest and strongest in thelumbar region?
Multifidus
What are the intervertebral muscles of the back?
Interspinalis
Intertransveralis
Rotatores
What si the action of the intervertebral muscles?
Slight extension or rotation
What are the 4 suboccipital muscles?
Obliquus capitis inferior
obliquus capitis superior
rectus capitis posterior major
rectus capitis posterior minor
What does the suboccipital triangle contain?
The first cervical nerve
The vertebral artery
A complex of veins
What forms the medial, lateral and inferiro border of the suboccipital triangle?
Inferior border: obliquus capitis inferior
Lateral border: obliquus capitis superior
Medial border: rectus capitis posterior major
What suboccipital muscles does NOT take part in the formation of the triangle?
Rectus capitis posterior minor
What muscles cause cervicogenic suboccipital head aches
Suboccipital triangle (obliquus capitis inferior and superior, rectus capitis posterior major and minor)
Where are the scalene muscles located? And their function?
On the lateral aspect of the cervical spine and
serve as frontal plane stabilizers along with the longissimus muscles posteriorly when they act as a group
Where do the anterior scalene muscles run from?
The first rib to the anterior tubercles of the transverse processes of C-3 to C-6
The anterior scalene muscles work with the _______ _________ to provide stability
Levator scapulae
The ______ and _______ scalene form a triangle through which the brachial plexus and subclavian artery and vein pass
Anterior and middle scalene
the site for compression on the neuromuscular structures by the _______ ______ muscle
Anterior scalene
Where does the middle scalene run from?
The first rib to the anterior tubercles of the TVP of C-3 to C-7
What muscles are laterally placed and theirline of pull makes them excellent frontal plane stabilizers?
Middle scalene
Where do the posterior scalene muscles run from?
The second rib to the posterior tubercles of the TVP of C-3 to C-7
What is the function of the posterior scalene muscles?
Predominately laterally flex the neck
Below the age of 40, the cortex supports ____ percent of the axial compressive load placed on it
45%
After the age of 40, the cortex supports _____ percent of the axial compressive load placed on it
65%
In ______ bone the inner layer of the bone is soft and spongy
Cancellous bone
________ bone is dense, outershell of the vertebra
_______ bone is inner, spongy bone
Cortical
Cancellous
Prior to the age of 40, the cancellous bone supports ________ percent of the compressive load
55%
After the age of 40, the cancellous bone supports ______ percent of the compressive load
35%
Bone density usually increased greatly during puberty and diminishes 35-30% between the ages of ______ and ______ years of age
20 and 80
The cortex before age 40: ________ %
After age 40:_______ %
45%
65%
Cancellous bone:
Before age 40: ________%
After age 40: ________%
55%
35%
What are the functions of the quadratus lumborum?
Extend vertebral column
Laterally flex spine
What group of muscles function to rotate the spine to the opposite side?
Semispinalis (thoracis, cervicis, capitis)
What are the functions of the multifidus?
Extension
Lateral flexion, rotation of spine to the opposite side
What is the nerve supply of the multifidus
Posterior ramus of all spinal nerves
What is the nerves supply and action of the longus capitis?
Flexes neck at atlantooccipital joint
Nerve supply: C2-C-6
What is the function of the rotatores?
Rotate vertebral column to opposite side.
Help with proprioception
What is the nerve supply of the rotatores?
Posterior ramus of the spinal nerves in that area
What is between the TVPs of all the spinal vertebrae?
Intertransversari
What two muscles function to extend, lateral flexion and rotate the the head toward the same side?
Rectum capitis posterior major and minor
What is the nerve supply of the rectus capitis posterior major and minor?
Posterior ramus of the first cervical nerve
________ _______ _______ rotates atlas and skull around the odontoid process of C2. And turns head to same side.
Obliquus capitis inferior
What action does the obliquus capitis superior do?
Turns head to same side
What is the function of the scalene?
Flex neck and elevate rib cage
Laterally flexes neck
What does the middle scalene function as?
Frontal plane stabilizers
______ ____ elevates first rib, flexes and rotates cervical vert to same side
Scalenus medius
_______ ____________ elevates the first rib in inspiration and bottom part contacts and anteriorly flexes, rotates C-spine to the same side
Scalenus Anticus
What elevates the 2nd rib in inspiration, laterally flexes and rotates cervical spine to the same side?
Scalenus posterior
What is the function of interspinalis?
Extension of spinal column
What is nerve supply for the splenius muscles (cervicis and capitis)
C- 4,5,6 (7,8)
What muscle aids in respiration by raising ribs during inspiration?
Serratus posterior superior
What muscle aids in respiration by pulling down or depressing the ribs during expiration?
Serratus posterior inferior
What nerves supply the levator scapulae?
C3 and C4 and dorsal scapular nerve
What muscle helps extend the cervical spine and allows for lateral flexion and rotation of the neck to the same side. Also helps elevate the scapula?
Levator scapulae
What is the nerve supply of the latissimus dorsi?
Thoracodorsal nerve
What muscles adducts scapula so that the inferior angle of the scapula moves medially and holds scapula to the trunk?
Rhomboid major and minor
What is the nerve supply for the rhomboids?
Dorsal scapular nerve
