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Unit 3 Biomechanics Winter 2024 > Cervical and thoracic regions > Flashcards

Cervical and thoracic regions Flashcards

1
Q

What are the primary and secondary curves of the spine?

A

Primary:
- kyphosis (thoracic and sacral)

Secondary:
- Lordosis (cervical & lumbar)

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2
Q

What happens to the cervical curves during sagittal plane movement?

A

Flexion: decrease/flatten out lordotic curve

Extension: increases lordotic curve

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3
Q

What happens to the thoracic curves during sagittal plane movement?

A

Flexion: increases kyphotic curve

Extension: decreases/flattens out kyphotic curve

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4
Q

What happens to the lumbar curves during sagittal plane movement?

A

Flexion: decrease/flatten out lordotic curve

Extension: increases lordotic curve

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5
Q

What happens to the sacral curves during sagittal plane movement?

A
  • Fixed, fused together so doesn’t move
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6
Q

What is one negative of having spinal curves?

A
  • shear forces
  • can lead to spondylolisthesis
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7
Q

Where does the LoG fall for each spinal curve?

A
  • falls on the concave side of each curve
  • Anterior = kyphotic
  • Posterior = lordotic
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8
Q

Is it a good thing or bad thing that the LoG falls on the concave side of each curve?

A
  • Good!
  • helps keep curves in line & decreases work needed from ligaments/muscles to maintain good posture & ideal LoG
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9
Q

What are anatomical factors for ideal posture?

A
  • shape of discs or vertebral bodies
  • facet joint orientation
  • ligament composition
  • muscles stiffness
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10
Q

What happens to the PLL as it descends through the lumbar spine?

A
  • it starts to narrow as it moves down
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11
Q

How does the narrowing of the PLL affect the discs in the lumbar region?

A
  • hard to stop a bulging disc which leads to increased chances of bulging disc injury
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12
Q

Describe a “motion segment” and its components

A

Segments of the vertebral column that allow movement
- transverse & spinous processes
- apophyseal joints
- interbody joints

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13
Q

Define osteokinematics as it relates to movement at a spinal motion segment

A
  • 3 degrees of freedom
  • AoR through interbody joints
  • movement is described by what the joint is doing and where the front goes
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14
Q

Define arthrokinematics as it related to movement at a spinal motion segment

A
  • describes motion of the facets
  • sliding, gapping, approximation
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15
Q

Define the AoR as it related to movement at a spinal motion segment

A
  • interbody joint is the AoR
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16
Q

What are the functions of the interbody joints?

A
  • absorb & distribute loads
  • glues vertebrae together
  • approximate axis of rotation
  • discs = spacers
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17
Q

What are “intra-articular inclusions?”

A
  • small, accessory structures that exist around joints
    EX: subscapular fat pads & fibro-adipose meniscoids (FAMs)
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18
Q

How can these intra-articular inclusions affect facet joints?

A
  • fill up spaces b/w facet joints
  • help dissipate compressive forces
  • partially cover articular cartilage
  • FAMs can become impinged during whiplash
  • can lock facet joints
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19
Q

What facet orientation allows for different kinds of movement?

A
  • more vertical facet orientation = more frontal/sagittal plane movement
  • more horizontal facet orientation = more axial rotation
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20
Q

What part of the intervertebral disc has nerve and blood supply?

A
  • annulus fibrosus -> outer layer innervated/vascularized
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21
Q

How does the annulus help dissipate loads?

A
  • comprised of collagen & elastin w/ layers
  • alternates orientation w/ each layer
  • oriented 65 degrees from vertical & 25 degrees from horizontal
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22
Q

How does the disc get nutrition?

A
  • diffusion
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23
Q

Why are we taller in the morning than in the evening?

A
  • disc swells overnight
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24
Q

Why would a disc be more painful in the morning?

A
  • weight-bearing compresses disc & pushes water out
  • painful for those w/ issues
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25
Q

Explain the process of disc degeneration

A

1) Aging, excessive, or abnormal mechanical loading -> reduced permeability & increased calcification of endplates
2) reduced nutrient flow to disc
3) Inhibition of cellular metabolism & proteoglycan synthesis -> can’t attract & retain water -> decreased ability to absorb & transfer loads

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26
Q

How does the disc help transmit loads through the spine at each motion segment?

A
  • endplates move toward nucleus
  • nucleus slowly deforms radially (which is incompressible)
  • annulus resists radial deformation
  • pressure transmitted to other vertebra
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27
Q

How does the disc respond to movement of the spinal motion segments in the sagittal plane?

