Spine Flashcards by Alex Stein

General function of vertebral column

Support for head and internal organs
Stable attachment for all soft tissues, extremities, rib cage, and pelvis
Protection of internal organs and spinal cord
Attenuates forces from above and below

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Components of vertebral column

24 freely movable and 9 fused bones

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Cervical variations -

Two atypical (atlas and axis) which allow for increase AROM in rotation without compressing spinal cord
Uncinate processes
Transverse foramen

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Cervical variations - uncinate joints - found at

C3 to C7

Limit lateral cervical movement

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Thoracic variations - demifacets for articulation with

ribs

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Thoracic variations - spinous process

Follow rules of 3
SP of T1-T3 even with TP of same level
SP T4-T6 SP found 1/2 level below TP of same level
SP T7-T9 SP one full level below TP of same level
T10 - full level below
T11 - 1/2 level
T12 - level

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Atlanto-occipital joint

Synovial articulation between occiput and C1

YES joint

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Atlanto-axial joint

Nonsynovial articulation between dens of C2 and anterior arch of C1
NO joint

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Apophyseal or Facet joints

Synovial/diarthordial joints with capsule and synovial membrane
Guide movement of the spine

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Intervertebral joints

Between IVD and adjacent sup and inf vert body

Allow mvmnt between bodies and transmits load from one vertebral segment to another

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Sacroiliac joint

Diarthrosis/Synarthrosis (syndesmosis) combination
Ilial articulation is convex (covered with fibro)
Sacral articulation is concave (covered with hyaline)

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Fibroadipose meniscoid
Composed of ___
Found ___
Function ___

Composed of dense CT and adipose tissue
Found at sup and inf aspects of facet joints
Protects cartilage of facet surface during extremes in motion

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Inspiratory muscles

Diaphragm
Levator costarum
External intercostals
Ant internal intercostals

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Forced expiratory muscles

Internal oblique
External oblique
TA
Posterior internal intercostals 
Rectus abdominis

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Spinal extension

Erector spinae
Transversospinalis
Interspinalis
Rotatores intertransversarii

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Spinal flexion

Rectus abdominis
External obliques
Internal oblique
Psoas major

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Spinal lateral flexion

Quadratus lumborum

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Spinal rotation

Rotators
Internal/Ext obliques
Intertransversarii
Transversospinalis

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Annulus fibrosus

Concentric layers or lamellae composed of type II collagen and fibrocartilage
65% water

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Abbulus fibrosus - outer 1/3 innervated by

branches from sinovertebral nerve

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Annulus fibrosus - functions to

sustain compressive, torsional, shearing, and distraction loads

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Nucleus pulposus

Gel with imbiding capabilities composed of water and proteoglycans with a minimal amount of type 1 collagen
Avascular and aneural structure
70-90% water

Nucleus pulposus - function

to sustain compressive, torsional, shearing, and distraction loads
Makes up 20-33% height of vertebral column

Vertebral endplate

Continuous with annulus and nucles

Sits inside ring apophysis of vertebral body

Vertebral endplate - composed of

proteoglycans, collagen, and water as well as both fibrocartilage (side closest to disc) and hyaline cartilage (side closest to vertebral body)

Vertebral endplate - functions to

provide passive diffusion of nutrients

Capsules - facet joint

Assist ligaments in providing limitation of motion and stability of spine Strongest in thoracolumbar and cervicothoracic regions

Capsules - sacroiliac

Synovial capsule present in surrounding joint - very prominent ant Is lost post with posterior interossseous ligament

Thoracolumbar fascia - function

Provides stability of vertebral column when a force is applied Acts as a corset when tension is created by contraction of abs, glutes, and lumbar mm

Nerves - Dorsal roots transmit

sensory fibers to spinal cord

Nerves - Ventral roots transmit

motor fibers from spinal cord to spinal nerve

Spinal nerves are connected centrally to spinal cord by

a dorsal and ventral root which join to become the spinal nerve in the intervertebral foramen Spinal nerves divide into dorsal and ventral rami

Dorsal rami innervate structures of the

posterior trunk

Ventral rami

Cervical - form cervical and brachial plexuses Thoracic - innervate anterior thoracic trunk Lumbar - form lumbar and lumbosacral plexuses

Cervical plexus

C1 - C4

Brachial plexus

C5 - T1

Spinal nerves - Cervical spinal nerves come out

at the level above its associated vertebrae

Spinal nerves - Thoracic/Lumbar spinal nerves comes out

at level below its associated vertebrae

Spinal cord terminates at about

L1/L2 disc

Biomechanics - Spinal flexion

Upper facets glide anteroproximally and tilt forward

Biomechanics - Spinal extension

Upper facets move downward, slightly posterior, and tilt backward

Biomechanics - Side bending ???

When SB R upper facet moves down and slightly ant. L facet moves upward and slightly post Both facets move to the left

Biomechanics - Cervical right rotation causes

facets on right to glide down and back | causing approximation of facet joints on the right

Biomechanics - lumbar/thoracic rotation

Very little But this motion causes separation and approximation of the facet joints If L3 rotates right, there is separation at R L3-L4 joint and approximation at left L3-L4 joint

Biomechanics - Coupled motions - Cervical

SB and Rot occur in same direction from C2 - C7 REGARDLESS of whether spine is in neutral/extension or flexion When occiput SB, C1 rotates in opp direction

Biomechanics - Coupled motions - Lumbar/Thoracic - Neutral/Extension

Lumbar segments SB and Rot in OPP directions | SB R results in segment rotating left

Biomechanics - Coupled motions - Lumbar/Thoracic - Flexion

Lumbar segments SB and Rot in SAME direction

Biomechancis - Lumbopelvic rhythm - during flexion

spine (primarily lumbar) - goes through 60-70 of motion and then pelvis will rotate ant to allow more movement, eventually followed by flexion of hips

Biomechanics - Lumbopelvic rhythm - during extension (coming from flexed position)

Hips extend, pelvis rotates post, and then spine begins to extend

Sacroiliac joint osteokinematics - motion at SIJ joint

is limited but during gait movement takes place in multiple planes

Sacroiliac joint osteokinematics - Nutation and Counternutation is what

coupling motion that occurs between sacrum and ilium during gait

Sacroiliac joint osteokinematics - Nutation is what

A movement that involves flexion of sacrum and posterior rotation of ilium

Sacroiliac joint osteokinematics - Counternutation is what

A movement that involves extension of sacrum and anterior rotation of ilium