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Spine - Coggle Diagram

- - - - • Pivot point for motion and support of the head at the cervical region
      - • Transmits weight of head, shoulder girdle, upper extremities, and trunk
      - • Protection to the spinal cord and vital organs (skull, rib cage, and pelvis)
      - • Movement
      - • Shock absorption and transmission
  - - - what type of curves does it have
        
        Anterior/Posterior (AP) curves
        
        function of these curves
        
        Provides the vertebral column with strength and
        resilience
    - - cervical
        
        how many vertebrae
        
        7
        
        anterior curve is convex or concave
        
        convex
        
        atlas
        
        what vertebrae is this
        
        C1
        
        how is it different from other vertebrae (3)
        
        ring-shaped, no body, no spinous process
        
        7 landmarks
        
        • Anterior arch
        
        • Articular process for the occipital bone
        
        • Transverse foramen
        
        • Posterior arch
        
        • Transverse process
        
        • Outline of odontoid process
        
        • Vertebral foramen
        
        2 special joints here
        
        atlanto-occipital articulation (C0-C1)
        
        what specifically articulates together
        
        Condyles of the occiput articulate with the
        superior articular processes of the atlas
        
        what ligaments are here (2)
        
        Anterior atlanto-occipital membrane
        
        2 more items...
        
        tectorial membrane
        
        1 more item...
        
        what do these ligaments do
        
        1 more item...
        
        what type of joint is it
        
        condyloid, synovial joint
        
        Atlantoaxial articulation (C1-C2)
        
        what type of joint is it
        
        pivot synovial jt.
        
        how many synovial cavities
        
        2
        
        what specifically articulates together
        
        the anterior arch of the atlas articulates with the dens (odontoid process) of the axis
        
        what ligaments are here (5)
        
        • Anterior atlantoaxial ligament
        • Posterior atlantoaxial ligament
        
        1 more item...
        
        Transverse/Cruciate Ligaments
        
        3 more items...
        
        Alar Ligaments
        
        2 more items...
        
        Apical Ligaments
        
        4 more items...
        
        axis
        
        what vertebrae is this
        
        C2
        
        what does it form
        
        the pivot upon which the atlas rotates
        
        3 landmarks
        
        superior facets
        
        articulate with C1
        
        Dens
        
        description
        
        Large vertical projection that is the Anterior aspect of C2
        
        what movement does it allow
        
        cervical rotation
        
        1 more item...
        
        which ligament sits posterior to the dens
        
        transverse ligament
        
        aka
        
        Odontoid process
        
        1 special joint here
        
        Atlantoaxial articulation
        
        Mid-cervical vertebrae C2-7
        
        joints
        
        which special joints do they have
        
        Uncovertebral Joints
        
        aka
        
        1 more item...
        
        what do they facilitate
        
        1 more item...
        
        location
        
        1 more item...
        
        what is the joint anteriorly
        
        Strong, weight-bearing articulation between vertebral bodies
        
        what are the joint posteriorly
        
        2 facet joints
        
        what foramen is here other than the vertebral foramen
        
        transverse foramen
        
        description
        
        holes or opening in the transverse processes
        
        1 more item...
        
        Motions
        
        Cervical flex
        
        what are the 4 descriptions of this motion
        
        upglide, flex, open, SAL
        
        what does SAL stand for
        
        1 more item...
        
        Cervical ext
        
        what are the 4 descriptions of this motion
        
        downglide, extension, close, IMP
        
        what does IMP stand for
        
        1 more item...
        
        description of the cervical orientation
        
        triplanar
        
        what does this mean
        
        large ROM of all 4 motions (what are they
        
        1 more item...
        
        Vertebrae Prominence
        
        which vertebrae is called this
        
        C7
        
        why
        
        bc its a long and prominent spinous process
        
        how to distinguish between C6
        
        if neck is extended, C6 will disappear
        
        is the C7 n. above or below the C7 vertebrae
        
        above
        
        whats below
        
        1 more item...
        
        what does it resemble
        
        thoracic vertebrae
        
        functions (4)
        
        • Supports the head
        
        • Allows freedom of motion of the head on the neck
        
        • Allows for entrance and exit of nervous tissue
        
        • Allows for entrance and exit of major blood vessels in the skull
      - thoracic
        
        how many vertebrae
        
        12
        
        anterior curve is convex or concave
        
        concave
        
        what special facets are here
        
        joints (2)
        
        costal facets
        
        what do they attach to
        
        ribs
        
        when theres an issue w the first rib, what can it also affect
        
        1 more item...
        
        how many are there on 1 thoracic vertabrae
        
        3 (locations)
        
        On the transverse processes of thoracic vertebrae
        
        1 more item...
        
