Chapter 9 Study Guide

Movement of the spine occurs in which plane(s)? a. sagittal b. frontal c. transverse d. all of the above

d. all of the above

The sacral region of the spine is fused to which of the following bones? a. the ilium b. the ischium c. the pubis d. all of the above

d. all of the above

The term "slipped disc" is often used to describe a _______________ disc.

herniated

Describe the range of motion in all three planes for each vertebral region relative to the other regions.

Frontal plane movement of the sine away from anatomical position is termed lateral flexion. The largest ROM for lateral flexion occurs in the cervical region (with approximately 9-10* of motion allowed at C4-C5). Somewhat less lateral flexion is allowed in the thoracic region where ROM between the adjacent vertebrae is about 6*, except n the lower segments where lateral flexion capability may be between 8-9*. Lateral flexion in the lumbar spine is also about 6*, except at L5-S1 where it is reduced to only about 3*. Spinal rotation in the transverse plane is freest in the cervical region, with up to 12* of motion allowed at C1-C2. It is next freest in the thoracic region where approximately 9* of rotation is permitted among the upper motion segments. From T7-T8 downward the range of rotational capability progressively decreases with only 2* of motion allowed in the lumbar spine due to the interlocking of the articular processes. At the lumbosacral joint, rotation on the of 5* is allowed.

Explain proper lifting including rationale. Also, explain why twisting should be avoided when lifting.

Lifting with the legs is the proper way to lift an object, and it is recommended to hold moderate to heavy loads close to the body. This minimizes trunk flexion and thereby minimized torque generated on the spine by body weight. When the spine undergoes lateral flexion and axial twisting a more complex pattern of trunk muscle activation is required than for flexion and extension. Tension in antagonist trunk muscles produces a significant part of these increased loads. Asymmetrical frontal plane loading of the trunk also increases both compressive and shear loads on the spine because of the added lateral bending movement.

Describe the most common back injury, including degree of incidence, possible causes and treatments.

Low back pain is an extremely prevalent problem; it is second only to the common cold in causing absences from the workplace, and back injuries are the most frequent and most expensive of all worker's compensation claims in the U.S. The incidence of low back pain in the U.S. has been steadily increasing for more than the past decade, likely as a direct result of the increasing incidence of overweight and obesity. Most back injuries involve the lumbar region. Although psychological and social components are a factor in some cases, mechanical stress typically plays a significant casual role in the development of low back pain. Occurs in occupations that involve handling heavy materials, common in children (inactive and those involved in sports), and athletes. Recommended treatment typically involve abdominal exercises as both a prophylactic and treatment for low back pain.

List and discuss the primary abdominal muscles, explaining how they perform motion in all three planes.

The main abdominal muscles are the rectus abdominis, the external obliques, and the internal obliques. Functioning bilaterally, these muscles are the major spinal flexors and also reduce anterior pelvic tilt. Unilateral tension development by the muscles produces lateral flexion of the spine toward the tensed muscles. Tension development by the internal obliques causes rotation toward the spine toward the same side. Tension development by the external obliques results in rotation toward the opposite side. If the spine is fixed, the internal obliques produce pelvic rotations toward the opposite side, with the external obliques producing rotation of the pelvis toward the same side.

*List and describe the three abnormal deviations in the spinal curvature, including symptoms, possible causes, and treatment options.

Three abnormal deviations of the spinal curvature are lordosis, kyphosis, and scoliosis. Lordosis is an exaggeration of the lumbar curvature, often associated with weakened abdominal muscles and anterior pelvic tilt. Causes include congenital spinal deformity, weakness of the abdominal muscles, poor postural habits, and over-training in sports requiring repeated lumbar hyperextension. The excessive compressive stress on the posterior elements of the spine is an added risk factor for low back pain development. Kyphosis is an exaggerated throacic curvature. Kyphosis can result from a congenital abnormality, a pathology such a osteoporosis, or Scheuermann's disease, in which one or more wedge-shaped vertebrae develop because of epiphyseal plate behavior. Scoliosis is a lateral deviation or deviations in spinal curvature; it may appear as either a C- or S-curve involving the thoracic spine, the lumbar spine, or both. Scoliosis result from a variety of causes: congenital abnormalities and selected cancers, leg discrepancy of local inflammation. Symptoms vary with the severity of the condition. Treatment of mild cases may consist of exercise to strengthen the muscles, bracing or surgery for the most severe cases.

The most superior cervical vertebrae is called what? a. atlas b. axis c. atlanto-axial d. none of the above

a. atlas

What type of articulation occurs between the bodies of adjacent vertebrae? a. cartilaginous b. non-axial gliding c. hinge d. condyloid

a. cartilaginous

Which of the following vertebral regions has the best range of motion? a. cervical b. thoracic c. lumbar d. sacral

a. cervical

What is the most common type of spinal loading during daily activities? a. compression b. tension c. shear d. torsion

a. compression

Anterior pelvic tilt facilitates what type of spinal motion? a. flexion b. extension c. lateral flexion d. rotation

a. flexion

Spinal relaxation phenomenon explains what? a. inactivity of spinal extensors during full flexion b. inactivity of spinal flexors during full flexion c. sit and reach flexibility test d. yoga

a. inactivity of spinal extensors during full flexion

Sprains occur in what type of tissue? a. muscles b. tendons c. ligaments d. all of the above

a. muscles

The spinous processes of the thoracic vertebrae inhibit movement in which plane? a. sagittal b. frontal c. transverse d. all of the above

