Shared Flashcard Set

Details

Spine Oral Exam Mid-term
S-1 Fall 2010
168
Anatomy
Professional
09/06/2010

Additional Anatomy Flashcards

 


 

Cards

Term
Name all of the joints of the atlas.
Definition

- 1 anterior odontoid joint

- 2 superior facet joints

- 2 inferior facet joints

Term
Name all of the joints of the axis.
Definition

- 2 superior facet joints

- 2 inferior facet joints

-2 odontoid (ant. & post.)

- 2 Von Luschka

-1 intervertebral disc joint

Term
Name all of the joints of a cervical spine vertebrae.
Definition

- 2 superior facet joints

- 2 inferior facet joints

- 4 Von Luschka joints

- 2 intervertebral disc joints

Term
Name all of the joints of a thoracic vertebrae.
Definition

- 2 superior facet joints (synovial)

- 2 inferior facet joints (synovial)

- 2 intervertbral disc joints (fibrocartilaginous)

- 4 costovertebral joints

- 2 costotransverse joints

Term
Name all of the joints of a lumbar vertebrae.
Definition

- 2 superior facet joints

- 2 inferior facet joints

- 2 disc joints

Term
Name all of the joints of the sacrum.
Definition

- 1 sacral coccygeal joint

- 1 L5-S1 disc joint

- 2 L5-S1 superior articular facets (junctions)

- 2 SI joints

Term
Which part of the facet contacts the head of the rib in the thoracic spine?
Definition
Demi facet
Term
How many vertebrae are in the spine, including the sacrum and coccyx?
Definition
33
Term
How many total intervertebral discs are in the spine?
Definition
23
Term
Why are there 7 cervical vertebrae but 8 cervical nerves?
Definition
The 1st cervical nerve come above C1 and the last cervical nerve comes out below C7/above T1.
Term
If there is an L4-5 disc herniation, which nerve root will it encroach upon?
Definition

L5

(because L5 nerve root is still in the canal)

Term
If there is a C5-6 disc herniation which nerve root will be encroached?
Definition
C6
Term
If there is a L5-S1 disc herniation, which nerve root will it encroach upon?
Definition
S1
Term
If there is a lateral foraminal stenosis of L4-5, which nerve root will be compressed?
Definition
L4
Term
Where does the spinal cord end?
Definition
L1-2
Term
What is the functional unit of the spine called? And what is it composed of?
Definition

A segment.

The inferior half of 1 vertebrae above, the superior half of the vertebrae below and everything including disc, nerve, blood vessels inbetween.

Term
What is the weakest part of the vertebrae? And what commonly occurs here?
Definition

Pars interarticularis

Scotty dog fracture

Term
What is unique about the curvatures of the spine?
Definition
Distribution and absorption of forces and shock.
Term
What is the significance of the intervertebral notches?
Definition
When veretrae are stacked on top of eachother they become the lateral foramen where the nerve roots exit. DDD, DJD can develop here, narrowing the foramen, causing lateral foraminal stenosis.
Term
What tests could be performed to determine radiculopathy?
Definition

-myotomes

-dermatomes

-neural reflexes

-neural tension

Term
How many synovial joint surfaces are in the thoracic spine?
Definition

10

-only the the intervertebral disc are fibrocartilaginous not synovial

Term
What runs through the transverse foramen of the cervical spine and at what level does it enter?
Definition

-vertebral artery

-C6

Term
At which level does the 1st bifid spinous process appear?
Definition
Axis
Term
What is the significance of the lateral wall of the uncinate process in the cervical spine?
Definition

They prevent lateral herniation and help stabilize the disc.

(the uncinate processes are WB and take pressure off of the disc)

Term
Why are the transverse processes of the thoracic spine better "handles" for manipulation than the cervical spine?
Definition

Because in the C spine they are more anterior/lateral, while in the T spine they are more posterior.

