Term
what is the orientation of the thoracic spine |
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Definition
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|
Term
what is the orientation of the facets of the thoracic spine |
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Definition
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|
Term
in what plane do thoracic vertebrae facets facilitate movement? |
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Definition
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|
Term
|
Definition
looks like you're in flexion, but it's fixed |
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Term
describe spinous process of thoracic spine |
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Definition
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Term
how does downward angle of thoracic spinous process affect palpation |
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Definition
you're palpating at the level below |
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|
Term
where are the costal facets on thoracic vertebrae? |
|
Definition
on body and on transverse processes |
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|
Term
which 2 thoracic vertebrae are atypical and why? |
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Definition
T11, T12: ribs only attach to body, no costal facet on transverse process |
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|
Term
what are the thoracic vertebrae ligaments? |
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Definition
anterior longitudinal ligament anterior to vertebral bodies, posterior longitudinal ligament posterior to vertebral bodies, ligamentum flavum on posterior side of spinal canal, intertransverse ligaments between transverse processes, interspinous ligaments between spinous processes, facet capusle |
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Term
at what 2 joints do ribs articulate with vertebrae? |
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Definition
costotransverse joint, costovertebral joint |
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|
Term
which ribs don’t have constotransverse joints? |
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Definition
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|
Term
what are the ligaments at costotransverse joints? |
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Definition
costotransverse ligaments |
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|
Term
what are the ligaments at the costovertebral joint? |
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Definition
capsular and radiate ligaments |
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|
Term
why is the intervertebral disc in the thoracic spine rarely injured? |
|
Definition
structural stability from rib articulations and ligaments |
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Term
describe motion/strength in thoracic spine |
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Definition
We have less motion and more stability/strength in the thoracic spine. Ligaments are strong. Not as many disc injuries in thoracic spine |
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|
Term
what influences osteokinematics and provides stability to thoracic vertebrae? |
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Definition
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|
Term
how much flexion in T spine? |
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Definition
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|
Term
how much extension in T spine? |
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Definition
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|
Term
why is there less extension than flexion? |
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Definition
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Term
what happens when you sidebend to the right? |
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Definition
right side of vertebra slides posterior, left side of vertebra slides superior |
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Term
how much lateral flexion is in the thoracolumbar spine? |
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Definition
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Term
how much axial rotation is in the thoracolumbar spine |
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Definition
30 deg, decreases distally |
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Term
how is lateral flexion coupled with axial rotation in upper T spine |
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Definition
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|
Term
how is lateral flexion coupled with axial rotation in lower T spine? |
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Definition
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|
Term
how to maximally close left in lower T spine |
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Definition
sidebend to left, rotate to right |
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|
Term
what motion always closes spine? |
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Definition
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|
Term
Why is T spine often involved in postural dysfunctino? |
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Definition
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|
Term
how much is normal kyphosis? |
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Definition
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|
Term
how much is normal kyphosis in kids? |
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Definition
