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Lecture 4

HSS2511 Lecture 4: Posture Ch 9+10

11 Pages

Health Sciences
Course Code
Steve Pelletier

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Posture Ch 9+10 Axial Skeleton Vertebral Column • 5 regions: cervical, thoracic, lumbar, sacral and coccyx • Each region has a different number of vertebrae Curve of the vertebral column • Cervical lordosis (inward) • Thoracic kyphosis (outwards) • Lumbar lordosis • Sacro-coccyx kyphosis • Lordosis are considered secondary curves because they form after birth (when the baby starts walking) • Abnormal curves are called hyperkyphosis (hunchback, curvature in thoracic spine), hyperlordosis (indent of lumbar spine, causes muscle spasms) and scoliosis • Curves are dynamic and will change with movement (except the sacro-coccyx), causes more strain on the muscles Scoliosis • Easy to identify • Shoulders should be equal in height • Scoliosis within 15-20 degrees is not a big deal, nobody has a perfectly straight spine • More than 20 degrees they will take action (surgery) Posture • Good posture is important to have good biomechanics throughout the body • Good posture prevents muscular fatigue • Good posture prevents injuries • Good posture assures optimal performance in sports and other physical activities • Bad posture in the shoulders can affect the strength of a throw and can increase the risk of getting hurt Line of gravity 1. Mastoid process 2. Middle of shoulders 3. Second scral vertebrae 4. A bit posterior of the centre of the hips 5. A bit anterior of the rotation axis of the knee 6. A bit anterior to the lateral malleolus • Always deviation, starting point for posture is the bone on your ankle • Body should be more or less symmetrical Vertebrae Function: • Vertical stability • Protect the spinal cord and spinal nerves Vertebrae can be divided into 3 sections: • Anterior (vertebral body) • Posterior: transverse process (level, muscular contractions), spinal process (bone sticking out of your back), lamella and articular process • Pedicules are the bridges that bond the anterior and posterior parts of the vertebrae • Ligaments around the vertebrae prevent flexion and extension • Anterior longitudinal ligament prevents flexion (one on inside of vertebrae, opposite to spinal processes) • Yellow ligament: from axis to the 2nd sacral vertebra, connect the vertebrae on inside of vertebral canal Vertebral Ligaments and functions • Yellow ligament: limits flexion • Inter and super spinous ligaments: limits flexion • Inter-transverse ligaments: limits flexion and lateral flexion • Anterior longitudinal ligament: limits extention or excessive lordosis; reinforces the anterior parts of the intervertebral disks • Posterior longitudinal ligament: limits flexion; reinforces the posterior parts of the intervertebral disks • Zygapophysial articular facet: reinforces zygapophysial articulation Typical intervertebral junction • Transverse and spinal processes: allow for rotation and movement (done with help from muscles) • Zygapophysial articulations • Intervertebral joints • Difference between C1 and C2 Zygapophysial articulation structure and function • 24 pairs in the vertebral column • Formed by the articular surfaces or the opposite articular process • The angle of the articular surface guides the movement between vertebrae Amount of movement in each plane • Sagittal: lots of flexion and extension • Horitontal: other than in C1/C2, limited flexion and extension • Frontal plane: limited flexion and extension Structure and function of intervertebral disks • Most of the studies done on the disks are done with lumbar region • Each joint has a disk and 2 vertebral trays/planes • Vertebral disks composed of a nucleus puposus and a annulus fibrosus ring • Parts of the vertebral endplate are also flexible and can absorb force • Fibrous ring is gelatinous and flexible, it contains 15-25 layers, fibres from each layer are oriented in a 65-degree angle, with each adjacent layer oriented in the opposite direction that the previous • Only way to hurt your disks is by doing flexion • Lateral posterior area are more likely to get hurt • Do flexion of the back while turning your back if you want to get hurt • Vertebral endplate: fibro-cartilaginous, flexible, important for absorbing force • Disks are there to absorb more force than the vertebral column • In a neutral position, compression pushed the vertebral endplate towards the inside of the disk • The nucleus is liquid so it cannot compress very much, this means the force will have to be redirected against the fibrous ring on the outside • The forces are distributed in a uniform way in a health disk In-vivo measurement of inner-disk pressure • The higher the force, the higher the risk of injury • The amount of force put on the spinal column is different in different anatomical positions • Highest amount of pressure when bending forward from the hips to pick up something heavy • Lowest amount of pressure is when lying horizontally Changes in the disks during the night (sleeping) • When a person is sleeping, the nucleus pulposus becomes dehydrated (especially in people under 35) • The vertebral column is longer in the morning than at night • Decreased amplitude of flexion in the morning • 30 minutes after being standing, 54% of the height acquired during the night is lost • Increase of 300% of bending stress in the morning Spinal nerves • Each one is formed by union of dorsal and ventral roots (dorsal= sensory; ventral=motor) • At the level of the intervertebral foramen, the roots form spinal nerves (both sensorial and motor) • Getting hurt at a certain disk will cause specific symptoms Characteristics of the lumbar vertebrae • Vertebral body: massive and in a bean shape • Spinal process: short and tall • Transverse process: thin and slender • Vertebral foramen: triangular Articular lumbar movements • Flexion • Extension • Lateral flexion (right and left) • Rotation (right and left) L1-L4 region • Zygapophysial articulations are almost vertically oriented (sagittal plane) • Flexion and extension are more pronounced L5-S1 region • apophyseal joint is oriented more in the frontal plane compared to L1-L4
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