a. sagittal

A typical geriatric disc has a fluid content that is reduced by approximately how much? a. 5% b. 35% c. 50% d. 85%

b. 35%

In anatomical position, where is the center of gravity located relative to the spine? a. posterior b. anterior c. lateral d. inferior

b. anterior

The rectus abdominis causes flexion when contracted ________. a. unilaterally b. bilaterally c. eccentrically d. all of the above

b. bilaterally

What causes the pumping action (influx and outflux of water containing nutrients and waste) of the intervertebral discs in adults? a. blood supply b. body motion c. neural activity d. both A and B e. all of the above

b. body motion

Which of the following is not true about lordosis? a. often accompanied by anterior pelvic tilt b. can be caused by poor abdominal flexibility c. often accompanies weight gain and pregnancy d. all of the above are true

b. can be caused by poor abdominal flexibility

The condition of exaggerated thoracic curvature is known as which of the following? a. lordosis b. kyphosis c. scoliosis d. none of the above

b. kyphosis

Which type of exaggerated curve is often caused by osteoporosis? a. lordosis b. kyphosis c. scoliosis d. all of the above

b. kyphosis

What joint is usually the culprit in low back pain? a. sacroiliac b. lumbosacral c. sacrococcygeal d. acetabulum

b. lumbosacral

What type of joint occurs between the superior and inferior articulating facets of adjacent vertebrae? a. cartilaginous b. non-axial gliding c. hinge d. condyloid

b. non-axial gliding

What is the most common type of vertebral fracture? a. fracture to the coccyx b. stress fracture of the pars interarticularis c. cervical fracture d. none of the above

b. stress fracture of the pars interarticularis

Attachment to the ribs limits range of motion in which vertebrae? a. cervical b. thoracic c. lumbar d. sacral

b. thoracic

What injury can occur when the neck undergoes sudden acceleration and deceleration (such as in a car accident)? a. herniated disc b. whiplash c. spondylolisthesis d. spondylolysis

b. whiplash

Which part of the vertebrae bears the most weight? a. lamina b. superior articulating facet c. body d. inferior articulating facet

c. body

Transverse or spinous process fractures may result from which of the following? a. extremely forceful contraction of the attached muscles b. the sustenance of a hard blow to the back of the spine c. both A and B d. none of the above

c. both A and B

Which of the following are potential consequences of spinal fractures? a. paralysis b. death c. both A and B d. none of the above

c. both A and B

What is the result when part of the nucleus pulposus of the disc protrudes and presses on a nerve? a. stress fracture b. acute fracture c. herniated disc d. contusion

c. herniated disc

What action(s) do posterior trunk muscles cause when they contract unilaterally? a. extension b. hyperextension c. lateral flexion d. both A and B e. all of the above

c. lateral flexion

What musculoskeletal problem causes the most absences from work? a. ankle sprain b. carpal tunnel syndrome c. low back pain d. herniated disc

c. low back pain

Which vertebrae are the largest? a. cervical b. thoracic c. lumbar d. sacral

c. lumbar

Lateral deviations in spinal curvature are called what? a. lordosis b. kyphosis c. scoliosis d. all of the above

c. scoliosis

What is the dominant force on the spine during activities requiring backward leaning of the trunk, such as rappelling? a. compression b. tension c. shear d. torsion

c. shear

The articulations between adjacent vertebral bodies are which of the following types of joints? a. pivot joints b. hinge joints c. symphysis joints d. none of the above

c. symphysis joints

From superior to inferior, there are 7 _______________ vertebrae, 12 _______________ vertebrae, 5 ___________________ vertebrae, 5 _______________ vertebrae, and 4 _______________ vertebrae.

cervical; thoracic; lumbar; sacral; coccygeal

Unusually high incidences of pars interarticularis fractures have been documented in which of the following groups of athletes? a. female gymnasts b. interior football linemen c. weight lifters d. all of the above

d. all of the above

Which statement is not true about the intervertebral discs? a. act as cushions between the vertebrae b. account for approximately 1/4 of the height of the spine c. are responsible for spinal movement due to compression d. all of the above are true

d. all of the above are true

Lack of flexibility in which of the following muscle groups can cause anterior pelvic tilt? a. hip flexors b. erector spinae c. abdominals d. both A and B e. all of the above

d. both A and B

Which abdominal muscles cause rotation to the left? a. left internal oblique b. right external oblique c. left rectus abdominis d. both A and B e. all of the above

d. both A and B

Which of the following helps the spine absorb shock? a. spinal curves b. intervertebral discs c. ligaments d. both A and B e. all of the above

d. both A and B

What is the enlarged cervical portion of the supraspinous ligament called? a. anterior longitudinal ligament b. posterior longitudinal ligament c. ligamentum flavum d. ligamentum nuchae

d. ligamentum nuchae

Which of the following spinal curves are referred to as primary curves? a. the thoracic and cervical curves b. the cervical and lumbar curves c. the cervical and sacral curves d. the thoracic and sacral curves

d. the thoracic and sacral curves

Which of the following contributes to increased spinal loading? a. rotation (as compared to flexion) b. asymmetrical frontal loads c. increased lifting speeds d. both A and B e. all of the above

e. all of the above

The major extensor and hyperextensor of the trunk is the _______________ ___________ muscle group.

erector spinae

Extreme lumbar curvature is called ___________________.

lordosis

Two adjacent vertebrae and the associated soft tissues form a ____________ ________________, the functional unit of the spine.

motion segment