Weeks 13 & 14: Vertebral Column Flashcards
What are all the articulating surfaces of the vertebral column?
(8)
- Intervertebral jts
- Facet jts
- Atlanto-occipital (A-O)
- Atlanto-axial (A-A)
- Sternocostal
- Costovertebral
- Lumbo-sacral Junction
- Sacro-iliac (SI)
Facet Jts
What prime motions are available at cervical facet jts?
(C2-C7)
rotation
SB
flex
ext
Facet Jts
What prime motions are available at thoracic facet jts?
(In what directions do they occur?)
SB and rotation (occur together)
opposite directions
Facet Jts
What prime motions are available at lumbar facet jts?
flex
ext
Question:
If a pt SB to the R, which direction will the vertebrae rotate?
(Which part of the spine?)
L
thoracic
Question:
If a pt rotates to the R, which direction will the vertebrae SB?
(What part of the spine?)
L
thoracic
Atlanto-occipital Jt
What two structure form the A-O jt?
Which motion(s) are available?
atlas (C1) and occiput
flex, ext
Atlanto-axial Jt
What three structures form the A-A jt?
Which motion(s) are available?
axis (C2)
atlas (C1)
transverse ligament
rotation
Atlanto-axial Jt
What are the processes of the axis (C2) called?
What kind of processes are they?
dens
odontoid
Atlanto-axial Jt
What structure runs through the transverse foramen?
To and from which vertebrae does it run?
vertebral artery
C5/6-C2
Sterno-costal Jts
Where are the sterno-costal jts located?
anterior attachment of the ribs to the sternum
Sterno-costal Jts
- ribs 1-7
- ribs 8-10
- 11-12
Describe
- true ribs (attach directly to sternum through their own cartilage)
- false ribs (attached indirectly through common costal cartilage)
- floating ribs (no sternal attachment/attached to each other)
Costovertebral Jts
Where do the costovertebral jts articulate?
What aer the two areas of articulation?
posteriorly with the thoracic vertebrae
transverse process
vertebral body (facet)
Costovertebral Jts
What are the prime motion(s) available?
slight motion during rib expansion during respiration
The ribs limit all motions of the thorax
Lumbo-sacral Junction
Where do the lumbo-sacral jts articulate?
L5-S1
- majority of low back motion occurs at this junction
- frequent site of disc herniation
Lumbo-sacral Junction
What is the lumbosacral angle?
What is the normal value?
What factors can affect the lumbosacral angle?
What is the result?
top line parallel to top of scarum
bottom line parallel to floor
Normal value ≈ 30º
lumbar lordosis
increased LS angle = anterior pelvic tilt
decreased LS angle = posterior pelvic tilt
Sacro-iliac Jt
Where does the SI jt articulate?
What is its function?
between sacrum and ilium*
provide stability
* together with the ischium, these three bones form the pelvic girdle
no voluntary motion is available, however motion does occur with gait (may be excessive or reduced)
Ligaments
Where is the iliolumbar ligament located?
Which motion(s) does it limit?
runs laterally from the transverse process of L5 to the inner lip of the posterior iliac crest
What is the thoracoculumnar fascia?
What does it consist of?
thick structure of fascia that provides dynamic support to the spine
Composition:
* three layers of fascia
* the aponeuroses of the latissimus dorsi, serratus posterior inferior, internal obliques, and transverse abdominus
During trunk flexion…
What happens to the nucleus pulposis?
The annulus fibrosis?
The intervertebral space?
(Which aspect of the intervertebral space?)
nucleus - moves posterior
annulus - posterior part taut, anterior part lax
intervertebral space - widens
(posterior aspect)
During trunk flexion…
What happens to the nucleus pulposis?
The annulus fibrosis?
The intervertebral space?
nucleus - moves anterior
annulus - anterior part taut, posterior part lax
intervertebral space - narrows
Question:
In what position would a pt with lumbar disc problems be most comfortable?
trunk flexion
NOT helpful for recovery
What is the cartilaginous end plate?
What is its function?
thin layer of connective tissue between the vertebral body and the disc
provides nutrition to the disc via diffusion from the vertebral body marrow
Lordosis
In which plane is this curvature located?
From which view can it be noted?
Where in the spine does normal lordosis occur?
Is this curve primary or secondary? Why?
sagittal
lateral view
cervical & lumbar regions
Secondary as these curves develop later in life
Kyphosis
In which plane is this curvature located?
From which view can it be noted?
Where in the spine does normal kyphosis occur?
Is this curve primary or secondary? Why?
sagittal
lateral view
thoracic region
Primary due to position of fetal development
What is the closed pack position of the spine?
extension
This is true for all three regions: cervical, thoracic, lumbar
Cervical Muscles
What are the prime movers in head flexion?
prevertebrals
Cervical Muscles
What are the prime movers in head extension?
suboccipitals
Cervical Muscles
What are the four muscles that compose the prevertebrals?
longus colli
longus capitis
rectus capitis anterior
rectus capitis lateralis
Cervical Muscles
What are the four muscles that make up the suboccipitals?
obliquus capitis superior & inferior
rectus capitis posterior major & minor
Cervical Muscles
What are the prime movers in cervical flexion?
(3)
SCM
scalenes
longus colli
Cervical Muscles
What are the prime movers in cervical extension?
(7)
splenius cervisis & capitus
longissimus cervisis
iliocostalis cervisis
semispinalis cervisis
multifidus
upper trapezius
Cervical Muscles
What are the prime movers in cervical SB?
(7)
SCM
scalenes
splenius cervisis & capitus
longissimus cervisis
iliocostalis cervisis
levator scapulae
Spine AROM
What is the inclinometer norm for thoracic/lumbar flexion?
