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Biomechanics of back

where do we find intervertebral disc Between each vertebral pair. Exception C1-C2 and sacral vertebrae
where in spinal cord is missing intervertebral disc? C1 and C2, Sacral vertebrae
what happen to intervertebral disc when a force is compressing to the vertebrae it will put pressure on nucleus pulposus where it will be squeeze to reduce compression on the vertebrae body
Which population has higher risk of compresion fracture Elder
What are the 2 component of intervertebral disc 1) anulus fibrosus (form sclerotome) 2) nucleus pulposus (from notochord)
what happen to nucleus pulposus when we flex back push the nucleus pulposus posteriorly
what happen to nucleus pulposus when we extend back push the nucleus pulposus anteriorly
Describe facet and nucleus pulposus motion during flexion Facet "open", Nucleus pulposus: posteriorly
Describe facet and nucleus pulposus motion during Extension Facet "closed", Nucleus pulposus: anteriorly
Describe facet and nucleus pulposus motion during Sidebending left Convex facet (Right side): open, Concave facet (Left side) : close, Nucleus pulposus: convexity to Left
Describe spinal motion during rotation to R Transverse process is more palpable at R side spinous process is more to the L side
which plane does cervical vertebral facet (C2-C7) sitting on mostly on axial plane (horizontal)
what is the limitation of cervical vertebral flexion movment? it is limited by the tension in posterior vertebral ligament
why cervical vertebral has limited extension movement? It is limited by the contact of adjacent spinous process
does cervical vertebral has limited rotation and sidebending movement? Yes. However, if the movement occurs all the same, the limitation is reduced
What special structure does cervical vertebral has to assist its motion? Uncinate process. It insures that the vertebrae are "stay on track" and ensure the translation process (anteriorly or posteriorly)happen smoothly.
What happen when cervical vertebral flex or exten? they tend to translate either posteriorly or anteriorly.
what plan does thoracic vertebral facet has? Coronal plane
What limit the motion of throacic vertebral? 1) the ribcage==> flexion and rotation is possible with rib movement. 2) The downwardly-oriented spinous process will limit its extension
What plan does lumbar facet has? Inner Lumbar facet joint are primarily sagittal.
What kind of motion does lumbar has 1) Flexion is the best. 2) Contact of facet limited extension 3) Rotation is better than extension 4) Sidebending is the allowed
Which throacic vertebrae has lumbar like morphology? T11 and T12
That plane is lumbosacral facet? Sagittal and cornal
which nerve innervate Intervertebral disc and spinal dura? Recurrent meningeal nerve
Which nerve innervate facet joint and capsule Posterior ramus from 2 adjacent level
cause of thoracic hyperkyphosis 1) Compression fracture 2) osteoporosis
Cause of lumbar lordosis 1) pregnancy 2) carry excessive belly fat 3) when abdominal muscle tone decrease
Cause of disappearance of lumbar lordosis situation when there is a flattaning of back muscle, may due to back muscle spasm
cause of Scolosis -abnoraml lateral curvature of spine 1) poor posture 2) carry excessive weight 3) short leg 4) Genetic bone pathology
what is the effect of ligament to vertebrae movement The ligament limit the extend of sidebending and flexing motion of the vertebrae
List the ligament which connect to the vertebrae 1) Anterior longitudinal ligament 2) posterior longitudinal ligament 3) interspinous ligament 4) supraspinous ligament 5) Intertransverse ligament 6) ligament flavum
Nuchal ligament and where does it connect to -From occipital bond to T1 -ligament specific to cervical vertebrae -extend posteriorly from cervical region and provide large surface area for cervical muscle attachment
Relationship of thoracic ligament and rib the thoracic ligaments tether the vertebrae stongly to the rib
List 3 special ligament at the sacrum region 1) Supraspinous ligament 2) Posterior sacrococcygeal ligament 3) Illolumbar ligament
Posterior sacrococcygeal ligament it attach coccyx to sacrum and it is the place where we have epidural injection
Illolumbar ligament - it connect transverse process of L4 and L5 to the illiac rest
How does illolumbar ligament contribute to Low back pain It can be calcified with aging and the dysfunction result in pain. The pain can mimic muscle pain or it can radiate down to gluteal and thigh but will not radiate along dermatome
where is spinal nerve come out from? Intervertebrael foramina
What are the structure that make up intervertebral foramina border? iit is formed by superior and inferior vertebral notch from 2 adjacent vertebrae -superior: pedicle -inferior; pedicle -anterior: vertebral body and intervertebral disc -posterior: facet joint
what is the most common cause of Radiculopathy? Herniated nucleus pulposus
Where is the pain from HNP usually radiate to? dermatome.
