MS-Anatomy & Biomechanics Review

kms013's version from 2016-02-01 19:00


Question Answer
bellybutton --which spine?T10
Our goal is not perfect, its ....p! free
___ degrees of cervical lordosis30-40
___ degrees of thoracic kyphosis40
_________- degrees of lumbar lordosis45
The exiting root takes the name of which vertbral body?the name of the VBunder which it travels into the neural foramne
b/c of hte way the nerve root exit, L4 L5 disc pathology usually affects the ____ root rather than the ___ rootL5, L4
What makes lumbar so different and why do we care?bigger (bears lot more weight)
____ jt is biggest p! generator of lumbar spinefacet jt
fxl segmental unit or "mobile segment"cant move one w/o moving the other (you move one, and it moves the one above and below-- 3 jt complex)
spine stability- 3 componentspassive (inert/static structures--bones and ligs) agcctive (dynamic-- mm) Neural control-- (NM control)
CP-- with spinal stability, think of ____3 legged stool...each one above is a leg of the stool; if one of those legs is faulty it affects the stability as a whole
lumbar passive structuresfacet jts (capsules), ligs, discs, nerves (SC, Spinal nerves) ---> Each of these can be a p! generator!!!
every jt we have, our body was meant to be in neutral. We don't like to ...stay in end ranges for long period of time, (compressed, or stretched)
Creepwhen ligs slowly but surely stretch (20ish mins) when we lay back on our hands watching moving, and when we come back up and you're stiff-- the passive structures starts moving more-- then when you go back to normal they don't just go back to normal--takes a while
Normal structures--IV discsannulus fibrosus, nucleus pulposus, cartilaginous end plates
annulus fibrosus tensile strenght, outer portion of disc, made of dense collagen fibers and fibrocartilage, supported byant and post longitudianal ligs
nucleus pulposuscompression--shock absorption; center of disc, gelatinous mass
cartilaginous end platesnutrition; connects the vertebrae above/below
what position leaves discs most vulernerable?flexion + rotation (because going forward, only 50% of the discs working to restrict a motion, then go to the side, and that 50% taken away
Thoracolumbar fascia..acts as both passive AND active structures; generally impedes mobility
Lumbar passive structuces-- what makes it dysfxl?HYPERMOBILITY(overuse) -->laxity (instability, inabiliity to control), --> prolonged postures --> creep, HYPOMOBILITY(disuse) --> prolonged posture, lack of use, BOTH (area of hypermobility tends to be hypomobile above/below)
do we need to stabilize laxity?ONLY if its unstable
its our job to find the ____ impaired mobility that is leading to abnormal mvmt patterns (p!) and correct itimpaired mobility
if its stuck(hypomobile) --> unstuck it
if it moves too much(hypermobile) --> stabilize it
if its both hypo and hyper -mobilemobilze the hypomobile segment & stabilze the hypermobile segment
lumbar active structuresspine mm (main movers, main stabilizers, both)
main spine mm moverserector spinae, (back) obliques (sides) rectus abdominus (front)
main spine mm stabilizersTA (Front/side) multifidus (back) pelvic floor (bottom) diaphragm (top)
main spine mm movers and stabilizers Ilioposas (front) Int/ext obliques (side) QL (side)
are movers usually tight or loose?tight
if something crosses a jt it...ACTS on that jt, stabilizes it
erector spinae 3)mover-- look back to slide
multifidideepest stabilizers/posterior
lwhat makes active lumbar structures dysfxl?movers tend to be tight (overuse) and stabilizers tend to be weak (mis/disuse)
its our job to find the mm imblances that are leading
if alignment is off or there is mvmt dysfx, there is usually a mm imbalance
mm imbalance:if something is tight on one side pulling it and something weak on opposite side allowing it to be pulled 2. somethiing is being overworked while something else is not doing its job, or is doing its job incorrectly (overuse + disuse = misuse)this is where we get our cross syndromes
stretch the front, strenghten the back
Lumbar movers: Roles of the main movers (ES, Ob, RA, Iliopsoas)1. move the spine 2. stabilize the spine when the stabilizers aren't doing their job
weakest spot in spine?L5- S1 bc of sheer fx
most damaging direction of the spine? the one its not supposed to do...the vert on top sliding forward on the one below it in sheer fx due to lack of stability
the stabilizers "The cylinder"TA, Multifidus, Pelvic floor, Diaphragm
These are the mm that are prone to being weak or lack NM controlTA, Multifidus, Pelvic floor, Diaphragm
____ % pple with back p! report incompetence 40 ....which means there is a problem in pelvic floor
lumbar NM control-- what makes it dysfxl?when the movers are working and the stabilizers are not!
