KNES 360 EXAM 2 Trunk & Spinal Column

Question 1

Vertebral Column

Answer 1

*Complex

24 intricate and complex articulating vertebrae (+ sacrum/coccyx)

Question 2

Abdominal muscles

Answer 2

several sections linked by fascia and tendinous bands (really important)
do not attach from bone to bone (not designed for movement)

Question 3

Bones

Answer 3

24 articulating and 9 fused vertebrae:
-7 cervical (neck) vertebrae
-12 thoracic (chest) vertebrae
-5 lumbar (lower back) vertebrae
-4 coccyx (tail bone) vertebrae
First 2 cervical vertebrae: shapes allow for extensive rotary movements of head to side

Question 4

Atlantoccipital Joint

Answer 4

First joint
Formed by occipital conduces of skull sitting on articular fossa of the 1st vertebrae
Allows flexion and extension

Question 5

Atlantoaxial Joint

Answer 5

Atlas (C1) sits on axis (C2)
Most cervical rotation occurs here
Pivot-type joint
Most mobile joint of any two vertebrae

Question 6

Vertebrae C3 through L5 Architecture

Answer 6

Body-Anterior bony block
Central vertebral foramen for spinal cord
Transverse process projecting out laterally
Spinous process projecting posteriorly

Question 7

3 Normal Curves within the Spine

Answer 7

-Thoracic spine curves anteriorly (kyphosis)
-Cervical & lumbar spine curve posteriorly (lordosis)
-Spinal curves enable it to absorb blows & spocks
Vertebrae increase in size from cervical to lumbar region due to lower back having to support more weight

Question 8

Lordosis

Answer 8

increased posterior concavity of lumbar & cervical curves

Question 9

Kyphosis

Answer 9

increased anterior concavity of thoracic curve

Question 10

Hypolordosis

Answer 10

reduction of normal lordotic curve, resulting in a flat-back appearance

Question 11

Scoliosis

Answer 11

lateral curvatures or sideward deviations of spine

Question 12

Changing lumbar curvature

Answer 12

Lumbar spine is happiest in a neutral lordotic posture. Any constant deviations from the posture puts your spine at risk of injury

Question 13

Hyperlordosis

Answer 13

Common mechanism of back injury/pain in younger people

Muscular spasm and nerve impingement

Question 14

Hypolordosis

Answer 14

Common mechanism of back injury/pain in older people

Leads to posterior disc herniation

Question 15

Joints

Answer 15

Minimal movement between any 2 vertebrae (except atlantoaxial joint)

• Cumulative effect of combined movement from several vertebrae allows for substantial movements
• Vertebral body articulations classified as arthrodial: symposis (slightly moveable)
• Gliding type joints due to limited gliding movements (facet joints)
• Gliding movement between superior and inferior articular processes of facets joints

Question 16

Intervertebral Discs

Answer 16

Annulus fibrosus: outer rim of dense fibrocartilage
Nucleus pulposus: central gelatinous, pulpy substance
Between vertebral bodies:
-Fibrocartilaginous disc
-Composed of annulus fibrosis and nucleus purposes
-Discs act to absorb shock through spine

Question 17

Ligaments

Answer 17

Anterior longitudinal ligament (ALL)
Posterior longitudinal ligament (PLL)
Supraspinous ligament
Additional ligaments between adjacent vertebrae
SI joint has strong ligaments to maintain its stable position

Question 18

Ribs

Answer 18

12 pairs of ribs
-7 pairs of true ribs attach directly to sternum
-5 pairs of false ribs: 3 attach indirectly to sternum, 2 pairs of floating ribs (ends are free)
All ribs attached posteriorly to thoracic vertebrae

Question 19

Sternum

Answer 19

Manubrium, body of sternum, xiphoid process

Question 20

Movements

Answer 20

Spinal movements are often preceded by the name given to the region of movement
Ex. flexion of trunk at lumbar spine is known as lumbar flexion, extension of neck is cervical extension
Pelvic girdle rotates as a unit due to movement occurring in hip & lumbar spine (anterior pelvic tilt: paris hilton, posterior pelvic tilt: flat back)

Question 21

Facet Joints

Answer 21

Part of posterior element, control movement
Angle of facet joint changes at different spinal level to allow certain movements and prevent others
-Thoracic v. lumbar

Question 22

Spinal flexion

Answer 22

• Anterior movement of spine; in cervical region the head moves toward chest; in lumbar region the thorax moves toward pelvis
• Sagittal plane movement

Question 23

Spinal extension

Answer 23

return from flexion or posterior movement of spine; in cervical spine, head moves away from the chest and thorax moves away from pelvis
sagittal plane movement

Question 24

Lateral flexion

Answer 24

left or right
sometimes referred to as side bending; head moves laterally toward the shoulder and thorax moves laterally toward pelvis
frontal plane movement

Question 25

Spinal rotation

Answer 25

left or right | rotary movement of spine in traverse plane; chin rotates from neutral toward shoulder and thorax rotates to one side

