Unit 4 Lecture Flashcards
How many vertebrae do each of the regions of the spine have?
cervical - 7
thoracic - 12
lumbar - 5
sacral - 5
what is the importance of curves in the spine?
they provide the vertebral column with more strength & resilience than if it was straight
what are the motions, planes, & axis of the neck & trunk
- flexion, extension, hyperextension sagittal plane, frontal axis
- lateral bending frontal plane, sagittal axis
- rotation transverse plane, vertical axis
can rotation occur between C1 and the skull?
no
nuchal line
ridge that runs horizontally along the back of the head from the occipital bone towards the mastoid process
foramen magnum
opening through which the spinal cord enters the cranium
occipital condyles
lateral to formen magnum
provides articulation with atlas C1
what are important landmarks of a vertebra?
- size
- body shape
- transverse process
- superior articular process
- vertebral notch
transverse process
attachment for muscles & ligaments
describe the spinous processes of each type of vertebrae
cervical - bifid/pronged
thoracic - long, slender, and points inferiorly
lumbar - thick & points posteriorly
describe the superior articular processes of each type of vertebrae
cervical - face medially
thoracic - face posteriorly & laterally
lumbar - face posteriorly
vertebral notch
depressions on the pedicle
intervertebral discs
- 23 in the spine
- function to absorb & transmit shock & to maintain flexibility of the vertebral column
- make up 25 % of total length of vertebral column
name the joints of the spine
- atlanto-occipital joint
- atlantoaxial joints
median atlantoaxial joint
lateral atlantoaxial joint - C2-S1
- posterior articulations on each side via facet joints
- synovial joint
describe the atlanto-occipital joint
- C1
- ring shaped with no body or spinous process
- C1 and skull articulation
- formed by the condyles of occiput articulating with the superior articular process of atlas
- strong union supports weight of head
-nodding
describe the atlantoaxial joints
- C2
- dens/odontoid process from the pivot
- articulations between the atlas & axis (3 total)
- MEDIAN ATLANTOAXIAL JOINT
- dens of axis & anterior arch of atlas
- dens of axis & transverse ligament posteriorly
- LATERAL ATLANTOAXIAL JOINT
- between the articular processes of the 2 vertebrae (inferior articular process of C1 & superior articular process of C2)
describe the articulations of C2-S1
- strong WB articulations
- articulate anteriorly on the vertebra between the vertebral bodies
facet
- a small, smooth, flat surface on a bone
- found on thoracic vertebrae at point of contact with a rib
demifacet
- “half” facet
- articulate with only half of the rib
- rib will articulate with the demifacet of thoracic vertebrae superiorly, inferiorly, and laterally
synovial joint
- formed by superior articular process of the vertebra below & inferior articular process of the vertebra above
- AKA apophyseal (where 2 or more joints join the spine) or zygapophyseal
what are the motions & plane(s) of the cervical spine facet
cervical spine facet does all motions & is located between the sagittal & frontal plane
what are the motions & plane(s) of the thoracic spine facet?
thoracic spine facet does side bending & rotation & is located in the frontal plane
what are the motions & plane(s) of the lumbar spine facet?
lumbar spine facet does flexion & extension & is located in the sagittal plane
describe the mobility & job of the cervical spine
very mobile
job is to:
allow nervous tissue to enter the vertebral canal
entrance/exit of blood vessels in the skull
freedom to have motion of the head & neck
describe the mobility & job of the thoracic spine
- less motion
job:
provide attachment for ribs
limits motion due to long spinous processes
protects the spinal cord
describe the mobility of the lumbar spine
- least amount of motion
- most motion occurs between L4 & S1
name the ligaments of the neck & trunk
- anterior collateral ligament
- posterior longitudinal ligament
- supraspinous ligament
- interspinous ligament
- nuchal ligament
- ligamentum flavum
describe the anterior collateral ligament
- runs on the anterior, outside surface of the vertebral bodies
- runs from occiput to sacrum
- prevents excessive hyperextension
- thin superiorly & thick where it fuses with the sacrum
- very strong
describe the posterior longitudinal ligament
- runs posteriorly on the inside of the vertebral foramen
- prevents excessive flexion
- thick superiorly (supports the skull) & thin inferiorly in the lumbar spine (many injuries)
- very strong in the cervical area
describe the supraspinous ligaments
runs from C7 to sacrum along the tips of the spinous processes
describe the interspinous ligaments
run between spinous processes
