Lecture 3 Quizlet cards Flashcards
(182 cards)
1
Q
How many intervertebral discs are there compared to vertebrae?
A
23 discs vs 33 vertebrae
2
Q
What are the 2 layers of the body of vertebra (weight-bearing structure)?
A
- cancellous (inner)
- cortical (outer)
3
Q
What are the 2 components of the neural arch?
A
- pedicles
- posterior elements
4
Q
Do pedicles increase or decrease in size caudally?
A
Increase
5
Q
Which part of the vertebra defines the size/shape of the vertebral canal?
A
Pedicles
6
Q
What are the 3 posterior elements of the neural arch?
A
- lamina
- articular processes
- spinous & transverse processes
7
Q
Which posterior element protects the spinal cord and transfers forces through pars interarticularis?
A
Lamina
8
Q
Which posterior element connects with vertebra above/below to resist forces?
A
Articular process
9
Q
Which posterior elements are sites for muscle attachments?
A
Spinous process & transverse process
10
Q
Which process resists compression and transmits forces to laminae?
A
Spinous
11
Q
Where does spondylolysis/spondylolisthesis most frequently occur?
A
L5-S1
12
Q
Do intervertebral discs increase in size cranially or caudally?
A
Caudally
13
Q
What are the functions of intervertebral discs?
A
Increase available motion & transmit load
14
Q
What percentage of water is the nucleus pulposus? How about the annulus fibrosis?
A
- nucleus: 80%
- annulus: 60%
15
Q
The vertebral endplate is made up of hyaline cartilage and what else?
A
Fibrocartilage
16
Q
Which portion of the annulus fibrosis is innervated?
A
Outer 1/3-1/2
17
Q
Which nerve is associated with the surrounding connective tissue & ligaments?
A
Sinuvertebral
18
Q
True or False: IV discs get nutrition from major arterial branches.
A
False
No major arterial branches
19
Q
What 4 movements can be done by interbody joint (cartilaginous)?
A
- sliding
- distraction
- compression
- tilting
20
Q
Which joints can do gliding/sliding?
A
Zygapophyseal
21
Q
Which 2 structures resist extension?
A
- anterior longitudinal ligament
- anterior atlantooccipital & atlantoaxial membranes
22
Q
At which spinal levels is the ALL located?
A
C2-sacrum
23
Q
At which spinal levels is the PLL located?
A
Same but posterior
24
Q
ALL & PLL fibers blend with what?
A
Annulus fibrosis
25
Where is the tensile strength of ALL strongest?
Lumbar
26
At which spinal levels do anterior OA & AA membranes resist extension?
C2 - occiput
27
What 4 structures resist flexion?
- PLL
- ligamentum flavum
- interspinous ligament
- supraspinous ligament
28
Where is the ligamentum flavum located?
- posterior surface of spinal canal
- lamina to lamina from C2-sacrum
29
Which ligament is under constant tension even in neutral?
Ligamentum flavum
30
Which ligament connects SP of adjacent vertebra?
Interspinous
31
Which ligament connects tips of SP and contains mechanoreceptors?
Supraspinous
32
Which ligament resists lateral flexion & provides stretch/compression?
Intertransverse
33
Which 2 structures resist rotation?
- alar ligaments
- facet capsules
34
Where are alar ligaments located?
Atlas (C0-C2)
35
What do alar ligaments limit?
Ipsi lateral flexion & contra rotation
36
What motion does facet capsules resist?
Forward flexion & rotation
37
Where are facet capsules strongest?
Transition zones:
- cervicothoracic (lordosis --> kyphosis)
- thoracolumbar (kyphosis --> lordosis)
38
What motion makes facet capsules vulnerable?
Extreme flexion
39
What is the term for consistent association of 1 motion about an axis with another motion around a different axis?
Coupling
40
What depends on the size of the disc and what is determined by the orientation of facets?
- Amount of motion available
- Direction of motion
41
In which plane is the lumbar oriented and what motion is associated with it?
