EXAM #2 Flashcards
(201 cards)
1
Q
The act of moving from one
place to the other
A
Locomotion
2
Q
The manner of walking
A
Gait
3
Q
A smooth, highly coordinated, rhythmical, undulating, reciprocal movement by which the body moves step by step in the required direction at the necessary speed
A
Walking
4
Q
The period of time from one event (usually initial contact) of one foot to following occurrence of the same event with the ipsilateral foot
A
Gait cycle
5
Q
Described as the period from the initial contact of a particular limb to the point of initial contact of the SAME limb and is equivalent to one gait cycle
A
stride
6
Q
Described as the period from initial contact of one limb to the initial contact of the contralateral limb
A
Step
7
Q
Normal Gait:
There are _ _ in each stride (or gait cycle)
A
two steps
8
Q
Normal gait:
The period of time when the foot is in contact with the ground
A
stance phase (ST)
9
Q
Normal gait:
The period of time when the foot is not in contact with the ground
A
swing phase (SW)
10
Q
Normal gait:
The period of time when both feet are in contact with the ground
- This occurs twice in the gait cycle, at the beginning and end of the stance phase
A
Double support (DS)
11
Q
Normal gait:
The period of time when only one foot is in contact with the ground
- In walking, this is equal to the swing phase of the other limb
A
single support (SS)
12
Q
The point in the gait cycle when the foot initially makes contact with the ground
- Represents the beginning of the stance phase
A
Initial contact (IC)
13
Q
The point in the gait cycle when the foot leaves the ground
- This represents the end of the stance phase or
beginning of the swing phase
- Also referred to as foot-off
A
Terminal contact (TC)
14
Q
Normal gait:
When terminal contact is made with the toe
A
toe-off (TO)
15
Q
Normal gait:
The point in time in the stance phase when the full foot is in contact with the ground
A
Foot flat (FF)
16
Q
Normal gait:
The point in the stance phase when the heel leaves the ground
A
Heel off (HO)
17
Q
Gait:
The distance from a point of contact with the ground of one foot to the following occurrence of the same point of contact with the other foot
- Expressed in meters (m)
A
Step length
18
Q
Gait:
Is the period of time taken for one step and is measured from an event of one foot to the following occurrence of the same event with the other foot
- Expressed in seconds (s)
A
Step period
19
Q
Gait:
The distance from initial contact of one foot to the following initial contact of the same foot
- Sometimes referred to as cycle length
- Expressed in meters (m
A
Stride length
20
Q
Gait:
The period of time from initial contact of one foot to the following initial contact of the same foot
- Expressed in seconds (s)
A
Stride period or cycle time
21
Q
Gait:
The rate of change of linear displacement along the direction of progression measured over one or more strides
- Expressed in meters per second (m/s)
A
Velocity
22
Q
Gait:
Rate at which a person walks, expressed in steps per minute
A
Cadence
23
Q
Gait:
The ratio of the stance period to the swing period
A
60% stance / 40% swing
24
Q
Gait:
Controlled by the _ _ _ (postural reflex activity)
A
central nervous system
25
Gait:
Major afferent stimuli is provided by:
- Tactile impulses from the sole of the foot
- Proprioceptive impulses (from the lower limb,
trunk, and neck)
26
In normal walking: Approximately _ steps
are taken per minute
50-60
27
Phases of gait:
- The “weight-bearing” phase
- Provides the stability of the gait
- Necessary for accurate swing phase to take
place
Stance phase
28
Includes: 5 Stages of Gait Cycle
- Initial contact
- Loading response
- Mid-stance
- Terminal Stance
- Pre-Swing
29
Gait - Stance phase:
- First position of “double support”
- The _ _ of the leading stance foot and the toes of the other foot are both on the ground
Initial Contact
30
Gait - Stance phase:
- Weight transferred onto the outstretched limb
- The first period of double support
Loading Response
31
Gait - Stance phase:
