Vertebal Column

Question 1

Interdependence of curves of the spine

Answer 1

Curves are dynamically interdependent= change in position of one segment results automatically in change of position for adjacent segments- like a gear moving other gears as they move

Question 2

Flexion / extension of the vertebral column

Answer 2

In the sagittal plane

About a medial- lateral axis of rotation

Flexion: bending over to touch toes
Extension: back bend

Question 3

Lateral flexion of the vertebral column

Answer 3

In the frontal plane

About an anterior posterior axis of rotation

Trunk bending to the left and the right

Question 4

Axial rotation of the vertebral column

Answer 4

In the horizontal plane

About a vertical axis of rotation

Twisting trunk to the right and to the left

Question 5

2 main articulations of the vertebral column

Answer 5

Apophyseal (facet joints) = synovial

Interview joints= cartilaginous

Question 6

A joint’s range of motion is determined by the __________ and the _________.

Answer 6

Surface area of articular cartilage

Orientation of articular cartilage

Question 7

Apophyseal/facet vs inter body joints

Answer 7

Apophyseal/ facet joints= formed by articulation of opposing facet surfaces, synovial (designed for movements)

Interbody joints= formed by the connections between the intervertebral disc and adjacent vertebral bodies (for shock absorption)

Question 8

Structure of intervertebral joint

Answer 8

Central nucleus pulposus surrounded by an annulus fibrosus bordered superiorly and inferiority by vertebral plates

Question 9

Nucleus pulposus

Answer 9

Pulp like gel (mostly water) within an intervertebral disc

Very high GAG content

Question 10

Annulus fibrous

Answer 10

10-20 layers of collagen fibers that trap water based nucleus pulposus

Question 11

Function of IV disc

Answer 11

compression raises the pressure within the nucleus pulposus (jelly within donut wants to get out)

Pressure is directed outward into the annulus fibers, which resists displacement (the donut keeping the jelly inside)

Pressure of the nucleus is then exerted on the vertebral end plates, distributed to the next vertebral body

Amount of pressure generated in a disc - amount of displacement of nucleus pulposus

The most pressure occurs from activities required forward bending, axial rotation, and vigorous trunk muscle contraction (ex: Picking something up from the ground)

Question 12

3 important points of disc pressure

Answer 12

Disc pressures are larger when one holds a load in front of the body
———- The farther you hold an object from your body, the more force required of your trunk extensors

Lifting a load with the knees straight causes greater pressure than lifting with your knees bent
———— Straight knees requires bending your vertebral column (bad)

Sitting in a forward slouched posture produces greater pressure than when sitting up

Question 13

A fusion of C1 and C2 would result in limitation of what motion?

Answer 13

Axial rotation

Question 14

Anterior pelvic tilt

Answer 14

Force couple between hip flexors and back extensor muscles
muscles

Results in increased lordosis and lumbar extension

Question 15

Posterior pelvic tilt

Answer 15

Force couple between hip extensors

Results in decreased lordosis and lumbar spine flexion

Question 16

The primary muscle controlling forward bending of the trunk is:

Answer 16

Erector spinae! Using eccentric control

Question 17

Erector spinae muscles:

Bilateral concentric activation?

Bilateral eccentric activation?

Unilateral activation?

Answer 17

Bilateral concentric activation: extends the spine

Bilateral eccentric activation: controls the descent of the trunk into flexion (when bending over)

Unilateral activation: ipsilateral lateral flexion and axial rotation

Question 18

Transversospinalis

Bilateral concentric activation?

Bilateral eccentric activation?

Unilateral activation?

Answer 18

Bilateral concentric: extends the spine

Bilateral eccentric: controls the descent of the spine into flexion

Unilateral activation: contralateral axial rotation

Question 19

Abdominal muscles

Bilateral activation?

Unilateral activation?

Answer 19

Bilateral activation: flex the thoracic and lumbar spine, posterior lay tilting the pelvis (like in a crunch)

Unilateral activation: lateral flexion

Question 20

Muscles produce an __________ amount of force on proximal and distal ends.

Answer 20

Equal

Question 21

Quadratics Lumborum:

Bilateral activation?

Unilateral activation?

Answer 21

Bilateral activation causes extension

Unilateral activation causes ipsilateral lateral flexion

Question 22

If a patient had a right CVA with left hemiplegia (paralysis of the left side), in which direction would the trunk of the patient lean?

Answer 22

Patient would lean to the RIGHT

Unilateral activation causes lateral flexion

In an attempt to restore normal posture, you would stretch the trunk to the LEFT to try to activate the left erector spinae muscles

Question 23

In what ways can you reduce force demands while lifting?

Answer 23

Reduce the weight of external load

Or reduce the length of the external moment arm- bring the load closer to your body

Question 24

Sternocleidomastoid :

Unilateral activation?

Bilateral activation?

Answer 24

Unilateral activation: ipsilateral flexion and contralateral rotation
Ex: Torticollis

Bilateral activation: flexion of the cervical spine and extension of the head
Ex: protraction

Question 25

Longus Coli & Capitis:

Answer 25

Provide critical element of vertical stability

Highly active during chin tucks (retracting the head)

Question 26

Scalenes

Answer 26

Provides vertical stability to mid-lower cervical spine

Accessory muscles of respiration

Question 27

Selenium capitis & cervicus:

Unilateral activation?

Bilateral activation?

Answer 27

Unilateral activation: extension

Bilateral activation: ipsilateral lateral flexion and axial rotation

Question 28

When you’ve been in a forward head posture (slouching) you feel a pain in your neck. Which muscle is experiencing increased strain?

Answer 28

Splenius muscles

Question 29

Stabilizing the head and the neck

Answer 29

30 muscles across the region

Question 30

Forward head sets off a cascade of faulty posture:

Answer 30

Increased stress on posterior muscles is needed to support the weight of the forward head (splenius)

Anterior muscles are shortened (sternocleidomastoid)