 

Term
At what level does the 1st vertebral body appear?
Definition
C2 (AXIS)
Term
What are some conditions that can cause transverse ligament laxity?
Definition

-downs syndrome

-pregnancy

-RA (attacks the synovium of the joints causing high susceptibility to instability in the C spine. Therefore people with RA are directly contraindicated for manipulation)

Term
What percentage of motion occurs at the AA joint and why?
Definition
50% of motion because it is a convex on convex relationship
Term
The anterior odontoid joint should not translate more than how many mm before its an emergency?
Definition
3 mm within the atlantodental interval
Term
What ligament wraps around the dens and type of cartilage does it become the closer it gets to the bone?
Definition

-transverse ligament

-hyaline cartilage

Term
What is the attachment site of the transverse ligament?
Definition
Medial tubercles of the Atlas
Term
What is the difference between arthrokinematics and osteokinematics?
Definition

arthrokinematics- motion within the joint (roll/glide)

osteokinematics- the resultant movement of the limb (flexion/extension)

Term
What is the definition of component motion?
Definition

Motions that take place in a joint to facilitate a particular active motion. Motion that takes place between 2 joint surfaces and takes place from natural classical motion.

(under voluntary control i.e. roll/glide)

Term
What is the definition of joint play?
Definition

Occurs only in response to an outside force.

(not under voluntary control)

ex: distraction

Term
What percentage of the lumbar facet joints are in the saggital plane?
Definition
- 2/3 in saggital plane
Term
What percentage of the lumbar joint is in the frontal plane, and why is this significant?
Definition
- 1/3 The frontal plane hook provides stability and helps prevent spine slippage. If this frontal plane orientation begins to wear then slippage can occur leading to spondylolisthesis.
Term
Where does the ligamentum flavum start?
Definition
- C2/C3. If it began at C1/C2 it would limit rotation. This is a membrane not the ligamentum flavum.
Term
Where does the ligamentum nuchae run?
Definition
- Occiput to C7
Term
What does the tectorial membrane turn into?
Definition
- posterior longitudinal ligamnet at C2
Term
What is the attachment site for the disc?
Definition
- annulus fibrosis
Term
What attaches to the dens?
Definition
- the alar ligament and the apical ligament
Term
What composes the cruciform ligament?
Definition
- the transverse ligament of atlas and the superior and inferior longitudinal ligaments of atlas
Term
Where does the apical ligament attach?
Definition
- from the superior portion of the odontoid to the foramen magnum
Term
Where does the alar ligament attach?
Definition
- from the posterior lateral odontoid of C2 to the occiput
Term
Which direction do the fibers of the interspinous ligament run?
Definition
- superior posterior to allow for forward bending
Term
Why do more discs herniate in the lumbar spine versus the C spine?
Definition

1. The PLL is very wide in the cervical and becomes more narrow in the lumbar spine.

2. No uncinate processes are in the lumbar spine.

3. The lumbar spine has more weight and increased force production

4. Nucleus pulposus is more posteriorly located in the lumbar spine and more anterior in the cervial spine.

5. lateral walls of the Von Luschka prevent herniation

6. The disc begin to dry out in the lumnbar spine by age 55-60.

Term
What is the best position to put a patient in to hydrate the disc?
Definition

- supine with legs  at 90 90

(within 1 hour, 80% imbibition occurs)

Term
Where does the supraspinous ligament stop and what does this allow?
Definition
- L3-L4 to allow for forward bending
Term
How does the disc receive nutrients?
Definition
The disc is avascular, but the outer 2 layers of the annulus are vasucular and imbibe nutrients through the nutrient foramen in the endplate into the disc. It is the unweigthing of the disc that allows for diffusion.
Term
Explain the purpose of the glycoaminoglycans and the proteoglycans?
Definition
- GAGs and proteoglycans are are protein aggregates that are negatively charged attracting water. The negative charges repel each other expanding causing an enlargement of the disc. This is why when a herniation occurs the disc will continue to expand.
Term
How are the fibers of the annulus related to function?
Definition
- annular fibers are 30-45 degrees angled fibers. Only 50% of the fibers will support your spine whenever you lift and twist.
Term
Can disc material re-enter the disc? Why or why not?
Definition
No. It is like putting toothpaste back into the tube.  Exercises are effective for pain relief, but the theory that McKenzie has that nucleus pulposus can be relocated has no supporting evidence.
Term
What are the two reasons Dr. Paris began studies in manipulative and manual therapy?
Definition