- Defined as the time the opposite limb leaves the floor until the body weight is aligned over the forefoot
- Body progresses over a single, stable limb
Mid-Stance
32
Gait - Stance phase:
- The heel is raised as the body moves forward over the stance limb
- The body moves ahead of the limb
Terminal Stance
33
Gait - Stance phase:
- The second (and final) double support period
- Defined from the time of initial contact of
the contralateral limb to ipsilateral toe-off
- Unloading of the limb occurs as weight is transferred to the contralateral limb
Pre-Swing
34
Initial contact
35
Loading response
36
Mid-stance
37
Terminal stance
38
Pre-swing
39
Gait:
- Defined as the non-weight-bearing phase of
the reference limb
- Begins as soon as the foot of reference limb
leaves the ground (after foot-off), and finishes
just prior to initial contact of the same limb
Swing phase
40
Gait- Swing phase:
Begins once the foot of the swing limb leaves
the ground until the point at which the swing
limb is directly under the body or at maximum
knee flexion
Initial swing
41
Gait- Swing phase:
Begins from maximum knee flexion (when the
swing limb is under the body) until the swing
limb passes the stance limb and the tibia is in
a vertical position
Mid-swing
42
Gait - Swing phase:
From the point at which the tibia is in a
vertical position to the point just prior to
initial contact
- The momentum slows down as the limb
moves into the stance phase again
Terminal swing
43
Initial swing
44
Mid-swing
45
Terminal swing
46
Normal gait - joint position:
Initial contact
- Ankle
Neutral
- neither dorsiflexed nor plantar flexed
47
Normal gait - joint position:
Initial contact
- knee
Flexed
- Slight flexion helps absorb the impact of the foot contacting the ground
- Weight of body behind the knee
48
Normal gait - joint position:
Initial contact
- HIp
Flexed
- Lengthens limb in preparation for contact between heel and ground
- Helps provide for proper placement of foot so that the heel makes contact with the ground
49
Normal gait - joint position:
Mid-stance
- Ankle
dorsiflexed
50
Normal gait - joint position:
Mid-stance
- Knee
Extended
- Lengthens limb to help support weight of torso which is now directly over limb
51
Normal gait - joint position:
Mid-stance
- Hip
neutral
52
Normal gait - joint position:
Terminal stance
- Ankle
Plantar flexed
- Calf muscles begin to contract strongly bringing the ankle joint into a plantar flexed position
53
Normal gait - joint position:
Terminal stance
- Knee
Flexed
- Shortens limb to allow clearance from ground
54
Normal gait - joint position:
Terminal stance
- HIp
Extended
- Torso on the opposite side has moved forward of reference limb
55
Normal gait - joint position:
Swing phase
- Ankle
neutral
56
Normal gait - joint position:
Swing phase
- Knee
Flexed/extended
- shorten limb to maintain foot off of the ground
- Extend knee in preparation for initial contact
57
Normal gait - joint position:
Swing phase
- Hip
Flexed
- Limb catches up to and then passes the torso
58
Normal gait - Muscle action:
Ankle:
- Tibialis anterior and toe extensors (pre-tibial muscles) maintain foot position in preparation for loading response
Knee:
- Quadriceps contract to prepare for loading response
Hip:
- All hip extensors are active in preparation for their role in stabilizing the thigh during loading response
Initial contact
59
Normal gait - Muscle action:
Tibialis anterior muscles
swing phase
60
Normal gait - Muscle action:
Ankle:
- Plantar flexion torque quickly forces the foot to the floor
Knee:
- Eccentric quadriceps activity peaks to meet torque demands and to absorb shock
Hip:
- Extensor muscles fire to counteract flexion torque
- All gluteus muscles fire to stabilize pelvis in frontal plane
Loading response
61
Normal gait - Muscle action:
Gastrocnemius/soleus complex
stance phase
62
Normal gait - Muscle action:
Ankle:
- The soleus and gastrocnemius are active to control forward progression of the tibia
Knee:
- Quadriceps activity provides dynamic stability
- Calves act to restrain tibia, allowing femur to advance faster than tibia
Hip:
- Pelvis stabilized in frontal plane by hip abductors
