Unit 5 Kuchera Flashcards
Superior division of the cervical spine consits of
Occiput
Atlas
Axis
And their respective joints
In the occipitoatlanto joint, rotation and sidebending to the same side only occur
Following severe trauma or congenital defect
The Occipitoatlanto joint accounts for how much forward and back bending in the cervical spine
45 degree so half
The atlanto-axial joint accounts for how much rotation in the cervical spine
45 degree so half
The inferior division of the cervical spine consists of
C2-C7 and the synovial joints between them
In Neutral mechanics of the cervical spine ____ occurs first and then ____ follows
rotation
sidebending
In cervical spine, only difference between neutral and non-neutral mechanics is
nonneutral motion, side bending occurs before rotation but still to the same side
Sidebending of the lumbars on the sacrum engages what sacral axis
Oblique sacral axis on the side of side bending.
Definition of vertebral unit
Two adjacent vertebrae , their joints and the intervertebral discs between them
How is the vertebral unit named
Superior member of the unit (Superior vertebrae)
How is the motion of the sacrum determined
indirectly by the actions of muscles that funciton ot move the back or legs
Ganglion impar is what
Single sympathetic ganglion formed by the right and left sympathetic chains end by joining together on the ventral surface of the coccyx
Sacral promontory
Most anterior and superior projections of the 1st sacral vertebral body,
Sacral canal
Posterior to the bodies of the sacral vertebrae and medial to the sacral crest
Carries nerves of the sacral portion of cauda equina
Defect near the apex of sacrum called
Sacral hiatus and cornu
How is sacral hiatus and cornu formed
by failure of lamina of 5th sacral vertebrae to meet in the midline
Where is the opening for a epidural
Sacral hiatus and cornu
The point of change in direction of the sacrum is
Inferior lateral angle of the sacrum (ILA)
Sacrotuberous ligament attaches
Lateral to the ILA’s of sacrum and extends down to ischial tuberosities
Sacral sulcus
Space between spine of the sacrum and lateral sacral crest
Sacroiliac joints are primarily strengthened by
Anterior interosseous and posterior sacroiliac ligaments
Accessory ligaments - sacrospinous, sacrotuberous and iliolumbar ligaments
First ligament to become strained when lumbosacral imbalance is present
Iliolumbar
Lumbar spine disks are
thicker anteriorly then posteriorly to maintain normal lumbar lordosis
Both anterior and posterior longitudinal ligaments attach where
Intervertebral disks
Capsular and ligamentum flava is found where
between lamina
How many transverse axis of the sacrum are there
3;
Superior transverse axis
Middle transverse axis
Inferior transverse axis
The middle transverse axis of the sacrum is located in which plane
Horizontal plane
The sacral base rocks anteriorly and posteriorly about what axis
Middle transverse axis of sacrum
motion of sacrum during walking is around the inferior transverse axis
How many oblique axis of the sacrum are there
2
How are the oblique axis of the sacrum named
According to the side of the body toward which the superior end of the oblique axis is located at
The innominate rotates
Anteriorly & posteriorly around the inferior transverse axis of the sacrum
True pelvic ligaments
Anterior sacroiliac ligament
Interosseous sacroiliac ligament
Posterior sacroiliac ligament
Accessory pelvic ligaments
Sacrotuberous
Sacrospinous
Iliolumbar
Anatomy of Sacrotuberous ligament
Forms medial border of greater and lesser sciatic foramen
Caudally it is connected with biceps femoris tendon
Anteriorly it is continuous with the falciform
ligament which connects with obturator internus fascia
Landmark to find ILA
Anatomy of Sacrospinous ligament
Divide greater from the lesser sciatic foramen
Partial attachment for coccygeal muscle
Prudendal nerve passes under it
Help locate ischial spine for proper administration of a prudendal block
Anatomy of Iliolumbar ligament
Keeps L5 from sliding anteriorly
Allows smooth symmetry of motions between sacrum and innominate while walking
Often 1st ligament to become painful and produce symptoms when their is a decompensation of the lumbosacral region
If irritated, may produce back pain but also hernia-like pain or symptoms in inguinal area
Without strong ligaments in the lumbosacral region and sacroiliac region
Sacral base would rock anteriorly and apex posteriorly
Increasing lumbosacral angle
What ligaments keep sacral base from rocking anteriorly
Sacroiliac ligaments and iliolumbar
Movement of the sacrum about the sacral axes is produced by
Tension on the ligaments and downward effects of gravity upon those ligaments
Primary pelvic muscles
Coccygeus
Levator ani and its divisons & subdivisions
Secondary pelvic muscles
Piriformis
Obturator internus
Iliopsoas
The narrowing of what ligament leaves the posterolateral lumbar disks weak
Posterior longitudinal ligament
Which motion occurs first in neutral mechanics of the T&L spine
Sidebending
Which motion occurs first in non neutral mechanics of the T& L spine
Rotation
Somatic dysfunction in neutral mechanics of the T& L spine occurs typically over
4 vertebral segments
Somatic dysfunction of the T&L spine in non - neutral mechanics typically occurs
In a single segment. Often at transition zone.
What is spinal dysfunction?
When the spinal diagnosis does not fall into the fryette mechanical theory