what motion does the ES do?flexion
what motion does the Iliopsoas do?ext
what motion does the QL/Obliques do?rotation, lateral flexion
these mm tend to be tight, thus possibly limiting corresponding motionsES, Iliopsoas, QL, Obliques
Arthokinematics of facet jts: Cervical spine facet jts are angled at...45 degrees (roof shingles)
Cervica spine: primary motion- both flexion, ext, and lat flex
thoracic spine facets are primarily in what plane?frontal
priamry motion of T spinelat flex
lumbar spine facets primarily in what plane?sagittal
priamry motion of L spineF/E
_______orientation dictates mvmtfacets
Lumbar arthokinematics SD and rotation to the __sideopposite
flexion always _______opens
ext always _________ closes
R SB and L rotation ____ the R sidecloses
L SB and R rotation ____ the L sidecloses
max lumbar closing:Ext + ipsi SD + contra rot
max lumbar opening: flex + contra SB +ipsi rot
ipsilateral side bending TOWARDS always _____ that sidecloses
lumbar has same arthokinmatics as what other part of spine?C spine
static stability-- passive strcutres: the goal is segmental stabilty
Neutral zone = neutral spine (segment is in mid range, jt capsule and lig provide passive resistance)
elastic zone (spine mvmt)-- as segment moves toward...end range (in any direction)
Elastic zone-- inert structues provide passive restraint to mvmt in ....that direction of mvmt
sensory receptorsin jt capsules/ligs; sense spinal positional changes; gives feed back to CNS to fire off appropriate mm for dynamic stabilization
dynamic stability -- active structures movers and stabilizers they work _____TOGETHER TO SUPPORT the spine when moving
_______ is the root of most evil when it comes to spinal dyfxmm imbalance (movers doing too much, staabil. not doing enough)
without the dynamc stab. the spine would _____ collapse (figurately) and become multisegmentally unstable
synamic stab. interpreted means:dynamic (movers) stabilization (stabilzers) --- Think of alternating blocks/balls stacked on top of each other w no support (wouldn't move very well)
The moversparaspinales (ES), RA, Obliques, Ilipsoas
the movers characteristics:produce motion one way while controlling motion in opposite direction (ex. ES concentriclaly contract to produce cervical ext and eccentrically contract ho control cervical flexion(so w a forward trunk posture...they're on all the time eccentrically) act like large guy wires holding up our turnks; this incrs compressive loading of of spine; cannot control individual spinal segments bc they cross multiple segments ( this is the job of hte stabs); issue arises when the movers have to act as both overs and stabs
CP: of the movers--- focus is usually on toning these down so...not so tight. but you have to turn on the stabs at the same time or they'll just get tight again
stabs (small guys)TA, M, Obliques, QL, IP
stabs characteristics:attach to teach vert. seg. controlling segmental motion regardless of direction of mvtm; provide dynamic support to individual seg along the spine so each seg. remains in a stable position so the inert tissues (capsule/lig) are not too over stressed; greater % of type 1 mm fibers which means developing mm endurance is of greater importance than developing strenght for stabilization (this is why we do higher reps/longer holds for stab. ES's)
Stability is when ___ act togethermovers & stabilizers
Neurological contrrolinfluence on stability (this is the 3rd leg in the stab. stool--rob the most important)
feedforward control of spinal stability:the CNS activiates the stabilizers in anticipation of the laod imposed by limb mvmt (the movers) to maintain stability of hte spoine
NORMALneurological control-- brain things about moving a limb/body and the stabs...automatically engage (before or at the same time ) in anticipation of tis mvmt
IMPAIRED neurological control: - firing pattern/strenght of stab. is off and movers star...moving limb/body before stabs hav enegaged thus allowing abnormal mvmts of spine
what is movment?a chain of coordinated jts wokring together for common purpose (both mob and stab, each jt serving its purpose, lumbars roleis stability for the rest of the body)