Mid-stance
63
Normal gait - Muscle action:
Hamstring muscles
swing phase
64
Normal gait - Muscle action:
Ankle:
- Calf muscle activity peaks to prevent forward tibia collapse and allow the heel to rise
Knee:
- Restraint of the tibia by the calf muscles continue to stabilize the knee
Hip:
- TFL becomes active, possibly to restrain hyperextension of the hip (highly variable)
Terminal stance
65
Normal gait - Muscle action:
Gluteus medius
Stance phase
66
Normal gait - Muscle action:
Ankle:
- Residual plantar flexor activity and passive tension contributes to ankle moving into plantarflexion
Knee:
- Motion occurs with only minimal knee flexor activity from the gracilis
Hip:
- Adductor longus activity dynamically contributes to the femur flexing forward
Pre-swing
67
Normal gait - Muscle action:
Hip flexors
stance phase & swing phase
68
Normal gait - Muscle action:
Ankle:
- Pretibial muscles are active in preparation for ankle dorsiflexion
Knee:
- Activity peaks for biceps femoris short head, sartorius and gracilis (knee flexion)
- Knee flexion is aided by hip flexion
Hip:
- Iliacus, gracilis, and sartorius peak in activity (hip flexion)
Initial swing
69
Normal gait - Muscle action:
Quadriceps muscles
Stance phase & swing phase
70
Normal gait - Muscle action:
Ankle:
- Pretibial muscles are active
Knee:
- Knee extension is created by momentum and gravity
- Hamstrings become active in late mid-swing
Hip:
- Hamstrings initiate activity in late mid-swing
Mid-swing
71
Normal gait - Muscle action:
Ankle:
- The pretibial muscles are active
Knee:
- Quadriceps are active concentrically to ensure full knee extension
- Hamstring activity peaks in function to decelerate the thigh
Hip:
- Hamstrings peak in activity as they function to decelerate leg
- Gluteus muscles and TFL become active in preparation for role in weight acceptance
Terminal swing
72
Major Pathological Gait Defects
- Variance from the normal smooth locomotory function of gait can be associated with a deformity in:
- Osseous (developmental, congenital)
- Neurological (sensory, motor)
- Muscular soft tissue (laxity, fibrosis)
- Functional (lack of coordination, neuromuscular)
73
This is a characteristic gait of a spastic child
with marked bilateral adductor spasm at the
hips and equinus spasm in the ankle
scissoring gait
74
Also called “Festinating Gait”
- Gait is characterized by increase in cadence,
shortened stride, lack of heel strike and toe
off, as well as diminished arm swinging
Parkinson's Gait
75
An interference on coordinating functions of
the cerebella, so the person tends to walk
with a wide base of gait with an unsteady
irregular gait, even if watching feet
Cerebellar gait
76
Spinal - proprioceptive pathways of the spine or
brainstem are interrupted
- Loss of position and motion sense
- Ambulates with a wide base of gait with foot slap at heel contact
- Often watch feet as they walk
Ataxic Gait
77
Pathological Gait:
Hip extensor weakness
- The individual will throw the hip backward
with a "lurch" using abdominal and paraspinal
muscle activation just after heel strike on the
affected side
- Also seen in dislocated hip and muscular
dystrophy
Gluteus Maximus Lurch
78
Pathological Gait:
Gluteus medius weakness
- Drop of the pelvis more than the usual 5°on the unaffected side beginning with initial contact on the affected side and continuing until initial contact on the unaffected side
- Lateral excursion occurs on the affected side
- May compensate by laterally bending trunk to the affected side
Trendelenburg Gait
79
Pathological Gait:
Most apparent during initial contact through the stance phase of gait
- The affected knee must be locked in
hyperextension at or preceding initial contact by compensatory activity of the gluteus maximus extending the femur and the soleus which extends the tibia
- Repetitive hyperextension of the knee results in stretching of the ligaments and capsule of the
knee and resultant recurvatum of the knee
during the stance phase
Quadriceps weakness
80
Pathological Gait:
- Results in loss of ankle plantarflexion control
