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Applied Kinesiology > Week 2 > Flashcards

Week 2 Flashcards

1
Q

List the 2 primary curves and the 2 secondary curves

A

2 primary - kyphotic

  • thoracic
  • sacral

2 secondary - lordotic

  • cervical
  • lumbar
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2
Q

How do the secondary curves develop?

A

developed as we grow (tummy time) then continue to develop as we develop to crawling and sitting

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3
Q

What is the advantage of a curved vertebral column as opposed to a straight rod?

A
  • allows for transmission of forces - increased ability to resist compressive load
  • area of transitions are weaker
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4
Q

Define what the motion segment is

A
  • functional unit of the spine

- consists of any 2 adjacent vertebrae, intervertebral disc, and soft tissue that secures them

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5
Q

Describe what happens in a bilateral fracture at the pars interarticularis. Where is this most likely to occur in the spine and why?

A
  • fractures occurs because of insufficient cortical bone
  • results in forward slipping of vertebra (spondylolisthesis)
  • most common at L5/S1
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6
Q

What transmits tension and bending forces from posterior elements to vertebral body?

A

pedicles

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7
Q

What is the portion of laminae between superior and inferior articular processes? What stress is it subject to?

A
  • pars intearticularis of Laminae

- subject to bending forces

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8
Q

What forms the articular pillar?

A

articular processes AKA zygapophyseal joint

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9
Q

What is the function of lamina?

A

transmit forces from the articular, transverse and spinous processes to the pedicles

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10
Q

What determines size of intervertebral discs?

A

amount of motion and magnitude of the load that is being transmitted

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11
Q

How is available motion determined in intervertebral disc? Where is motion the greatest-least?

A
  • ratio of disc height to vertebral body height
  • larger ratio = greater movement
  • greatest in cervical, lumbar, then least in thoracic
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12
Q

What activities and body positions place the most amount of pressure on the intervertebral discs? How can you use this information when educating patients on lifting mechanics?

A
  • high disc pressure when holding load in front with forward bending
  • slouching produces greater disc pressure than sitting erect
  • used to teach proper lifting and sitting techniques to reduce disc pressure
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13
Q

What 2 factors affect available motion of articular process and facets?

A

shape and orientation

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14
Q

What is the function of anterior longitudinal ligament?

A
  • limit extenision

- reinforce anterolateral portion of anulus fibrosus and anterior aspect of intervertebral joints

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15
Q

What is the function of posterior longitudinal ligament?

A
  • limits forward flexion and reinforces posterior portion of the anulus fibrosus
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16
Q

What is the function of ligamentum flavum?

A

limits forward flexion, particularly in lumbar

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17
Q

What is the function of interspinous ligaments?

A

limits forward flexion

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18
Q

what is the function of supraspinous ligaments?

A

limits forward flexion

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19
Q

What is the function of intertransverse ligaments?

A

limits contralateral lateral flexion

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20
Q

What is the function of facet joint capsules?

A

limits motion and adds stability

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21
Q

describe joint coupling

A

association of one motion around an axis with another motion around another axis
ex: lateral flexion and rotation

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22
Q

Coupling patterns vary based on what?

A
  • spinal posture
  • spinal curvature
  • orientation of articulating facets
  • fluidity/elasticity/thickness of the discs
  • extensibility of the muscles, ligaments, and joint capsules
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23
Q

what part of motion segment determines magnitude of movement?

A

interbody joints - distributes load and creates space for movement and passage of the spinal nerve roots

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24
Q

what part of motion segment determines direction of movement?

A

facet joints - “train tracts” that are influenced by geometry, height, and spinal orientation

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25
Q

List the osteokinematic motions that occur in the vertebral column

A
  • flexion/extenison
  • lateral flexion/sidebending
  • rotation
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26
Q

When describing the arthrokinematics motion occurring at a motion segment we are describing the motion that is occurring by which segment moving on which segment?

A

superior segment on inferior segment

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27
Q

When we move into flexion, what happens to the posterior aspect of the motion segment? What happens to the anterior aspect of the motion segment?

A
  • anterior tilt and anterior glide of superior vertebra
  • posterior - distraction of annulus fibrosis
  • anterior - anterior compression of annulus fibrosis
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28
Q

What structures limit the amount of spinal flexion available?

A
  • supraspinous and interspinous ligaments
  • tension in facet joint capsules
  • ligamentum flava
  • posterior longitudinal ligament
  • posterior anulus fibrosus
  • back extensors
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29
Q

When we move into extension, what happens to the posterior aspect of the motion segment? What happens to the anterior aspect of the motion segment?

