Biomechanics: Spinal Biomechanics

Front 1

The frontal, sagittal and transverse ____ are flat surfaces determined by the position of three points in space.

Back 1

plane

Front 2

Which motions occur in the sagittal plane?

Back 2

Flexion and extension

Front 3

Right and left lateral flexion occur in the ____ plane and rotation occurs in the _____plane.

Back 3

Right and left lateral flexion occur in the frontal (coronal) plane and rotation occurs in the transverse (axial) plane.

Front 4

In this type of packed joint position (loose or closed)...
- the capsule and ligaments maximally tightened
- there is no joint play
- there is maximal contact between the articular surfaces

Back 4

CLOSED-packed joint position

Note: Facet joint closed-packed position...extension

Front 5

In this type of packed joint position (loose or closed)...
- joint capsule and ligaments are most relaxed
- maximum joint play is possible
- articulating surfaces are maximally separated
- position used for traction or joint mobilazation

Back 5

LOOSE-packed joint position

Note: Facet joint loose-packed position...half way between flexion and extension

Front 6

What spinal region(s) has a primary curve? What is another name for this?

Back 6

THORACIC region has a primary curve. This is also known as KYPHOSIS or "C" curve

Front 7

What spinal region(s) has a secondary curve? What is another name for this?

Back 7

CERVICAL and LUMBAR regions have secondary curves. This is also known as LORDOSIS.

Front 8

TRUE or FALSE

There is some degree of spinal rotation during side bending.

Back 8

TRUE

Front 9

TRUE or FALSE

In terms of regional range of motion, there is more movment in the transition area.

Back 9

FALSE

There is less movement in transition area.

slide 241

Front 10

TRUE or FALSE

Regional range of motion remains constant whether you are backward bending or forward folding.

Back 10

FALSE

see slide #242

Front 11

In the occiput, the condyles..
- face (laterally/medially) and (superiorly/inferiorly)
- form (concave/convex) rockers
- sit in concave surface of superior articular facet of C1

Back 11

In the occiput, the condyles..
- face LATERALLY and INFERIORLY
- form CONVEX rockers
- sit in concave surface of superior articular facet of C1

Front 12

In the atlas (C1), the facets...
- (concave/convex) surface
- face (medially/laterally)
- compliment condyles
- allow occiput condyles to rock

Back 12

In the atlas (C1), the facets...
- CONCAVE surface
- face MEDIALLY
- compliment condyles
- allow occiput condyles to rock

We will think of an egg on a spoon in NMT

Front 13

During CO-C1 Flexion and Extension...
- Occiput glides (anteriorly/posteriorly) which is (flexion/extension)
- Occiput rolls (anteriorly/posteriorly) which is (flexion/extension)
- (greatest/least) range of motion
- excursion is ___

Back 13

During CO-C1 Flexion and Extension...
- Occiput glides POSTERIORLY which is EXTENSION
- Occiput rolls ANTERIORLY which is EXTENSION
- GREATEST range of motion
- excursion is 10 degrees flexion to 25 degrees extension.

Front 14

During CO-C1 Lateral Flexion...
- occiput (rolls/glides) on side of lateral flexion and (rolls/glides) on opposite side.
- range of motion is _______

Back 14

During CO-C1 Lateral Flexion...
- occiput ROLLS on side of lateral flexion and GLIDES on opposite side.
- range of motion is 5 degrees each side (minimal)

Front 15

During CO-C1 Rotation...
- occiput glides (anteriorly/posteriorly) on side of rotation and (anteriorly/posteriorly) on side opposite rotation.
- limited by ____ ligament
- range of motion _______

Back 15

During CO-C1 Rotation...
- occiput glides POSTERIORLY on side of rotation and ANTERIORLY on side opposite rotation.
- limited by ALAR ligament
- range of motion 5 degrees each side (minimal).

Front 16

Spinal segments exhibit ___ degrees of freedom of motion.

Back 16

six

Front 17

Instantaneous axis or rotation occurs when a rigid body moves in a plane and is used to describe any vertebral motion in a _____ plane.

Back 17

two-dimensional

Front 18

The _______ is the functional unit of the spine. It describes the movement of six joints between any two vertebrae.