80º
Spine AROM
What is the incinometer norm for thoracic/lumbar extension?
25º
Spine AROM
What are the landmarks for measuring thoracic/lumbar flex/ext with a tape measure?
C7 - S2
Spine AROM
What are the landmarks for measuring thoracic/lumbar flex/ext with an inclinometer?
T1 - S2
Spine AROM
What are the landmarks for measuring lumbar flex/ext with a tape measure?
S2 - 15 cm superior to S2
Spine AROM
What are the landmarks for measuring lumbar flex/ext with an inclinometer?
T12 - S2
Spine AROM
What is the AROM norm for thoracic/lumbar SB?
35º
Spine AROM
What are the landmarks for measuring thoracic/lumbar SB with a tape measure?
distance between third fingertip and floor
Spine AROM
What are the landmarks for measuring thoracic/lumbar SB with an inclinometer?
T1 - S2
Spine AROM
What are the goni landmarks for thoracic/lumbar SB?
Axis: S2
Stationary arm: perpendicular to floor
Moving arm: spinous process of C7
Spine AROM
What is the AROM norm for thoracic/lumbar rotation?
45º
Spine AROM
What are the goni landmarks for thoracic/lumbar rotation?
Axis: center of head
Stationary arm: line between the two prominent tubercles of the iliac crest
Moving arm: line between the acromial processes
Ligaments
Where is the anterior longitudinal ligament located?
What motion does it limit?
Is it intersegmental or intrasegmental?
anterior aspect of vertebral body
extension
intersegmental
Ligaments
Where is the posterior longitudinal ligament located?
What motion does it limit?
Is it intersegmental or intrasegmental?
posterior aspect of the vertebral body and anterior aspect of the vertebral foramen
flexion
intersegmental
Ligaments
Where is the ligamentum flavum located?
Is it intersegmental or intrasegmental?
What motion does it limit?
posterior aspect of the vertebral foramen
connects the laminae* of the vertebra
intrasegmental
flexion
*the lamina is the bony part of the vertebra that surrounds the spinal column
Ligaments
Where is the interspinous/interspinal ligament located?
Is it intersegmental or intrasegmental?
What motion does it limit?
between each spinous process
flexion
Ligaments
Where is the intertransverse ligament located?
What motion does it limit?
Is it intersegmental or intrasegmental?
between each transverse process
sidebending
intrasegmental
Ligaments
Where is the supraspinal ligament located?
What motion does it limit?
Is it intersegmental or intrasegmental?
along the tips of the spinous processes from C7 to sacrum
flexion
intersegmental
Ligaments
Where is the ligamentum nuchae located?
What motion does it limit?
Is it intersegmental or intrasegmental?
along the tips of the spinous processes from occiput to C7
flexion
intersegmental
Cervical Muscles
What are the prime movers for cervical rotation?
(6)
SCM
scalenes
spelnius cervicis
splenius capitis
levator scapulae
multifidus
Cervical Muscles
When contracting unilaterally, to which side do the cervical rotation muscles rotate the neck?
(same or opposite?)
SCM: opposite
scalenes: opposite
multifidus: opposite
spelnius cervisis/capitis: same
levator scapulae: same
example:
R SCM contracts - neck rotates L
R levator contracts - neck rotates R
Trunk Muscles
What are the prime movers of trunk flexion?
rectus abdominis
internal obliques
external obliques
Trunk Muscles
What are the primer movers of trunk extension?
erector spinae*
mulifidus
quadratus lumborum
*spinalis, longissimus, iliocostalis
Trunk Muscles
What are the prime movers of trunk sidebending?
To which side do they bend if contracting unilaterally?
external obliques
internal obliques
longissimus thoracic
iliocostalis
quadratus lumborum
psoas major
same side
Trunk Muscles
What are the prime movers of trunk rotation?
external obliques
internal obliques
rotatores
multifidus
Trunk Muscles
When contracting unilaterally, to which side do the trunk muscles rotate the spine?
external obliques: opposite
rotatores: opposite
multifidus: opposite
internal obliques: same
Muscle Actions
What are the prevertebral muscles?
What is this muscle group called?
(4)
longus colli
longus capitis
rectus capitis anterior
rectus capitis lateralis
anterior head flexors
Muscle Actions
What is the purpose of the prevertebral muscles?
- maintain postural control
- perform chin tuck exercise
Muscle Actions
What are the suboccipital muscles?
(4)
What is this muscle group called?
obliquus capitis superior/inferior
rectus capitis posterior major/minor
synergistic group that performs head extension
Muscle Actions
What are the trunk extensors?
Splenius capitis/cervicis*
Erector spinae
Transversospinalis
Quadratus lumborum
*cervical region only
Muscle Actions
What are the muscles of the erector spinae?
spinalis
longissimus
iliocostalis
Muscle Actions
What does the spinalis muscle connect?
spinous processes
Muscle Actions
What does the longissimus muscle connect?
transverse processes
Muscle Actions
What does the iliocostalis muscle connect?
attach laterally to the ribs
Muscle Actions
What are the transversopsinals muscles?
What do they do?
What is their line of pull?
semispinalis
rotatores
multifidus
trunk extension
oblique
Muscle Actions
What does the semispinalis muscle connect?
spans 5+ vertebra
Muscle Actions
What do the rotatores connect?
spans 1 vertebra
Muscle Actions
What does the multifidus connect?
spans 2-4 vertebra
Muscle Actions
What is the deepest abdominal muscle?
What is its function?
transverse abdominis
compress and support the abdominal viscera