- incident in gymnasium

- his father's story

Term
In what year did Americans begin/adopt manual therapy?
Definition
- 1980
Term
What are Maigne's two rules for manipulation and why are they important?
Definition

1. Manipulate in the direction of least restriction

2. cause no pain

These rules apply to gross techniques of manipulation for those that are less trained in manipulation

Term
What was Alan Stoddard known for? What were his view of causes of back pain?
Definition

He was an MD and DO and was a great maniplator who used spring testing techniques (to sense resistance to pressure)

He believed that back pain came from the SI joint, the disc and the facets (compare to Paris and Cyriax)

Term
What did osteopaths, chiropractors, Cyriax, Stoddard, and Kaltenborn view as the cause of back pain?
Definition
chiropractors thought that it was a vertebrae out of place, osteopaths saw it as the ‘law of the Artery’, Cyriax saw it as just the disc, Stoddard saw it as the SI joint, facet and disc, and Kaltenborn stayed out of it and wanted to normalized mechanics and function of a joint.
Term
What ideas is Kaltenborn known for?
Definition

-the convex-concave rule

-he gave classifications to graded movement with traction (i.e. PA glides are easier with a grade I distraction vesus a grade II)

Term
What is Maitland known for?
Definition

-used manipulation techniques to treat ‘reproducable s/sx’ rather than to reduce a disc and developed graded oscillations and concepts such as reactivity.


Term
What is Robert Elvey known for?
Definition
-He started neural tension techniques.
Term
Who wrote the book "The Spinal Lesion" and what is included in it?
Definition

-Stanley Paris

-It includes a classification system that is a hybrid of Kaltenborn's and Stoddard's that talked about movement. This system is called 'passive intervertebral motion' or 'PIVM' (see separate card)

Term
describe passive inter vertebral movement (PIVM) classified by Paris
Definition

0 fused-no therapy

1 considerable restriction-non thrust

2 slight restriction- non thrust to thrust (be careful!)

3 normal-

4 slight increase-

5 considerable increase- stabilization (posture training)

6 unstable-stabilization to surgery

 

Term
what idea is 'Codman's Paradox' based on?
Definition

  The body works on DIAGONALS , not on sagittal or frontal. 

-abd of the shoulder joint should be measured more in the scapular plane. -Straight abd is considered ER and straight flexion is IR and scaption is neutral.

Term
What is McKenzie known for?
Definition

-his techniques involve repetitive motion  -Repeptitive ext is good for pts and pain is often centralized.

-just like Codman noticed if u do back and forth motions to the shoulder, u can centralize pain, McKenzie saw this in the back too by using repetitive motion. (He assumed he was putting the disc back into place. By MRIs and CTs we now see that is impossible.)

 

Term
What is Mulligan known for?
Definition

 -He developed concepts of performing manipulation with active movements along facet planes. He manipulated with movement (pts do AROM at same time).

-Having the pt help u manipulate their joints is a therapeutic advantage.

(he wrote the chapter on traction in Paris’s “The Spinal Lesion” book.)

 

Term
What was Rocobado known for?
Definition
He worked with a dentist and became interested in the TMJ joint
Term
When did manual therapy (MT) come to America?
Definition

-it was around in the 1920s but faded out (was taken by chiropractors)

-there was a rebirth in the 1960s

Term
What is the brief timeline of the 1960's rebirth of MT in the US?
Definition

1961-no manipulation in US, only done by chiropractors

1963- Paris comes to Boston and the Dean at Allied Health at Boston U said PTs were not allowed to perform, teach, write, etc about manipulation

1967- North American Academy of Manipulation Medicine is founded and PTs aren’t welcome, only physicians (founded by Trevell, Maigne and Mennell).