Back 18

motion segment

Front 19

Coupled motion describes the consistent association of one motion (translation or rotation) about one ____ with another motion about a second ____.

Back 19

axis

Front 20

Lower cervical biomechanics (C3-7):
_____ of ____ form age 6-9 and are completed by age 18. They limit lateral flexion to only a few degrees and serve as guides to couple lateral flexion with rotation.

Back 20

Joints of Luschka

Front 21

The cervical lordotic curve of 20-50 degrees is a secondary curve that develops in response to upright posture. What joints determine the curve?

Back 21

facet and disc planes

Front 22

Cervical discs 3-7 are higher anteriorly and contribute to cervical lordosis with a disc to height ration of 2:5. This allows for a greater ____ in the cervicals.

Back 22

ROM

Front 23

Which cervicals have the greatest range of flexion-extension?

Back 23

mid cervicals- movement is a combination of segmental tipping and gliding

Front 24

When the lower cervicals (C3-7) go into flexion, the __ glide apart producing stretching and joint gapping.

Back 24

facets
Anterior disc compression and posterior distraction

Front 25

T/F Flexion of C3-7 is anterior disc distraction and posterior compression.

Back 25

False- Extension of C3-7 is anterior disc distraction and posterior compression.

Front 26

Lateral flexion of the cervical spine is coupled with _____.

Back 26

ipsilateral axial rotation

Front 27

The greatest flexion is found in which part of the cervical spine?

Back 27

C0-1

Front 28

Lower cervical lateral flexion:
Lateral disc wedging and approximation are present on the side of lateral flexion and _____ is present on the side of opposite lateral flexion

Back 28

distraction
The inferior facet glides down and medially on the side of lateral flexion and up and laterally on the side of opposite lateral flexion.

Front 29

During lower cervical rotation, the inferior facet on the side opposite rotation glides ________.

Back 29

up and lateral

Front 30

LUMBAR BIOMECHANICS (L1-L5)

Articular facets primarily in _____ plane but become more _____ at the lumbosacral junction.

Back 30

Articular facets primarily in SAGITTAL PLANE plane but become more CORONAL at the lumbosacral junction

Front 31

LUMBAR BIOMECHANICS (L1-L5)

- greatest motility is in ________
- ________ limits rotational flexibility

Back 31

- greatest motility is in FLEXION-EXTENSION
- FACET ORIENTATION limits rotational flexibility

Front 32

What is the lumbar disc height-to-body ratio?

Back 32

1:3 ... allows ROM

Front 33

What is the function of the lumbar disc?

Back 33

The lumbar disc
- allows for movement
- resists axial compression forces

Front 34

The annulus fibrosus layers are made of criss-crossing fibers. What function does this serve?

Back 34

The criss-crossing pattern reinforces the annular ring and makes it stronger.

Front 35

Discuss the innervation and blood supply to the lumbar disc.

Back 35

- the outer 1/3 is innervated for pain
- low blood supply, poor healing

Front 36

Name the 3 portions of the lumbar disc.

Back 36

- NUCLEUS PULPOSUS
- ANNULUS FIBROSUS
- VERTEBRAL ENDPLATE

Front 37

What happens to the hydrostatic pressure in the nucleus pulposus when the lumbar disc experiences compression force from body weight and muscle contraction?

Back 37

Compression force from body weight and muscle contraction RAISES hydrostatic pressure in the nucleus pulposus.

Front 38

What does it mean if there is a protrusion of a lumbar disc?

Back 38

PROTRUSION...displaced nucleus pulposes remains within the annulus fibrosis, but may create a presssure bulge on a nerve root or spinal cord.

Front 39

What does it mean if there is a prolapse of a lumbar disc?

Back 39

PROLAPSE...displaced nucleus pulposus reaches the posterior edge of the disc, but remains confined within the outer layers of the annulus fibrosus.

Front 40

Discuss the innervation and blood supply to the lumbar disc.

Back 40

- the outer 1/3 is innervated for pain
- low blood supply, poor healing

Front 41

Name the 3 portions of the lumbar disc.

