Spine

Question 1

Where does the ligamentum flavum attach?

Answer 1

Between the anterior surface of one lamina and the posterior surface of lamina below

Question 2

What motion does the ligamentum flavum limit?

Answer 2

flexion

Question 3

Where do the supraspinous and interspinous ligaments attach?

Answer 3

Between adjacent spinous processes from C7 to sacrum

Question 4

What motion do the supraspinous and interspinous ligaments limit?

Answer 4

flexion

Question 5

Where do the intertransverse ligaments attach?

Answer 5

Between adjacent transverse processes

Question 6

What motions does the intertransverse ligament limit?

Answer 6

Contralateral lateral flexion and forward flexion

Question 7

Where does the ALL attach?

Answer 7

Between the basilar part of the occipital bone and along the entire length of the anterior surfaces of all vertebral bodies, including the sacrum

Question 8

What are the 2 functions of the ALL?

Answer 8

• Limits extension or excessive lordosis in cervical and lumbar regions.
• Reinforces anterior sides of IVDs

Question 9

Where does the PLL attach?

Answer 9

Throughout the length of the posterior surfaces of all vertebral bodies, between axis (C2) and sacrum

Question 10

What are the 2 functions of the PLL?

Answer 10

• Limits flexion

- Reinforces posterior sides of IVDs

Question 11

Where do the capsules of the apophyseal joints attach?

Answer 11

Along the margins of each apophyseal joint

Question 12

What is the function of the apophyseal joint capsules?

Answer 12

To strengthen the apophyseal joints

Question 13

What are the 3 functional components of the intervertebral unction?

Answer 13

(1) transverse and spinous processes
(2) apophyseal joints
(3) an interbody joint (IVD)

Question 14

What is the function of spinous processes and transverse processes?

Answer 14

They provide mechanical levers that increase mechanical leverage of muscles and ligaments

Question 15

What is the main function of the apophyseal joints?

Answer 15

They guide intervertebral motion

Question 16

Vertebral column flexion/extension occur in what plane? What about lateral flexion to the right or left? And axial rotation to the right or left?

Answer 16

Sagittal
Frontal
Horizontal

Question 17

Horizontal facet joints favor what movement?

Answer 17

axial rotation

Question 18

In what vertebral region are horizontal facet joints dominant?

Answer 18

cervical; this is why axial rotation is far greater in the cervical region rather than in the lumbar region

Question 19

The layers of the annulus fibrosus are oriented about __° from the vertical

Answer 19

65°

Question 20

How much flexion and extension occur at the atlanto-occipital joint?

Answer 20

Flexion: 5
Extension: 10

Question 21

How much lateral flexion occurs at the atlanto-occipital joint?

Answer 21

5 degrees

Question 22

How much flexion and extension occur at the atlanto-axial joint complex?

Answer 22

Flexion: 5
Extension: 10

Question 23

How much axial rotation occurs at the atlanto-axial joint complex?

Answer 23

35-40 degrees

Question 24

How much lateral flexion occurs at the atlanto-axial joint complex?

Answer 24

none

Question 25

How much flexion and extension occur at the intracervical (C2-C7) region?

Answer 25

Flexion: 35-40 Extension: 55-60

Question 26

How much axial rotation occurs at the intracervical (C2-C7) region?

Answer 26

30-35 degrees

Question 27

How much lateral flexion occurs at the intracervical (C2-C7) region?

Answer 27

30-35 degrees

Question 28

How much flexion and extension occur (total) over the craniocervical region?

Answer 28

Flexion: 45-50 Extension: 75-80

Question 29

How much axial rotation occurs (total) over the craniocervical region?

Answer 29

65-75 degrees

Question 30

How much lateral flexion occurs (total) over the craniocervical region?

Answer 30

35-40 degrees

Question 31

Describe the arthrokinematics at the atlanto-occiptal joint, alanto-axial joint, and in the intracervical region during extension

Answer 31

Posterior roll and anterior slide at the alanto-occipital joint Inferior tilt at alanto-axial complex Posterior-Inferior slide in the intracervical region

Question 32

Describe the arthrokinematics at the atlanto-occiptal joint, alanto-axial joint, and in the intracervical region during flexion

Answer 32

Anterior roll and posterior slide at the alanto-occipital joint Superior tilt at alanto-axial complex Anterior-Superior slide in the intracervical region

Question 33

During protraction of the cranium, lower-to-mid cervical spine _____ as upper craniocervical region _____.

Answer 33

flexes | extends

Question 34

During retraction of the cranium, lower-to-mid cervical spine _____ as upper craniocervical region _____.

Answer 34

extends | flexes

Question 35

Describe the arthrokinematics at the atlanto-axial joint and in the intracervical region during right rotation

Answer 35

there is a posterior slide on the right side and anterior slide on the left side at all joints

Question 36

Describe the arthrokinematics at the atlanto-occipital joint during right lateral rotation

Answer 36

There is a roll in the same direction of the movement (right) and slide in the opposite direction (left)

Question 37

Describe the arthrokinematics in the intracervical region during right lateral rotation

Answer 37

There is a posterior-inferior slide on the right and anterior-superior slide on the left

Question 38

What is the angle of inclination of the articular facets of C2 - C7?