A
  • posterior tilt and posterior glide of the superior vertebra
  • posterior - compression of annulus fibrosis
  • anterior - distraction of annulus fibrosis
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30
Q

What structures limit the amount of extension available?

A
  • bony contact of spinous processes
  • tension in facet joint capsuls
  • anterior longitudinal ligament
  • anterior anulus fibrosis
  • anterior trunk muscles
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31
Q

When we move into lateral flexion, what happens to the contralateral aspect of the motion segment? What happens to the ipsilateral aspect of the motion segment?

A
  • lateral tilt, rotation, and translation of superior over inferior vertebra
  • contralateral - widening of intervertebral foramen
  • ipsilateral - narrowing of intervertebral foramen
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32
Q

What structures limit the amount of lateral flexion available?

A
  • annulus fibrosis
  • intertransverse ligament
  • trunk muscles
  • contralateral side limits lateral flexion
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33
Q

Our ability to resists the loads applied to the vertebral column depend on what factors

A
  • type/duration/rate of loading
  • person’s age
  • posture
  • structural elements
  • integrity of nervous system
34
Q

What is considered upper cervical spine? What is considered lower cervical spine?

A

upper - occiput, C1 (atlas), C2 (axis)

lower - C3 - C7

35
Q

List the atypical vertebra in the cervical spine. What are their unique characteristics?

A
  • Atlas - no body or spinous process, shaped like a ring, 2 lateral masses
  • Axis - dens, large, bifid spinous process
  • C7 - largest cervical vertebra, long spinous process
36
Q

What are the functions of atlas vertebra?

A

cradle occiput and transmit forces from occiput to lower C-spine

37
Q

What are the functions of axis vertebra?

A

transmit combined load of the heat/atlas to C-spine and provide axial rotation of head/atlas

38
Q

Summarize the characteristics of the typical vertebra in the cervical spine

A
  • small body w/ uncinate processes to give upper surface concave shape
  • transverse foramen for vertebral artery on transverse process
  • bifid spinous process
39
Q

Describe atlanto-occipital joint (OA joint)?

A
  • convex occipital condyles on concave superior facets

- synovial plane joint

40
Q

Describe atlanto-axial joint (AA joint)

A
  • dens and anterior arch of atlas/transverse ligament
  • synovial pivot joint
  • biconvex w/ meniscoids - inferior facets of atlas w/ superior facets of axis
41
Q

What is the role of the transverse atlanto ligament?

A
  • holds dens in place

- prevents anterior displacement of C1 over C2

42
Q

What is the role of the alar ligament? When is it taut?

A
  • limit lateral flexion and prevent distraction of C1 on C2

- taut during neck flexion and w/ axial rotation

43
Q

What conditions can comprise transverse ligament and what does this result in?

A
  • long standing RA and down syndrome

- results in instability of C1/C2

44
Q

What is the orientation of the facet joints in the cervical spine? What does this result in?

A

45 degrees off frontal and transverse plane - allows for motion in all 3 planes (flexion/extension, rotation, lateral flexion)

45
Q

Describe what happens in the upper and lower cervical spine with protraction

A

Upper cervical extension

Lower cervical flexion

46
Q

Describe what happens in the upper and lower cervical spine with retraction

A

Upper cervical flexion

Lower cervical extension

47
Q

what are the arthrokinematics at OA joint flexion?

A

convex on concave (move in opposite direction)

- occipital condyles anterior roll and posterior slide

48
Q

what are the arthrokinematics at OA joint extension?

A

convex on concave (move in opposite direction)

- occipital condyles posterior roll and anterior slide

49
Q

what are the arthrokinematics at OA joint lateral flexion?

A

convex on concave (move in opposite direction)

- inferior roll and superior slide

50
Q

What are arthrokinematics at AA joint rotation to the right?

A
  • right facet slides posterior and left facet slides anterior
51
Q

What ligament limits rotation at the AA joint?

A

alar ligament

- left alar ligament limits movement to the right

52
Q

What ligament limits tilting of atlas at the AA joint with flexion?

A

transverse ligament

53
Q

Describe the spinal coupling relationship in the lower cervical spine

A
  • couple in same direction

- lateral flexion and rotation in same direction

54
Q

What are arthokinematics of facet joints of lower cervical spine during flexion and extension?

A

flexion - inferior facet slides anterior and superior

extension - inferior facet slides posterior and inferior

55
Q

What are arthokinematics of facet joints of lower cervical spine during rotation?

