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Samenvatting MOB IIIB HOC Theorie

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Samenvatting MOB IIIB HOC Theorie

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  • August 17, 2020
  • 217
  • 2019/2020
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MOB Theorie: HOC 1 (K. Ickmans)



1. Uitgangspunt




2. Cervicale wervelkolom

Functionele anatomie en beweeglijkheid

Zie flipped classroom ‘PO Wervelkolom deel TWK’ op Canvas → Panopto



Functionele anatomie

- Morfologisch en functioneel wordt de CWK onderverdeeld in drie verschillende delen:

o Hoogcervicale WK (C0-C2): zeer specifieke en uitgebreide bewegingsmogelijkheden

o Mid- en laagcervicale WK (C3-C7): typische cervicale bewegingen

o De cervicothoracale overgang (CTO) (functioneel tot T3)




Bewegend segment:


- = segment waarin beweging kan optreden als antwoord op actie van de musculatuur

- Tussen twee opeenvolgende wervels – discus intervertebralis – ligamentaire structuren

- Twee facetgewrichten – gewrichten van Luschka (processi uncinati – C3-C7)

- Geheel wordt verder ondersteund door spieren, neurogene en vasculaire structuren




1

, Vertebrae: naast de basiskenmerken heeft elke soort wervel ook zijn eigen specifieke kenmerken


- Corpus vertebrae

- Foramen vertebralis – canalis vertebralis (ruggenmerg)

- Arcus vertebrae

o Pediculus = verbinding met corpus

o Laminae = processus spinosus (dorsaal), transversus (lateraal), articulares inf. en sup.




Vertebrae cervicales:


- Opening processi transversi (foramen transversarium) waar A. vertebralis doorloopt (niet bij C7)

- Gespleten processus spinosus (C3-C7)

- Processus uncinatus – uncovertebrale gewrichten van Luschka

- Afwijkende vorm van de halswervels:

o Atlas C1: geen corpus, geen proc. spinosus, wel massae lateralis en arcus ant. en post.

o Axis C2: dens (arcus anterior atlas) (vertaling = draaier)

o C7 = vertebra prominens




2

,3

, Discus intervertebralis (DIV):


- De meest craniale discus intervertebralis bevindt zich tussen C2 en C3

- De morfologie van de cervicale disci verschilt sterk van die van de andere regio’s:

o Relatief hoge discushoogte (± 3 mm) door aanwezigheid van proc. uncinati (Mercer ’96)

o Bevat minder water en proteoglycanen ivm. lumbale disci door verschillende functionele

eisen → minder lasten dragen (Grant 2002)




Hoe groter verhouding discushoogte / wervellichaam, hoe groter segmentale beweeglijkheid (C > L >T).


- C = cervicaal, L = lumbaal, T = thoracaal




Ligamentaire structuren:


- Ligamentum nuchae

- Membrana tectoria (= verlengde van Lig. Longitudinale posterius)

- Ligamenta alaria

- Ligamentum transversum atlantis




4

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