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28 Cards in this Set
- Front
- Back
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What is coupled motion? |
- One motion component translates or rotates along or about one axis results in another motion component translating or rotating about another axis
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Describe the cervical curve |
-Convex anteriorly and concave posteriorly - Positions the head over the pelvis - Works as shock absorbers |
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What type of joints are spinal joints? |
- Synovial joints |
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What are the three synovial structures? |
- Articular capsule (fibrous, continuous with periosteum) -Articular cartilage (lines articular process provides loading and unloading mechanism to resist load and shock) - Synovial fluid (inner layer of fibrous articular capsule) |
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What are the three parts that make up the intervertebral disc? |
- Annulus fibrosis (Type I collagen, high tensile strength) - Nucleus pulposis (Type II collagen, compressable) - Cartilaginous endplate (Hyaline cartillage, transports nutrients to avascular disc) |
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Why is the cervical spine vulnerable to traumatic forces? |
- The cervical spine forms a long lever with the head, weighing about 10% of the body weight, balanced on top of the spine |
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What will forces and loads generated in the upper spine when the head is unsupported cause? |
- A whip like motion, jamming the upper and lower cervical joints and stretching the middle cervical ligaments *Note the cervical spine is at the end of an open chain |
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What is the most mobile part of the spine? |
- The cervical spine, it sacrifices stability for mobility |
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How does the mobility of the cervical spine differ in the upper cervical area and the lower cervical area? |
- Upper cervical = 2 inter - dependent moving complexes extremely supported by ligaments - Lower cervical = uniformed moving segments |
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What sort of lever system is the c2/3 to l4/5 lever system? |
-First class lever - Joints = force or load - spinouses between the interspinous ligament =force or load - Intervertebral disc = fulcrum |
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What causes Degenerative Joint/ Disc Disease aka OA? |
- Subluxation and fixation > calcium deposits along the lines of the ligaments fibrosis and repair and receptor insensitivity > Traction and IVP Osteophytic growth leads to joint stability > partial joint fusion to full joint fusion creates stress for rest |
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What does the alignment of the C3 to C7 facets help? |
- To prevent excessive anterior translation and is important in weight baring. |
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Why are the joint capsules in the lower cervical spine more lax than than other areas of the spine? |
- To allow for gliding movements of the facets |
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Describe the uncinate processes of the cervical spine |
- More pronounced between C3-C5 for adde stability and movement - Synovial joints which help slide and glide joints in flexion and extension - Limit lateral bending - Prevent z axis translation upon - Early degeneration site before the disc |
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Describe the patterns of motion of the cervical spine |
- Determined by the orientation of the facet joints, intervertebral discs and uncovertebral joints - The degree of rotation that is coupled with lateral flexion decreases in the more caudal motion segments |
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Describe the articular process height of the cervical spine |
- Increases with caudal progression which determines the quality of flexion and extension - Articular pillar is short at C2/C3 because 60% of rotation occurs there |
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What degenerates faster in Cervical and Lumbar, Discs or facets? |
- Cervical - facets - Lumbar - discs |
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Where does the most movement for Flexion/ extension, Lateral flexion and Rotation occur in the cervical spine? |
- Flexion extension - C4/5 and C5/6 - Lateral flexion - C3/4 and C4/5 - Rotation - C3/4, C4/5, C5/6 |
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What happens during coupled motion lower cervical in flexion and rotation? |
- Spinous will rotate to the side opposite of lateral flexion - Left lateral flexion couples with right axial rotation - Right lateral flexion couples with left axial rotation - Strongest coupling pattern - mid- cervical due to facet orientation |
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What happens during lateral flexion in the cervical spine? |
- In left lateral flexion, the left inferior facet of superior segment slides down and posterior on the 45 degree incline of the superior facet below. - At the same time the right facet of the superior segment rides up the 45 degree incline and is displaced anteriorly |
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What happens during coupled motion lower cervical rotation? |
- 0.75 degree of lateral flexion occurs with 1 degree of rotation - During head rotation, contralateral lateral flexion of upper cervical region is needed to counterbalance the coupled ipsilateral flexion that occurs with mid lower cervical rotation |
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Describe patterns of motion in sagittal plane or flexion/ extension? |
- Flexion / extension of cervical spine is plane motion of x-axis rotation, z-axis translation and y axis translation and y-axis translation -C2 = flat pattern, more translation less translation - C4 = more arched pattern -C6 and C7 = most arched pattern |
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What are lower cervical limits of motion? |
- Extension -vertebra tilts and slides posteriorly, superior facets slide posteriorly on facets below, extension limited by ALL and neural arches -Flexion - vertebra tilts and slides anteirorly, superior facets slide anteriorly and superiorly, flexion limited by PLL, capsular ligaments, ligamentum flavum, ligamentum nuchae |
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What are the consequences of axial rotation? |
- degree of axial rotation can cause kinking of the vertebral arteries that run in the transverse foramina of C6 to the atlas - Nausea, vomitting, visual problems, vertigo and stroke |
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What are the weight bearing characteristics of the cervical spine? |
- Load of skull through occiput and lateral masses of C1 - Transferred to pedicles and laminae of C2 to articular pillars - From C2, load is transferred inferiorly to the articular pillars (64%) and the vertebral bodies (36%) |
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Describe the head balancing on the cervical spine |
- Skull, occipital condyles and atlas = 1st class lever system - Head approx 4 - 5kg - Centre of gravity at sella turcica which lies anteriorly to CO/C1articulation - Posterior muscles stronger than anterior due to anterior COG - When sleeping posterior muscles relax, head falls forward |
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Describe loss of cervical lordosis |
- Cervical lordosis should be 35 - 45 degrees - When COG is shifted anteriorly, the force required to hold the head up increases proportionally - Further the weight gets away from the fulcrum (CO/C1 joint) the more force by the posterior neck muscles to balance the head |
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What are the limitations of Motions for C1/C2? |
- Flexion - with flexion of CO/C1, tectorial membrane is taut and restricts motion of C1/C2 - Extension - limited by tectorial membrane - Rotation - limited by contralateral alar ligament |