- Foot-off will be delayed and the push-off
phase will be decreased
Gastrocnemius weakness
81
Pathological Gait:
Ankle dorsiflexion weakness
- With mild weakness, the gait abnormality will
be noted at heel-strike and results in loss of
plantarflexion control
- Loss of dorsiflexion produces a high knee lift
to raise the foot clear of the ground
“Drop Foot,” “Slap Foot” or “Steppage
Gait”
82
Pathological Gait:
- Person tries to avoid pain associated with
weight-bearing and ambulation
- Often quick, short, and soft foot steps
Antalgic gait
83
To go quickly by moving the legs more rapidly than at a walk and in such a manner that for an instant in each step all or both feet are off the ground
Running
84
Running vs. walking
Running requires:
- more balance
- more muscle strength
- more force absorption
- more ROM
- more energy/burns more calories
85
Running cycle swing to stance phase ratio
30% stance / 70% swing
86
Running: stance phase
- foot strike
- Midstance/midsupport
- take off
87
Running: stance phase
- follow through
- forward swing
- double swing/float
- foot descend
88
Running cycle:
- stride and step length _
- frequency of steps _
- increases
- increases
89
Running cycle:
As speed increases, stance time _ and swing time _
- decreases
- increases
90
Cadence = frequency of steps
walking: _ steps per minute
50-60
91
Cadence = frequency of steps
running: _ steps per minute
170-200
92
Running vs. walking: Base of support
walking: shoulder width
Running: narrow, both feet on one line
93
Running vs. walking:
- walking has double _
- Running has double _
- support
- swing (double "float")
94
Walking vs. running:
Running requires more _
ROM
95
Walking vs. running: Range of motion
- Hip flexion walking at initial contact: _
- Hip flexion running at initial contact/foot strike: _
- 30 degrees
- 50 degrees
96
Walking vs. running: Range of motion
- Hip extension walking at push off: _
- Hip extension running as follow through: _
- 10 degrees
- 50 degrees
97
Walking vs. running: Range of motion
- Walking _ knee flexion at forward swing
- Running _ knee flexion at forward swing
- 60 degrees
- 125 degrees
98
Walking vs. running: Range of motion
- walking ankle dorsiflexion at midstance: _
- Running ankle dorsiflexion at midstance/mid support: _
- 10 degrees
- 30-40 degrees
99
Largest risk factor for running injuries
being female
100
_ lumbar vertebrae
_ of all the vertebrae
- 5
- largest
101
Lumbar Vertebrae: structure
- each vertebrae contains
- Body
- vertebral foramen
- Transverse process
- Spinous process
102
Lumbar Vertebrae: function
base of support
103
Lumbar Vertebrae: function
- Link between _
- protects _
- hip/pelvis and T-spine
- spinal cord
104
Lumbar Spine Joints
- intervertebral disc
- facet joints
105
Lumbar Spine Joints
Intervertebral disk make up _ of the height of the column and thickness varies from 3mm in _ region, 5mm in _ region to 9 mm in the _ region
- 20-30%
- cervical
- thoracic
- lumbar
106
Ratio between the vertebral body height
and the disk height will dictate the _ between the vertebra –
- Highest ratio in _ region allows for
motion
- Lowest ratio in _ region limits motion
- mobility
- cervical
- thoracic
107
Disc structure:
_ is located in the center except in lumbar lies slightly posterior
Nucleus Pulposus (NP)
108
Disc structure:
Hydration of the disc will also decrease with
_ _ - this loss of hydration decreases its mechanical function
compressive loading
109
Disc structure:
- 80-90% is H2O – decreases with age.
- Disc volume will reduce _ (reversible)
which causes a loss of 15-25 mm of height in the spinal column
- Acts as a hydrostatic unit allowing for uniform
distribution of pressure throughout the disc
20% daily
110
Spine joints:
- Articulation between the superior (concave) and inferior (convex) facets
- Guide intervertebral motion through their orientation in the transverse and frontal planes
Facet joint
111
Spine joints:
- Limit motions
- Resist both flexion and extension
- Resists rotation in lumbar region.
- Facet joints are synovial joints.