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Term
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Definition
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|
Term
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Definition
osteoporosis causes wedged vertebral bodies => kyphosis |
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|
Term
describe kyphosis and internal forces |
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Definition
when the spine is in flexion, the internal extensor muscles have to work hard to pull you up against gravity. However, they are also lengthened because of flexion, so they are not as strong. |
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|
Term
why does kyphotic orientation worsen? |
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Definition
creep: posterior ligaments have a constant force pulling on them, so they stretch longer |
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|
Term
describe compression fractures and kyphosis |
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Definition
caused by compression on vertebral body. The bone collapses/fractures and the vertebral body forms a wedge shape. |
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Term
where do compression fractures of the spine usually occur |
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Definition
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|
Term
what part of spine does scoliosis mostly affect? |
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Definition
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|
Term
what is a right thoracic curve? |
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Definition
scoliosis that is convex to right |
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|
Term
what is a right thoracic-lumbar curve |
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Definition
scoliosis that is convex in lower right |
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|
Term
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Definition
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|
Term
how is lateral flexion and axial rotation coupled in scoliosis? |
|
Definition
contralaterally: as in lumbar spine |
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|
Term
what is functional scoliosis? |
|
Definition
curve corrects with change in posture |
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|
Term
how is ventilation different from respiration? |
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Definition
ventilation = air in and out; respiration = exchange of gases |
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|
Term
what principle guides movement of air in and out of lungs? |
|
Definition
Boyle's Law: pressure and volume are inversely related, so that as volume increases, pressure decreases AND air travels from areas of high pressure to areas of low pressure |
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|
Term
describe interpleural space |
|
Definition
has negative pressure that makes it link lungs to chest wall. |
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|
Term
how does movement of the chest wall increase volume of lungs? |
|
Definition
lungs are linked to chest wall by interpleural space |
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|
Term
what is inside interpleural space? |
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Definition
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|
Term
|
Definition
collapsed lung: puncture of interpleural space causes air to leak out of space and destroy the connection between lungs and chest wall |
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|
Term
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Definition
we can control volume, and by boyle's law we control pressure. Air always flows from areas of high pressure to areas of low pressure. |
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|
Term
what are our components of breathing |
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Definition
rib cage, muscles of ventilation, diaphragm |
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Term
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Definition
1. increase volume in the thoracic cavity and the lungs, 2. lower intrathoracic pressure, 3. air flows into the lungs because it goes from high pressure outside to low pressure inside |
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|
Term
around which 2 joints do ribs elevate superiorly for inspiration/ |
|
Definition
costovertebral, costotransverse |
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|
Term
where is the axis of rotation for rib elevation for inspiration? |
|
Definition
through imaginary line between costotransverse and costovertebral joints |
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|
Term
what does rib elevation do to assist inspiration? |
|
Definition
increases anterior/posterior diameter of thorax |
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|
Term
what type of fibers are in the muscles that elevate the rib cage? |
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Definition
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|
Term
what do the mucles that elevate ribs work against? |
|
Definition
resistive forces of lung elasticity, airway resistance |
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|
Term
what is quiet ventilation? |
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Definition
normal breathing, using primary muscles |
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|
Term
what is forced breathing? |
|
Definition
taking deep breaths, using accessory muscles |