Back 41

- NUCLEUS PULPOSUS
- ANNULUS FIBROSUS
- VERTEBRAL ENDPLATE

Front 42

What happens to the hydrostatic pressure in the nucleus pulposus when the lumbar disc experiences compression force from body weight and muscle contraction?

Back 42

Compression force from body weight and muscle contraction RAISES hydrostatic pressure in the nucleus pulposus.

Front 43

What does it mean if there is a protrusion of a lumbar disc?

Back 43

PROTRUSION...displaced nucleus pulposes remains within the annulus fibrosis, but may create a presssure bulge on a nerve root or spinal cord.

Front 44

What does it mean if there is a prolapse of a lumbar disc?

Back 44

PROLAPSE...displaced nucleus pulposus reaches the posterior edge of the disc, but remains confined within the outer layers of the annulus fibrosus.

Front 45

What does it mean if there is an extrusion of the lumbar disc?

Back 45

EXTRUSION...annulus fibrosus ruptures, allowing the nucleus pulposus to escape from the disc into the epidural space.

Front 46

What does it mean if there is a sequestration of the lumbar disc?

Back 46

SEQUESTRATION...parts of the nucleus pulposus and fragments of the annulus fibrosus become lodged within the epidural space.

Front 47

Describe the following in regards to the LUMBAR SPINE (L1-L5):
- pedicles and laminae
- spinous processes
- transverse processes

Back 47

- pedicles and laminae: short, broad and strong
- spinous processes: thick and broad
- transverse processes: long, slender and flattened on anterior/posterior surfaces

Front 48

THORACIC BIOMECHANICS (T2-T8):

What do the costovertebral joint on side of vertebral body articule with?

Back 48

RIB HEADS

Front 49

THORACIC BIOMECHANICS (T2-T8):

What do the costotransverse joints on transverse processes articule with?

Back 49

TUBERCLES OF RIBS

Front 50

THORACIC BIOMECHANICS (T2-T8):

Articular facets form a ____ angle from the transverse toward the coronal plane and a ____ angle from the coronal toward the sagittal plane

Back 50

Articular facets form a 60 degree angle from the transverse toward the coronal plane and a 20 degree angle from the coronal toward the sagittal plane.

Front 51

Atypical Thoracic Vertebrae (T1 and T9-T12)

- T1 resembles ___ and has a whole facet for articulation with the _______
- T9-T12 have variations on the location of the facets on the body and transverse process for articulation with the ____
- T11 and T12 begin to take on the characteristics of ________

Back 51

- T1 resembles C7 and has a whole facet for articulation with the FIRST RIB
- T9-T12 have variations on the location of the facets on the body and transverse process for articulation with the RIBS
- T11 and T12 begin to take on the characteristics of LUMBAR VERTEBRA.

Front 52

Is the thoracic curve kyphotic or lordotic? Is it a primary or secondary curve?

Back 52

KYPHOTIC CURVE (average is 45 degrees) is a PRIMARY curve.

Front 53

Where is the apex of the thoracic curve?

Back 53

Apex is at T6-T7 disc space

Front 54

What effect does flattening of the thoracic curve have on the following?
- Cervical curve (increase/decrease) and shift (forward/back)
- Lumbar curve (increase/decrease)

Back 54

- Cervical curve DECREASES and shifts FORWARD
- Lumbar curve INCREASES

Front 55

What is the disc height-to-body ratio of the thoracic disc?

Back 55

1:5...smallest ratio in the spine

Front 56

The thoracic disc contributes to (increased/decreased) flexibility in the thoracic spine.

Back 56

The thoracic disc contributes to (DECREASED flexibility in the thoracic spine.

Front 57

Describe the position of the nucleus pulposus within the annulus of each of the following discs:
- cervical
- thoracic
- lumbar

Back 57

- cervical: slightly possterior
- thoracic: centrally
- lumbar: posteriorly

Front 58

Both thoracic and lumbar flexion and extension combines _____ plane rotation with slight _____ plane translation (minimal)

Back 58

Both thoracic and lumbar flexion and extension combines SAGITTAL plane rotation with slight SAGITTAL plane translation (minimal)

Front 59

In thoracic flexion, articular facets glide (apart/together) as the disc opens (anteriorly/posteriorly)

Back 59

In thoracic flexion, articular facets glide APART as the disc opens POSTERIORLY.

