Term
| what is the most common patient complaint |
|
Definition
|
|
Term
| what makes up 90% of workmens comp claims |
|
Definition
|
|
Term
| what percent of adults will encounter an episode of disabling back pain |
|
Definition
|
|
Term
| what is the vertebral unit |
|
Definition
| two adjacent vertebra (the one referenced and the one BELOW) and they associated intervetebral disc, arthroidal, ligamentous, muscular, vascular, lymphatic, a neural elements |
|
|
Term
| what do we describe the motion of the vertebea in reference to |
|
Definition
|
|
Term
| physically, what determines the motion of a vertebrae |
|
Definition
|
|
Term
| what drives the motion of a vertebra |
|
Definition
| the muscles that attach to it |
|
|
Term
| what stabilizes the motion of a vertebrae |
|
Definition
| fascial and ligamentous structures |
|
|
Term
| what vertebra marks the iliac crest |
|
Definition
|
|
Term
| what vertebra marks the PSIS |
|
Definition
|
|
Term
| what vertebra marks the spine of the scapula |
|
Definition
|
|
Term
| what vertebra marks the inferior angle of the scapula |
|
Definition
|
|
Term
|
Definition
| arching of the lumbar spine anteriorly |
|
|
Term
| what is thoracic kyphosis |
|
Definition
| arching of the thorasic spine posteriorly |
|
|
Term
| what is cervical lordosis |
|
Definition
| arching of the cervival spine anteriorly |
|
|
Term
| in regards to surface anatomy, is using L4 and L5 for a mark of the iliac crest and PSIS relativly stable |
|
Definition
|
|
Term
| in regards to surface anatomy, is using T3 and T7 for the spine and angle of the scapula relativly stable |
|
Definition
|
|
Term
| list the order of the lordosis and kyphosis development begining with which develops first |
|
Definition
| thorasic kyphosis was always there, then cervical lordosis develops, then lumbar lordosis |
|
|
Term
| what vertebra is the thickest and most solid, what is the functional result of this |
|
Definition
| lumbar, can bear more weight |
|
|
Term
| in what direction do the lumbar superior and inferior articularing facets face |
|
Definition
| the anterior posterior plane |
|
|
Term
| what is special about the shape of the L5 vertebra, what does it have this shape |
|
Definition
| it is a transitional shape, from the verticle vertebral column to near-horizontal sacrum. it is thicker in the front |
|
|
Term
| what is the pars interarticularis |
|
Definition
| between articular processes, some are not born with it fused and relationship with it and the one bwlow is distupted |
|
|
Term
| describe the relationship between the rib number and the vertebra number |
|
Definition
| rib articulates with the transverse process of the body of the same numbered vertebea and with the body of the vertebra below |
|
|
Term
| what vertebra have facets for rib attachment, where are the located |
|
Definition
| thorasic, on the transverse process and the body |
|
|
Term
| describe the relationship of the tip of the transverse process of T1-3 and the location of the body |
|
Definition
|
|
Term
| describe the relationship of the tip of the transverse process of T4-6 and the location of the body |
|
Definition
|
|
Term
| describe the relationship of the tip of the transverse process of T7-9 and the location of the body |
|
Definition
|
|
Term
| describe the relationship of the tip of the transverse process of T10 and the location of the body |
|
Definition
|
|
Term
| describe the relationship of the tip of the transverse process of T11 and the location of the body |
|
Definition
|
|
Term
| describe the relationship of the tip of the transverse process of T12 and the location of the body |
|
Definition
| at the same level as the body |
|
|
Term
| describe the orientation of the thorasic superior facets, what does this orientation provide functionally |
|
Definition
| backward, upward, lateral. (sticking up and facing backward in the middle area of the vertebra) favors rotation as major motion |
|
|
Term
| what happes to the thorasic vertebra as it gets closer to the lumbar vertabrae |
|
Definition
| spinous processes get more thick and blunt, bodies become more thick and solid |
|
|
Term
| how much of the spine is composed of intervetebral discs |
|
Definition
|
|
Term
| where are the intervetebral discs the thickest |
|
Definition
|
|
Term
| why are the intervetebral discs thicker in the cervical area |
|
Definition
|
|
Term
| why are the intervetebral discs thicker in the lumbar area |
|
Definition
| greatest weight bearing region |
|
|
Term
| describe the layers and composition of the intervetebral disc |
|
Definition
| fibrous anulus fibrosus on the outside and gooey nucleus pulposus on the inside |
|
|
Term
| where is the posterior longitudinal ligament located |
|
Definition
| anterior in aspect to the vertebral canal |
|
|
Term
| where is the posterior longitudinal ligament wider |
|
Definition
|
|
Term
| what is the function of the posterior longitudinal ligament |