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|
Term
what are the primary muscles of inspiration? |
|
Definition
diaphragm, scalenes, external intercostals |
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|
Term
what is the primary force of expiration? |
|
Definition
passive, elastic recoil of lungs: volume decreases, pressure increases, forces air out |
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|
Term
what does diaphragm do to increase thoracic volume? |
|
Definition
|
|
Term
how far does the diaphragm move in normal inspiration? |
|
Definition
|
|
Term
how far does the diaphragm move in forced inspiration? |
|
Definition
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|
Term
what muscle accounts for 80% of inspiration? |
|
Definition
|
|
Term
how do the scalenes contribute to ventilation? |
|
Definition
raise the rib cage, counteract the effects of diaphragm to help stabilize rib cage |
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|
Term
when does the activity of the scalenes increase? |
|
Definition
at the end of inspiration |
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|
Term
how do the external intercostals contribute to ventilation? |
|
Definition
raise and spread the rib cage |
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|
Term
how do the external intercostals change the position of the ribs |
|
Definition
ribs move from downward resting position to almost perpendicular to spinal column |
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|
Term
how much does the chest cavity expand from the intercostals? |
|
Definition
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|
Term
what pushes diaphragm back up in expiration? |
|
Definition
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|
Term
what reverses the action of the scalenes during expiration? |
|
Definition
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|
Term
how do the internal intercostals contribute to expiration? |
|
Definition
depress and squeeze the ribcage |
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|
Term
what muscles assist in forced expiration? |
|
Definition
rectus abdominis, external oblique, internal oblique, transversus abdominus |
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|
Term
when are accessory muscles used in breathing? |
|
Definition
increased activity, disease |
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|
Term
where do accessory breathing muscles attach? |
|
Definition
shoulder, head, or vertebral column |
|
|
Term
what are the accessory muscles of inspiration? |
|
Definition
sternocleidomastoid, trapezius, pectoralis major, pectoralis minor, subclavius |
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|
Term
how does the sternocleidomastoid contribute to inspiration? |
|
Definition
(accessory) elevates ribs |
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|
Term
how does trapezius contribute to inspiration? |
|
Definition
(accessory) fixes head for SCM action |
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|
Term
how does pectoralis major contribute to inspiration? |
|
Definition
when arms are up, pec major helps inspiration by lifting rib cage |
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|
Term
what accessory muscles assist in expiration? |
|
Definition
pectoralis major, abdominals, quadratus lumborum |
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|
Term
how does the pectoralis major contribute to expiration? |
|
Definition
(accessory) when arms are down, pec major compresses the rib cage to help expiration |
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|
Term
how does quadratus lumborum assist with expiration? |
|
Definition
(accessory) stabilizes ribs |
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|
Term
what does air resistance in the body's airways depend on? |
|
Definition
viscosity/thickness of air, smoothness of container walls, diameter of the container |
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|
Term
what is a ventilation disorder |
|
Definition
anything that impedes movement of thoracic cavity |
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|
Term
what types of things cause ventilation disorders? |
|
Definition
injury or paralysis of muscles of inhalation, restrictions of airway openings (obstructions, bronchospasms, asthma), decreased rib cage compliance |
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|
Term
what are the mechanical effects and results of COPD? |
|
Definition
decreased lung elasticity causes outward pull of rib cage to be greater than elastic recoil of lungs, leading to barrel shaped chest. Muscles are placed in shortened positions. Can't expire completley |
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|
Term
how does scoliosis affect ventilation? |
|
Definition
curve crushes lung on convex side; length-tension relationships are altered; rib mobility reduced |
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|
Term
how does scoliosis affect length-tension relationships of ventilation muscles? |
|
Definition
muscles on convex side stretched, muscles on concave side shortened |
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|
Term
what are the normal aging effects on ventilation? |
|
Definition
decreased lung elasticity, decreased rib cage compliance, decreased mobility of thoracic spine and rib cage (from kyphosis), decreased muscle strength |
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|
Term
|
Definition
reactive airway disease; change area; can't get as much air in |
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|
Term
how are rheumatoid conditions ventilation disorders? |
|
Definition
decreased joint mobility bc it hurts to move joints |