- Each joint is surrounded by a capsule of connective tissue and produces a fluid to nourish and lubricate the joint
- The joint surfaces are coated with cartilage allowing joints to move or glide smoothly against each other
Facet Joint Capsule
112
Lumbar Spine Ligaments (5)
1. Anterior Longitudinal Ligament
2. Posterior Longitudinal Ligament
3. Ligamentum Flavum
4. Supraspinous Ligament
5. Interspinous Ligament
113
Lumbar spine ligament actions:
Anterior longitudinal ligament
- Resists lumbar extension
- Traverses entire anterior spinal column
114
Lumbar spine ligament actions:
Posterior Longitudinal Ligament
- Resists lumbar flexion
- Traverses entire spinal column
115
Lumbar spine ligament actions:
- Composed of mainly elastic fibers
- Yellow in color (flavum is Latin for yellow)
- It runs from an anterior-inferior surface
of a cranial lamina to the posterior-superior surface of the caudal lamina
Ligamentum Flavum
116
Lumbar spine ligament actions:
- Strong fibrous cord
- Connects together the apices of the
spinous processes
Supraspinous Ligament
117
Lumbar spine ligament actions:
- Connects spinous processes of adjacent
vertebrae
- Thin and membranous
Interspinous Ligament
118
3 layers of lumbar spine muscles
1. superficial
2. intermediate
3. deep
119
3 layers of lumbar spine muscles fucntion
1. superficial
2. intermediate
3. deep
support
120
Lumbar spine muscles:
- superficial
- flexion to extension (bending over into an upright position)
erector spinae muscles
121
Lumbar spine muscles:
- support and stability
deep
122
Lumbar spine motion
- flexion/extension
- right and left lateral flexion
- rotation
123
Pathological Lumbar Curves:
- “Sway Back”
- Facilitated by high heels or lying on stomach
Hyperlodosis
124
Pathological Lumbar Curves:
- flat back
Hypolordosis
125
Many Different Treatments:
- No TX = Time
- Massage
- PT
- Acupuncture/Acupressure
- Chiropractic
- Surgery
- Low Back Pain Video
Lumbar pain
126
Best sleeping position
back sleeping - pillow under knees and neck
side sleeping - pillow between legs and under neck
127
Disc injuries
- lumbar disc herniation
- sciatica
- Degenerative disc disease
- Spondylolysis and Spondylolisthesis
- Scotty Dog Fracture
- Facet Joint Disease
- Lumbar Stenosis
128
Disc injuries:
- Anterior slippage of vertebrae
- Grades 1-4
- -lolysis = slippage with fracture of the pars
articularis (Scotty Dog Fracture)
- -listhesis = forward slippage may or may not
involve Scotty Dog Fracture
Spondylolysis and Spondylolisthesis
129
Disc injuries:
- Fracture of the pars articularis
- Occurs in spondylolysis
Scotty Dog Fracture
130
Disc injuries:
- caused by the cartilage in the joints being worn down as a result of wear and tear, aging, injury or misuse
Facet Joint Disease
131
Disc injuries:
- Definition = Narrowing
- Can be central (spinal canal) or lateral
Lumbar Stenosis
132
- Microdiscectomy
- Discectomy
- Laminectomy
- Fusion
- Artificial Disc Replacement
Lumbar Spine Surgeries
133
Lumbar Spine Surgeries:
- Non-invasive procedure involving replacing Discectomy (more invasive involving larger surgical incision)
Lumbar Microdiscectomy
134
Lumbar Spine Surgeries:
Laminectomy
135
Lumbar Spine Surgeries:
- Is an operation that causes the bones of the spine in the lower back to grow together
- The goal is to have the two vertebrae fuse (grow solidly together) so that there is no longer any motion between them
Lumbar Fusion
136
Lumbar Spine Surgeries:
- Emerging surgical procedure
- Replacing Lumbar Fusion
- Goal: Keep motion at that spinal segment
Artificial Disc Replacement
137
Composed of _ thoracic vertebra
12
138
12 pairs of ribs-all attaching posteriorly to thoracic vertebra
- _ true ribs (attach directly to the sternum)
- _ false ribs (3 attach to sternum via cartilage
and 2 are floating ribs(no sternal attachment)
- 7
- 5
139
Thoracic vertebra bones:
sternum
- Manubrium
- Body
- Xiphoid process
140
Spinal curves:
- Cervical – Lordosis (inward)
- Thoracic - _
- Lumbar- Lordosis (inward)
Kyphosis (outward)
141
Thoracic spine movements
- Flexion
- Extension
- Right and Left Rotation
- Right and Left Lateral Flexion
142
Thoracic joints:
- facet joints
- Costovertebral joints
142
Thoracic joints:
- articulations that connect the heads of the ribs with the bodies of the thoracic vertebrae
- Joining of ribs to the vertebrae occurs at
two places, the head and the tubercle of the
rib
Costovertebral joints
143
Thoracic ligaments
- Anterior longitudinal ligament
- Posterior longitudinal ligament
- Ligamentum flavum
- Interspinal ligament
- Supraspinal ligaments
144
Thoracic spine muscles:
Erector spinae muscle: extends on each side of the spinal column from pelvis to cranium
Divided into 3 muscles
1. spinalis
2. logissimus
3. illocostalas
145
Thoracic spine muscles:
Aid in movement of spinal column
Abdominal muscles
146
Thoracic spine muscles:
abdominal muscles
- rectus abdominis
- internal/external oblique
- transverse abdominis
147
These muscles help aid in respiration
- Scalenes
- External intercostals
- Internal intercostals
- Diaphragm
- Levator costarum
- Subcostales
- Serratus anterior
- Serratus posterior
Muscles of the thorax - thoracic spine
148
Thoracic spine injuries:
The T-spine has a relatively low occurrence of
injuries due to increased _ from the ribs.