The cause of HNP The nerve root exist intervertebral foramen is compressed by enlarged facet or by herniated root
HNP at Lumbar region usually affect spinal nerve at upper or lower level LOWER, area where nerve exist is superior to where the nucleus pulposus would bulge
HNP at cervical region affect which part of nerve? Since spinal nerve travel horizontally, it will affect nerve existing at same level. however, the affecting nerve is still the one below
at C1-C7, where does nerve exist intervertebral foramen as compared to its corresponding vertebrae Superior to their corresponding vertebra
where does C8 exist the intervertebral foramen? Between C7 and T1 since there is no C8 vertebrae
List 3 extrinsic back muscle and their innervation 1) Trapezium : Accessory nerve 2) Latissmius Dorsi: Thoracodorsal nerve 3) Levator scapulae: dorsal scapular
What nerve innervate all the intrinsic muscle Posterior rami
list categories of intrinsic muscle Erector spinae muscle group, semispinalis captitis and cervicis, deep intrinsic muscle(rotatore, multifidi, semispinalis), minor deep intrinsic muscle (Muscle of subocciptial region, interspinalis, levator costorum, intertransveraril)
Erector spinae muscle group (name the muscle) and its contraction to body movement 1) Spinalis, 2) longissimus 3) illocostalis contract bilaterally result in extension of back while contract unilaterally result in side-bending
Contraction of semispinalis cervicis and capitis to body movement contract bilaterally result in neck extension while unilaterally result in rotate toward ipsilateral side (w/ extension) of neck
What slightly separate semispinalis cervicis from capitis levator scapulae
Name group of muscles in transversospinalis muscle 1) rotatore (1-2 level) 2) multifidus (3-4 level) Multifidus lumborum 3) Semispinalis (5-6 level)
what is minor deep intrinsic muscle really for? it is for sensing proprioception more than movement
name the muscle in minor deep intrinsic muscle 1) levator costorum 2) intertransverarii 3) muscle of suboccipital region 4) interspinalis
Thoracolumbar fascia complext CT structure in back
What is the role of thoracolumbar fascia to Latissmus dorsi act as Aponeurosis
What is the role of thoracolumbar fascia to Erector spinae act as Retinaculum, make contraction more efficient
What group of muscle does thoracolumbar fascia wrap around? 1) erector spinae 2) transverosphalis 3) quadratus lumborum
Fascia -arranged in several direction with no particular shape -resist force equally in many directions and keeps structures in place with some wiggle room
Tendon -arranged in one direction in a bundle, resist force strongly along the line of force as muscle pulls bone
Ligament -arranged in one direction in a bundle, resist bone from another bone
Aponeurosis arranged in one direction in flat sheet, broad flat tendon connecting muscle to bone
Retinaculum arranged in one direction that restrain/tethers a muscle group to prevent bowstringing
fascia that wrap around muscle deep or investing fascia
trace the pathway of Spin Tap skin==> subcantaneous fat ==> thoracolumbar fascia ==> supraspinous ligament ==> interspinous ligament ==> dura mater ==> anarchonid mater ==> subarachonid space
List the muscle group of subocciptial triangle 1)rectus capitis posterior major 2) rectus capitis posterior minor (not part of triangle) 3) oblique capitis superior 4) oblique capitis inferior
what is the major function of suboccipital muscle they are extensor of head and upper cervical segment, give propriceptive input from region
which nerve innervate the suboccipital muscle suboccipital nerve (posterior ramus C1)
Atlanto-axial joint -superior articular facet of axis (C2) and inferior articular facet of atla (C1) are flat and smooth, den of C2 act as pivot which control rotation
Atlanto-occipital joint between superior articular facet of atlas and occipital bone, major for flexion and extension
Den it is tethered to occipital bone and atlas ligament while allow rotation of atlas
where does Myodural bridge originate from it is a sheet of CT originate from 1) rectus capitis posterior minor, pierce of posterior atlanto-occiptal membrane and fused with dura mater
the clinical importance of myodural bridge this direction connection with pain sensitive dura and posterior neck muscle make it a consideration when treating headach
Whiplash a sudden violent acceleration / deceleration that may result in flexion or extension injury to the neck and CNS
Concussion when the flexion and extension overpower the muscle supporting head, cerebral cortex will impact the skull
who are more vulnerable to cerebral trauma when shaken babies because they have weak neck muscle, cannot support their head
Created by: powerbaby