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Biomechanics > Spine > Flashcards

Spine Flashcards

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1
Q

Attachment of Ligamentum flavum:

A

B/w anterior surface of one lamina and posterior surface of lamina below

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2
Q

Function of Ligamentum flavum:

A

limits flexion

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3
Q

Attachments of supraspinous and interspinous ligaments:

A

B/w adjacent spinous processes from C7 to sacrum

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4
Q

Fuction of supraspinous and interspinous ligaments:

A

limit flexion

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5
Q

Attachment of Intertransverse ligaments:

A

Between adjacent transverse processes

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6
Q

Function of Intertransverse ligaments:

A

Limits contralateral lateral flexion and forward flexion

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7
Q

Attachment of Anterior longitudinal ligament

A

B/w basilar part of occipital bone and entire length of anterior surfaces of all vertebral bodies, including sacrum

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8
Q

Function of Anterior longitudinal ligament

A

Limits extension or excessive lordosis in cervical and lumbar regions. Reinforces anterior sides of intervertebral discs (IVDs)

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9
Q

Attachment of Posterior longitudinal ligament

A

Throughout length of posterior surfaces of all vertebral bodies, b/w axis (C2) and sacrum

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10
Q

Function of Posterior longitudinal ligament

A

Limits flexion.

Reinforces posterior sides of IVDs

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11
Q

Attachment of Capsules of the apophyseal joints

A

Capsules of the apophyseal joints

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12
Q

Function of Capsules of the apophyseal joints

A

Strengthen apophyseal joints

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13
Q

Intervertebral junction has three functional components:

A

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

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14
Q

What is primarily responsible for guiding intervertebral motion:

A

apophyseal joints

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15
Q

What increases mechanical leverage of muscles and ligaments?

A

SP and TVPs provide mechanical levers

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16
Q

Plane of movement of flexion and extension of axial skeleton

A

sagittal

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17
Q

Plane of movement of lateral flexion (right or left) of axial skeleton:

A

frontal

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18
Q

Plane of movement of axial rotation (right or left) of axial skeleton

A

horizontal

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19
Q

AOR axial rotation (right or left) of axial skeleton

A

vertical

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20
Q

AOR of flexion and extension of axial skeleton

A

medial-lateral

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21
Q

AOR of lateral flexion (right or left) of axial skeleton

A

anterior-posterior

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22
Q

What strongly influences kinematics at different regions across vertebral column?

A

orientation of plane of facet surfaces within each joint

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23
Q

Horizontal facet surfaces favor:

A

axial rotation

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24
Q

Vertical facet surfaces (either in sagittal or frontal planes) block:

A

axial rotation

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25
Why is axial rotation is far greater in cervical region than lumbar region?
plane of facet surfaces
26
What is the orientation of each collagen fiber?
65 degrees from vertical
27
How are the collagen fibers arranged?
concentric layers with fibers in every other layer running in identical directions -130 degrees relative to each other
28
ROM atlanto-occipital joint (C0-C1) flexion and extension:
Flexion: 5 Extension: 10 Total: 15
29
ROM atlanto-axial joint complex (C1-C2), flexion and extension:
Flexion: 5 Extension: 10 Total: 15
30
ROM intracervical region (C2-C7), flexion and extension:
Flexion: 35-40 Extension: 55-60 Total: 90-100
31
Total ROM across craniocervical region, flexion and extension:
Flexion: 45-50 Extension: 75-80 Total: 120-130
32
ROM atlanto-occipital joint (C0-C1) axial rotaiton
negligible
33
ROM atlanto-occipital joint (C0-C1), lateral flexion
about 5
34
ROM Atlanto-axial joint complex (C1-C2) axial rotation
35-40
35
Atlanto-axial joint complex (C1-C2) lateral flexion
negligible
36
ROM Intracervical region (C2-C7) axial rotation
30-35
37
ROM Intracervical region (C2-C7) lateral flexion
30-35
38
ROM Total across craniocervical region axial rotaiton
65-75
39
ROM Total across craniocervical region lateral flexion
35-40
40
Protraction of cranium, lower-to-mid cervical spine:
flexes as upper craniocervical region extends
41
Retraction of cranium, lower to mid cervical spine:
extends as upper cranicervical region flexes
42
Kinematics of craniocervical axial rotation C2-C7:
inferior facets slide posteriorly and slightly inferiorly on the same side as rotation and anteriorly and superiorly on the side opposite rotation.
43
What does the 45° inclination of articular facets of C2 to C7 dictate?
mechanical spinal coupling b/w movements in frontal and horizontal planes
44
Because upper vertebra follows plane of articular facet of lower vertebra:
lateral flexion and axial rotation occur simultaneously
45
Lateral flexion and axial rotation in mid-and-low cervical region area:
coupled in ipsilateral fashion | -lateral flexion to right occurs with slight axial rotation to right and vice versa
46
Approximate ROM for Thoracic Region, flexion and extension:
flexion: 30-40 extension: 20-25 total: 50-65
47
Approximate ROM for Thoracic Region axial rotation
30-35
48
Approximate ROM for Thoracic Region lateral flexion
25-30
49
Approximate ROM
 for Lumbar Region, flexion and extension:
flexion: 40-50 extension: 15-20 total: 55-70
50
Approximate ROM
 for Lumbar Region axial rotation
5-7
51
Approximate ROM 
for Lumbar Region lateral flexion
20
52
Total flexion between thoracic and lumbar regions:
85 degrees (35 thoracic, 50 of lumbar)
53
Total extension between thoracic and lumbar regions:
35-40 degrees (20-25 thoracic extension, 15 lumbar extension)
54
Total axial rotation between thoracic and lumbar region
-40 degree arc: sum of about 35° of thoracic rotation and 5° of lumbar rotation
55
Total lateral flexion of thoracic and lumbar region:
-45 degrees, sum of 25° of thoracic lateral flexion and 20° of lumbar lateral flexion
56
Large amount of motion in cervical spine and why:
large motion in all three planes, highest is axial rotation permitted at atlanto-axial joint
57
Thoracic spine permits:
constant amount of lateral flexion: reflects general frontal plane orientation of apophyseal joints combined w/stabilzing effect of ribs
58
Thoracolumbar spine, from crainial-to caudal direction permits:
increasing amounts of flexion and extension at expense of axial rotation
59
Orientation of apophyseal joints in cervical-thoracis junction:
horizontal and frontal planes
60
Orientation of apophyseal joints in lumbar region
near sagittal plane and vertical orientation
61
Prevailing near-sagittal plane and vertical orientation of lumbar region naturally favor :
flexion and extension but restrict axial rotation
62
Lumbar spine, in combination with flexion and extension of ribs:
forms primary pivot point for sagittal plane motion of entire trunk
63
SI joints mark transition between...
caudal end of axial skeleton and lower appendicular skeleton
64
What are the components of the pelvic ring?
sacrum, pair of SI joints, three bones of each hemipelvis (ilium, pubis and ischium) and pubic symphysis
65
What does the pelvic ring do?
transfers body weight bidirectionally b/w trunk and femurs
66
What does the strength of the pelvic ring depend on?
primarily on tight fit of sacrum wedged b/w two halves of pelvis
67
What are the movements at the SI joints?
nutation and countermutation
68
Nutation:
anterior sacral tilt posterior iliac tilt forward movement of sacral apex/anterior pelvic tilt
69
Countermutation:
posterior sacral tilt | anterior iliac tilt
70
Nutation is couped with
lumbar extension
71
Countermutation is coupled with
lumbar flexion
72
Mechanisms of injury for low back
trauma | fatigue
73
What are the orientations of the trabecular design within cancellous bone?
one vertical | two oblique
74
What compresses cancellous bone?
NP pressurizes & causes cartilaginous end plates of vertebra to bulge inward
75
What plays the role of shock absorbers?
vertebral bodies
76
How do end plates bulge into seemingly rigid bone?
design of cancellous bone
77
Vertebral cancellous bone structure dominated by system of columns of bone that run...
vertically from end plate to end plate
78
Vertical columns tied together with what?
smaller transverse trabeculae
79
Under axial compression, as end plates bulge into vertebral bodies....
these columns experience compression and appear to bend
80
Under extreme compressive load...
bending columns will buckle as smaller bony transverse trabeculae fracture
81
How much of cancellous bone can rebound back to original shape?
95% of original unloaded shape
82
What causes microdamage to trabeculae?
highly repetitive loads, even at low magnitudes
83
What is lost in osteoporotic vertebrae?
transverse trabeculae are far fewer in number and smaller in diameter then longitudinal trabeculae
84
When does osteporotic vertebrae begin to collapse?
gradually when exposed to excessive load, with serial buckling or failure of columns of bone
85
Transverse trabeculae were thick and dense from...
weightlifters
86
Schmori's node:
local area of bone collapses under end plate to create a pit or crater that gradually forms
87
What injury is associated with spinal compression when spine is in neutral ROM?
schmori's node/end plate fracture
88
What remains intact with end plate fracture?
AF of disc
89
In an end plate fracture, if there is substantial loss of nucleus from disc, what results?
immediate loss of disc height & compromise of nerve root | -mimics symptoms of true herniation
90
Why is end plate fracture misdiagnosed as a herniated or degnerated disc?
b/c in films loss of disc nucleus results in flattened interdiscal space
91
What has a shell of cortical bone?
posterior elements of vertebrae (pedicles, laminae, spinous processes and facet joints)
92
What can lead to spondylolisthesis?
failure of posterior elements in conjunction with facet damage
93
What appears to be somewhat flexible during flexion/extension movements?
neural arch in general (pedicles and lamina)
94
Damage to posterior elements mar be associated with what?
full ROM
95
Repeated, cyclic full spine flexion and extension leads to fatigue within arch (repeated stress reversals) can lead to what?
a pars fracture- spondylolisthesis
96
Patients with pars fractures do not do well with what?
therapeutic exercises that take spine through ROM, stability objective maybe better
97
During craniocervical extension, the atlanto-occipital joint demostrates a ______ roll and ______ slide, while atlanto-axial joint demonstrates a ______tilt.
posterior, anterior, posterior
98
During craniocervical flexion, the atlanto-occipital joint demostrates a ______ roll and ______ slide, while atlanto-axial joint demonstrates a ______tilt.
anterior, posterior, anterior
99
C2-C7 lateral flexion, inferior articular facets on side opposite side lateral flexion slide______ and; ________.
superior anteriorly

Biomechanics (13 decks)

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