- Sagittal
- Flex/extend
42
In which plane is the thoracic oriented and what motion is associated with it?
- Frontal
- Lateral flexion
43
For flexion, the superior body tilts ________ and the inferior facets of the superior body slide up or down?
- Anteriorly
- Up
44
For extension, the superior body tilts and the inferior facets of the superior body slide up or down?
- Posteriorly
- Down
45
For lateral flexion, the IV foramen opens on which side and rotation accompanies?
Contralateral
46
What is the result of gravity, GRF, & muscle & ligament pulls?
Axial compression
47
Which structures resist axial compression the most? Which are the first to fail?
- Resist: discs & vertebral bodies
- Fail: cartilaginous end plates
48
Which structures help with axial compression?
Arches & facets
49
Which structure exhibits creep with axial compression?
Nucleus pulposus
50
What is axial rotation & coupled motion called?
Torsion
51
Which 2 structures resist torsion?
- Annulus fibers
- Facet joints
52
What is shear in relation to the disc and how is it resisted in the lumbar region?
- Sliding
- Facets
53
During flexion, there's anterior compression and posterior stretch. What do these limit?
Flexion
54
During extension, there's anterior stretch and posterior compression. What do these limit?
Extension
55
During lateral bending, there's ipsilateral compression and contralateral stretch. What do these limit?
Lateral flexion
56
Which spinal levels are included in upper cervical?
- Occiput (C0)
- C1
- C2
57
Which spinal levels are included in lower cervical?
C3-7
58
What is the purpose of transverse foramen on TP?
Vertebral artery
59
In the OA joint, which part is convex and which is concave?
- Convex: occiput's condyles
- Concave: C1 superior facet
60
What is the function of the OA joint?
Nodding of head on C1
61
In the AA joint, C1 inferior facet is concave or convex and C2 superior facet is concave or convex?
Both convex
62
What is the function of the AA joint?
Rotation of C1 on C2
63
The posterior OA & AA ligaments are a continuation of which ligament?
Ligamentum flavum
64
The anterior OA & AA ligaments are a continuation of which ligament?
ALL
65
What is the continuation of PLL?
Tectorial membrane
66
What motion does the ligamentum nuchae resist?
Flexion
67
Which ligament is critical in maintaining C1/2 stability?
Transverse
68
Where are the alar ligaments located?
- Dens to occipital condyles
- Dens to C1
69
What motion do alar ligaments resist?
Axial rotation
70
Side bending to the right causes which occipital fibers to become tight and which C1 fibers to become taught?
- Contralateral
- Ipsilateral
71
Rotation to the right causes C2 spinous process to move which direction?
Left
72
In the lower cervical region, there's small cervical bodies with uncinate processes which creates what type of joint?
Saddle joint
73
Lower cervical superior facets are flat/oval and face which directions?
- Superior: superior & posterior
- Inferior: inferior & anterior
74
Lower cervical discs are crescent-shaped with thicker end anteriorly or posteriorly?
Anteriorly
75
How many degrees of flexion/extension are there in upper cervical?
15-25
76
OA joint is convex on concave or concave on convex?
Convex on concave
77
During flexion of OA joint, what direction is the roll & slide?
- Roll: anterior
- Slide: posterior
78
During extension of OA joint, what direction is the roll & slide?
- Roll: posterior
- Slide: anterior
79
Which joint does 50% of cervical rotation? What else occurs there?
- AA
- Lateral flexion, flexion, extension
80
Upper cervical lateral flexion is coupled with which rotation?
Contralateral
81
For lower cervical flexion, there's which tilt & slide with coupled UP slide of ZAJ?
Anterior
82
For lower cervical extension, there's which tilt & slide with coupled DOWN slide of ZAJ?
Posterior
83
Which cervical spinal levels have the greatest range of flexion/extension?
C5/C6
84
For lower cervical lateral flexion, there's which rotation?
Ipsilateral
85
For lower cervical lateral flexion to the right, there's ipsilateral tilt & slide to the right and ipsilateral slide ___ of right ZAJ and contralateral slide ___ of left ZAJ? (down/up)?