A

Flexion:
- compression anterior
- stretches posterior
- nucleus migrates posterior

Extension:
- compression posterior
- stretches anterior
- nucleus migrates anterior

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28
Q

How does the disc respond to movement of the spinal motion segments in the frontal plane?

A

Lateral flexion:
- compression ipsilateral
- stretches contralateral
- nucleus migrates contralateral

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29
Q

How does the disc respond to axial compression?

A
  • resisted by discs & vertebral bodies
  • transmitted through discs to end plates to vertebral bodies
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30
Q

How does the disc respond to bending?

A
  • compression 1 side
  • tension other side
  • nucleus migrates away from compression
  • creep of viscoelastic structures
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31
Q

How does the disc respond to torsion?

A
  • resisted by vertebral bodies, discs, facets
  • annular fibers rupture w/ torsion & axial compression & forward bending
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32
Q

How does the disc respond to shear?

A
  • vertebral translation
  • resisted by facets & discs
  • disc creep leave facets only to resist
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33
Q

Explain the spinal coupling that occurs in the mid-lower cervical spine

A
  • lateral flexion + ipsilateral rotation
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34
Q

What happens if the transverse ligament of the atlas is ruptured?

A
  • Dens is free to move which could injury spinal cord
  • atlas slips anteriorly
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35
Q

What is meant by the “transitional zone” when discussing the spine?

A
  • the change of apophyseal joint orientation
36
Q

What muscles is used when you turn your head to the left?

A
  • right SCM
37
Q

What is spinal coupling?

A
  • movement in 1 plane associated with automatic movement in another plane
38
Q

What are some explanations for spinal coupling?

A
  • muscle action
  • facet alignment
  • pre-existing posture
  • attachment of ribs
  • stiffness of connective tissues
  • normal spinal curves
39
Q

What happens if an Alar ligament is ruptured?

A
  • resists rotation
  • if ruptured, excessive movement/rotation to contralateral side
40
Q

What are the arthrokinematics of A-O joint flexion?

A
  • convex occipital condyles roll anterior and slide posterior
41
Q

What are the arthrokinematics of A-O joint extension?

A
  • convex occipital condyles roll posterior and slide anterior
42
Q

What are the arthrokinematics of A-O joint rotation?

A
  • not much movement
43
Q

What are the arthrokinematics of A-O joint lateral flexion?

A

Right:
- roll right, slide left

Left:
- roll left, slide right

44
Q

What are the arthrokinematics of A-A joint flexion?

A
  • atlas tilts about 15 degrees forward
45
Q

What are the arthrokinematics of A-A joint extension?

A
  • atlas tilts about 15 degrees backward
46
Q

What are the arthrokinematics of A-A joint rotation?

A
  • atlas twists around dens

contralateral vertebral artery taut

47
Q

What are the arthrokinematics of C2-7 flexion?

A
  • top vertebra slides superior & anterior

OOP

48
Q

What are the arthrokinematics of C2-7 extension?

A
  • top vertebra slides inferior & posterior

CPP

49
Q

What are the arthrokinematics of C2-7 rotation?

A
  • ipsilateral facet slides inferior and posterior
  • contralateral facet slides superior and anterior
50
Q

What are the arthrokinematics of C2-7 lateral flexion?

A
  • ipsilateral facet slides inferior and posterior
  • contralateral facet slides superior and anterior
51
Q

What does protraction cause the mid-lower cervical spine and upper cervical spine to do?

A

Mid-lower:
- flexion

Upper:
- extension

52
Q

What does retraction cause the mid-lower cervical spine and upper cervical spine to do?

A

Mid-lower:
- extension

Upper:
- flexion

53
Q

What vertebral artery becomes taught with right cervical rotation?

A
  • left vertebral artery

always contralateral artery becomes taut

54
Q

Why doesn’t the upper cervical spine follow the natural coupling pattern of the rest of the cervical spine?

A
  • to keep our gaze level so the coupling pattern has to change to stay level
55
Q

What happens during lateral flexion of upper cervical coupling pattern?

A

A-A:
- ipsilateral lateral flexion = capital rotation contralaterally

56
Q

What happens during rotation of upper cervical coupling pattern?

A

A-O:
- capital rotation right = lateral flexion left

57
Q

What cervical spine position increases foraminal opening?

A
  • flexion
  • contralateral rotation &/or lateral flexion
58
Q

What cervical spine position decreases foraminal opening?

A
  • extension
  • ipsilateral rotation &/or lateral flexion
59
Q

What action does the SCM perform?