1967-APTA turns down request for manipulation section.

1968-North American Academy of Manipulative Therapy is formed in Boston.

 

Term
What is Paris's definition of manipulation?
Definition

"the skilled passive movement to a joint"

 

later changed to "the skilled passive movement to a joint with a therapeutic intent"

Term
who founded the International Federation of Orthopaedic Manipulative Therapy (IFOMT)? What was different about this section in the APTA?
Definition

-Stanley Paris

-  To be in IFOMT u had to pass an exam within the orthopaedic section of the APTA unlike any other section

Term
What events lead to the beginning of The University of St. Augustine?
Definition

In 1979 the following activities in Atlanta, Ga enabled the formation of USA:


-Atlanta back clinic (first multidisciplinary clinic in the country and owned and run by a PT)

-southwestern clinics (West Paces ferry Headache and Facial Pain clinic, Back School of atl, Clayton General hospital)

-Doctoral Studies

-Institute of PT 

(The Institute of Graduate Health Sciences became the University)

Term
What are some unique features of The University of St. Augustine?
Definition

-FIRST proprietary school of PT and OT

-One of the first to offer the DPT and the t-DPT and t-OTD

-The only school to offer the dual degree

-The first to offer a full on-line DPT option (boca raton and san diego)

-Also offers DHSc and EdD- mostly online

-2nd campus in San Diego

 

Term
How does the guide to PT practice describe manipulation?
Definition

They use a modified version of Paris's definition.

 

type

location

Fired by

Type I

postural

Capsule

Oscillations, graded or progressive

Type II

Dynamic

Capsule

Oscillations, graded or progressive

Type III

Inhibitive

Capsule, ligaments

Stretch or sustained pressure, thrust

Type IV

Nociception

Most tissues

Injury & inflammation

Term

Who created a classification of "end feels"?

what does it refer to?

Definition

-Paris and Patla have identified 5 normal and 9 abnormal end feels

- it is about the sense of motion at the end of a passive range. Differentiating between them helps PTs to select the correct treatments.

Normal:

Muscle- as in SLR

Ligament-as in knee abd

Capsule- shoulder elevation

Cartilage- elbow ext

Soft tissue- knee flexion

 

Term
Describe the breakthrough for MT in 1996
Definition

In 1996- a large breakthrough in evidence of MT occurred when the Agency for Health Care Policy and Research (AHCPR) said that valid literature was a milestone in the acceptance of MT.

They said the tx of acute low back pain included MT amongst others such as posture training.

Term
What do studies show concerning orthopaedic surgery versus conservative treatment for back pain?
Definition

-paresis does not require immediate surgery (wait 2 months).

-Conservative management (medical+ sometimes PT) is equal to or better than surgery -PT and surgery both have a 70% success rate. -Aggressive rehab (medical, injection+ stabilization) gives 90% improvement @ 31 months –young age is a positive factor.

 

Term
describe the 2 schools of thought for the treatment of back pain
Definition

1.       Those that tx s/sx: Maitland, McKenzie, Cyriax (disc), Sarhmann

2.       Those that tx dysfunction: Kaltenborn, Paris, Mulligan, Osteopathy, Chiropractic

 

Term
explain spinal instabilty as described by Paris
Definition

Spinal instability: is where the osseo-ligamentous and or neuromuscular component of the spinal segment are unable to hold the segment either in spinal neutral or at other points in range, against creep and slippage and other aberrant motions (paris)

-it is not hyper mobility

- it is a patho-anatomical entity

-it is quite common

- single largest reason for back pain

- it is treatable

- stabilization will reduce/remove the pain

-thus, instability can become a stabilized and painless hypermobility

 

 

(Tight joints lead to instabilities

Hypermobility is NOT instability (until or unless fatigued)

In an unstable spine with a torn disc, forward bending extrudes the disc and backward bending extrudes it further back.)