- Down
- Up
86
True or False: cervical has equal transverse & anteroposterior diameters.
False
## Footnote
Thoracic
87
Thoracic is wedge-shaped with increased posterior height, resulting in which curvature?
Kyphotic
88
Thoracic facet joints are 20 degrees off the frontal plane, so which motions are increased?
- Lateral flexion
- Rotation
89
Which thoracic region starts to decrease lateral flexion & rotation and increase flexion/extension?
Lower
90
Which spinal region has the smallest intervertebral disc ratio?
Thoracic
91
What motion do these limit in thoracic?
- facet orientation
- rib cage
- PLL
- ligamentum flavum
- interspinous ligaments
Flexion
92
What motion do these limit in thoracic?
- structure (SP, laminae, facets)
- tension from ALL, ZAJ jt capsules, abs
Extension
93
Which thoracic region has increased coupling of lateral flexion & axial rotation and is primarily ipsilateral?
Upper
94
Thoracic rotation causes posterior rib shift and anterior rib shift. Which is ipsilateral and which is contralateral?
- Post=Ipsilateral
- Ant=Contralateral
95
ZAJ 1-4 mammillary processes at superior facets are an attachment site for which muscle?
Multifidus
96
Which ZAJ is vertical and faces slightly anterior & lateral?
Inferior
97
Describe how L5 is different from the others.
- Wedge-shaped body that's wider in front & has smaller SP
- Inferior ZAJ are larger & wider apart & more anterior
98
Increased anterior pelvic tilt will increase what type of stress?
Shear stress
99
Lumbar discs are arranged in sheets called what?
Lamellae
100
Lumbar disc concavity anteriorly or posteriorly resists tension with forward flexion?
Posteriorly
101
At which spinal level does the supraspinous ligament terminate? What does it blend with?
- L4
- Thoracolumbar fascia
102
Which ligament prevents anterior displacement on L5 due to shear forces?
Iliolumbar ligament
103
Contraction of which 2 muscles tensions the thoracolumbar fascia?
- Glute max
- Contralateral lat
104
For lumbar flexion/extension, tilt & slide occur in the same or opposite direction?
Same
105
For lumbar rotation, body tilt & slide translate ipsilateral so ipsilateral ZAJ distracts or compresses and contralateral ZAJ distracts or compresses?
- Ipsilateral: distracts
- Contralateral: compresses
106
For lumbar lateral flexion, body tilt & slide translate ipsilateral so there's up or down slide of ipsilateral ZAJ and up or down slide of contralateral ZAJ?
- Down
- Up
107
When forward bending, what follows lumbar flexion?
Anterior pelvic tilt
108
When returning to erect stance, posterior pelvic tilt is followed by what motion?
Lumbar extension
109
How does increased lordosis change how much force is divided between lumbar interbody joints & facets?
Usually interbody: 80% & facet: 20% but this makes facets take on more load
110
True or False: walking produces 3x body weight.
False
## Footnote
2x
111
Shear forces are secondary to which position in lumbar spine?
Lordotic
112
Which spinal level of lumbar region bears 65% of shear forces at ZAJ?
L4-5
113
When there's increased shear loads in lumbar region, discs play a more significant role in what?
Shear
114
Where is the base & apex of sacrum?
- Base: S1
- Apex: S5
115
For sacroiliac ligament, anterior is considered capsular & long posterior runs to which structures?
- PSIS
- Adjacent ilium
- Thoracolumbar fascia
116
Where does the SS ligament run?
Ischial spine to lateral sacrum/coccyx
117
Where does the ST ligament run?
Ischial tuberosity to posterior spine @ ilia & lateral sacrum/coccyx
118
Interosseous ligament is a major bond between sacrum & what?
Ilium
119
Symphysis pubis are pubic bones with articular cartilage & fibrocartilaginous disc & aponeurotic expansions from which 4 muscles?
- Transverse abdominis
- Rectus abdominis
- Internal obliques
- Adductor longus
120
Nutation is when the sacral base rotates anteriorly or posteriorly on fixed innominates?