        Superiorly and inferiorly on the sides of the vertebral bodies
        
        1 more item...
        
        facet joints
        
        the facet joints in the thoracic spine is more in what plane
        
        frontal plane
        
        Motion
        
        what 2 motions are primary here
        
        rotation
        
        lateral flexion
        
        what limits lateral flex
        
        ribs
        
        ROM (4) (degrees right after)
        
        flex
        
        ~ 30° – 40°
        
        ext
        
        ~ 20°- 25°
        
        rotation
        
        ~ 30°
        
        lateral flex
        
        ~ 25°
        
        is there more or less motion here than cervical and lumbar region
        
        less
        
        why (3)
        
        3 more items...
      - lumbar
        
        how many vertebrae
        
        5
        
        anterior curve is convex or concave
        
        convex
        
        what is the only joint here
        
        facet joints
        
        the facet joints in the lumbar spine is more in what plane
        
        sagittal plane
        
        what special ligaments are here (2)
        
        Iliolumbar ligaments
        
        Intertransverse ligament
        
        Motion
        
        what 2 motions are primary here
        
        where does most movement occur (2 areas)
        
        between L4-L5 and L5-S1
        
        what to know about these 2 levels
        
        1 more item...
        
        flexion & extension
        
        why
        
        no ribs int he way
        
        ROM (4) (degrees right after)
        
        flex
        
        ~ 50°
        
        ext
        
        ~ 15°
        
        rotation
        
        ~ 5°
        
        lateral flex
        
        ~ 20°
        
        what is it know as
        
        Region of body most often injured
        
        function
        
        Absorbs most of our body weight and
        anything we carry
        
        where is usually the COG
        
        ~ 2” anterior to S2
      - sacral
        
        how many vertebrae
        
        5 (fused)
        
        anterior curve is convex or concave
        
        concave
        
        Fortin finger test
        
        what is it
        
        when pt has pain at the PSIS
        
        what does this mean
        
        there is dysfunction at the SI joint
        
        sacralization
        
        description
        
        when L5 is fused to S1
        
        lumbarization
        
        description
        
        when S1 is not fused to S2
      - all the facet joints are what type of joints
        
        synovial joints with synovial membrane
        
        what type of capsule do they have
        
        articular capsule
    - - Vertebrae
        
        Facet joint
        
        description
        
        Articulation between the superior articular
        process and inferior articular process
        
        is the inferior articular process the vertebrae above or below?
        
        above
        
        is the superior articular process the vertebrae above or below?
        
        below
        
        aka (2 other names)
        
        • “Apophyseal”
        • “Zygapophyseal”
        
        what is special about the Thoracic vertebrae facets
        
        facets at the point of contact with a rib
        
        what is special about the cervical vertebrae facets
        
        face 45 degrees to the transverse plane (downwards)
        
        Body
        
        description (2)
        
        anterior, weight-bearing
        
        what is important about the size of the body
        
        it gets larger as we move down the spinal column (caudally)
        
        Except for which vertebrae
        
        not on C1 and C2
        
        Vertebral arch
        
        aka
        
        neural arch
        
        location
        
        posterior to the body, forms the walls of the vertebral foramen
        
        vertebral foramen description
        
        Opening for spinal cord
        
        what 2 things are apart of the vertebral arch
        
        pedicle
        
        location
        
        posterior to body, anterior part of vertebral arch
        
        lamina
        
        location
        
        Posterior part of neural arch
        
        Transverse process
        
        where is it formed
        
        at union of the lamina and pedicle
        
        function
        
        attachment for mm. and ligaments
        
        Articular process
        
        what is this
        
        Superior and inferior facets
        
        Spinous process
        
        description (2)
        
        most posterior, palpable
        
        function
        
        attachments for mm. and ligaments
        
        what 4 ligaments attach here
        
        4 more items...
        