|
Definition
| prevent central disc herniations in the cervical and thorasic region where it is thicker |
|
|
Term
| what is the function of the posterior longitudinal ligament in the lumbar region |
|
Definition
| allow herniation to the sides, because it is thinner |
|
|
Term
| where is the ligametum flavum located |
|
Definition
|
|
Term
| what is hypertrophy, what does it cause |
|
Definition
| narrowing of the spinal canal due to the ligamentum flavum, causing central spinal stenosis |
|
|
Term
| what are the superificial muscles of the back |
|
Definition
| trapezius, latissimus dorsi |
|
|
Term
| what are the intermediate muscles of the back |
|
Definition
| serratus posterior superior and inferior, rhomboid major, rhomboid minor |
|
|
Term
| what are the superficial deep muscles of the back |
|
Definition
| longissimus thoracis, iliocostalis, spinalis thoracis |
|
|
Term
| what are the deep deep muscles of the back |
|
Definition
| multifidius, levatores costarum, rotatores |
|
|
Term
| what does the diaphragm attach to |
|
Definition
| costal margin, sternum, 12th rib, acurate ligaments, curae, L1-3 on right, L1-2 on left |
|
|
Term
| what is the origin and insertion of the quadratus lumborum |
|
Definition
| 12th rib to iliac crest, slips to vertebra inbetween |
|
|
Term
| what is the quadratus lumborum deep to |
|
Definition
|
|
Term
| what nerves pierce the quadratus lumborum |
|
Definition
| iliohypogastric and ilioinguinal (L1) |
|
|
Term
| what is the origin and insertion of the psoas |
|
Definition
| L1-4/5 to the lesser trochanter |
|
|
Term
| what is the psoas deep to |
|
Definition
|
|
Term
| what happens if the psoas spasms |
|
Definition
| flexed, sidebent posture, type 2 |
|
|
Term
| what is the biggest and best movement in the upper thorasic spine |
|
Definition
|
|
Term
| what is the biggest and best movement in the lower thorasic spiine |
|
Definition
|
|
Term
| what limits flexion and extension in the normal body, all the time, in the thorasic region |
|
Definition
|
|
Term
| what type of dysfunction is less likley in the lumbar region |
|
Definition
|
|
Term
| what happens to facets in flexion |
|
Definition
|
|
Term
| what happens to facets in extension |
|
Definition
|
|
Term
| what facilitates sidebending and rotation at the level of the single vertebral segment |
|
Definition
| unilateral contraction nof the small muscles of the back: interspinalis, intertransversarii, rotatores |
|
|
Term
| what motions do the rotatories allow |
|
Definition
| bilateral contraction (extension), unilateral contraction to the opposite side (rotation) |
|
|
Term
| what motions to the intertransversarii allow |
|
Definition
| bilateral contraction (vertebral unit rigidity), unilateral contraction (sidebending) |
|
|
Term
| what kind of motion is done in type one mechanics |
|
Definition
| side bending without flexion or extension, neutral |
|
|
Term
| during type one mechanics, describe the relationship between the rotation and curvature of the spine in sidebending |
|
Definition
|
|
Term
| what kind of motion is done in typw two mechanics |
|
Definition
| side bending with flexion or extension, non-neutral |
|
|
Term
| during type two mechanics, describe the relationship between the rotation and curvature of the spine in sidebending |
|
Definition
| rotation away from the convexity |
|
|
Term
| in type one mechanics, how many vertebrae are effected |
|
Definition
|
|
Term
| in type two mechanics, how many vertebrae are effected |
|
Definition
|
|
Term
| normally, what is the onset of a type one mechanics tysfunction like |
|
Definition
|
|
Term
| normally, what is the onset of a type two mechanics tysfunction like |
|
Definition
|
|
Term
| what plane and axis is flexion or extension in |
|
Definition
| plane: saggital, axis: transverse |
|
|
Term
| what plane and axis is rotation in |
|
Definition
| plane: transverse, axis: vertival |
|
|
Term
| what plane and axis is sidebending in |
|
Definition
| plane: coronal, axis: anterior posterior |
|
|
Term
| what do you do in a supine evaluation of the lumbar spine |
|
Definition
| respiration, lumbar lordosis, pelvic roll, iliac crest heights, ASIS heights, thoracolumbar junction, quadratus lumborum |
|
|
Term
| what should you note about respiration |
|
Definition
| costal, abdominal, or mixed. diaphragmatic excursion. moving by pubis or umbilicus. rate. |
|
|
Term
| what is the most important thing to notice when looking at respiration, why, what position should it be seen in for sure |
|
Definition
| diaphragmatic respiration movement should be seen in the supine position because it helps more air, blood, and lymph |
|
|
Term
| what can increased lumbordosis cause |
|
Definition
1. pubic symphysis moves inferiorly making myofacial and ligamentous strain between the pelvis and thorax restricting eficiency of the thoracoabdominalpelvic pump.
