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74 Cards in this Set

  • Front
  • Back
% of axial load carried by facet joints; in persons w/degenerative discs
20-25%; 70%
% of torsional and shear strength provided by facets
Closed packed position (lumbar spine); open pakced position
extension; midway between flex./ext.
total length of vertebral column made up by disc
how much of the nucleus pulposus is made of water
when do degenerative chages begin to occur and what level does water content drop too
second decade of life; 65% (nucleus begins to resemble the annulus)
What are schmorl's nodules?
caused by excessive pressure through cartilaginous end plate herniating the nucleus into the vertebral body
three main lumbar fascial systems
thoracolumbar, abdominal, fascia lata
muscles associated w/ thoracolumbar fascia
pull - latissimus dorsi, transverse abdominus, internal oblique, gluteus maximus; push - superficial and deep erector spinae, multifidi
muscles associated w/ abdominal fascia
pull - transverse abdominus, internal and external obliques, pec major, serratus anterior; push - rectus abdominus
muscles associated w/ fascia lata
pull - gluteus maximus, TFL; push - quadriceps, hamstrings, abductors
what structures around the spine are innervated?
peripheral posterior and lateral aspect of annulus fibrosus, anterior and posterior longitudinal ligament, vertebral body, lumbar nerve roots, facet joint cartilage
Fryette's Law I
thoracic and lumbar spine, when in neutral, sidebending and rotation occur in the opposite direction
Fryette's Law II
thoracic and lumbar spine in full flex. or ext. (locked facets) side bending and rotation occur in same direction; this is always true in the cervical spine
Fryette's Law III
cervical, thoracic, and lumbar spine as motion is introduced in one plane motion in other planes is reduced
3 core stabilizing systems
passive, active, and neural
Passive contribution to stability
not enough stability near neutral, provide reactive forces @ end range motions, in neutral it functions as transducers, measure of joint position and motion
active musculoskeletal subsystem contribution
provide force for movement and stability, transducers in muscle measure force production
neural control subsystem
"central processor", analyzes information and leads to stability or movement goal achievement via the active subsystem
enhancing the stabilizing system through the passive subsystem
ensure proper system balance to increase system balance
enhancing the stabilizing system through the active subsystem
increase muscle strength (decrease risk of LBP), obtain adequate muscle flexibility to facilitate better core stability
enhancing the stabilizing system through the neural subsystem
trunk muscle contraction is altered and there is an increase in recruitment time in pt's w/ LBP, LBP and spinal stenosis increase body sway when pt is on unbalanced surface w/ eyes closed
adequate core stability allows what?
"proximal stability for distal mobility", significant force production for task performance, obtimal shock absorption and weight transference
what comes from inadequate core stability?
inefficient structure and function, serial distortion, decreased performance and predisposition to injury
Articular surface on the lateral sacral surface
contained in first three segments, short arm in vertical plane, long arm in a/p plane
main 7 connective tissues associated with SI joint
ventral SI lig., interosseous SI lig., long dorsal SI lig., sacrotuberous lig., sacrospinous lig., iliolumbar lig., thracodorsal fasia
ventral SI lig (important info)
weakest of the SI lig's, palpated at Baer's point
interosseous SI lig (important info)
strongest SI lig, between lateral sacral crest and iliac tuberosity
long dorsal SI lig (important info)
tension increases w/ conternutation and loading of sacrotuberous lig., decreases w/ nutation and contraction of lat or glut
sacrotuberous lig (important info)
piriformis, biceps femoris, and glut max attach to it
Thoracodorsal fascia (info related to SI joint)
tension increases w/ any motion, contraction or stretching of muscles attached to it; this increase improves pelvic girdle and low back stability
sacrococcygeal joint
symphysis, has 3 ligaments associated to it
Mechanics of sacral nutation
occurs w/ supine to stand and flexion of LE; causes sacrum to glide posterior and inferior
Mechanics of sacral counternutation
occurs w/ stand to supine and extension of LE; causes sacrum to glide anterior and superior
Mechanics of posterior innominate rotation
occurs w/ ext. of trunk and flex. of LE; causes innominate to glide anterior and superior
Mechanics of anterior innominate rotation
occurs w/ spine to sitting and ext. of LE; cuases innominate to glide posterior and inferior