Front 60

In thoracic extension, _____ and _____ approximate.

Back 60

In thoracic extension, FACET JOINTS and POSTERIOR DISC approximate.

Front 61

During lumbar flexion...
- vertebra tilts and slides (anteriorly/posteriorly)
- facets glide (superiorly/inferiorly)
- disc is compressed (anteriorly/posteriorly) and stretched (anteriorly/posteriorly)

Back 61

During lumbar flexion...
- vertebra tilts and slides ANTERIORLY
- facets glide SUPERIORLY
- disc is compressed ANTERIORLY and stretched POSTERIORLY

Front 62

During lumbar extension...
- vertebra tilts (anteriorly/posteriorly)
- facets (spread/approximate)
- facet capsule, disc and anterior longitudinal ligament are stretched (anteriorly/posteriorly)

Back 62

During lumbar extension...
- vertebra tilts POSTERIORLY
- facets APPROXIMATE
- facet capsule, disc and anterior longitudinal ligament are stretched ANTERIORLY

Front 63

Lumbar lateral flexion is coupled with _______

Back 63

Lumbar lateral flexion is coupled with OPPOSITE SIDE ROTATION.

This is opposite of the coupled motion in the cervical and upper thoracic spine.

Front 64

Lumbar lateral flexion:

- facets on side of lateral flexion (glide together/glide apart)
- facets on side opposite lateral flexion (glide together/glide apart)

Back 64

Lumbar lateral flexion:

- facets on side of lateral flexion GLIDE TOGETHER
- facets on side opposite lateral flexion GLIDE APART.

Front 65

In lumbar rotation, facets (approximate/glide apart) on side fo rotation and (approximate/glide apart) on side opposite rotation.

Back 65

In lumbar rotation, facets GLIDE APART on side of rotation and APPROXIMATE on side opposite rotation.

Front 66

What movements are coupled with lumbar rotation?

Back 66

Lumbar rotation is coupled with LATERAL FLEXION and slight sagittal plane ROTATION.

Front 67

- Rotation of L1-L3 is coupled with (same/opposite) side lateral flexion
- Rotation of L4-L5 is coupled with (same/opposite) side lateral flexion.

Back 67

- Rotation of L1-L3 is coupled with OPPOSITE side lateral flexion
- Rotation of L4-L5 is coupled with SAME side lateral flexion.

Front 68

Thoracic spinal biomechanics:
With inspiration, which thoracic ribs are pulled up and forward in the "pump handle action"?

Back 68

T 1-6
This increases the A-P diameter of the rib cage. The rib head rolls downward, elevating the anterior end of the rib like the handle of a pump.

Front 69

Thoracic spinal biomechanics:
With inspiration, which thoracic ribs are elevated and depressed in the "pump handle action"?

Back 69

T 7-10
This increases the transverse diameter of the rib cage. The ribs ride up and dawn on the transverse process.

Front 70

With inspiration, thoracic ribs T8-12 move ____ in the caliper action.

Back 70

laterally. These movements increase the lateral diameter of the rib cage.

Front 71

The sacrum forms the keystone of an arch suspended by strong sacroiliac ligaments, which resist anterior and posterior displacement of the sacrum. Inferior displacement is resisted by_____.

Back 71

The wedge of the sacrum.
Ant displacement is also resisted by the pubic symphisis

Front 72

What are the components of the form closure (self-locking mechanism) of the pelvis?

Back 72

The SI joints promote stability :
1. wedge shape of the sacrum
2. interlocking groove of the sacrum with the ridge of the ilium
3. "s"-shaped joint surfaces

Front 73

The transverse processes of T2-8 are ___, ____ and _____. and the spinous processes are long and slender.

Back 73

thick, strong and long

Front 74

Costotransverse joints on transverse processes articulate with the ____ of the ribs.

Back 74

tubercles

Front 75

The inferior facets inferiorly, medially and ____(ant or post).