A

ipsilateral - inferior facet slides posterior and slightly inferior
contralateral - inferior facet slides anterior and slightly superior

56
Q

What are arthokinematics of facet joints of lower cervical spine during lateral flexion?

A

ipsilateral - inferior facet slides inferior and slightly posterior
contralateral - inferior facet slides superior and slightly anterior

57
Q

What is the function of cervical spine?

A

stability and protection - large vertebral canal for spinal cord and transverse foramen for vertebral artery

58
Q

Describe what happens when an individual assumes forward head posture for an extended period of time

A
  • lead to trigger points and extra tension in muscles because those muscles are extended for a prolonged period of time
59
Q

Detail a few reasons that may cause a muscular imbalance of the muscles in the cervical spine responsible for maintaining posture

A

1) Excessive or violent hyperextension movement strain SCM, longus colli and anterior scalenes causing chronic spasm/guarding
2) Inhibition, pain, weakness or fatigability of deep flexors (longis colli/capitis) resulting in SCM and anterior scalene becoming more dominant
3) Ergonomics: protracting to improve visual contact with computer screen

60
Q

Discuss the mechanism of a whiplash injury

A
  • hyperextension typically exceeds hyperflexion
  • Anterior longitudinal ligament and alar ligament vulnerable
  • Excessive strain also placed on longus colli and longus capitis
  • Position of the neck moves more towards a relatively straight or even slightly flexed c-spine
61
Q

Patients who suffer a whiplash injury and have a strained or painful longus colli demostrate what difficulties? What is this an example of?

A
  • demonstrate difficulty shrugging shoulders - motion completed by upper trap
  • loss of stable cervical attachment which results in the muscle being able to less effectively elevate the shoulders
  • example of interdependence of muscle function
62
Q

What is interdependence muscle function?

A

One muscles action depends on the stabilization force of another

63
Q

What muscle if shortened is typically responsible for torticollis?

A

SCM

64
Q

What are articulations of TMJ joint?

A
  • Articulation of mandibular condyle and mandibular fossa of temporal bone
  • biconcave disc separates upper and lower articulations
65
Q

What is the function of articular disc in TMJ?

A

Disc functions to cushion the large, repetitive force of mastication

66
Q

Compare and contrast the capsule in the medial/lateral direction verses the anterior/posterior direction.

A
  • Available joint motion is determined by the elasticity of the joint capsule and ligaments
  • capsule is firm medially/laterally
  • capsule is thin and loose anterior/posterior
67
Q

What is the normal resting position of the TMJ and what muscle maintains that position?

A
  • lips closed and teeth several millimeters apart

- temporalis muscle

68
Q

What osteokinematic motions occur at the TMJ?

A
  • depression/elevation
  • protrusion/retrusion
  • left and right lateral excursion
69
Q

What are arthrokinematics of mandibular depression?

A
  • early phase posterior roll

- late phase anterior slide

70
Q

What are arthokinematics of mandibular elevation?

A
  • early phase posterior slide

- late phase anterior roll

71
Q

What are arthrokinematics of mandibular protrusion?

A

anterior and slightly inferior slide of condyle and disc

72
Q

What are arthrokinematics of mandibular retrusion?

A

posterior and slightly superior slide of condyle and disc

73
Q

What are arthrokinematics of mandibular lateral excursion to the left? right?

A

LEFT
- Left condyle spins and Right condyle slides anterior and to the left

RIGHT
- Right condyle spins and Left condyle slides anterior & to the right

74
Q

TMJ norms for depression, protrusion, and lateral excursion

A
  • depression - 40-50 mm
  • protrusion - lower teeth surpass upper teeth
  • lateral excursion - 8-11 mm
75
Q

What is functional screen for mandibular depression?

A

2 knuckles = functional

3 knuckles = normal

76
Q

What symptoms are associated with TMJ disorders?

A

pain, popping, reduced bite force, reduced ROM with mouth opening, headaches, tinnitus trigger points

77
Q

What are TMJ deviations?

A

motion that produces an S curve w/ depression or protrusion

- - can be caused by unilateral tightness

78
Q

What are TMJ deflections?

A

Motion that produces a C curve w/ depression or protrusion

- can be caused by unilateral tightness

79
Q

Compare and contrast articular disc displacement with reduction and without reduction.

A

W/ REDUCTION - reciprocal click when you open and close jaw

W/O REDUCTION - click only occurs during opening of mouth and they have trouble relocating jaw

80
Q

How are the TMJ, C-spine and posture related?

A
  • head and neck positions affect tension in cervical muscles which can influence the function of the mandible

Applied Kinesiology (7 decks)

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