inner unit of muscle for SI stability
pelvic floor muscles, transverse abdominus, multifidi, and diaphragm
outer unit of muscle for SI stability
post. oblique (lats, glut maxs, TFL)
deep longitudinal (erector spinae, TFL, sacrotuberous lig, biceps femoris)
ant. oblique (oblique abs, contralat adductors, ant abdominal fascia)
Lateral (glut medius and minimus, contralat adduction of thigh)
anatomy of the atlas
wide, thin ring w/ well developed transverse processes that sit on the axis
anatomy of the axis
dens on anterior portion, well developed spinous processes
upper cervical function
protect medulla, increase rotation (50% of c-spine rotation), nodding occurs @ OA joint and rotation @ AA
lower cervical function
facets angle towards the eyes, joint of luschka, movement in all 3 planes
muscle groups of the neck
superficial posterior, deep posterior, superficial anterior, deep anterior
superficial posterior musculature of the neck (w/ attachments)
levator scapulae (C1-4 transverse process), trap, splenius capitis (C7-T3 spinous process to base of occiput), splenius cervicis (T3-6 spinous process to C1-3 transverse process), rhomboids (C7-T5 spinous process)
deep posterior musculature of the neck (w/ attachments)
suboccipitals - rectus capitis post. major (spinous process C2 to lateral occiput), rectus capitis post. minor (post C1 to medial nuchal line), oblique capitis superior (transverse process of C1 to lateral nuchal line), oblique capitis inferior (C2 spinous process to inferior transverse process of C1)
intertransversarus and interspinalis
superficial ant. musculature of the neck (w/ attahcments)
SCM, ant. scalene (1st rib to transverse process of C3-6), mid. scalene (1st rib to transverse process of C2-7), post. scalene (2nd rib to transverse process of C4-6), suprahyoid (pull down on mandible), infrahyoid (pull down on hyoid), masseter and temporalis (stabilize jaw)
deep ant. musculature of the neck (w/ attachments)
longus colli (along vertebral bodies), longus capitis (ant tubercle of transverse process of C3-6 to ant portion of occiput)
nuchal ligament
continuation of supraspinous lig
tectorial ligament
C2 spinous process to occiput
cruciform ligament
surrounds the dens, attaches to occiput
transverse ligament
tested in sharp-purser test, part of the cruciform ligament
alar ligament
integrity tested w/ palpation of C2 spinous process, checks lateral flexion
apical ligament
checks distraction of the head
clinical neural problems in the cervical region
peripheral entrapment of brachial plexus by scalenes, 1st rib or clavicle; suboccipital muscles may trap first and second dorsal rami
Fryettes Law in OA and AA motion
left rotation (AA - L rotation, OA - R sidebend), left sidebend (AA - R rotation, OA - L sidebend)
anatomy of thoracic vertebrae
T1-3 spinous process (SP) project posterior, T4-6 SP project down between own TP and ones below, T7-9 SP project down tip at level below, T10 same as 7-9, T11 same as 4-6, T12 same as 1-3
anatomy of T1
full costal facet superiorly for 1st rib and partial inferiorly for 2nd rib; very elongated spinous process
anatomy of T11 and 12
full costal facet on each for 11th and 12th ribs respectively; neck of those ribs don't articulate with transverse processes
Posterior trunk muscles
superficial (trap, lat, serratus ant, rhomboids, levator scapula)
intermediate (serratus post superior and inferior)
deep (erector spinae, transversospinal, short segmental)
Anterior/lateral trunk muscles
all abdominals
primary muscles of, quiet, inspiration
diaphragm, scalenes, intercostales
muscles of forced inspiration
serratus ant. and both posterior, pec minor and major, levator costae, SCM, lats, quadratus lumborum, iliocostalis thoracis and cervicis
movement in the thoracic spine
30-40 degrees flex, 20-25 degrees ext, 30 degrees rotation, 25 degrees sidebending
thoracic stability provided by...
core muscles, extensive ligaments, sterno-costo-vertebral ring
sharp, posterior angulation; kyphotic deformity, result of anterior wedging
dowager's hump
results from postmenopausal osteoporosis (upper thoracic and mid cervical spine)
pectus carinatum
pigeon chest (sternum out forward and down)
pectus excavatum
funnel chest (eg. connor hunt)
barrel chest
sternum out forward and upward
respiration occurs with movement at what 5 joints
manubriosternal, sternocostal, interchondral, costotransverse, costovertebral
normal rib alignment
upper ribs - horizontal, run more obliquely as you descend
pump handle action
first six ribs, increase a/p diameter, rotate up - elevation, rotate down - depression
bucket handle action
ribs 7-10, increase lateral dimension, increase infrasternal angle by up back and medial motion of the rib
caliper action
ribs 8-12, increase lateral dimension