Question 26

Important landmarks for abdominals

Answer 26

``` xiphoid process iliac crest anterior superior iliac spine (ASIS) linea alba pubic symphysis inguinal ligament ```

Question 27

Trunk and Spinal Column Muscles

Answer 27

Abdominal wall muscles do not go from bone to bone but attach into aponeurosis (fascia) around rectus abdomens area -external oblique abdominal, internal oblique abdominal, and transversus abdominis

Question 28

Rectus Abdominis

Answer 28

Marked weakness permits an anterior pelvic tilt and a lordotic posture from erect position O: pubic crest and pubic symphysis I: cartilage of 5th-7th and xiphoid process A: flexes trunk and compresses abdomen IN: intercostal nerves 7-12

Question 29

External Oblique

Answer 29

O: Infeior 8 ribs I: Anterior portion of iliac crest; abdominal aponeurosis to linea alba A: Together- Compress abdomen and flex vertebral column Singulary- Laterally flex and rotate vertebral column to opposite side IN: Intercostal nerves 8-12, iliohypogatric and ilioinguinal nerves

Question 30

Internal Oblique

Answer 30

O: Iliac crest, lateral half of inguinal ligament, and thoracolumbar fascia I: cartilage of lower 3-4 ribs; abdominal aponeurosis to linea alba A: Together- Compress abdomen and flex vertebral column Singularly- laterally flex and rotate vertebral column to the same side IN: Intercostal nerves 8-12, iliohypogastric, and ilioinguinal nerves

Question 31

Transversus Abdominis

Answer 31

Acts like a girdle to flatten the abdominal wall and compress the viscera Weakness permits a bulging of anterior abdominal wall O: Iliac crest, lateral potion of inguinal ligament, thoracolumbar fascia and carriages of inferior six ribs I: abdominal aponeurosis to linea alba A: Compress abdoment IN: Intercostal nerves 7-12, iliohypogastric, ilioninguinal nerves

Question 32

Abdominal Cross-Section

Answer 32

1. Skin 2. Superficial fascia: - fatty layer (of camper) - membranous layer (of scarpa) 3. External oblique 4. Internal oblique 5. Transversus 6. Fascia transversalis 7. Extraperitoneal fatty areolar tissue 8. Peritoneum

Question 33

Erector Spinae

Answer 33

largest muscle extends on each side of spinal column from pelvic region to cranium divided into 3 muscles: -Spinalis, longissimus, and iliocostalis -From medial to lateral side, has attachments in lumbar, thoracic, and cervical regions -actually made up of 9 muscles

Question 34

Erector Spine (O, I, A, IN)

Answer 34

O: Spinous processes of T9-T12 I: Spinous process of T1 and T2 and cervical vertebrae A: extension of vertebral column IN: posterior branch of spinal nerve

Question 35

Muscles of the Thorax

Answer 35

``` *For respiration Diaphragm (quiet breathing) Intercostals (forced breathing) -External intercostals (inspiration) -Internal intercostals (expiration) ```

Question 36

Diaphragm

Answer 36

Involved almost entirely in respiration Responsible for breathing during quiet rest As it contracts and flattens, thoracic volume is increased and air is inspired to equalize the pressure When larger amounts of air are needed, as in exercise, other thoracic muscles have a more significant role in inspiration

Question 37

External intercostals

Answer 37

further expand the chest volume when they contract

Question 38

Internal intercostals

Answer 38

contract to decrease the chest volume

Question 39

Quadratus Lumborum

Answer 39

``` Stabilizes pelvis and lumbar spine O: Iliac crest, iliolumbar ligament I: last rib and transverse processes A: Unilateral- lateral flexion Bilateral- depression of rib cage IN: 12th thoracic and first through 4th of lumbar nerves ```

Question 40

Triangle of Auscultation

Answer 40

Borders: -Latissimus dorsi -Trapezius -Rhomboid major The triangle enlarges when the arm is drawn across the body Location for stethoscope placement for respiratory sound examination

Question 41

Quadratus Lumborum Dysfunction

Answer 41

Heavily implicated in low back pain (LBP) - Connects pelvis to spine -> can extend the lower back when contracting bilaterally - -When the erector spinae muscles are weak (in basically everyone who sits all day), the QL picks up the slack and extends the lower back - However, QL is at a mechanical disadvantage (short moment arm) and thus has to perform substantial work to extend the back, causing muscles fatigue -> overuse -> injury

Question 42

Quadratus Lumborum Hip

Answer 42

also assists hip abduction when the gluteal muscles are weak (medias and minimus) -> results in hip hiking during the swing phase in gate -Raise the pelvis on the unsupported side

Question 43

Disc Herniation

Answer 43

Generally a flexion mechanism Causes posterior herniation Upper back posture is important Extensions as exercises can help

Question 44

Spondylosis

Answer 44

Cause: degeneration of vertebrae or defect in the articular process -Occurs as a stress fracture in vertebrae -Repetitive hyperextension of spine (swimming, gymnastics, serving, lifting weights, etc.) Signs: persistent aching pain across the low back, pain after physical activity Care: bracing, rest, strengthen core and trunk stabilizers