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31 Cards in this Set
- Front
- Back
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Ligaments of the spine |
Anterior longitudinal ligament: occiptal bone --> sacrum. attach margin of bodies Posterior longitudinal ligament: cord like, in vertebral canal. axis-->sacrum. attach margin of bodies. ligamentum flavum: between laminae. articular capsule --> junction of lamina to the spine. elastic, movement control. interspinous ligaments: spines supraspinous ligaments: tips of spines |
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superficial intrinsic muscles |
erector spinae: - spinalis - longissimus - iliocostalis
type 1 fibres, postural attach sacral--> thoracic so head is independant |
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deep intrinsic muscles of the back |
transverspinalis - rotatores - multifidus - semispinalis postural and proprioception attach at spines and transverse processes |
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thoracolumbar fascia associated muscles |
origin for latissimi dorsi attachment for internal oblique and transversys abdominis intimate with gluteal fascia contains erector spinae |
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Quadratus lumborum |
iliac crest --> rib 12, L1-4 lateral flexion |
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Psoas major |
T12-L5 transverse processes and lateral IV discs --> lesser trochantur of the femur lateral flexion and lumbar lordosis hip flexion |
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anterior abdominal muscles |
external oblique: rib 5-12 --> linea alba, inguinal ligament internal oblique: thoracolumbar fascia --> linea alba transversus abdominus: thoracolumbar fascua --> linea alba |
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triad - back injury |
lumbar flexion rotation lateral flexion --> disc prolapse |
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spinal fracture |
usually: compression; thoracic denis columns: % of fractures ant = 30% middle=40% post = 20%
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end plate fracture |
disc failure. compression loading + age --> concave nucleus polposus causes end plate to bulge into vertebral body |
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herniated disk |
bending -->tensile force on annulus + compression --> nucleus herniation or annular collapse most common posteriorly. |
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consequences of disc failure - henriation/end plate fracture |
increased loading of posterior column disc may lose height and impinge nerves lose fluid --> slack ligaments --> instabilitbody responds to instability by producing osteophytes (--> lose ROM) |
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cauda equina impingement |
saddle anasthesia sciatica (L4-S3) urinary system/bowel problems -S2-4 |
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Spondylolysis |
idiopathic pars interarticularis fracture 85% L5; rest L4 spondylolisthesis: displace forward - scotty dog (-->scoliosis in kids) often asymptomatic |
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C Spine injury |
atlas fracture: impact of occipital condyles on ring. usually low risk. 3m halo axis fracture: if lig snaps posterior displacemrnt is instantly fatal subluxation: flexion - in lower neck extension - uncommon, requires ant. lig. to rupture |
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unstable spinal injury |
potential displacement 50% reduction in disc height thoracolumbar junction >20° failure of 2+ denis columns compression of 3 sequential vertebrae |
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development of posture |
2 mo IU thoracic kyphosis (concave) 8 wk head raised back rounded elderly: butt/neck tone lost. loss of 2° curves. arms back for balance |
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Rickets |
vitD deficiency soft boeing bones short humerus long forearm |
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Pelvic tilt |
L5-->symphysis meets perpendicular at 60° back tilt: hams and gluteal shorten; abdo muscles stretched forward tilt: erector spinae short-back stiff. psoas major comprimised |
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ideal posture |
sacrovert angle 60° abdo wall in tone COG: 5cm infront of ankle infront of knee just behind hip front of shoulder through mastoid process |
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muscles active in posture |
soleus: stop forward fall tibialis anterior if in heels iliopsoas glut med and tfl: counteract postural sway erector spinae lower int oblique - protect inguinal canal |
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Flat back |
knee flexed increased thoracic kyphosis loss of lumbar lordosis age; hiding breast/bum; after stooping |
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Hollow back |
hip flexed, bum out abdomen overhangs increased lumbar lordosis weight on heels due to increase abdo bulk or loss of abdo tone |
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sway back |
hips over extended knees pushed back increased thoracic kyphosis scooped nexk most common |
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POM back pain |
95% no pathology - low education status - depression - psychosocial exam better predictor than mri - sick role? - cbt antidepressents exercise |
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Rate of bone loss post menopause |
2-4%/yr |
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transmission of force in feet |
55% to heel, rest to metacarpals acc. to size |
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Walking gaut cycle |
stance -60% initial contacr foot flat midstance heel of toe off Swing acceleration mid swing deceleration - prevents large forces |
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double supprot in gait cycle |
2 periods = 22% cycle heel strike and heel off |
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loading response |
foot flat |
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foot angle |
7° - larger in elderly and children |
