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Questions and Answers
Which osteokinematic movement occurs in the sagittal plane around a medial lateral axis of rotation?
Which osteokinematic movement occurs in the sagittal plane around a medial lateral axis of rotation?
What is the term used for lateral flexion in the context of spinal movement?
What is the term used for lateral flexion in the context of spinal movement?
Which type of spinal motion occurs in the horizontal plane around a vertical axis of rotation?
Which type of spinal motion occurs in the horizontal plane around a vertical axis of rotation?
In osteokinematics, how is movement predominantly described?
In osteokinematics, how is movement predominantly described?
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When discussing the motion of C4 acting on C5, what is the primary action being demonstrated if right axial rotation is mentioned?
When discussing the motion of C4 acting on C5, what is the primary action being demonstrated if right axial rotation is mentioned?
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What term describes the movement when two articular facets come together?
What term describes the movement when two articular facets come together?
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What occurs on the contralateral side of the apophyseal joint during right axial rotation?
What occurs on the contralateral side of the apophyseal joint during right axial rotation?
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How is spinal coupling defined?
How is spinal coupling defined?
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Which joint primarily allows for rotation in the horizontal plane of the spine?
Which joint primarily allows for rotation in the horizontal plane of the spine?
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What type of motion primarily occurs at the atlanto-occipital joint?
What type of motion primarily occurs at the atlanto-occipital joint?
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What occurs at the atlanto-occipital joint during craniocervical flexion?
What occurs at the atlanto-occipital joint during craniocervical flexion?
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How does the AA joint behave during neck rotation?
How does the AA joint behave during neck rotation?
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How does lateral flexion occur at the C2 through C7 segments?
How does lateral flexion occur at the C2 through C7 segments?
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What is the main action occurring during craniocervical protraction?
What is the main action occurring during craniocervical protraction?
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Study Notes
Spine Osteokinematics and Arthrokinematics
- Osteokinematic motions are described from cranial to caudal (superior to inferior) and from the anterior portion of the more cranial vertebral segment.
- Flexion/extension occurs in the sagittal plane around a medial-lateral axis (forward/backward bending).
- Lateral flexion (right or left, side bending) occurs in the frontal plane around an anterior-posterior axis.
- Axial rotation occurs in the horizontal plane around a vertical axis.
Arthrokinematic Terminology
- Arthrokinematic motions describe movement at the apophyseal joints.
- Approximation/compression: articular facets come together (e.g., contralateral apophyseal joint compression during right axial rotation).
- Separation/gapping: articular facets move apart (e.g., ipsilateral apophyseal joint separation during right axial rotation).
- Sliding/gliding: translation across a joint's planar segment (e.g., flexion/extension in the mid-lower cervical spine).
Spinal Joint Orientation and Arthrokinematics
- Atlanto-occipital (AO) joint: Convex occipital condyle articulates with the concave superior articular facet of the atlas; allows flexion, extension, and limited lateral flexion.
- Atlanto-axial (AA) joint: Relatively flat articular surfaces maximize axial rotation (approximately 50% of spinal rotation).
- Cervical spine (C2-C7): Facets are oriented at a 45-degree angle; flexion involves anterior and superior gliding, extension involves posterior and inferior gliding.
- Thoracic spine: Facets are oriented 15 degrees off the frontal plane; flexion involves superior and anterior gliding, extension involves posterior and inferior gliding. Axial rotation causes contralateral gliding. Lateral flexion causes ipsilateral inferior and posterior gliding and contralateral superior and anterior gliding.
- Lumbar spine: Facets are oriented 25 degrees off the sagittal plane; flexion involves superior and slight anterior gliding, extension involves inferior and slight posterior gliding. Limited rotation due to facet orientation.
Spinal Coupling
- Vertebral movement in one plane is associated with movement in another plane (e.g., lateral flexion in C3-C7 is coupled with axial rotation). This is particularly prominent in the cervical spine.
Craniocervical Movements
- Flexion: AO joint: anterior roll, posterior slide; AA joint: anterior tilt; C2-C7: anterior and superior slide.
- Extension: AO joint: posterior roll, anterior slide; AA joint: posterior tilt; C2-C7: posterior and inferior slide.
- Protraction: Flexion of mid-lower cervical spine, extension of upper cervical spine (C1-C2).
- Retraction: Extension of mid-lower cervical spine, flexion of upper cervical spine.
- Axial rotation: Primarily at the AA joint (posterior slide on ipsilateral side, anterior slide on contralateral side); C2-C7: slight posterior/inferior slide on ipsilateral side and anterior/superior on contralateral side.
- Lateral flexion: AO joint: roll to the ipsilateral side, slide to the contralateral side. C2-C7: posterior/inferior slide on ipsilateral side and anterior/superior on contralateral side. Spinal coupling causes slight axial rotation.
Thoracic and Lumbar Movements
- Thoracic flexion/extension involves superior/anterior and inferior/posterior gliding, respectively.
- Thoracic axial rotation involves contralateral gliding.
- Thoracic lateral flexion involves ipsilateral inferior/posterior gliding, and contralateral superior/anterior gliding.
- Lumbar flexion/extension involves superior/slight anterior and inferior/slight posterior gliding, respectively. Rotation is limited.
Regional Kinematic Summary
- Cervical spine: Significant flexion/extension and rotation.
- Thoracic spine: Limited flexion/extension, some rotation; primary role in ventilation.
- Lumbar spine: Significant flexion/extension, limited rotation. Transition from frontal plane to near sagittal plane orientation of apophyseal joints.
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