Answer 38

45°

Question 39

What 2 motions occur simultaneously in the upper vertebrae?

Answer 39

lateral flexion and axial rotation

Question 40

With lateral flexion to the right at the mid-and-low cervical regions slight axial rotation to the ___ also occurs

Answer 40

right (ipsilateral)

Question 41

Why is this compensatory action of atlanto-axial joint important?

Answer 41

It minimizes the overall rotation of the head, which helps the eyes fixate on a stationary object during lateral flexion of neck

Question 42

How much movement occurs in the sagittal plane (flexion/extension) in the thoracic region?

Answer 42

50-65 degrees

Question 43

How much movement occurs in the sagittal plane (flexion/extension) in the lumbar region?

Answer 43

55-70 degrees

Question 44

How much movement occurs in the horizontal plane (axial rotation) in the lumbar region?

Answer 44

5-7 degrees

Question 45

How much movement occurs in the frontal plane (lateral flexion) in the lumbar region?

Answer 45

20 degrees

Question 46

Describes the arthrokinematics at the thoracic and lumbar regions during flexion

Answer 46

There is an anterior-superior slide of the facet joints

Question 47

Describes the arthrokinematics at the thoracic and lumbar regions during extension

Answer 47

There is a posterior-inferior slide of the facet joints

Question 48

Describes the arthrokinematics at the thoracic region during axial rotation

Answer 48

Slide occurs in the same direction as the movement

Question 49

Describes the arthrokinematics at the lumbar region during axial rotation

Answer 49

The ipsilateral and contralateral facet joints approximate in the lumbar region (not much movement therefore there is no slide)

Question 50

Describes the arthrokinematics at the thoracic and lumbar regions during lateral flexion

Answer 50

Inferior slide on the ipsilateral side and superior slide on the contralateral slide

Question 51

What are the 4 components of the pelvic ring

Answer 51

- sacrum - 2 SIJs - 3 bones of each hemipelvis (ilium, pubis, and ischium) - pubic symphysis joint

Question 52

What is the purpose of the pelvic ring?

Answer 52

It transfers body weight bidirectionally between the trunk and femurs

Question 53

What does the strength of the pelvic ring depend on?

Answer 53

The tight fit of the sacrum wedged between the two halves of the pelvis

Question 54

What is the keystone of the pelvic ring?

Answer 54

The sacrum

Question 55

During anterior pelvic tilt the sacrum ____ and the lumbar spine _____.

Answer 55

counternutates | extends

Question 56

During posterior pelvic tilt the sacrum ____ and the lumbar spine _____.

Answer 56

nutates | flexes

Question 57

The cancellous bone within the vertebral body has a trabecular design. Describe the orientation of this design

Answer 57

There is one vertical and two oblique lines that interweave

Question 58

What is the primary shock absorber in the lumbar spine?

Answer 58

Cancellous bone (not the IVDs)

Question 59

Describe how the cancellous bone can be a shock absorber when compressed

Answer 59

The nucleus pulposus pressurizes and causes the cartilaginous end plates of vertebrae to bulge inward, thus compressing the cancellous bone

Question 60

Which trabeculae are crucial in determining compressive strength?

Answer 60

Transverse trabeculae

Question 61

With extreme compressive loading the end plates begin to bulge into the vertebral bodies and cause what?

Answer 61

Fractures or cracks in the end plate sometimes large enough to permit liquid NP to squirt through end plate into the vertebral body

Question 62

What is a Schmorl’s node?

Answer 62

Protrusion of the cartilage of the IVDs through the vertebral body endplate and into the adjacent vertebra, however the annulus fibrosis remains intact

Question 63

A Schmorl’s node is developed how?

Answer 63

By spinal compression when spine is in neutral ROM (i.e., not flexed, bent or twisted)

Question 64

How are the posterior elements of the vertebrae damaged?

Answer 64

Repeated, cyclic full spine flexion and extension

Question 65

3 components of the IVDs

Answer 65

nucleus pulposus annulus fibrosis end plates

Question 66

4 conclusions about disc lesions

Answer 66

- disc must be bent to full ROM in order to herniate - the mechanism of injury is fatigue - found more in those with sedentary occupations and sitting posture - occurs more often is younger spines

Question 67

Disc herniation is due to what?

Answer 67

fully flexing the spine for repeated or prolonged period of time

Question 68

What is the function of rotatores and intertransversarii muscles?

Answer 68

Vertebral position sensors at every thoracic and lumbar joint

Question 69

What are the 3 back extensors (1 group)?

Answer 69

Erector Spinae Group - Longissimus - Iliocostalis - Spinalis

Question 70

What are the 3 layers of the abdominal wall?

Answer 70

- external oblique - internal oblique - transverse abdominis