Exam 2: Cervical Spine/whiplash Flashcards Preview

GM Biomechanics > Exam 2: Cervical Spine/whiplash > Flashcards

Flashcards in Exam 2: Cervical Spine/whiplash Deck (87):
1

What region has more muscles associated with it than anywhere else

Cervical

2

What is the cervical spines job

Maintain head posture, great deal of mobility

3

Cervical curve is the ___ distinct of all the spinal curves

Least

4

What is the most complex region of the axial skeleton

Occiput atlas axis

5

What is the orientation of superior articular process of atlas

Concave and medial

6

What is the anatomical structure of C0/C1 inn saggital and frontal planes

Cuplike

7

Why is there little rotation of occiput-atlas

Lat mass of C1 is shaped like a peanut

8

If occiput=atlas doesnt translate P-A or A-P how does it create flexion extension

Rotating post and sup and rotating ant sup

9

Flexion of occiput - atlas is limited by what

Posterior neck muscular tension

10

What is extension of the occiput - atlas limited by

Suboccipital muscle compression against the occiput

11

What is the range of x axis rotation in the occiput - atlas

Mean value between 14-35 degrees

12

Y axis rotation of occiput - atlas limited by

Elastic range, ant/post walls of C1 socket, joint capusle tension, mostly alar ligament tension

13

What is the range of y axis ratoation of occiput - atlas

4-8 degrees

14

Z axis of occiput-atlas is not physiological accomplished but can be what

Induced by elevating out of one socket while other is pivot

15

What is the range of z axis roation occiput - atlas

4-11 degrees (in cadavers)

16

What limits z axis rotation of occiput - atlas

Alar ligament attachement

17

Z rotation of occiput - atlas is coupled by what

Rotation in opposite direction leading of chin away from side of lateral flexion

18

What are the C1 inferior articular processes shaped

Flat, slightly convave, medial

19

The configuration of the cartilage of atlas axis creates what type of articulation

Biconvex

20

The x axis rotation c1-c2 biconvexity combined has a theta x of what

20 degreese

21

Increasing the anterior curvature of the dens increases what

X axis rotation

22

What is a path that identifies where one body will rotate relative to another body at a given instant in time

Instant axis of rotation (IAR)

23

What is the major role of C2

Permit lots of Y axis rotation

24

What limits the rotation of C1-C2

Alar ligaments

25

What is the range of C1-c2 y axis rotation

43-50

26

Where does over 50% of the rotation of the neck take place

Y axis rotation C1-c2

27

What is the role of the intra articular meniscoids

Keep film of synovil fluid applied to articular cartilages not in contact with one another

28

What happens to intra articular meniscoids in y axis rotations

They are displaced and passively return

29

What is y axis rotation at c1-c2 coupled with

Y translation

30

Why is lateral bending limited at c1-c2

Alar ligaments and bony anatomy

31

Does c1-c2 have x axis translation

No, only apparent

32

As the head is laterally flexed to one side at c1-c2 what happens to the ipsilateral articular process

Takes on a greater loade

33

How does the c2 inferior articular surface act during lateral flexion

Slopes inferiorly

34

How does the spinous rotate during lateral ben of c2

Rotates toward convexity of lateral bend - the opposite side

35

During flexion/extension what is the coupled motion

Translaton in sagittal plane

36

Where does more translation occur

In the upper c/s

37

Where are the steepest arches at for x axis rotation

At C6/C7

38

What happens to the acuity of the arc with degeneration

Are decreases

39

What is the shape of the vertebral body at superior/inferior surfaces

Sellar or saddle shaped

40

In lower c/s x axis translation is ____ and rotation is _____

Reduced, promoted

41

What limits pure lateral flexion in lower c/s

Uncinate process

42

What are the uncinate processes a guide to

Couple lateral flexion with axial rotation

43

Degeneration at uncovertebral joints is due to DDD resulting in what

Body outgrowth (osteophytosis)

44

What does DDD osteophytosis impinge

Adjacent anatomy, can create stenosis in conjunction with disc bulge/herniation

45

What can osteophytosis create stenosis with

Vertebral artery or cervical spinal nerves

46

What is the facet orientation of lower cs

Tear drop shape, Angled 45 degrees b/w coronal/transverse planes

47

What is the superior facet orientation of lower cs

Post, sup, medial

48

What is the inferior facet orientation of lower cs

Ant, lateral, inferior

49

Prior to what age is the thickness of articular cartilage 1-1.3 mm

20years

50

What does age do to z joint

Thins articular cartilage, thickens subarticular bone, ostophyte formation

51

Sensory proprioception of cs is from what in order

1) IVD
2) facet joints
3) cervical musclulature

52

What is the arrangement of innervation of IVD

Circumferential, superficial to deep

53

What does the IVD sense

Peripheral compression/tension, deformation/alignment

54

What is responsive to extremes rather than mid range joint motions

Facet mechanoreceptors

55

Each facet mechanoreceptor is responsible for what size receptive field

Large

56

What muscle group contain high density of spindles

Suboccipital muscles

57

Why is there higher spindle content in suboccipitals

Head eye coordination, comlex proprioceptive inputs

58

What theory is that the more open gates the more pain messages pass through and hgiher level of pain and more closed gates = fewer messages = less pain

The gate theory

59

Chronic neck pain affects muscle how?

Atrophy and fatty infiltration/degeneration

60

When does cervical curvature begin to develop

Prior to birth

61

What aids in absorbing spinal loads in c/s

Lordosis

62

What is the degree of cervical lordosis

About 30-45 degrees

63

What part of the c/s is kyphotic

Occiput to axis

64

What can kyphosis of the c/s create

Ischemia and dysfunx, possible demyelinating disease

65

What is the primary load on the cervical spine

Compression

66

Compressive loads increase during what

Flexion/extension

67

What is the max isometric action on the spine

1200N

68

What type of load is best on c/s

Compressive follower load

69

What does the follower load minimize

Bending moments and shear

70

What produces a follower load in c/s

Coactivation of muscles

71

What is a mechanism whereby the neck is whipped in one direction and recoils in the opposite direction

Whiplash

72

Who is most likley to get injured in car acciden

Females 20-24

73

How do we determine mechanism of energy in whiplash injuries

Direction of force, patient position, relationship of head/spine, state of tension in neck muscles

74

What end of the neck will move with greater velocity

Distal end compared to proximal end

75

What are the 2 mechanisms of injury to the joint in a whiplash injury

Pinching of synovial fold, strain of capsule

76

Capsular strain in c/s. Can result in what response

Inflammatory response involving spinal cord

77

With aging what happens to bones mass

25% reduction in bone mass and 50% in strength

78

What is the first structure to fail when subject to compressive loads

The endplate

79

When are injuries more severe at alar and transverse ligaments in whiplash injury

When head is turned

80

What discs are most vulnerable when rear impacts happens

C5-c6

81

When are discs especially vulnerable during rear impacts

At lower speeds (<38 mph)

82

What disks are most at risk during front impacts

C2/c3 - c7/t1, c5/c6 most vulnerable

83

What grade of the WAD grating system of whiplash has no symptoms

WAD 0

84

What grade of the WAD grating system of whiplash has pain, stiffness, but no physical signs

WAD 1

85

What grade of the WAD grating system of whiplash neck complains, decreased ROM, point tenderness

WAD 2

86

What grade of the WAD grating system of whiplash neck complaints plus neuro signs

WAD 3

87

What grade of the WAD grating system of whiplash have a fracture/dislocation or cord injjury

WAD 4