Back 75

anteriorly
Superior facets face posteriorly

Front 76

_____ closure is the tension in muscles, ligaments and fascia that helps stabilize the SI joints. What does this accomplish?

Back 76

Force- creates lateral to medial pressure from the ilium to sacrum and creates anterior closure of symphysis. Agresta called this the "myofascial sling".

Front 77

The pelvis ______ and ____ to absorb, adapt (transmit) to forces generated between the trunk and lower extremity during movement.

Back 77

Slides and pivots. This decreases stress to the lumbar spine and opposite SI joint.

Front 78

Nutation is...

Back 78

the sacral base rotates anteriorly on the ilium and the ilium rotates posteriorly on the sacrum

Front 79

What is it called when the sacral base rotates POSTERIORLY on the ilium and the ilium rotates anteriorly on the sacrum?

Back 79

Counternutation

Front 80

T/F Moving into nutation decreases the lumbar lordotic curve.

Back 80

False: Nutation increases the curve. Counternutation decreases the lordotic curve

Front 81

Which plane does the pubic symphysis rotate in?

Back 81

sagittal

Front 82

Flexion of the hip and ilium is accompanied by ipsilateral _____ ____ movement of the sacral base.

Back 82

anterior inferior

Front 83

During anterior pelvic tilt, the force couples are flexing the hip and extending the back. Which muscles are they?

Back 83

Hip flexor: iliopsoas and rectus femoris
Back extensors: erector spinae

Front 84

During posterior pelvic tilt, the force couples are hip extensors and abdominal muscles. Which muscles are they?

Back 84

Hip ext: gluteus maximus and hamstrings
Ab: rectus abdominus and oblique externus abdominus

Front 85

Upper thoracic lateral flexion is coupled with axial ____.

Do the motions occur to the same side?

Back 85

Upper thoracic lateral flexion is coupled with axial ROTATION.

YES, upper thoracic lateral flexion & rotation occur to the SAME side.

Front 86

What is the average degree of lateral flexion in the thoracic spine

Back 86

6 degrees

Front 87

In upper thoracic lateral flexion, inferior facets glide ____ on the side of flexion and ___ on the opposite side of flexion.

What is this due to?

Back 87

In upper thoracic lateral flexion, inferior facets glide MEDIALLY on the side of flexion and LATERALLY on the opposite side of flexion.

Due to strong coupled axial rotation.
What is this due to?

Front 88

True/False:

Rotation decreases in middle thoracics and is minimal in lower thoracics.

Back 88

True!
The largest degree of thoracic rotation occurs in the upper thoracic region.

Front 89

In thoracic rotation, inferior facet facet glides ____ on same side of rotation & glides ____ on side opposite of rotation.

Back 89

In thoracic rotation, inferior facet glides INFERIORLY on same side of rotation & glides SUPERIORLY on side opposite of rotation.

Front 90

How many True ribs are there? How many False ribs?

Back 90

True ribs = 7
False ribs = 5

Front 91

Name the ligaments that are part of a costovertebral joint.

Back 91

-Lateral costotransverse ligament
-Intertransverse ligament
-Superior costotransverse ligament
-Radiate ligament of head of rib
-Interarticular ligament

Front 92

Axial rotation in the lumbar region of the spine is very limited by ____.

Back 92

Axial rotation in the lumbar region of the spine is very limited by SAGITTAL FACETS.

Front 93

Rotation of L1-L3 is coupled with ____ side lateral flexion.

Rotation of L4-L5 is coupled with ____ side lateral flexion.

Back 93

Rotation of L1-L3 is coupled with OPPOSITE side lateral flexion.

Rotation of L4-L5 is coupled with SAME side lateral flexion.

Front 94

LUMBAR CURVE

- lordotic curve
- begins at ____ and extends to _____
- apex is _____
- secondary curve
- anterior pelvic tilt (increases/decreases) lordosis
- posterior pelvic tilt (increases/decreases) lordosis

Back 94

- lordotic curve
- begins at L1-L2 and extends to SACRUM
- apex is L3-L4
- secondary curve
- anterior pelvic tilt INCREASES lordosis
- posterior pelvic tilt DECREASES lordosis