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The spine Flashcards

1
Q

the change of the spinal cord through newborn to adult

A
  • Size and shape changes with development from newborn to full adult
  • Adapts to support and balance body segments in a vertical orientation.
    o Newborns have one primary curve in their spine – these changes as we develop throughout our lives and are exposed to gravity, need for balance, etc.
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2
Q

spine curves

A

Cervical = concave posteriorly (lordosis)
Thoracic = convex posteriorly (kyphosis)
Lumbar = concave posteriorly (lordosis)

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3
Q

Regional differences in vertebrae size and morphology

A
  • Cervical < thoracic < lumbar (Vertebrae body and disc sizes)
  • Posterior and transverse processes differ in length and orientation
  • Facets differ in orientations
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4
Q

what is the function of the spinous and transverse processes

A

provide attachment points for muscles and ligaments

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5
Q

how the shape of the processes change

A

they change in different spinal regions  movements and forces

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6
Q

what is the the effect of the overlapping of transverse process

A

can limit movement

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7
Q

function of the articular process

A
  • Restrain movement
  • Sensory – provide information
    about vertebrae position
  • Viscoelastic elongation to loading
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8
Q

Lumbar joints (type):

A
  • Facet joints:
  • Superior articular process
  • Inferior articular process
  • Intervertebral joint
  • Vertebrae bodies
    Intervertebral disc
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9
Q

facet joints (characteristics)

A
  • Synovial joints
  • Increase loading on facet with extension
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10
Q

function of the facet joints

A
  • Guide segmental motion
  • Resist anterior shear
  • Resist torsion
  • Resist compression
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11
Q

function of the intervertebral joints

A
  • Maintain space between vertebrae
  • Allow movement
  • Resist compression
  • Resist rotation
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12
Q

intervertebral disc (2 composants)

A

annulus fibrosus + nucleus pulposus

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13
Q

annulus fibrosus

A
  • Outer portion
  • Rings of fibrocartilage
  • Rings obliquely orientated
  • Resist tensile forces and compression
  • Many mechanoreceptors & free nerve endings
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14
Q

function of annulus fibrosis

A

resist tensile forces and compression
* Layers with different fiber patterns woven to contribute to load bearing and reduce bulging of disc
* Many mechanoreceptors and free nerve endings, suggests significant contribution to proprioception

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15
Q

nucleus pulposus = middle

A
  • 70-90% water
  • Resist compression
  • Role in nutrition
  • disc (except for outer portion) is avascular
    inner portion
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16
Q

function of ligaments and fascia in the spine

A

provide integral support and selected flexibility to the collective vertebral column.

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17
Q

tensile integrity

A
  • System of isolated components under compression within a network of cords under constant tension
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18
Q

function of the tensile integrity

A
  • Helps maintain structural integrity, mechanical stability, and optimize loading.
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19
Q

the effect of thicker spinal column

A

the column could prevent buckling (B) but bone structure would be much heavier making movement less efficient, could reduce ROM

20
Q

the function of bone segments

A

assist with maintaining an upright structure and avoiding buckling (D)

21
Q

degrees of freedom

A
  • Three translations
  • Distraction/compression
  • Anterior/posterior shear
  • Left/right shear (glide)
  • Three rotations
  • Flexion/extension
    Left/right side bend (sideflexion, lateral flexion)
  • Left/right rotation
22
Q

Functional Spinal Unit

A

= vertebrae + intervertebral disc + vertebrae

23
Q

how does the movement between vertebrae is limited

A

by the binding fibers of the intervertebral discs

24
Q

movement of 2 vertebrae together

A
  • A) left/right shear
  • B) compression/distraction
  • C) anterior/posterior shear
  • D) left/right side bend
  • E) left/right rotation
  • F) flexion/extension
25
Q

lumbar facet joints

A

more parallel to sagittal plane than thoracic facets
* Allows flexion and extension, limits rotations and side flexion

26
Q

Instantaneous centers of rotation (ICR)

A
  • Point of rotation for the spine is not fixed
  • Implications for clinical treatment
  • The point of rotation is not fixed in space at any one time and the center of rotation can change
  • Rehab, training, stability
27
Q

general trends of movement of the lumbar spine, thoracic and cervical

A

Lumbar spine has high flexion and extension
Thorax- more rotation than lumbar spine
C-spine- lots of rotation at c1-c2

28
Q

how ROM is calculate

A
  • Illustration from a study using 3D tracking to compare the trunk (body) and the pelvis orientation during walking
29
Q

why the ROM is useful

A
  • Useful analysis for clinical populations
30
Q

Lumbar flexion/extension

A

Nucleus pulposus moves with lumbar movement
- Lumbar flexion- posterior migration
- Lumbar extension- anterior migration

31
Q

bending

A

some axial rotation will also naturally occur
* Tension with the other elements creates these coupled motions

32
Q

Lumbar pelvic rhythm

A
  • Spinal column moves in relation to pelvis to maintain balance
33
Q

anterior pelvic tilt

A

natural hyperextension of lumbar spine

34
Q

posterior pelvic tilt

A

forward flexion of lumbar spine

35
Q

what is the function of the anterior / posterior pelvic tilt

A

Greater ROM than just hip flexion alone

36
Q

Rotation:

A
  • Rotation resisted by annulus fibrosus
  • Facet joints limit rotation, but provides less protection while in flexion
  • more likely injured during rotation in flexion
37
Q

compression

A
  • Hoop stress- vertical load (compression) converted to circumferential tension
  • Tension resisted by annulus fibrosus and vertebral end plates
38
Q

Lumbar shear / compression force

A
  • Shear and compression forces are the lumbar joint reaction forces
  • Forces on the vertebrae due to gravity on trunk, loading in arms, and muscles/ligaments
39
Q

can lifting position have an impact on the spine movement

A

yes: Minimize the shear movement of the spine by some techniques (ex.: bended the knees)

40
Q

In vitro measures of dynamic forces:

A
  • Prosthetic implants can go into the body to bridge between healthy bone structures
  • They also have sensors and can measure the force being applied

Ex: vertebral body replacement / internal spinal fixator

41
Q

Statics:

A
  • Increase mass of the body above the waist/legs (increasing force)
  • COM is projected anteriorly, increasing lever arm & increasing disc pressures
42
Q

impact of obesity and pregnancy on the spine

A

increase the body mass anteriorly = affect the way the forces are acting on the spine

43
Q

Lumbosacral joint

A
  • Force transmitted from the spine to the legs when you’re standing
  • Force transmitted to ischial tuberosities when sitting down
44
Q

Discs:

A
  • Nucleus pulposus interaction with annulus fibrosus
  • Collagen fiber orientation prevents tearing of the annulus fibrosus when force is applied
  • Dampens peak forces between vertebrae during motions
45
Q

Theory of weight bearing

A
  • Off-centered forces may lead to pinching of the IVD
  • Can lead to herniation of the disc
46
Q

Static pressures vary with posture

A
  • Needled pressure sensors placed into the vertebral discs allowed for pressure readings during different activities
  • Numbers are %BW
47
Q

Intradiscal pressure

A

Sitting posture variation
* Disc pressure while sitting

  • As incline is increased, IVD pressure is reduced
  • Decrease in muscle activation = decreased IVD pressure
  • Sitting
  • Ergonomics/occupational biomechanics
  • Different postures change the way the spine experiences forces and pressure

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