2. diaphragm is in state of contraction inhibiting it affecting movement of blood, lymph, and CSF |
|
|
Term
| what should you evaluate during a lumbar lordosis check |
|
Definition
| it is resting comfourtably on the table relaxed, note the hright, extent superiorly and inferiorly, the apex |
|
|
Term
| what does the pelvic roll evaluate |
|
Definition
|
|
Term
| what does the iliac crest heights evaluate |
|
Definition
|
|
Term
| how do you evaluate the thoracolumbar junction |
|
Definition
| push on the transverse processes and motion test for rotation |
|
|
Term
| what can dysfunctions of the 11th and 12th rib cause |
|
Definition
| muscle spasm in the quadratus lumborum |
|
|
Term
| what can hypertonicity or spasm in the quadratus lumborum cause |
|
Definition
| 12th rub inferior movement and restriction during respiration |
|
|
Term
| how do you begin diagnosing a type 2 dysfunction |
|
Definition
| put patient in flexed or extended position and compare rotation or sidebending at each vertebral segment |
|
|
Term
| how do you test lumbar extension prone |
|
Definition
| have patient raise onto elbows to extend lumbar and relax and feel the tips of the transverse processes of each vertebra |
|
|
Term
| how do you test lumbar flexion seated |
|
Definition
| patient sits on table with feet planted on ground, you stand beind them patient flexes towards ground, locate transverse processes of each vertebra and evaluate rotation |
|
|
Term
| what are type 2 dysfunctions often the result of |
|
Definition
|
|
Term
| how are type two dysfunctions maintained |
|
Definition
| short restrictors of the spine |
|
|
Term
| how do you find a type two dysfunction |
|
Definition
| flexion or extension by palpating the transverse processes |
|
|
Term
| describe a type 2 flexed dysfunction, what happens to the facets when the patient extends, what is the rotation / side beind of the vertebra a result of |
|
Definition
| one facet is locked open, so in extension both facets should close but because one is locked open extension is limited causing vertebra to rotate and sidebend to the opposite side of the locked open facet |
|
|
Term
| what causes the movement of the vertebra in an exended dysfunction |
|
Definition
| a facet is locked closed, in flexion vertebra rotate and sidebend to the side of the locked closed facet |
|
|
Term
| how can you tell you have a type one dysfunction |
|
Definition
| if the posterior transverse process remains the same in all three positions or increases in neutral |
|
|
Term
| what vertebral level is the umbilicus |
|
Definition
|
|
Term
| what is the definition of muscle energy |
|
Definition
| system of diagnosis and treatment where the patient voluntarily moves the body from a percisely controlled position against a defined resistance |
|
|
Term
|
Definition
| patient is performing the activity |
|
|
Term
|
Definition
| patient remains relaxed, physician performs the technique |
|
|
Term
|
Definition
| engages the restrictive barrier |
|
|
Term
|
Definition
| moves away from the restrictive barrier into a position of ease |
|
|
Term
| what can muscle energy be used for |
|
Definition
| alter muscle length, descrease peripherial edema, mobilize a restrited joint |
|
|
Term
| what type of technique is muscle energy |
|
Definition
| direct, active patient, active physician |
|
|
Term
| how does muscle energy reset muscle length |
|
Definition
| uses muscle tension feedback loop |
|
|
Term
| what barriers does muscle energy move, in which direction |
|
Definition
| moves restrictive barrier towards the pathological barrier |
|
|
Term
|
Definition
| muscle that is contracting to cause motion being evaluated, muscle maintain somatic dysfunction |
|
|
Term
|
Definition
| muscle that moves the joint in the opposite direction of the motion evaluated, it relaxes when the agaonist is contracting |
