1
Q
What makes up an inter body joint
A
- disc
- apposing vertebra
2
Q
What is a disc made up of
A
- nucleus pulposus (inner region)
- annulus fibrosus (outer region)
3
Q
What are the primary/kyphosis curves of the spine
A
- thoracic spine
- sacrum
4
Q
What are the secondary/lordosis curves of the spine
A
- lumber spine
- cervical spine
5
Q
Where does the typical line of gravity pass through
A
- anterior to ankle
- anterior to knee
- posterior to hip
- anterior to 2nd sacral vertebra
- straight through the ear hole
6
Q
Functions of the cranium
A
- protection
- sensory organ housing
7
Q
Signs of a basilar skull fracture
A
- bruising behind the ears
- raccoon eyes
- blood coming out of the eyes
8
Q
What motion puts tension on all of the spinal ligaments
A
- cervical rotation
9
Q
What motion tensions the transverse ligaments
A
- cervical contralateral lateral flexion
10
Q
What makes the ligaments flavum have a yellow hue
A
- elastin
11
Q
Main function of the ribs
A
- protect the thoracic cavity
12
Q
Where do ribs 1-7 attach
A
- directly on the sternocostal
13
Q
Where do ribs 8-10 attach
A
- indirect attachment to sternum through superior ribs
14
Q
Where do ribs 11-12 attach
A
- they are floating ribs
- no sternal attachment
15
Q
What is the cost of the curvature of our spine
A
- it causes shearing force
16
Q
What parts of the spine move the most
A
- cervical
- lumbar
17
Q
How many cervical vertebra
A
- 7
18
Q
How many thoracic vertebra
A
- 12
19
Q
How many lumbar vertebra
A
- 5
20
Q
How many sacral vertebra
A
- 5
21
Q
How many coccygeal vertebra
A
- 4
22
Q
Define coupled motion
A
- motions that can’t or tend not to occur in isolation
23
Q
What motion is coupled with spinal lateral flexion
A
- rotation
24
Q
Define ipsilateral rule
A
- rotation is coupled with side bending to the same side
25
Define contralateral rule
- rotation is coupled with side bending to the opposite side
26
What rule does C2-T2 follow
- ipsilateral rule
27
What rule does T3-T7 follow
- contralateral rule
28
What rule does T8-S1 flexion follow
- ipsilateral rule
29
What rule does T8-S1 extension follow
- contralateral rule
30
What angle is the annulus fibrosus collagen orientation
- about 60 degrees
31
What is the role of the annulus fibrosus
- its role is to contain the nucleus pulposus and provides resistance to tension
32
Describe endplates
- cartilage caps
- fibrocartilage where adheres to disc
- calcified cartilage where adhere to vertebral body (fracture risk)
33
Describe the annulus fibrosis
- only the outer layer is vascularized
- rest of disc gets nutrition by diffusion
- limited healing
34
What happens during spine flexion
- anterior parts are approximating
- posterior parts are being pulled apart
35
Which way will a disc herniate
- it will herniate is the path a least resistance
36
What is the position of least disc pressure
- laying supine
37
Is standing straight up or sitting straight have more disc pressure
- sitting straight up causes more disc pressure than standing straight up
38
What position causes the most disc pressure
- stooping
39
What is a common herniation direction
- posterior lateral
40
What are the distinguishing features of the cervical vertebrae
- small
- mobile
- transverse foramina for the vertebral artery to pass through
41
Which cervical vertebrae are unique
- C1
- C2
- C7
42
Describe cervical vertebrae
- wider from side to side rather than front to back
- superior surface if concave medial to lateral
- inferior surface is convex anterior to posterior
- superior facets oriented superiorly & posteriorly
- inferior facets oriented inferiorly & anteriorly
43
What does the dens of C2 (axis) articulate with
- the anterior arch of C1 (atlas)
44
What vertebra does the majority of vertical rotation occur in the cervical spine
- C2 (axis)
45
Distinguishing features of thoracic vertebrae
- demi facets
- frontal plane facet joints
- spinous process tip posterior to facet of the vertebra below
46
What is the close packed position for the spine
- extension
47
Describe lumbar vertebrae
- inferior facets face anteriorly & laterally
- superior facets face posteriorly & medially
- bigger & wider vertebral bodies
- facets face more in the sagittal plane
48
What do apophyseal joints do
- guide motion
- assist with load acceptance & distribution
49
Where does most of our rotation come from
- Atlanto-axial joint
50
What does the transverse ligament do
- stabilizes
- resists anterior translation of the head
51
What does the annular ligament resists
- rotation
52
Cervical extension ROM
- 75 to 80 degrees
53
Cervical flexion ROM
- 45 to 50 degrees
54
What happens in the cervical spine during extension
