1Functional Goals of the Vertebral Column
Protect -
Movement -
Stability -
Protect spinal cord and organs
Allows for multiple planes of movement
Stability to move UE and LE in space
2why is spine alternating curves?
improve's spines ability to handle compressive loads (springy)
3vertebral body regional differences
body biggest at lumbar spine, smallest at cervical spine
4posterior vertebra experiencing what kind of load?
tensile
5anterior vertebra experiencing what kind of load?
compressive
6what is the nucleus made up of?
PG and GAG's - Water
Mostly Type II collagen - compressive loads
7what is the annulus made up of?
Type I collagen - tensile forces
8what is the vertebral end plate made of?
fibrocartilagenous structure
9intervertebral disc functions
allow for motion
force transmission
10regional differences in vertebral disc
size of the disc varies
11nutrition of intervertebral discs via
diffusion
waste out through compression
release allows for new nutrients to get in
12what kind of joint is the interbody joint?
cartilagenous - symphysis
stable af
13motions at the interbody joint
gliding, tipping, compression, distraction
14what is in between facet joints?
fibromenisci pads which help to attenuate compressive loads since these joints are small
15motions at the facet joints
up glide
down glide
16if the ligamentum flavum gets hypertrophied
canal size reduced and can compress the spinal cord
17flexion arthrokinematics
Interbody - Anterior tilt, anterior glide
Facet - up glide
Disc - stretched posteriorly, compressed anteriorly
18flexion restricted by
posterior ligaments
posterior facet capsules
posterior annular fibers
posterior muscles
19extension arthrokinematics
interbody - posterior tilt, posterior glide
facet - down glide
disc - stretched anteriorly, compressed posteriorly
20extension restrained by
anterior ligaments
facet joint capsules
spinous processes
anterior annular fibers
anterior muscles
21lateral flexion arthrokinematics
interbody - ipsilateral tilt, ipsilateral glide
facet - ipsilateral down glide, contralateral up glide
disc - stretched contralaterally, compressed ipsilaterally
22lateral flexion restrained by
contralateral intertransverse ligament
facet joint capsule
contralateral musculature
23transverse processes of C2 sit mostly in the transverse plane, so main function is
rotation
24upper cervical joints
OA - 2 synovial joints (L and R)
AA - 3 synovial joints (L, R, and dens)
no discs
25transverse ligament
holds the dens and prevents anterior translation of occuput on C1
26alar ligaments are in tension when
tipping head left or right
dens moves in the opposite direction of the flexion
27lower cervical structure motion
small vertebral body
disc height to body height ratio is largest, highest motion available
28lower cervical structure facets lie midway between frontal and transverse which means
lots of sidebend and rotation
29lower cervical structure, shape of bones
uncinate processes - forms concavity, saddle joint at interbody
helps provide some stability and limit gliding
30OA during flexion
anterior roll, posterior glide
31OA during extension
posterior roll, anterior glide
32cervical kinetics
typical CoM anterior - flexion moment
internal moment from short neck extensors
levator scapulae helps to offset anterior shear from gravity
33adaptations to forward neck posture
shortening - SCM, Scalenes, Sub occipital exensors
lengthening - levator, upper traps
34intervention to adaptive lengthening of levator and upper traps
activate the deep cervical neck extensors
35upper trap at the cervical spine
usually does upward rotation and retraction, can also extend the neck
stopped by cervical flexors
36thoracic strucure
taller posterior vertebral body - supports kyphotic shape
down sloping spinous processes
same ligaments
articulations for ribs
37thoracic movement
least amount of movement - smallest ratio
38thoracic facets lie largely in the frontal plane
side bending and lateral flexion
39what motion required at the thoracic spine to do overhead movement?
extension - in order to posterior tipping, and to not have shortened pec minor
40upper ribs
pump handle motion - open up and forward (a/p diameter)
41lower ribs
bucket handle motion - sideways (m/L)
42lumbar facets are oriented largely in the saggital plane
flexion extension
43rotation at the lumbar arthrokinematics
no gliding
contralateral compressed, ipsilateral distraction
44how does the abdominal hoop help with stability
co contraction - tension throughout hoop
45superficial erector spinae
extend lumbar spine
46deep erector spinae
closer to bone and smaller MA
control segment movement
control anterior shear in lumbar spine
47gravity wants to compress
L5 on S1
48greater lordosis leads to
greater anterior shear
deep erector spinae and bones have to work harder
49short psoas major and iliacus leads to
increase in lumbo sacral angle (anterior pelvic tilt)
50slumped sitting
hip is flexed, wants to pull pelvis into posterior tilt which creates slouch
posterior ligaments working instead of muscles - tension in annular fibers and posterior disc
51squat lift vs stoop lift
not much difference in spinal loads
internal moment is diff - muscle vs passive tissue
52what are the only things that can cause SI joint dysfunction
pregnancy, hypermobility, and falling on your butt
53what type of joints are the anterior and posterior sacroiliac joints?
anterior is synovial
posterior is syndesmotic
54sacroiliac stability through
tension in opposite directions