 

Term
describe the innervation and vascularization of a disc as decribed by Paris
Definition

If the outer capsule tears (outer rings of annulus) u will see an effort at healing bc the otter portions are vascularized. These pts need to be treated with stabilization exercises to stop a further herniation through the tear.

A normal healthy disc has no innervations so has no way of conducting pain except from its periphery where it IS innervated. However, a degenerated disc is painful bc nerves accompany the ingrowth of vascularization and other materials (bloody disc)

 

Term
What is joint injury?
Definition
Joint injury includes such conditions referred to as osteoathrosis, instability and the after effects of sprains and strains, are IMPAIRMENTS (DYSFUNCTIONS) rather than diseases.
Term
What treatment of the joint is appropriate when a hypermobility is noted?
Definition
stabilization NOT manipulation
Term
What are the three things that literature shows supporting inmprovement n back pain?
Definition

education

exercise

manipulation

Term
How can a tight joint capsule lead to DJD in the gait cycle when referring to the hip?
Definition
Normally in initial contact the joint approximates tightly, in midstance the hip joint is unweighted and then procedes to the close packed position in terminal stance. However, a tight hip capsule will not allow for the unweighting during midstance leading to DJD. Tight hip flexors, joint capsule, rec fem, iliopsoas, weak glute med are all factors.
Term
As a PT do we treat pain or impairment and why?
Definition
Since impairment is the caus eof pian, the primary goal of physical therapy should be to correct the impairment rather than the pain.
Term
What are the three classifications of movement including joint manipulation and their components?
Definition

Classical movement- active, passive

Accessory Movement- component motion, joint play

Manipulation- distraction, non-thrust, thrust

Term
What is another term for classical movement and give examples?
Definition

osteokinematic

forward bending, side-bending, backward bending, rotation

Term
According to the Guide to Physical Therapy Practice what is the definition of manipualtion/mobilization?
Definition
"A manual therapy technique comprised a continuum of skilled passive movement to the joints and/or related soft tissues that are applied at varying speeds and amplitudes, including a small amplitude high velocity therapeutic movement."
Term
What are three components of pain and what do they represent?
Definition

1. Physical- actual tissue damage

2. Emotional- anxiety

3. Rational- patient's understanding

Term
According to Paris what is definition of pain?
Definition
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in such terms of damage.
Term
Kypholordosis can be casued from what tight muscle?
Definition
tight psoas
Term
Flat back posture can be caused from what tight muscle?
Definition
hamstrings
Term
With forward head posture what position is the atlas in?
Definition
posterior, becasue your cervical spine is in backward bending and the atlas folows the occiput.
Term
Make sure you can name 5 out of the 10 clinical philosophies.
Definition
pg. 2, 3 out of FCO
Term
When a patient presents with increased spinal tone in standing but in prone tone disappears what could this be indicative of?
Definition
muscle guarding around an instability or an unstable segment
Term
What could an osteophyte within the spine indicate or lead to?
Definition
Osteophytes indicate instablity and are the body's method of trying to acieve stability. They can lead to myelopothy due to Sharpey's fibers on the annulus being irritated.
Term
How do you know if a patient is presenting with a true spondylolisthesis or a small spinal process?
Definition

1. Have the patient lie prone with pillow under abdomen and observe for changes. If it changes it is an unstable spondylolistheses. If it does not change it is an anomaly or a stable spondylolisthesis.