|
|
Term
|
Definition
| muscle attachments become closer, muscle shortens |
|
|
Term
|
Definition
| muscle sttachment gets further apart, muscle lengthens while contracting |
|
|
Term
|
Definition
| patient force = physician force, no change in muscle length |
|
|
Term
|
Definition
| physician force > patient force, muscle lenghtens |
|
|
Term
|
Definition
| patient force > physician force, muscle shortens |
|
|
Term
| what combination of patient vs physician force is used most often |
|
Definition
|
|
Term
| what combination of patient vs physician force is used least often |
|
Definition
|
|
Term
| what is post isometric relaxation |
|
Definition
| after a muscle contracts isometrically, for a moment after contraction, it is refractory to continued stimulation then it relaxes |
|
|
Term
| what is the reciporical inhibition |
|
Definition
| when the agonist muscle contracts, the atagonist reflexly relaxes |
|
|
Term
| what is the crossed extensor reflex |
|
Definition
| when the agonist muscle on one limb contracts, the agonist muscle on the opposite limb relaxes |
|
|
Term
| what is the oculoephalogyric reflex |
|
Definition
| movements of the eye, head, and body are directed in interest of visual attraction |
|
|
Term
| what are the basic steps of using muscle energy |
|
Definition
1. perform static and dynamic exam to obtain diagnosis
2. position patient so the dysfunctional joint is engaging the restrictive barrier in 3 planes
3. move the joint into the restrictive barrier
4. patient applies counterforce for 3-5 sec (isotonic, isometric, isolytic)
5. everyone relaxes for 1-2 sec
6. repear steps 4 and 5 until dysfunctional joint has returned to normal motion
7. RE-CHECK |
|
|
Term
| what are the most common errors in muscle energy |
|
Definition
| not monitoring motion with palpation, patient too forceful, duration of relaxation too short, not repositioning to the new barrier after each contraction, forgeting to retest |
|
|
Term
| what is the primary dysfunctional movement in type one dysfunctions |
|
Definition
|
|
Term
| what are the physical signs of a flexion dysfunction |
|
Definition
| rotation and sidebending increase in flexion and decrease in neutral and extension (aka extended lesion) |
|
|
Term
| what are the physical signs of a extension dysfunction |
|
Definition
| rotation and sidebending increase in extension and decrease in neutral and flexion (aka flexed lesion) |
|
|
Term
| in the lumbar spine, lying on what side corrects for sidebend left |
|
Definition
|
|
Term
|
Definition
| degenerative changes of facets |
|
|
Term
| where could facet arthritis be located |
|
Definition
| on edges of vertebra, around facet |
|
|
Term
| what does facet arthritis cause |
|
Definition
| cartilage break down, bony spurs |
|
|
Term
|
Definition
| degenerative change of vertebral body |
|
|
Term
| how can you tell spondolodosis on an x ray |
|
Definition
| on a oblique x ray scorry dog has its head cut off |
|
|
Term
| what is spondylolisthesis |
|
Definition
| forward spli of a vertebra relative to another, L5 |
|
|
Term
| how can you tell spondylolisthesis on a x ray |
|
Definition
| on oblique x ray scotty dog has a collar |
|
|
Term
|
Definition
| nucleus pulposis is goind into intervetebral foramen or vertebral column |
|
|
Term
| why is a herniated disc painful |
|
Definition
| mechanical and chemical irritant |
|
|
Term
| what is sacrilization of L5 |
|
Definition
| unilateral or bilateral L5 fusion to sacrum. |
|
|
Term
| how can you test for sacrilization |
|
Definition
| spring test shows ridigidy on one or both sides (unilateral or bilateral) |
|
|
Term
| what can cause loss of height |
|
Definition
| loss of disc space or osteoperosis |
|
|
Term
| what does osteoperosis lead to in the spine |
|
Definition
