The movement systems: skeletal and muscular
Nick Draper, Helen Marshall in Exercise Physiology, 2014
The different types of synovial joint are shown in Figure 5.6. Gliding joints, such as between the vertebrae in the spine or the sternoclavicular joint as illustrated, are formed when the flat surfaces of bones come together. The amount of movement in a gliding joint is minimal. The elbow, knee and ankle are examples of hinge joints that enable flexion and extension of the arm and leg along with dorsiflexion and plantar flexion of the foot. The atlanto-axial joint in the spine is an example of a pivot joint which enables the head to rotate and is formed between the odontoid peg or dens of the axis bone and the ring of the atlas. An example of ellipsoid or condyloid joints can be found between the arm and hand at the wrist which are called the radiocarpal joints. The wrist enables movement in two planes and is formed where a convex surface fits in to a concave surface.
Disc Structure and Function
Peter Ghosh in The Biology of the Intervertebral Disc, 2019
There are 23 discs in the human spine which account for 20 to 30% of its length.5,6,7 Apart from the fused vertebrae of the sacrum and coccyx, the only vertebrae not connected by intervertebral discs are the two cervical vertebrae at the cranial extremity of the spine (the atlas and the axis) which pivot at the specialized atlanto-axial joint; the atlas and the base of the skull articulate at the specialized occipito-atlantal joint8 which also does not contain a disc. Other mammals have differing numbers of vertebrae, and the tail does not closely resemble the human coccyx, but the structures of their intervertebral discs in corresponding regions of the spine are often remarkably similar. (Further details on comparative anatomy are given in Chapter 3).
Nerve and Root Lesions
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
Most patients with neck problems, particularly root irritation, show pronounced spasm of the nuchal muscles causing greatly limited neck movements. Lateral flexion is particularly affected, for most rotation occurs at the atlanto-axial joint and proximally. Sometimes a ‘wry’ neck may develop. Lateral flexion or rotation of the neck, which aggravates ipsilateral pain referred down the shoulder or arm, suggests root compression on that side. Neck pain that is worsened on the side contralateral to the lateral flexion or rotation suggests a muscular origin to that pain.
Vertebro-basilar stroke due to Bow-Hunter syndrome: an unusual presentation of rotatory atlanto-axial subluxation in a fourteen year old
Published in British Journal of Neurosurgery, 2023
A 14-year-old male presented with sudden onset vertigo and imbalance while walking. Examination found slurring of speech, severe ataxia, and nystagmus with normal vision, power and sensations. He had a mild torticollis present since childhood, but never investigated. MRI of the brain revealed areas of diffusion restriction in the bilateral cerebellum and occipital lobes (Figure 1). MR angiography revealed a hypoplastic left vertebral artery and kinking of the right vertebral artery near the cranio-vertebral junction (Figure 2, 3). CT and MRI scan of the cervical spine revealed rotatory subluxation of the right atlanto-axial joint with aplasia of the right C1 arch and occipitalisation of the left C1 arch (Figures 4 and 5). He was treated by C1 lateral mass to C2 subfacetal screw and rod fixation.
Validity of eyeball estimation for range of motion during the cervical flexion rotation test compared to an ultrasound-based movement analysis system
Published in Physiotherapy Theory and Practice, 2018
Axel Schäfer, Kerstin Lüdtke, Franziska Breuel, Nikolas Gerloff, Maren Knust, Christian Kollitsch, Alex Laukart, Laura Matej, Antje Müller, Thomas Schöttker-Königer, Toby Hall
One method of measuring upper cervical movement impairment is the cervical flexion-rotation test (FRT) (Takasaki et al, 2011). In this procedure, the cervical spine is placed in end-range flexion and passive rotation to each side is measured. It is postulated that rotation in end-range cervical flexion occurs predominantly at the atlanto-axial joint (C1-C2) (Hall and Robinson, 2004; Ogince, Hall, Robinson, and Blackmore, 2007; Takasaki et al, 2011). If a firm resistance is encountered, pain provoked, and range is limited before the expected end range, then the test is considered positive. Normal range of motion is approximately 44° to both sides (Hall and Robinson, 2004). Range of motion less than 34° to one side is rated as abnormal based on ROC analysis in various studies (Hall, Briffa, and Hopper, 2010; Hall, Briffa, Hopper, and Robinson, 2010a, 2010b; Ogince, Hall, Robinson, and Blackmore, 2007).
Related Knowledge Centers
- Cervical Vertebrae
- Joint Capsule
- Joint
- Neck
- Atlas
- Axis
- Pivot Joint
- Transverse Ligament of Atlas
- Plane Joint
- Anterior Atlantoaxial Ligament