Lec. 3: Kin of the Spine (incomplete)

Question 1

zygapophyseal joints are also known as ___ joints

Answer 1

facets

Question 2

primary ligs that limit spine flex (2)

Answer 2

interspinous lig
supraspinous lig

Question 3

first lig to fail in hyperflex sprain is the ___

Answer 3

supraspinous lig

Question 4

These are feats of which lig:
-Runs anteriorly along adjacent vertebral bodies
-Loosely attached to the IVDs to reinforce annulus
-Inferior continuation of the atlanto-occipital membrane
-Runs from C2 inferiorly to the sacrum
-Limits extension

Answer 4

ANT longitudinal lig (ALL)

Question 5

These are feats of which lig:
-Runs posteriorly along adjacent vertebral bodies
-Strongly attached to the IVDs
-Inferior continuation of the tectorial membrane as it exits the foramen magnum of occiput
-Runs from C2 inferiorly to the sacrum
-Limits flexion

Answer 5

POST longitudinal lig (PLL)

Question 6

which lig does this describe:
-Inferior continuation of the posterior atlanto-occipital membrane
-Relatively elastic; contains elastin thus taut even in neutral position
-Maintains axial disc compression
-Present on anterior surface of the lamina
-Limits flexion especially in lumbar region

Answer 6

ligamentum flavum

Question 7

which lig does this describe:
-Between neighbouring TVPs
-Limits lateral flexion
-Contributes to thoracolumbar fascia

Answer 7

intertransverse lig

Question 8

occurs when one motion in the spine is associated with another

Answer 8

coupled motion of the spine

Question 9

coupled motion in the spine is d/t ligamentous and ___ attachment, facet joint ___ and spinal curvature

Answer 9

muscular, orientation

Question 10

in a neutral position what are the load bearing structures in the spine

Answer 10

VB and discs

Question 11

the facets control ___ and bear about 30% of load in which position

Answer 11

motion, EXT

Question 12

under high loads the ___ ___ will likely fail before the discs

Answer 12

vertebral endplates

Question 13

what occurs in the discs during sustained low load of the vertebral column. And what occurs to remedy this problem

Answer 13

fluid is forced out of discs, disc must reabsorb fluid via imbibition at night (sleep)

Question 14

the resistance to torsional forces of the spine increases from ___-___ spine down

Answer 14

mid-thoracic

Question 15

what aspect of disc is most resistant to torsional forces

Answer 15

annulus fibrosis

Question 16

the annulus fibrosis of discs is commonly injured during which combined motions/forces

Answer 16

high axial loading + torsion + distraction force (ie. act of shoveling snow, specifically throwing snow onto bank)

Question 17

2 actions that cause high shearing forces b/w VB

Answer 17

-lifting weight from ground
-upper body flexion

Question 18

shearing force on VBs causes translation which is generally resisted by ___ and ___ ___

Answer 18

discs
facet jts

Question 19

FLEX/EXT is maximized when the facets are oriented in which plane

Answer 19

sagittal plane (ie. most FLEX in upper lumbar spine)

Question 20

___ widens the IVFs and ___ narrows them

Answer 20

FLEX, EXT

Question 21

EXT of spine is limited by ___ ___. FLEX is limited by ___ and ___

Answer 21

bony contact (facets)
ligaments and muscles (passive mm tension)

Question 22

LAT FLEX is maximized when facets are oriented in the ___ plane. And is accompanied by ___ of the VBs

Answer 22

frontal, ROT

Question 23

during LAT FLEX of spine the VBs ROT ___ from C2-T6 and ___ from T6-L5

Answer 23

ipsilaterally
contralaterally

Question 24

ROT is always accompanied by ___ ___

Answer 24

LAT FLEX

Question 25

CCP, CP, and typ. dislocation of the C/SP

Answer 25

CPP: full EXT CP: LAT FLEX, ROT, EXT typ. dis.: posterior dislocation of medial atlantoaxial joint (rupture of transverse ligament)

Question 26

in C/SP FLEX is maximized at ___-___ and EXT is maximized at ___-___

Answer 26

C5-6 C4-5

Question 27

in C/SP OA is seen most at ___-___ and ___-___ b/c these are the locations where the more FLEX and EXT occur

Answer 27

C4-5 C5-6

Question 28

LAT FLEX is greatest in the ___ region of the C/SP and is accompanied by ___ ROT of VB

Answer 28

middle, ipsilateral

Question 29

arthrokin at atlanto-occipital jt

Answer 29

convex occipital condyles on concave SUP art. facet of C1; roll and glide in opposite directions

Question 30

arthrokin of MED atlanto-axial jt

Answer 30

concave atlas on convex dens so roll and glide in same direction

Question 31

5 relevant movers of the C/SP

Answer 31

-suboccipital group -scalenes -longus colli (cervicis) and capitis -SCM -erector spinae

Question 32

suboccipital group is commonly a source of ___ d/t FHC posture

Answer 32

headaches

Question 33

dysfunction of the scalenes can cause problems with the ___ and ___ ___ w/ subsequent arm symptoms