        Intervertebral foramen
        
        description
        
        lateral opening between two adjacent vertebrae
        
        what passes thru this foramen (2)
        
        nn. and blood vessels
        
        Intervertebral disc
        
        location
        
        between each vertebrae
        
        how many
        
        23
        
        function (2)
        
        • Absorb and transmit shock
        • Maintain flexibility of vertebral column
        
        what % of total length of vertebral column
        
        25%
        
        2 parts
        
        annulus fibrosis
        
        description
        
        Collagen fibers oriented diagonally and alternate in successive lamellae around the nucleus pulposus
        
        3 more items...
        
        are the anterior or posterior walls stronger
        
        anterior walls
        
        tears usually happen on what side
        
        posterior-lateral side
        
        what portion is innervated
        
        outer 1/3
        
        nucleus pulposus
        
        latin for what
        
        jelly donuy
        
        description
        
        Pulpy gelatinous substance
        
        has high content of what
        
        1 more item...
        
        what collage fiber is dominant here
        
        type 2
        
        Intradiscal Pressure
        
        what position is there most pressure on the dics
        
        slouched in a chair
        
        what percentage
        
        275%
        
        how much pressure standing straight up
        
        100%
        
        what position has the least pressure
        
        laying on back (what percentage
        
        25% pressure
        
        how much pressure sitting up in a chair
        
        140%
      - Skull
        
        how many bones
        
        21
        
        what is the basilar area
        
        base or inferior portion of the
        occiput
        
        what other important landmark does the occiput have
        
        occipital condyles
        
        how many
        
        1 more item...
        
        function
        
        1 more item...
- - - - neck (3 groups of mm.)
        
        Sternocleidomastoid
        
        actions
        
        bilaterally
        
        flexes neck
        
        unilaterally (2)
        
        : laterally bends the neck, rotation to opposite side
        
        Scalene (3)
        
        actions
        
        bilaterally
        
        assists neck flex
        
        unilaterally
        
        : lateral bending of the neck
        
        Prevertebral group (4)
        
        aka
        
        deep cervical flexors
        
        what 4 mm.
        
        • Rectus capitis lateralis
        
        • Rectus capitis anterior
        
        • Longus capitis
        
        • Longus colli
        
        which 2 specifically correct FHP by extending neck back
        
        1 more item...
        
        function (2)
        
        Postural control primarily
        
        neck flexion
      - trunk (4 mm.)
        
        Rectus abdominis
        
        function (2)
        
        • Trunk flexion
        • compression of abdomen
        
        External oblique
        
        functions
        
        bilaterally (2)
        
        trunk flexion, compression of abdomen
        
        unilaterally (2)
        
        lateral flexion, rotation to opposite side
        
        Internal oblique
        
        functions
        
        bilaterally (2)
        
        trunk flexion, compression of abdomen
        
        unilaterally (2)
        
        lateral flexion, rotation to SAME side
        
        Transverse abdominis
        
        functions (5)
        
        Coughing, sneezing, laughing, forced expiration, “bearing down”
      - these mm. do what action
        
        flexion
    - - neck (4 groups of mm.)
        
        Erector spinae group (3)
        
        functions (2)
        
        Provide postural control
        
        how
        
        1 more item...
        
        • Act as extensors by bringing head back from flexed position
        
        Splenius capitus
        
        Splenius cervicis
        
        Suboccipital group (4)
        
        location
        
        Below the base of the skull
        
        function (2)
        
        Work together to either extend the head
        
        • Or rotate the skull and atlas around the odontoid process
        
        which 4 mm. are here
        
        Obliquus capitis superior
        
        Obliquus capitis inferior
        
        Rectus capitis posterior minor
        
        Rectus capitis posterior major
        
        what 2 mm. can assist splenius capitis and splenius cervicis
        
        description of the splenius mm.
        
        Most superficial of neck extensors
        
        function of the splenius mm.
        
        bilaterally
        
        Extend the head and neck
        
        unilaterally (2)
        
        Rotate and laterally flex to the
        same side
        
        Upper Trapezius and Levator Scapula
        
        how does it assist
        
        Function in a reversal of muscle action so head and neck move on the scapula
        
        what is 1 criteria for this to occur
        
        If scapula is fixed
      - trunk (4 groups of mm.)
        
        Erector spinae group (3)
        
        how deep are they relative to the other mm.
        
        intermediate depth
        
        what are the 3 mm.
        
        Spinalis
        
        1 more item...
        
        Longissimus
        
        1 more item...
        
