Trunk Biomechanics - Q&A Flashcards by Ólafía Anna Hannibalsdóttir

TRUE OR FALSE - The major role of the alar ligament is to limit rotation at the atlas level

True

How well did you know this?

Not at all

Perfectly

TRUE OR FALSE - There is no intervertebral disc between C1 and C2

True

How well did you know this?

Not at all

Perfectly

TRUE OR FALSE - The intervertebral discs separate the vertebral bodies between C3 and L5

False (between C2 to S1)

How well did you know this?

Not at all

Perfectly

Which structure is only seen in thoracic vertebrae?
A) Vertebral body
B) Costalis facets
C) Transverse process
D) Pedicles

B) Costalis facets

How well did you know this?

Not at all

Perfectly

Which part of the rib is joined to the vertebrae?
A) Neck of the rib
B) Head of the rib
C) Costal tubercle of the rib
D) Body of the rib

B) Head of the rib

How well did you know this?

Not at all

Perfectly

Which group of muscles permits the extension of the head? 
A) Spinalis
B) SCM and Scaleni
C) Sub-occipitals
D) Splenius capitis

C) Sub-occipitals

How well did you know this?

Not at all

Perfectly

Name the central part of the IVD

Nucleus Pulposus

How well did you know this?

Not at all

Perfectly

Which ligament is present between transverse processes?

Intertransverse ligament

How well did you know this?

Not at all

Perfectly

TRUE OR FALSE - The anterior longitudinal ligament is in tension during flexion of the trunk

False

How well did you know this?

Not at all

Perfectly

Which group of muscles permits flexion of the trunk
A) Erector spinae
B) Abdominals
C) Quadratus lumborum
D) Ilio-psoas

B) Abdominals

How well did you know this?

Not at all

Perfectly

Which muscles are involved in flexion of the trunk?

Rectus abdominis

Obliquus abdominis

How well did you know this?

Not at all

Perfectly

Which muscles are involved in extension of the trunk?

Erector spinae: Iliocostalis, longissimus.

Quadratus lumborum

How well did you know this?

Not at all

Perfectly

Which muscles are involved in lateral bending of the trunk?

Obliquus internus, externus. (ipsilateral side)

How well did you know this?

Not at all

Perfectly

Which muscles are involved in rotation of the trunk?

Obliquus externus (contralateral)
Obliquus internus (ipsilateral)
Obliquus transversus (ipsilateral)

How well did you know this?

Not at all

Perfectly

Describe the different function of the spine.

Skeleton of the trunk
Supports the body and participated in the thoracic and pelvic cavity
Provides attachments for the ribs and strong muscles
Protects thoracic and pelvic viscera
Protects the spinal cord
Provides “stable” mobility

How well did you know this?

Not at all

Perfectly

Explain why C7 has a longer spinous process in the cervical spine?

Must balance the weight of the head atop a relatively thin and long lever, making it quite
vulnerable to traumatic forces.
The weight of the head will increase the cervical lordosis BUT: Cervical gravity line corresponding to a line from the center of the tip of the odontoid process that should touch the anterior body of C7 will tend to flex the head.
Increase in the lever arm in the inferior cervical spine
- Increase in the load weight
- Equilibration process by an increase development of the spinous process of C7 that will serve as a lever for the muscular system.

How well did you know this?

Not at all

Perfectly

A patient has pain when rotating his head at the middle of the movement. What does this suggest?

that the dysfunction lies within the mid cervical spine.

How well did you know this?

Not at all

Perfectly

A patient presents hypermobility of the A-A joint? What does this suggest?

The A-A joint, lacks an IVD and has relatively flat joint surfaces. Rotation at this level
therefore is predominantly limited by ligamentous structures, in particular the contralateral alar ligament. Damage to these ligaments may permit rotational hypermobility of the A-A joint and subsequently threaten closely associated structures such as the vertebral
arteries and spinal cord.

How well did you know this?

Not at all

Perfectly

Explain the movements of the ribs at the different levels.

•Movement of the upper ribs (2 to 5):
Anterior ends raise with the body of the sternum. The body of the sternum is lifted upwards and outwards. Increase of the anteroposterior diameter of the thorax,
looks like a movement of a handle of a pump when drawing water from a well.
PUMP-HANDLE MOVEMENT
•Movement of the lower ribs (8 to 10):
Anterior ends moves outward and upward
Lateral excursion of the ribs and costal cartilages causing a widening of the infrasternal angle. Increase in transverse diameter of the thorax. Flat costotransverse joints induces a rotation and gliding of one bone against the other. Upward and outward movement of the shaft of the rib looks like raising the handle from
the side of a bucket.
BUCKET-HANDLE MOVEMENT
•Movement of the medium ribs (6 to 7):
Pump-handle and bucket-handle types of movement.
•Movement of the 11th and 12th ribs:
Not attached anteriorly. Have little influence on increasing the diameter of the thorax. Give attachment to some fibers of the diaphragm.
With quadratus lumborum, provides a firm attachment to the diaphragm.

Which muscles are responsible of the extension of the head on the neck?