Anteriorly
121
True or False: anterior pelvic tilt is when innominate & sacrum move anteriorly together and is associated with hip flexion.
True
122
What is the term for when sacral base rotates posteriorly on fixed innominates?
Counternutation
123
What is posterior pelvic tilt associated with?
Hip extension
124
Which ligaments resist nutation?
- Sacrotuberous
- Sacrospinous
- Anterior sacroiliac
125
Which ligament resists counternutation?
Long posterior sacroiliac
126
Irregular joint surfaces increase or decrease stability and increase or decrease mobility?
- Increase stability
- Decrease mobility
127
The line of gravity for craniocervical/upper thoracic region passes anteriorly or posteriorly?
Anteriorly
128
Which muscle extends the neck and unilaterally ipsilaterally side bends and contralaterally rotates in craniocervical/upper thoracic?
Trapezius
129
Which muscle elevates and downward rotates the scapula, is a side bender and rotator, and resists lordotic position of cervical spine?
Levator scapulae
130
Which muscle(s) have large cross-section and moment arm, bilaterally extend, and unilaterally ipsilaterally rotate in craniocervical/upper thoracic?
Splenius capitis & cervicis
131
What is the effect of decreased mobility?
Decreased mobility can lead to various musculoskeletal issues.
132
Where does the LoG for craniocervical/upper thoracic region pass?
The LoG passes anteriorly, while posterior muscles counteract flexion.
133
Which muscle extends the neck and contributes to ipsilateral side bending and contralateral rotation in the craniocervical/upper thoracic region?
Trapezius
134
Which muscle elevates and downward rotates the scapula, assists in side bending and rotation, and resists lordotic position of the cervical spine?
Levator scapulae
135
Which muscles have a large cross-section and moment arm, extend the neck, and contribute to ipsilateral rotation in the craniocervical/upper thoracic region?
Splenius capitis and splenius cervicis
136
Which muscles extend and maintain lordosis and are associated with the greater occipital nerve in the craniocervical/upper thoracic region?
Semispinalis capitis and semispinalis cervicis
137
Which muscles stabilize the frontal plane, contribute to ipsilateral side bending, and are poor extensors due to a short moment arm in the craniocervical/upper thoracic region?
Longissimus capitis and longissimus cervicis
138
Which muscles contribute to occipital extension and ipsilateral rotation and side bending of the occiput on the atlas?
Suboccipital muscles
139
Which muscle flexes, contributes to ipsilateral side bending, and rotation in the craniocervical/upper thoracic region?
Anterior scalenes
140
Which muscle primarily stabilizes the frontal plane and contributes to ipsilateral side bending in the craniocervical/upper thoracic region?
Middle scalenes
141
Which muscle contributes to ipsilateral side bending in the craniocervical/upper thoracic region?
Posterior scalenes
142
Which muscle contributes to flexion, ipsilateral side bending, and contralateral rotation in the craniocervical/upper thoracic region?
Sternocleidomastoid (SCM)
143
Which muscles can flex but are better at providing compression/proprioceptive input and work synergistically with traps to stabilize the head?
Longus capitis and longus colli
144
Which muscles flex and are greater at proprioceptive function in the craniocervical/upper thoracic region?
Rectus capitis anterior and rectus capitis lateralis
145
What is associated with lats, glute max, obliques, TA, and surrounds erector spinae and multifidus in the lower thoracic/lumbopelvic region?
Thoracolumbar fascia (TLF)
146
Which muscles superficially extend and contribute to ipsilateral side bending and rotation with eccentric control during standing flexion in the lower thoracic/lumbopelvic region?
Erector spinae (longissimus and iliocostalis)
147
Which muscles deep create posterior compressive and shear forces to counteract anterior shear forces in the lower thoracic/lumbopelvic region?
Erector spinae
148
Which muscle in the thoracic spine contributes to contralateral rotation and local segmental control?
