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Cervical Spine
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Cervical Spine
• Purpose• Support head
• Shock absorption
• Allow large degree of flexibility and ROM
• Allow passage of nerves, vasculature,
etc
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Cervical Spine
• CO - occipital
• C1 - Atlas
•
C2 - Axis• C3-6 - general basic
structure
•
C7
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Cervical Spine • C1 - no body, disk
and spinousprocess
• Allows for freespace
• Large neutral zone
and cordprotection
• More motion
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Cervical Spine • Approximately 50% of flexion/extension
or nodding occurs at occiput-C1
• Minimal to no lateral flexion/rotation Occipital condyles
Foramen magnum
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Cervical Spine • The Axis (C2)
• The dens, orodontoid process
– is cradled in theanterior arch of theatlas
– is a pivot for therotation of the atlas
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Cervical Spine • C1-C2 segment
– The primary motion at the C1-C2
joint is rotation
• Account for up to50% of rotation in
the neck and mostof the initial ROM
anterior view
posterior view
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Cervical Spine
• C2-7
– Facet orientation isroughly 45 degrees
in the transverseplane
– Allows for motion
in all planes – More rotation and
lateral flexion thanother regions
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•45 degrees(transverse plane)
•0 degree (frontal plane)
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Cervical Spine
• Cervical lordosisC0-C7 averages 40°
– Most of the
lordosis occurs atthe C1-C2 segment
1
2
3
4
56
7
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Thoracic Spine
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Thoracic Spine
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Thoracic Spine
• 12 Thoracic vertebrae: T1-T12
• Articulate withribcage
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Thoracic Spine
• The vertebral body equals width and depth.
• The ratio of disc diameter to height ishighest
– Decrease tensile forces
– Decrease possibility of disc injury
• Posterior aspect becomes thicker and more
compressive forces• End-plates become larger (higher
compressive forces)
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Thoracic Spine • Joints of
Thoracic Spine
– Costovertebral
Joint
– CostotransverseJoint
• Flexion andextensionlimited
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Thoracic Spine • Less flexible due to rib articulation
• Upper thoracic spine facet orientation – Limits flexion extension
– 60 transverse/20 frontal
• Facets are more sagittal in T9-12 to allow flex/ext and rot of spinous process will be
toward concavity (lumbar coupling)
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• 60 degrees(transverse plane)
• 20 degrees (frontal plane)
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Ribcage
• Spine, ribs and sternumform a closed, cylindricalcavity
• Protects internal organs• Resists displacement
• Adds strength and stiffness
– Moment of inertia increasedto resist rotational motions
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Thoracic Spine
• Increased stiffness over osteoligamentousspine in four major physiologic directions
• Increased axial stability over
osteoligamentous spine by 4x
• Decreased flexibility in traction over ascoliotic spine
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Lumbar Spine
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Lumbar Spine
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Lumbar Spine
• Most load bearingstructures in theskeletal system
• Largest body/disc,lamina andpedicles short and
thick for load bearing
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• L5 transitional, wedge shape of body anddisc – Anterior > posterior.
• L5-S1 most flexion extension.
• Coupling of motion - right lateral flexion will result in right sidebend and leftrotation of vertebral body
Lumbar Spine
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Left Side ViewDisc
L1
L2
L3
L4
L5
Motion Segment
Sagittal View
http://www.spineuniverse.com/displayarticle.php/article65.html
Lumbar Spine
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•90 degrees(transverse plane)
•45 degrees (frontal plane)
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Lumbar Spine
• Lumbar lordosis L1-S1 ranges from 30° –80°
– The apex of lumbar
lordosis L3-L41
2
3
4
5
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Movement of the Spine
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Muscles of the Spine
• Superficial group
– Erector Spinae consists of 3 columns
– Extend from the vertebrae to the ribs
– Produce extension of the spine
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Muscles of the Spine • Deep group
– Interspinales, multifidus, rotatores,semispinalis, splenius
–Extend from one vertebra to another
–Extend and rotate the spine
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Several factors influencethe loads on the spine
• The position of the object
•
The size, shape, weight, and density
• The degree of flexion or rotation of
the spine
• The rate of motion
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L di f th i d i
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Loading of the spine duringstanding
• The line of gravity of passes ventral to thefourth lumbar vertebral body
• Forward-bending moment
– Counterbalanced by ligament forces anderector spinal muscle
– The erector spinae muscles ,the abdominal
muscles are often intermittently active
St ti l d th l b
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Static loads on the lumbarspine during lifting
• The highest loads on the spine aregenerally produced by external loads
• Holding the object close to the body
instead of away from it reduces the bending moment the lever arm isminimized
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Line of Gravity
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Exaggerated spinal curves • Lordosis - exaggerated lumbar curve
• Kyphosis - exaggerated thoracic curve
• Scoliosis - lateral spinal curvature
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Abdominal Muscles
• Rectus abdominis
• Internal obliques
• External obliques
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rectus abdominis
external obliques
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Internal obliques