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|
Term
|
Definition
mucous in lungs, not as much room for air |
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|
Term
do we have good or band control of temporomandibular joint? |
|
Definition
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|
Term
what kind of joint is TMJ? |
|
Definition
2 associated but distinct articulations (left and right); synovial joint with fibrocartilage instead of hyaline cartilage |
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|
Term
which 2 bones articulate at TMJ? |
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Definition
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|
Term
what is the primary articular surface of the temporal bone at the TMJ? |
|
Definition
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|
Term
what part of temporal bone articulates with mandibular condyle (with biconcave disc in between)? |
|
Definition
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|
Term
what is the body of the mandible? |
|
Definition
front part, where teeth are |
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|
Term
what are the rami of the mandible? |
|
Definition
part that sticks up from body and articulates with tempral bone |
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|
Term
where is the angle of the jaw? |
|
Definition
on mandible, where rami meet body |
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|
Term
what is the mandibular condyle? |
|
Definition
primary articular surface of mandible on temporal. Has medial and lateral poles |
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|
Term
what is the notch on the mandible between the coronoid process and the mandibular condyle? |
|
Definition
|
|
Term
what is another term for mandibular fossa? |
|
Definition
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|
Term
what surrounds the glenoid/mandibular fossa? |
|
Definition
posterior glenoid spine posteriorly, articular eminence anteriorly |
|
|
Term
how is the articular disk of the TMJ biconcave? |
|
Definition
both its superior (below articular eminence) and inferior (above mandibular condyle) surfaces are concave |
|
|
Term
what are the medial/lateral attachments of the TMJ disc? |
|
Definition
temporal bone, mandibular condyle |
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|
Term
what are the anterior attachments of the TMJ fibrocartilagnous disk? |
|
Definition
articular capsule, lateral pterygoid |
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|
Term
what are the posterior attachements of the TMJ disk? |
|
Definition
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|
Term
what separates an upper and lower joint in each side of the TMJ? |
|
Definition
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|
Term
what are the parts of the upper TMJ joint? |
|
Definition
temporal bone's glenoid fossa + disk |
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|
Term
what are the parts of the lower TMJ joint? |
|
Definition
disk + mandibular condyle |
|
|
Term
what kind of joint is the lower TMJ joint and how many degrees of freedom does it have? |
|
Definition
|
|
Term
what kind ofjoint is the lower TMJ joint? |
|
Definition
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|
Term
what type of movement does the lower TMJ do? |
|
Definition
primarily anterior-posterior translation |
|
|
Term
is the disc attached more firmly to temporal bone or to mandibular condyle? |
|
Definition
|
|
Term
how does the disc slide on the temporal bone? |
|
Definition
anteriorly and posteriorly |
|
|
Term
how does the disc move medially and laterally on the temporal bone? |
|
Definition
it doesn't move medially and laterally |
|
|
Term
describe the jaw's anterior/posterior capsule |
|
Definition
loose to allow forward glide |
|
|
Term
how is the looseness of the anterior/posterior capsule sometimes a bad thing? |
|
Definition
|
|
Term
what does the disc do as the mandible moves? |
|
Definition
the disc moves with the mandible |
|
|
Term
is the motion of the TMJ disc active or passive? |
|
Definition
|
|
Term
what does the disc glide against as it goes anteriorly/ |
|
Definition
|
|
Term
what are the 3 primary ligaments of the TMJ? |
|
Definition
temporomandibular ligament, stylomandibular ligament, sphenomandibular ligament |
|
|
Term
what are the 2 parts of the temporomandibular ligament? |
|
Definition
oblique portion, horizontal portion |
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|
Term
what does the oblique portion of the TM ligament attach to? |
|
Definition
neck of the condyle and articular eminence |
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|
Term
what is the function of the oblique portion of the temporomandibular ligament? |
|
Definition
limits downward/posterior motion of the mandible, limits rotation of the condyle during opening |
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|
Term
what does the horizontal portion of the temporomandibular ligament attach to? |
|
Definition
lateral condyle, posterior disk, articular eminence |
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|
Term
what is the function of the horizontal portion of the temporomandibular ligament? |
|
Definition
inhibit posterior motion of condyle thereby protecting the retrodiscal lamina |
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|
Term
what are the attachments of the stylomandibular ligament? |
|
Definition
styloid process of the temporal bone, posterior border of the ramus of mandible |
|
|
Term
what is the function of the stylomandibular ligament |
|
Definition
|
|
Term
what are the attachments of the sphenomandibular ligament? |
|
Definition
sphenoid bone and middle of ramus of mandible |
|
|
Term