Multifidus
149
Which muscle in the lumbar spine extends, acts as a synergistic stabilizer with abs, and provides local segmental control in the lower thoracic/lumbopelvic region?
Multifidus
150
Which muscles contribute to ipsilateral side bending, contralateral rotation, and are primarily proprioceptive in the lower thoracic/lumbopelvic region?
Rotatores and intertransversarii
151
Which muscle contributes to frontal plane stabilization and ipsilateral side bending in the lower thoracic/lumbopelvic region?
Quadratus lumborum
152
Which muscle flexes the trunk and contributes to ipsilateral side bending?
Rectus abdominis
153
Which muscle in the abdominal wall contributes to ipsilateral side bending and ipsilateral rotation?
Internal oblique
154
Which muscle in the abdominal wall contributes to ipsilateral side bending and contralateral rotation?
External oblique
155
Which muscle flexes the hip with spinal stabilization?
Psoas major
156
If psoas major is tight, which way will the pelvis tilt and what will this lead to?
Anterior pelvic tilt, leading to increased compression and anterior shear.
157
Which muscles lift the pelvic floor, constrict openings, and generate/maintain intra-abdominal pressure?
Levator ani (iliococcygeus and pubococcygeus)
158
Describe a squat lift.
- Neutral lumbar spine
- Erector spinae offset large anterior shear force
- Lower disc pressure, higher compressive forces
159
Describe a stoop lift.
- Elongated spinal extensor muscles, decreased moment arm
- Erector spinae less able to counteract
- Increased posterior disc pressure
160
What decreases with age, causing a decrease in loads that bones can handle?
Horizontal and vertical trabeculae
161
Discs lose what and water content as we age, leading to a decrease in disc height and ability to transfer loads?
Proteoglycans
162
What is the term for when nuclear material prolapses onto bone because vertebral endplates are unable to diffuse as well?
Schmorl's nodes
163
Disc prolapse or protrusion occurs as we age because of the lamellae of what separating?
Annulus
164
Where is the manubrosternal joint located?
- Where manubrium and body meet
- Rib 2
165
When does the manubrosternal joint ossify?
At 60 years
166
When does the xiphisternal joint ossify?
At 40-45 years
167
Which vertebrae does rib 6 articulate with?
- Inferior facet of T5
- Superior facet of T6
168
Which 4 ribs only articulate with 1 vertebra?
Ribs 1, 10, 11, and 12
169
Which ribs are classified as true, false, or floating?
- True: 1-7
- False: 8-10
- Floating: 11-12
170
Which rib has a larger, thicker articulation with stiffer costal cartilage allowing very little movement anteriorly?
1st rib
171
Which joints provide a single axis of motion for ribs 1-10?
Costovertebral and costotransverse joints
172
During inspiration, how do upper thorax ribs (2-7) move and what does this lead to?
Pump handle motion leads to increased anterior-posterior diameter.
173
During inspiration, how do lower thorax ribs (8-10) move and what does this lead to?
Bucket handle motion leads to increased lateral diameter.
174
Which ribs are only costovertebral?
Ribs 11 and 12
175
What are the primary muscles of ventilation?
- Diaphragm
- Intercostals
- Scalenes
176
Which muscles are accessory for breathing?
- SCM (elevates at manubrium)
- Traps (holds head for SCM)
- Pec major (when humerus stable)
- Pec minor (on ribs 3-5)
- Subclavius
- Serratus posterior inferior
- Abs (forced exhalation)
177
How are COPD patients' breathing affected?
- Barrel chest
- Shortened inspiratory muscles
- Flattened diaphragm
178
True or False: Neonate/infant's ribs and diaphragm are more horizontal compared to adults.
True
179
What percentage of an infant's diaphragm is fatigue resistant compared to adults?
20% in infants compared to 50% in adults.
180
When can babies start to use accessory muscles for breathing?
When head control is gained.
181
What helps bring the rib cage down and improves pump/bucket motions for babies?
Sitting
182
What condition do the elderly have that leads to decreased mobility of the thoracic spine and rib cage?
Increased kyphosis.