However some T-spine injuries include:
- Osteoporosis-causing excessive kyphosis
- Compression fractures
- Scoliosis
- Discogenic/disc bulge
- Rib fractures
stability
149
Thoracic spine injuries:
- Thinning of the bones that causes
them to become porous and fragile
- It affects women more than men, is
associated with aging, and progresses more
rapidly after menopause
- This disease is largely preventable and treatable
Osteoporosis causing excessive kyphosis
150
Thoracic spine injuries:
- MOI: Osteoporosis with or without trauma
- Signs and symptoms: pain and tenderness, decreased physical function, deformity
- Treatment for the vertebral fracture will
typically include non- surgical care, such as
rest, pain medication and slow return to
mobility
- Surgeries include:
- Vertebroplasty (bone cement is
injected into the fracture)
Compression fractures
151
Spine injuries:
- Describes an abnormal, side-to-side, curvature of the spine
- The spinal curve may develop as a single
curve (shaped like the letter C) or as two
curves (shaped like the letter S)
- known to be hereditary
scoliosis
152
Spine injuries:
- One shoulder is higher than the other
- One shoulder blade sticks out more than the other
- One side of the rib cage appears higher
than the other
- One hip appears higher or more prominent than the other
- The waist appears uneven
Scoliosis symptoms
153
Thoracic spine injuries:
- pain originating from a
damaged vertebral disc such as degenerative disc disease
- can usually be successfully treated with non-surgical treatments, such as pain medication and physical therapy and exercise, but chronic pain that is severe and limits the individual’s ability to function may need to be treated with surgery
Discogenic pain
154
Thoracic spine injuries:
Simple _ _ are the most common injury sustained following blunt chest trauma,
accounting for more than half of thoracic injuries from non-penetrating trauma
rib fractures
155
Thoracic spine injuries:
- Tenderness upon palpation, crepitus, and chest wall deformity
- Patients with rib fracture frequently complain of pain on inspiration and dyspnea.
- Swelling and bruising in the fracture area
- Severe local tenderness in the fracture area
- Internal bleeding
- Pain while breathing
signs and symptoms of a rib fracture
156
Thoracic spine injuries:
- Rest
- Protection
- Pain meds
- Physical therapy
- Breathing exercises
- Stretching
- Intercostal nerve blocks
- Epidural anesthesia
- Hospitalization
Rib fracture treatment
157
- Head
- vertebrae
- ribs
axial skeleton
158
- pelvis
- hips
- legs
- shoulders
- arms
appendicular skeleton
159
Cervical spine bones
- cranium
- vertebrae 1-7
- atlas
- axis
160
Cervical spine bones:
- Bones that protect the brain
- Mastoid process
- occipital bone
cranium
161
Cervical spine:
- _ bones called vertebrae
- Vertebrae 1 = _
- Vertebrae 2 = _
- Vertebrae 3-7 = normal
- 7
- atlas
- axis
162
Cervical spine Bones:
- 1st Cervical Vertebrae
- Supports the head
- Has no body
- Has no spinous process (has a posterior tubercle)
atlas
163
Cervical spine Bones:
- 2nd Cervical Vertebrae
- Rotation
- Has a dens, which is the body for the atlas
axis
164
Cervical spine movements
- Flexion
- Extension
- Rotation R, L
- Side Bending/Lateral Flexion R, L
- Protraction
- Retraction
165
- From the Spinal Cord
- Exit through the intervertebral foramen (canal) of the vertebrae
spinal nerves
166
Cervical spine nerves:
- Spinal Nerve exits neural (intervertebral)
foramen
Vertebral Neural Foramen
167
Cervical spine Joints:
- Facet Joint
- Intervertebral Disc
168
Cervical spine joints:
Movements:
- Flexion
- Extension
- Lateral (side) flexion
- “Yes” Joint
Atlanto-Occipital (A-O) Joint
169
Cervical spine joints:
Movements:
- Rotation
- Flexion
- Extension
- “No” joint
Atlanto-Axial (A-A) Joint