Answer 33

brachial and vascular plexuses

Question 34

longus colli and capitis are commonly strained in ___ type injuries

Answer 34

whiplash

Question 35

irritation and TPs in the SCM can cause ___ and ___

Answer 35

nausea and dizziness

Question 36

the erector spinae contract eccentrically to control ___

Answer 36

FLEX

Question 37

CPP and CP of all segments of the spine

Answer 37

CPP: full EXT CP: LAT FLEX, ROT, EXT

Question 38

typical dislocation of the T/SP

Answer 38

occurs w/ fracture, usually T4 or T7, no specific direction

Question 39

the facets of the thoracic vertebrae are oriented ~ ___ from horizontal and slightly ___. The SPs point ___ and the TVPs point ___. (looks like a giraffe head)

Answer 39

60, laterally inferiorly, superiorly

Question 40

the rigidity of the rib cage, facet orientation of the upper vertebrae and thinness of the disc cause a limitation of which mvts in the T/SP

Answer 40

flex/ext

Question 41

___ ___ increases as you move inferiorly w/in T/SP

Answer 41

LAT FLEX

Question 42

LAT FLEX b/w T6-12 is accompanied by ___ VB ROT

Answer 42

contralateral

Question 43

which ribs only articulate with the vertebrae

Answer 43

11 and 12 (floating ribs)

Question 44

ribs 1-7 are considered the ___ ribs

Answer 44

true

Question 45

during inspiration ribs 1-7 move in a pump-handle like motion meaning they move in the ___ plane and have a ___/___ axis

Answer 45

sagittal, medial/lateral

Question 46

during inspiration the false ribs (8-10) move in a bucket handle like motion meaning the move in a roughly ___ plane. When this happens it increases the ___ diameter w/in the rib cage

Answer 46

frontal, transverse

Question 47

ribs 11 and 12 move in a caliper like motion during inspiration, pivoting open at the costovertebral jts. This happen in the ___ plane and ___/___ axis

Answer 47

transverse, SUP/INF

Question 48

Rib humping will occur on the ___ side of the scoliotic curve as the vertebral body rotates (T1-T6 ipsilateral, T6-12 contralateral) to accommodate lateral flexion

Answer 48

convex

Question 49

in scoliosis, the curve is named according to the apex of the ___

Answer 49

convexity

Question 50

3 relevant movers of the T/SP

Answer 50

-diaphragm -intercostals -scalenes

Question 51

accessory movers of the T/SP (7)

Answer 51

-abdominals -erector spinae -quadratus lumborum -pec + and - -SCM -subclavius

Question 52

typical dislocation in lumbar spine where facets perch over one another

Answer 52

spondylolisthesis

Question 53

2 feats of the lumbar vertebrae

Answer 53

-Mammillary processes on SUP articular process -SPs point directly POST in L-spine -VBs and discs are larger to support the entirety of upper body -Changes in position of pelvis or body segments causes L-spine to compensate for shifted CoG

Question 54

facet of L1 is in ___ plane. facets of L2-L4 are oriented in a ___-___ position. and L5 is in ___ plane to limit motion of L5 on sacrum

Answer 54

sagittal, semi-sagittal, frontal

Question 55

what is being described: Various layers are continuous with the fascia from QL, lats and gluteus maximus. Provides an anatomic girdle between the lower abdominals and the spine

Answer 55

thoracolumbar fascia

Question 56

ROT and LAT FLEX decreases ___ in L/SP with rotation largely coming from cartilaginous deformation of discs

Answer 56

INF

Question 57

Nutation accompanies posterior tilt of the ___ ilium during gait

Answer 57

ipsilateral

Question 58

Counternutation accompanies ___ ___ of the ipsilateral ilium during gait

Answer 58

ANT tilt

Question 59

during gait what occurs at the sacrum

Answer 59

one side nutates while the other counternutates (gyroscopic motion, like figure 8)

Question 60

which mm stabilizes the lumbar spine in contralateral lateral flexion and prevents vertebral “collapse” in the frontal plane, e.g. scoliosis – type deformities

Answer 60

lumborum quadratus

Question 61

mms that act as synergists to stabilize the spine and pelvis primarily by generating tension in the thoracolumbar fascia which supports the spine in flexion especially

Answer 61

abdominals (specifically transversus abdominis and internal oblique)

Question 62

erectors contract eccentrically to control rate of flexion and limit ___ ___ b/w vertebrae

Answer 62

ANT shear

Question 63

at about 2/3 of flex the erectors cease active contraction (likely point of injury)

Answer 63

relaxation phenomena

Question 64

is muscular stabilization of ligamentous stabilization considered to be more important in the prevention of back injury (specifically w/ FLEX)

Answer 64

muscular stabilization is more important b/c w/out adequate strength increase stress is placed on spinal ligaments and increases risk of injury

Question 65

EXT places variable amounts of compressive forces onto the axial skel., how many Newtons of compression are placed on the L4-5 disc during quadra-ped single leg EXT, quadra-ped contralateral leg and arm extension, and prone bilateral arms and legs EXT

Answer 65

2000N 3000N 6000N