| compression fractors, loss of height |
|
|
Term
| how do you treat spondolosis |
|
Definition
| frog leg technique, on back gran and pull saccrum |
|
|
Term
| what are the functions of the thoracic cage |
|
Definition
| protection (static), motion (dynamic) |
|
|
Term
| what movements does the sternum make in expiration |
|
Definition
|
|
Term
| what happens to the diaphragm during inhalation |
|
Definition
|
|
Term
| what motion does the bucket handle do |
|
Definition
| lateral motion, increasing transverse diameter, mostly lower ribs, more AP |
|
|
Term
| what motion does the pump handle do |
|
Definition
| anterior mostly, some posterior, mostly upper ribs, axis of rotation is more transverse |
|
|
Term
| what is the 12th rib influenced by in breathing |
|
Definition
| diaphragm and quadraus lumborum |
|
|
Term
| which way do the caliper ribs move in breathing |
|
Definition
|
|
Term
| what are the caliper ribs |
|
Definition
|
|
Term
| what is the synarthroidal joint |
|
Definition
|
|
Term
| what rib is at angle of louis |
|
Definition
|
|
Term
| what does rib 2 articulate with |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what is vertebralchondral |
|
Definition
|
|
Term
| what is the radial ligament |
|
Definition
| keeps head of rib attached to vertebra |
|
|
Term
| what is the superior costral transverse ligament |
|
Definition
| transverse process above to rib below |
|
|
Term
| what do the external intecostals do |
|
Definition
|
|
Term
| what do the internal intercostals do |
|
Definition
|
|
Term
| what does the transverse thoracis do |
|
Definition
| interdifitate with diaphragm, works in active exhalation |
|
|
Term
| what does the latissimus dorsi do |
|
Definition
| moves ribs 11-2 inferior in inhalation |
|
|
Term
| why should you always check the cervical spine in respitory problems |
|
Definition
| because the diaphragm is innervated by ventral rami C3-5 phrenic nerve |
|
|
Term
| what is the fulcrum of the diaphragm |
|
Definition
|
|
Term
| what does the scalenes run between |
|
Definition
| from C4-6 transverse processes to first rib and posterior to second rib |
|
|
Term
| what is the respiration action of the scalenes |
|
Definition
| bring rib 1 and 2 up anterior in inhalation |
|
|
Term
| what is the respitory action of pectoralis |
|
Definition
| pull ribs 2-5 up anterior in inhalation |
|
|
Term
| what is the respitory action of serratus anterior |
|
Definition
| pull ribs 5-9 up anterior in inhalation |
|
|
Term
| where does the sympathetic chain lay in relation to the ribs |
|
Definition
|
|
Term
| what can restriction of the ribs do to the sympathetic chain |
|
Definition
|
|
Term
| what is an inhale dysfunction |
|
Definition
| restricted exhalation, can inhale |
|
|
Term
| what is an exhale dysfunction |
|
Definition
| can exhale, restricted inhalation, rib locked down |
|
|
Term
| what does it mean if a key rib is stuck up |
|
Definition
| bottom rib is preventing the inhale, it is a key rib |
|
|
Term
| what does it mean if the key rib is stuck down |
|
Definition
| top rib is preventing the movement, it is the key rib, exhale dysfunction |
|
|
Term
| where is an inhale dysfunction more common |
|
Definition
|
|
Term
| where is an exhale dysfunction more common |
|
Definition
|
|
Term
| what is an out of pattern rib |
|
Definition
| dysfunction in spite of fascia, opposite behavior patterns |
|
|
Term
|
Definition
| scolosis curve points to the right |
|
|
Term
|
Definition
| scolosis curve points to the left |
|
|
Term
| what is function scolosis |
|
Definition
| changes with sidebending into convexity of curve |
|
|
Term
| what type of dysfunction is function scolosis |
|
Definition
| type 1 normally, type 2 beneath |
|
|
Term
| what is structural scolosis |
|
Definition
| no apperance or chane in side bend into convexity |
|
|