170
Cervical spine joints:
Movements:
- Flexion
- Extension
- Rotation
- Side flexion
Joints C3-C7
171
Spinal Segment includes:
- 2 vertebral bodies
- 1 intervertebral disc
172
Intervertebral Disc:
Outer _
- Tougher, rings
Inner _
- More fluid, higher water content
- Annulus Fibrosus
- Nucleus Pulposus
173
Cervical spine ligaments:
Limits extension of vertebral column
Anterior Longitudinal Ligament
174
Cervical spine ligaments:
Limits flexion at vertebral bodies
Posterior Longitudinal Ligament
175
Cervical spine ligaments:
Ligamentum Flavum limits _
flexion
176
Cervical spine ligaments:
Interspinous Ligament aids in limiting _
flexion
177
Cervical spine ligaments:
Supraspinous Ligament limits _ of vertebral column
flexion
178
Cervical spine muscles:
- Sternocleidomastoid
- Splenius Capitis
- Rectus Capitis
179
Cervical spine muscles:
- A: Both together = flexion
- R SCM = left rotation, right lateral flexion
- L SCM = right rotation, left lateral flexion
Sternocleidomastoid
180
Cervical spine muscles:
A: Extension, Same Side Rotation and Lateral Flexion
Splenius Capitis
181
Cervical spine muscles:
Rectus Capitis action
extension, same side rotation
182
cervical spine injuries
- Disc bulge/herniation
- Facet Pain
- Stinger
- Nerve Root Injury
- Fractures/Dislocations
- Cervical Stenosis
- Cervical Fusion
183
Shoulder bones
- clavicle
- scapula
- proximal humerus
184
Shoulder bones:
Only bony attachment between the trunk and upper limb
clavicle
185
3 anatomical shoulder joints:
1. Glenohumeral joint (GH)
2. Acromioclavicular joint (AC)
3. Sternoclavicular joint (SC)
186
Shoulder joints:
Ball and socket joint
glenohumeral joint
187
shoulder joints:
- plane synovial joint
- weak joint capsule reinforced by ligaments
acromioclavicular joint
188
shoulder joints:
- saddle-shaped synovial joint
- poor joint congruence
sternoclavicular joint
189
Shoulder ligaments:
sternoclavicular joint - Four ligaments
1. Anterior sternoclavicular ligament
2. Posterior sternoclavicular ligament
3. Interclavicular ligament
4. Costoclavicular ligament
190
Shoulder ligaments:
Acromioclavicular joint - Three ligaments
1. Acromioclavicular ligament
- Small
2. Coracoacromial Ligament
3. Coracoclavicular ligament
- Larger
191
Shoulder ligaments:
Glenohumeral joint - Five ligaments
1. Superior Glenohumeral ligament
2. Middle Glenohumeral ligament
3. Inferior Glenohumeral ligament
4. Coracohumeral ligament
5. Transverse humeral ligament
192
Shoulder ligaments:
- Fibrocartilage to deepen the shoulder socket
- Enhances stability and proprioception
shoulder labrum
193
- Flexion
- Extension
- Abduction
- Adduction
- Internal Rotation
- External Rotation
- Scapular Protraction
- Scapular Retraction
- Scapular Upward Rotation
- Scapular Downward Rotation
Shoulder movements
194
Shoulder muscles:
4 rotator cuff muscles
1. Supraspinatus
2. Infraspinatus
3. Teres Minor
4. Subscapularis
195
Shoulder Girdle bones:
- clavicle
- scapula
196
Shoulder Girdle Movements
- scapula elevation
- scapular depression
- scapular tipping
- scapular winging
197
Shoulder injuries:
- Shoulder Separation
- Shoulder Dislocation
- Adhesive Capsulitis
- Shoulder Impingement
- Rotator Cuff Tear
- Shoulder Labral Tear
- Total Shoulder
198
Shoulder injuries:
Occurs in overhead motions
- Swimmers, Throwers, Pole Vaulters, Painters
- Non-traumatic
Treatment:
- Increase the space
- Stretching
- Biomechanics
- Surgery
shoulder impingement
199
Shoulder injuries:
Some tears are not painful or pathologic
- Skin wrinkles
- Causes
- Overhead Throwing
- Dislocation
- Trauma
Treatment
- Restore Correct Biomechanics
- Check the Cervical Spine
- Surgery
shoulder labral tear
200
Shoulder injuries:
Last Resort for Shoulder Pain
- Done for Pain Relief
- not necessarily for mobility
shoulder replacement