describe the nuchal ligament
thick & takes place of supraspinal & interspinal ligaments of cervical spine
describe the ligamentum flavum
connects adjacent laminae anteriorly
name the muscles of the cervical spine
- sternocleidomastoid
- scalene mm: anterior, middle, posterior
- prevertebral mm
- suboccipital mm
- splenius capitis & cervicis
sternocleidomastoid
O: sternum & clavicle
I: mastoid process
A:
bilateral: neck flexion, head hyperextension
unilateral: laterally bends neck & rotates to opposite side
N: accessory/cranial nn 11 (spinal root for motor) & 2nd & 3rd cervical nerves
scalene mm (anterior, middle, posterior)
- deep to superficial
- injury»_space; pain anywhere
A:
*bilaterally: assists in neck flexion
unilaterally: laterally bends neck
N: lower cervical nerve
prevertebral muscle group
- deep, tiny, anterior
- assists in neck/head flexion, maintains postural control, “tucking the chin”
I: into occipital bone & transverse processes of C1-C6
suboccipital muscles
- small, posterior
- clustered together below the base of the skull
A: head extension, lateral bending, rotation
splenius capitis
- superficial & posterior
A:
bilaterally: head & neck extension
unilaterally: laterally bend & rotate head to the same side
splenius cervicis
- deep & posterior
A:
bilaterally: neck extension
unilaterally: laterally bend & rotate neck to the same side
prime mover(s) of neck flexion
sternocleidomastoid
prime mover(s) of neck extension
splenius capitis & cervicis
prime mover(s) of head flexion
prevertebral muscle group
prime mover(s) of head extension
suboccipital group
prime mover(s) of head hyperextension
sternocleidomastoid
prime mover(s) of cervical lateral bending
sternocleidomastoid
splenius capitis & cervicis
scale muscles
prime mover(s) of same side cervical rotation
splenius capitis & cervicis
scalene muscles
prime mover(s) of opposite side cervical rotation
sternocleidomastoid
rectus abdominis
- abs: left & right separated by big, thick band of connective tissue
- can do reversal of mm action
O: pubis
I: xiphoid process & costal cartilages of 5th-7th ribs
A: trunk flexion & compression of abdomen
N: 7th-12th intercostal nerves
external oblique
- most superficial of 3
- large, broad, flat
A:
bilaterally: trunk flexion & compression of the abdomen
unilaterally: lateral bending to same side & rotation to opposite side
N: 8th-12th intercostal, iliohypogastric, ilioinguinal nerves
internal oblique
- middle of the 3
- looks like an inverted “V”
A:
bilaterally: trunk flexion & compression of abdomen
unilaterally: lateral bending & rotation to same side
N: 8th-12th intercostal, iliohypogastric, ilioinguinal nerves
transverse abdominis
- deepest of the 3
- does not move the trunk
- used during coughing, pooping, sneezing
A: compression of abdomen
N: 7th-12th intercostal, iliohypogastric, ilioinguinal nerves
erector spinae
- intermediate layer of back extensors that can be divided into 3 groups: medial, intermediate, lateral
- medial: trunk extension
- intermediate: trunk extension & lateral bending
- lateral: trunk extension & lateral bending
A:
bilaterally: trunk & neck extension
unilaterally: laterally bend trunk & neck
transversospinalis
- deepest of back extensor muscles
semispinalis span 5+ vertebrae/superficial
multifidus span 2-4 vertebrae
rotatores span 1 vertebrae/deep & short - support lumbar spine
O: transverse process
I: spinous processes of vertebrae above
A:
bilaterally: trunk extension
unilaterally: rotate to opposite side
interspinales
A: trunk extension
N: spinal nerves
quadratus lumborum
A: lateral bending
N: 12th thoracic & 1st lumbar nerves
- reversal of muscle action
prime mover(s) of trunk flexion
rectus abdominis
external & internal oblique
prime mover(s) of compression of the abdomen
- rectus abdominis
- external & internal oblique, transverse abdominis
prime mover(s) of trunk extension
- erector spinae
- transversospinalis & interspinales
prime mover(s) of lateral bending
- external & internal oblique
- erector spinae
- quadratus lumborum
prime mover(s) of same side trunk rotation
internal oblique
prime mover(s) of opposite side trunk rotation
- external oblique
- transversospinalis
what is the composition of the TMJ?
- 2 bones (temporal bone & mandible)
- a disk
- a joint capsule
- 4 ligaments
- 4 main muscles
when the mandible is at rest, its condyle sits in the ____________
mandibular fossa
describe the resting position of the TMJ
mouth closed, teeth mm apart
mastoid process
- posterior & inferior to ear
- large, bony area
what are the motions of the TMJ?
mandibular elevation & depression
lateral deviation
protrusion & retrusion
list the daily activities that the TMJ is involved in
- chewing
- talking
- yawning
- swallowing
what are the 4 main muscles of the TMJ?