Rectus capitis posterior major, Rectus capitis posterior minor, Oblique superior

Explain the role of the abdominal muscles

a.Walls are formed by bony structures and by muscles to protect the viscera and maintain
erect posture
b. Contraction of abdominal muscles:
•Help in expiration
•Raising intra-abdominal pressure (sneezing, coughing, micturating, defecating, lifting and
childbirth)
c. Stabilization of the spinal column

If I rotate the trunk to the left side. Which muscles is performing this movement?

Right external oblique and Left internal oblique. Flexion of the trunk might be involved as well so rectus abdominis. Do not forget, that in the upright standing position, eccentric contraction of the erectors, whereas in lying down position, flexion is due to rectus abdominis. Multifidus and rotatores.

Name the different forces applied on the IVD

Shear force
Bending force
Compressive force
Torsional

At the zygapophyseal joint level, during side bending, how are the facets moving?

The lower articular process on that side glides posteroinferiorly on the superior process of the vertebra below.
Contralateral joint spaces widen.
Accompanied by a slight rotation on the same side.

What is the difference in terms of limitation during rotation movement at the Atlanto-axial level vs the rest of the cervical spine?

At A-A level: Rotation at this level therefore is predominantly limited by ligamentous structures, in particular the contralateral alar ligament. Lower: Rotation in the sub-axial spine is limited by the IVD disc and articular facets.

During walking, explain what is happening at the thorax-lumbar region?

Rotation of the thoracolumbar part of the vertebral column is extremely important during walking • Complex mechanism: occurring in opposite direction in the upper and lower part regions. No rotation in the IVD between T7 and T8 but maximum rotation in opposite direction at the level up and down. - Decrease rotation towards the pectoral and pelvic girdle. As one leg swings through, ready for the next heel strike, the pelvis rotates about the hip joint of the supporting leg, carrying the trunk with it. • In order to maintain the head facing forward, the pectoral girdle rotates in the opposite direction.

On which side of the scoliosis can we observe the gibbosity?

Convex

On which side of the scoliosis are the muscle shortened?

Concave

How many degrees of rotation are present between C1 and C2 and for the rest of the cervical?

C1-C2:45° | Cervical: 50°

Name TWO structures that limits neck flexion

The posterior longitudinal ligament Zygapophyseal joint capsule Ligamenta flava Ligamentum nuchae Posterior vertebral muscles

Name all the muscles are responsible of the extension of the head on the neck?

Rectus capitis posterior major Rectus capitis posterior minor Oblique superior

Name three features of the Intervertebral disc at the cervical level.

The disc is about 2/5 the height of the vertebrae: ≅ 5mm | Position of the nucleus pulposus within the disc: central Oval shaped

How many degrees of flexion and extension are present at the thoracic level?

Flexion (30-40°) / Extension (20-30°)

How is the angle between the various segments of the thorax and between the thorax and the vertebral column during flexion of the thoracic?

Increased

Name and explain the movement of the sacro-iliac joint

Nutation: relative anterior tilt of the base (top) of the sacrum relative to the ilium Counternutation: reverse motion: relative posterior tilt of the base of the sacrum relative to the ilium

Explain the role of the abdominal muscles

a. Walls are formed by bony structures and by muscles to protect the viscera and maintain erect posture. b. Contraction of abdominal muscles: •Help in expiration •Raising intra-abdominal pressure (sneezing, coughing, micturating, defecating, lifting childbirth) c. Stabilization of the spinal column

Explain what is happening during a posterior tilt of the pelvis

Short-arc posterior rotation of the pelvis Flexion of the lumbar spine Decreases the lumbar lordosis

Why is there more pressure on the lumbar spine while sitting compared to standing?

Pelvis position while sitting: Increase Hip flexion and lumbar flexion - Lumbar Curvature à kyphosis - Increase compression on IVD

Which muscles are involved in Flexion from the upright position?

Trapezius, splenius capitis, longissimus capitis, semispinalis capitis, rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior

Which muscles are involved in Flexion from the supine position

Sternocleidomastoid, longus capitis, rectus capitis anterior muscles

Which muscles are involved in Extension from the upright position?

Sternocleidomastoid, longus capitis, rectus capitis anterior muscles

Which muscles are involved in Extension from the prone position?

Rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis superior, semispinalis capitis, splenius capitis muscles, cervical part of trapezius

Which muscles are involved in Lateral flexion?

Rectus capitis lateralis, trapezius, splenius capitis, semispinalis capitis, sternocleidomastoid

Which muscles are involved in flexion of the trunk?

* Rectus abdominis (bilateral) * External oblique (bilateral) * Internal oblique (bilateral)

Which muscles are involved in Extension of the trunk?

* Quadratus lumborum (bilateral) * Multifidus (bilateral) * Semispinalis (bilateral) * Erector spinae (bilateral) * Interspinales (bilateral)

Which muscles are involved in Lateral flexion of the trunk?

* Quadratus lumborum (ipsilateral) * Intertransversarii (ipsilateral) * External oblique (ipsilateral) * Internal oblique (ipsilateral) * Erector spinae (ipsilateral) * Multifidus (ipsilateral) * Semispinalis (ipsilateral)

Which muscles are involved in rotation of the trunk?

* Multifidus (contralateral) * Semispinalis (contralateral) * External oblique (contralateral) * Internal oblique (ipsilateral) * Transversus (ipsilateral)