- poster roll & anterior glide at the C0-C1 joint
- posterior tilt at C1-C2 joint
- posterior & inferior glide from C2 to C7
55
How many DOF does the C0-C1 joint have
- 1 DOF
56
How many DOF does the cervical spine have
- 2 DOF
57
Cervical spine rotation ROM
- 65 to 75 degrees
58
What happens in the cervical spine during rotation
- posterior glide on the ipsilateral side & anterior glide on the contralateral side at C1-C2
- posterior & a little inferior glide on the ipsilateral side & anterior & a little superior glide on the contralateral side from C2 to C7
59
Cervical spine lateral flexion ROM
- 35 to 40 degrees
60
What happens in the cervical spine during lateral flexion
- inferior & a little posterior slide on the ipsilateral side & superior & a little anterior slide on the contralateral side from C2 to C7
61
Thoracic spine normal ROM values
Flexion: 30-40 degrees
Extension: 15-20 degrees
Rotation: 25-35 degrees
Lateral flexion: 25-30 degrees
Resting kyphosis: 40 degrees
62
Thoracolumbar flexion ROM
- superior slide & a little bit anteriorly at the facets
- 85 degrees; 35 degrees from thoracic & 50 degrees from lumbar
63
Thoracolumbar extension ROM
- 35 to 40 degrees; 15-20 degrees from thoracic & 20 degrees from lumbar
- inferior & a little posterior at the facets
64
What direction is roll & slide in during thoracolumbar rotation
- the same direction
- anterior and inferior facet on the ipsilateral side slide posteriorly
- 5 degrees of rotation in lumbar region
65
What happens during thoracolumbar lateral flexion
- contralateral superior slide of inferior facet
- ipsilateral inferior slide of the inferior facet
- 45 degrees; 25 degrees from thoracic due to ribs limiting
66
What motion shrinks canal & foramina
- spinal extension
67
Describe lumbopelvic rhythm
- forward bend
- 60 degrees from hip
- 45 degrees form lumbar
- more lumbar flexion early on and more hip flexion later on the bending motion
68
Lumbar ROM
- 5 to 7 degrees of rotation
- 20 degrees of lateral flexion
69
hat is the normal angle between the sacrum & horizontal
- 40 degrees
- downward slope causes shearing force & compression forces
- restrained by disc, facets, & anterior longitudinal ligament
70
Describe nutation
- sacrum rotates anteriorly relative to ilium & pelvis rotates posteriorly
71
Describe counternutation
- sacrum rotates posteriorly relative to ilium & pelvis rotates anteriorly
72
What is the close packed position for the sacroiliac joint
- nutation
73
What ligaments are tension during nutation
- sacrotuberous ligament
- interosseous ligament
74
What muscles work as bilateral extensors and unilateral lateral flexors
- trapezius
- latissimus dorsi
- rhomboids
- levator scapula
- serrates anterior
- transversospinals
75
What posterior trunk muscles are related to ventilation
- serratus posterior superior
- serratus posterior inferior
76
What are the anterior lateral craniocervical muscles
- sternocleidomastoid
- scalenes
- longus colli
- longus capitis
- rectus capitis anterior
- recuts capitis lateralis
77
What are the muscle actions of the sternocleidomastoid (SCM)
- bilaterally does mid/lower cervical flexion and slight upper cervical extension
- unilaterally contralateral rotation and ipsilateral lateral flexion
78
What are the muscle actions of the scalenes
- bilaterally does slight flexion and act of vertical stabilizers
- unilaterally ipsilateral lateral flexion
79
What is the muscle action of rectus capitis anterior & rectus capitis lateralis
- Anterior: AO flexor
- Lateralis: AO lateral flexor
80
Muscle action of longus colli
- resists lordosis
- vertical stabilizer
81
Muscle action of longus capitis
- flexor and stabilizer
82
Describe forward head posture
- lower cervical flexion
- upper cervical extension
83
Describe whiplash
- frequently associated with damage to longus colli and capitis, alar ligaments especially when rotated
84
Describe muscle actions of the internal and external obliques
- external obliques will rotate to the contralateral side
- internal oblique will rotate to the ipsilateral
- right external oblique is coupled with left internal oblique
85
What are the trunk intrinsic stabilizers
- transversospinals
- short segmentals
86
What are the trunk extrinsic stabilizers
- erector spinae
- quadrates lumborum
- psoas major
87
Phases of a typical full sit up
- upper trunk first then lower trunk follows
88
Things to reduce reaction force/compression load
- make more trips with lower loads
- shorten the moment arm as much as you can
- don't let your back go into flexion
Kinesiology
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