Temporalis
Masseter
Medial & Lateral Pterygoid
temporalis
- broad & fan shaped
A:
bilaterally: elevation & retrusion
unilaterally: ipsilateral lateral deviation
N: cranial nerve V (5) trigeminal
Masseter
A:
bilaterally: elevation
unilaterally: ipsilateral lateral deviation
N: cranial nerve V (trigeminal)
medial pterygoid
A:
bilaterally: elevation & protrusion
unilaterally: contralateral lateral deviation
N: cranial nerve V (trigeminal)
lateral ptergoid
A:
bilaterally: depression & protrusion
unilaterally: contralateral lateral deviation
N: cranial nerve V (trigeminal)
what are the prime mover(s) of mandibular elevation?
temporalis
masseter
medial pterygoid
what are the prime mover(s) of mandibular depression?
lateral pterygoid
what are the prime mover(s) ipsilateral lateral deviation?
temporalis
masseter
what are the prime mover(s) for contralateral lateral deviation?
medial & lateral pterygoid
what are the prime mover(s) for protrusion?
medial & lateral pterygoids
what are the prime mover(s) for retrusion?
temporalis
what is the thoracic cage composed of?
- sternum
- ribs
- costal cartilage
describe the sternum
composed of
- manubrium
- sternal body
- xiphoid process (greek “sword”)
describe the ribs
- attach the posterior vertebral column to the anterior sternum
- 24 ribs, 12 on each side
true ribs (1-7) attach to sternum
false ribs (8-10) indirect attachment via costal cartilage of 7th rib
floating ribs (11-12) no anterior attachment
which structures border the chest cavity
- sternum borders anteriorly
- 12 thoracic vertebrae border posteriorly
- clavicle borders superiorly
- diaphragm borders inferiorly
describe the costovertebral joints
the ribs attach with the vertebrae at the body (facet) & transverse process
describe the costovertebral articulations
- ribs & sternum (costal cartilage in between)
nonaxial, diarthrodial gliding joints
little movement, but there is elevation & depression of the rib cage
describe the mechanics of respiration
- air flows from higher pressure to lower pressure until pressure is equalized
- lungs are passive during breathing
describe inhalation
- ribs move up & out
- diameter of chest increases > pressure decreases > air gets forced into the lungs
describe the phases of inspiration
quiet inspiration at rest/sitting quietly; diaphragm & external intercostal ribs pull up
deep inspiration increased need for O2; breathes harder
forced inspiration worked hard, needs more O2
describe exhalation
- ribs return down and in
- diameter of the chest decreases > pressure increases > air is forced out of the lungs
describe the phases of expiration
quiet expiration most passive; relaxation of external intercostals (rib cage pulled down)
forced expiration actively uses mm that pull down on the ribs, compress the abdomen, and force the diaphragm up
describe the internal & external intercostal muscles
- at a right angle to each other
- external: pull up to elevate ribs (superficial)
- internal: pull down to depress ribs (deep)
internal intercostal
expiration
O: rib below
I: rib above
A: depress ribs
N: intercostal T2-T6
runs superiorly & medially
external intercostal
inspiration
O: rib above
I: rib below
A: elevate ribs
N: intercostal T2-T6
rubs inferiorly & medially
describe the diaphragm muscle
- large & dome shaped
- separates the thoracic cavity from the abdominal cavity
- 3 openings for the esophagus, inferior vena cava, & aorta
because the muscle is mostly circular & inserts into the central tendon, & since the insertion is higher than the origin (xiphoid process, ribs, and lumbar vertebrae), the diaphragm pulls DOWN when it contracts
during contraction, the thoracic cavity becomes larger & the abdominal cavity becomes smaller
what is the action & nerve of the diaphragm?
A: inhalation
N: phrenic nerve C3, C4, C5 keeps the body alive
name the accessory muscles of inspiration
quiet
sternocleidomastoid
scalene muscles
pec major
deep
sternocleidomastoid
scalene muscles
pec major
levator costarum
serratus posterior superior
forced
pec minor
levator scapulae
upper trapezius
rhomboids
which accessory muscles of inspiration perform reversal of muscle action?
sternocleidomastoid
pec major
name the accessory muscles of expiration
quiet
quadratus lumborum
rectus abdominis
forced
quadratus lumborum
rectus abdominis
transverse abdominis
external & internal oblique
serratus posterior inferior
describe diaphragmatic breathing
- most effective method of breathing & requires the least amount of energy
- diaphragm contracts & lowers, causes the abdomen to shrink, lungs to expand, & air to flow into the lungs
- position: elevated HOB in supine, sitting, or standing
describe chest breathing
- greater effort because only upper portion of lungs is being used
- shorter breaths
- smaller volume of air drawn into lungs
- more prone to hyperventilate & faint
valsalva maneuver
- occurs when trying to exhale while holding your breathe
- causes an increase in intrathoracic pressure
- traps venous blood in veins
- when breathe is released:
- “trapped” blood quickly goes to heart which increases HR & BP
- could have no effect or lead to cardiac arrest