A
  • flexes mid/lower cervical spine
  • extend upper cervical
  • unilateral contraction turns capital to opposite side
60
Q

What action do the scalenes perform?

A
  • laterally flexes neck (unilateral contraction)
  • stabilizes
61
Q

What action does the longus colli perform?

A
  • flexes neck
  • reduces lordosis
  • stabilizes
62
Q

What action does the rectus capitis anterior & lateralis perform?

A
  • flexes & stabilizes
  • laterally flexes

Rectus capitis anterior:
- flexes A-O

Rectus Capitis lateralis:
- laterally flexes A-O

63
Q

What action do the splenius cervicis & capitis perform?

A

Unilateral:
- laterally flex
- ipsilateral rotation

Bilateral:
- extension

64
Q

What muscles would you want to train for neck stability?

A
  • scalenes, levator scapula, longus colli, traps

Shorter segment muscles:
- multifidi
- fine, motor control

Longer segment muscles:
- guy wires for vertical stability

65
Q

Why do osteophytes develop in the cervical spine and how do they affect other structures?

A
  • dehydrated, degenerated discs leading to increased compression of vertebra
  • leads to increased bone formation causing closing/decreased volume for exiting nerve roots
66
Q

Explain the effects of whiplash on structures of the neck

A
  • hyperextension
  • ALL injury, Alar ligaments, longus colli/capitis
  • compresses facets, discs, other posterior elements
  • spasms of muscles in the area
67
Q

What is regional interdependence?

A
  • one muscles action depends on stabilization force of another

EX:
- longus colli stabilizes neck = trap can elevate shoulders

68
Q

Describe the arthrokinematics of the thoracic facets during flexion

A
  • inferior facet of superior vertebra slides superior & anterior
69
Q

Describe the arthrokinematics of the thoracic facets during extension

A
  • inferior facet of superior vertebra slides inferior and posterior
70
Q

Describe the arthrokinematics of the thoracic facets during rotation

A
  • facets slides contralaterally

R rotation = facets slide left

71
Q

Describe the arthrokinematics of the thoracic facets during lateral flexion

A
  • ipsilateral facet slides inferior
  • contralateral facet slides superior
72
Q

What muscles are in the erector spinae group?

A
  • spinalis
  • longissimus
  • iliocostalis
73
Q

What muscles are in the transversospinal group?

A
  • semispinalis
  • multifidi
  • rotatores
74
Q

What muscles are in the short segmental group?

A
  • interspinalis
    -intertransversarius
75
Q

What is the flexion-relaxation phenomenon?

A
  • erector spinae ecc contract during flexion until about 2/3rds then are silent (stretch is still active)
  • this point passive tension is enough to create moment for flexion
76
Q

How does the flexion-relaxation phenomenon adversely affect the lower lumbar spine?

A
  • losses ability to oppose/resist anterior shear of lumbar vertebra
77
Q

How is the psoas major unique in its line of force throughout the lumbar spine in the sagittal plane?

A
  • increases lumbar lordosis & anterior tilts pelvis on fixed femur
  • upper lumbar spine = extensor
  • lower lumbar spine = flexor

MAJOR lumbar stabilizer

78
Q

What pathology can occur at the T-L junction?

A
  • hyperlordosis could occur (cerebral palsy)

Traumatic paraplegia:
- hyperflexion torque
- fracture/dislocation
- spinal cord injury

79
Q

How is scoliosis named?

A
  • described by the convexity

EX: right thoracic scoliosis

80
Q

What is the difference between function and structural scoliosis?

A

Functional:
- corrected w/ postural shift

Structural:
- fixed; can’t be corrected
- adolescent females > males (4x more)

81
Q

What coupling occurs with scoliosis?

A
  • contralateral spinal coupling
  • right lateral flexion = left rotation
  • right rib hump side of convexity
  • vertebral bodies face left & spinous processes face right
82
Q

How does thoracic kyphosis affect the moment created by the line of gravity?

A
  • increases gravitational EMA of thoracic flexion
83
Q

What affect does thoracic kyphosis have on the spine and thorax?

A
  • impacts inspiration, vital capacity, & balance (shifts CoM forward)
  • leads to increased flexion torque of thoracic spine & extensive torque on cervical spine
84
Q

What are ROM norms for cervical flexion/extension?

A

Flex:
- 45

Ext:
-45

85
Q

What are ROM norms for cervical rotation and lateral flexion?

A

Rotation:
- 60

Lateral flexion:
- 45

Unit 3 Biomechanics Winter 2024 (8 decks)

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