        Iliocostalis
        
        1 more item...
        
        Transversospinalis group (3)
        
        how deep are they relative to the other mm.
        
        deepest layer
        
        what line of pull do they have
        
        Oblique line of pull
        
        functions
        
        bilaterally
        
        extend
        
        unilaterally
        
        rotate to opposite side
        
        what are the 3 mm.
        
        Semispinalis
        
        how many vertebrae does it span
        
        1 more item...
        
        Multifidus
        
        how many vertebrae does it span
        
        1 more item...
        
        Rotatores
        
        how many vertebrae does it span
        
        1 more item...
        
        Interspinales
        
        what line of pull
        
        VERTICAL line of pull
        
        function
        
        Trunk extension
        
        Intertransversarii
        
        what line of pull
        
        VERTICAL line of pull
        
        function
        
        Trunk lateral flexion
      - these mm. do what action
        
        extension
    - - quadratus lumborum
        
        how deep are they relative to the other mm.
        
        deep
      - function (2)
        
        Trunk lateral bending, hip hiking or elevation
  - - - • Iliopsoas
      - • Gluteal
      - • Knee flexors
      - • Knee extensors
      - • Adductors
      - • Internal rotators
      - • External rotators
    - - pelvis
    - - spine and vice versa
- - - - sprain
        
        description
        
        Characterized by injury to ligament
      - strain
        
        description
        
        Characterized by injury to m.
      - common MOI (2)
        
        stretch injury or constant repetition of novel activity
      - when do they usually feel pain
        
        to palpation to soft tissue but not to joint
    - - description
        
        Defect of the pars interarticularis of the neural arch
        
        what is the pars interarticularis
        
        small segment of bone that connects the superior and inferior articular processes of the vertebra
      - commonly caused by what
        
        fatigue fx
      - this defect is not always the source for what kind of pain
        
        LBP
      - interesting fact to knw
        
        Roughly half are asymptomatic
    - - description
        
        Characterized by one vertebra slipping forward over another
      - where do most occur
        
        at L5-S1
        
        what percentage
        
        85%
        
        what does the other 15% occur at
        
        L4-L5
      - is anterior or posterior most common
        
        Anterior (most common)or posterior possible
      - Most common etiologies: (3)
        
        • Congenital
        
        • Degenerative changes
        
        • Trauma
    - - aka
        
        HNP
        
        what does this stand for
        
        Herniated Nucleus Pulposus
      - description
        
        Displacement of nuclear material beyond
        the normal confines of the annulus
      - what % of spinal injuries involve the disc
        to the point of rupture/herniation
        
        5-15%
        
        what % end up in surgery
        
        3-5%
        
        about how many people have back surgery annually
        
        o 250K-350K
    - - characterized by what 3 things
        
        Dehydration of the nucleus pulposus
        
        • Narrowing of the intervertebral space
        
        • Weak and degenerated annular rings
      - description
        
        Approximation of the facet joints
        
        what does this mean
        
        when the surfaces of the facet joints come closer together
        
        why does this occur
        
        from process of loss of fluid and elasticity
        
        1 more item...
      - when is bulging discs a problem clinically
        
        when it impinges on structures to cause inflammation
        
        what % of people have a bulging disc on CT or MRI even if not symptomatic
        
        50-80%
    - - where can this occur (3)
        
        Central canal, nerve root canal, or intervertebral foramina
        
        where is the central canal
        
        within the spinal cord itself that contains the CSF
      - what can it be caused by (4)
        
        disc herniation, ligamentum flavum thickening, spondylolisthesis or general degenerative changes
        
        what is the most common form
        
        Degenerative change
        
        common in which population
        
        50 years and older
      - can cause obstruction to what structures
        
        blood vessels, dural sleeve and/or nerve root
        
        what can this cause
        
        ischemia
    - - what is it characterized by
        
        lateral or frontal plane curvature of the spine
        
        what is it usually accompanied by
        
        rotation of the spine
      - mild cases are typically what
        
        asymptomatic
      - what can severe cases compromise
        
        organ function
        
        what may this require
        
        ORIF
        
        what does this mean
        
        Open reduction and internal fixation
    - - nn. easily injured by what 5 things
        
        Physical forces
        
        • Ischemia
        
        • Damage or distortion to blood vessels
        
        • Sympathetic alterations
        
        • Predisposition to injuries such as anomalies, disease or occupation