what is the function of the sphenomandibular ligament? |
|
Definition
|
|
Term
what is mandibular depression |
|
Definition
|
|
Term
what is mandibular elevation |
|
Definition
|
|
Term
what is mandibular protrusion |
|
Definition
|
|
Term
what is mandibular retrusion |
|
Definition
|
|
Term
what is left and right lateral deviation |
|
Definition
sliding teeth side to side |
|
|
Term
what TMJ joint moves first in mouth opening |
|
Definition
|
|
Term
what is the motion of the lower TMJ |
|
Definition
|
|
Term
how much motion is provided by the lower TMJ |
|
Definition
|
|
Term
describe the arthrokinematics of the lower TMJ |
|
Definition
convex mandibular condyle rolls posteriorly, slides anteriorly on concave disk |
|
|
Term
as the convex mandibular condyle rolls posteriorly on the concave disk, how does the disk move on the mandible? |
|
Definition
convex disk slides and rolls anteriorly on mandibular condyle |
|
|
Term
where does most of the mouth opening come from? |
|
Definition
|
|
Term
what type of movement does the upper TMJ do? |
|
Definition
|
|
Term
how much movement does the upper TMJ provide in mouth opening |
|
Definition
|
|
Term
describe arthrokinematics of upper TMJ |
|
Definition
anterior glide of concave disk on convex temporal bone |
|
|
Term
what is a functional ROM for mouth opening? |
|
Definition
|
|
Term
what is the normal ROM for mouth opening? |
|
Definition
|
|
Term
what is the breakdown of movement of opening at the TMJ? |
|
Definition
posterior rotation followed by anterior translation |
|
|
Term
what is the breakdown of movement of closing at the TMJ? |
|
Definition
closing starts with posterior glide, ends with anterior rotatoin |
|
|
Term
what is the first part of mouth closing? |
|
Definition
posterior translation of mandible from full open to half open? |
|
|
Term
what provides active disk movement? |
|
Definition
lateral pterygoids: forceful opening, eccentric control during mouth closing |
|
|
Term
what provides passive control of disk movement? |
|
Definition
ligaments, articular capsule |
|
|
Term
what joint movement creates protrusion/retrusion? |
|
Definition
movement between articular disk and temporal bone: gliding of upper joint |
|
|
Term
what does protrusion stretch? |
|
Definition
|
|
Term
how much movement can you get in protrusion? |
|
Definition
|
|
Term
what does protrusion look like? |
|
Definition
bottom teeth in front of top teeth |
|
|
Term
|
Definition
temporomandibular ligament |
|
|
Term
how much movement can you get in retrusion? |
|
Definition
|
|
Term
what are the motions of lateral deviation? |
|
Definition
ipsilateral condyle spins, contralateral condyle glides forward |
|
|
Term
how much normal motion can you get in lateral deviatoin? |
|
Definition
|
|
Term
what is TMJ rest position? |
|
Definition
teeth slightly apart, tongue on roof of mouth, least stress on joint |
|
|
Term
how much do our teeth contact a day? |
|
Definition
|
|
Term
what provides non-forceful mouth opening? |
|
Definition
|
|
Term
what provides forceful mouth opening? |
|
Definition
digastric, infrahyoids, lateral pterygoid |
|
|
Term
what muscles provide mouth closing? |
|
Definition
temporalis, masseter, medial pterygoid, eccentric control of disc from lateral pterygoids |
|
|
Term
what muscles control protrusion? |
|
Definition
lateral pterygoids, medial pterygoids, masseter |
|
|
Term
what muscles control retrusion? |
|
Definition
temporalis posterior fibers, digastric |
|
|
Term
what muscles pull contralateral side forward in lateral deviation? |
|
Definition
lateral pterygoid, medial pterygoid |
|
|
Term
what muscle pulls ipsilateral condyle posteriorly in lateral deviation? |
|
Definition
|
|
Term
what muscles are working during R lateral deviation? |
|
Definition
R temporalis, L lateral and medial pteryd |
|
|
Term
what are some TMJ pathomechanics? |
|
Definition
inflammation from rheumatoid arthritis, capsular fibrosis resulting in hypomobility, osseous mobility conditions resulting in hypermobility and dislocation, articular disk displacement, degeneration |
|
|
Term
how can you tell that a TMJ is hypermobile? |
|
Definition
laxity of capsule/ligaments/tendons, joint noise at the end of opening, unilateral hypermobility can produce lateral deviation |
|
|
Term
in a hypermobile TMJ, what causes the clicking? |
|
Definition
condyle sliding over eminence at end of opening |
|
|
Term
what happens in TMJ dislocation? |
|
Definition
condyle passes anteriorly to articular eminence |
|
|
Term
what happens if you have a dislocated TMJ? |
|
Definition
contralateral deviation, inability to close mouth after yawn, bite |
|
|
Term
what muscle is contracted during TMJ dislocation? |
|
Definition
|
|
Term
what happens in articular disc displacement? |
|
Definition
disc moves anteriorly over articular eminence |
|
|
Term
what are the 2 types of articular disc displacement? |
|
Definition
with and without reduction |
|
|
Term
describe articular disc displacement with reduction |
|
Definition
joint noise during opening and closing bc mandibular condyle touches retrodiscal tissue rather than disc at rest |
|
|
Term
describe articular disc displacement without reduction |
|
Definition
no noise, posterior ligaments are further stretched, condyle doesn't glide over disk but glides over retrodiskal tissue instead |
|
|
Term
in forward head posture, which TMJ muscles are stretche? |
|
Definition
infrahyoids (sternohyoid, omohyoid) |
|
|
Term
what happens to the mandibular condyle in forward head posture? |
|
Definition
|
|
Term
what happens to retrodiscal tissue on forward head posture? |
|
Definition
|
|
Term
what happens to lateral pterygoid in forward head posture? |
|
Definition
|
|
Term
where is the jaw pulled in forward head posture? |
|
Definition
|
|