2. Look at standing versus prone tone and shaking with AROM indicative of stable spondylolisthesis.

Term
Describe the spondylolisthesis grading system for slippage?
Definition
- It is a fraction out of 5. Grade 1+ is where the sx begin to develop. Grade II is symptomatic.
Term
If a patient shifts towards the side of pain what type of bulge is the indicative of?
Definition
medial disc bulge
Term
If a patient shifts away from the side of pain what type of disc bulge is this indicative of?
Definition
lateral disc bulge
Term
What are Paris's credentials?
Definition

PT, Ph.D., FAPTA

FNZSP, NZMTA (hon. life), IFOMT (founder+hon life) FAAOPMT, MCSP

 

Term
Who is said to be the first to speak of manual therapy and physical therapy techniques?
Definition
hippocrates
Term
Who coined the term “Orthopaedics”and what does it mean?
Definition

Abrose Pare

  in its original form means “straight child”

Term
Who wrote the first book on manipulation and in what year?
Definition

Wharton Hood

1870 (*key date)

Term
When did osteopathy first appear and by whom?
Definition
  Osteopathy came first on July 22, 1874 by an MD, Andrew Taylor Still
Term
What is the 'Law of the Artery' and what does it refer to?
Definition
it was created by Andrew Taylor Still, applies to Osteopathy, and talks about the importance of proper blood supply to tissues and prober blood nutrition
Term
Who founded chiropractic and when?
Definition

1896

DD Plamer and his son BJ Palmer

Term
What is the 'Law of the Nerve' and what does it refer to?
Definition

the body will be healthy at all times provided the vital nerve forces are intact. Vital force is interrupted with vertebrae subluxation(although this cause is not supported by evidence)

this law refers to chiropractic

Term
who wrote a book in 1934 that first addressed the role of facet joint planes and the need to manipulate them (although 'arthrokinematics' had not been coined yet)
Definition
Thomas Marlin
Term
Who first took x-rays of joints after manipulation to show the effects such as gas within the joint?
Definition
Mennell
Term
who was a believer in transverse friction to restart the inflammation process for healing.
Definition
Cyriax
Term
Dermatome L2 corresponds to which anatomical area?
Definition
lateral thigh
Term
Dermatome L3 corresponds to which coresponding anatomical area?
Definition
medial knee
Term
Dermatome L4 corresponds to which coresponding anatomical area?
Definition
medial calf
Term
Dermatome L5 corresponds to which coresponding anatomical area?
Definition
lateral calf
Term
Dermatome S1 corresponds to which coresponding anatomical area?
Definition
lateral foot
Term
Dermatome C4 corresponds to which coresponding anatomical area?
Definition
top of acromioclavicular joint/ upper trap
Term
Dermatome C5 corresponds to which coresponding anatomical area?
Definition
lateral side of upper arm (deltoid)
Term
Dermatome C6 corresponds to which coresponding anatomical area?
Definition
volar surface of 1st and 2nd digit of hand
Term
Dermatome C7 corresponds to which coresponding anatomical area?
Definition
volar surface of 3rd digit of hand
Term
Dermatome C8 corresponds to which coresponding anatomical area?
Definition
volar surface of 5th digit of hand
Term
Dermatome T1 corresponds to which  anatomical area?
Definition
medial surface of lower forearm
Term
Dermatome T2 corresponds to which coresponding anatomical area?
Definition
medial surface of arm
Term
Myotome C3 corresponds to which muscular action?
Definition
lateral cervical flexion
Term
Myotome C4 corresponds to which muscular action?
Definition
shoulder shrug
Term
Myotome C5 corresponds to which muscular action?
Definition
elbow flexion
Term
Myotome C6 corresponds to which muscular action?
Definition
wrist extension
Term
Myotome C7 corresponds to which muscular action?
Definition
elbow extension
Term
Myotome C8 corresponds to which muscular action?
Definition
thumb extension
Term
Myotome T1 corresponds to which muscular action?
Definition
hand intrinsics
Term
Myotome L2 corresponds to which muscular action?
Definition
hip flexion
Term
Myotome L3 corresponds to which muscular action?
Definition
knee extension (quads)
Term
Myotome L4 corresponds to which muscular action?
Definition
DF (ant. tib)
Term
Myotome L5 corresponds to which muscular action?
Definition
extensor hallucis longus (toe extension)
Term
Myotome S1 corresponds to which muscular action?
Definition

great toe flexion (FHL)

or

plantar flexion (gastroc/soleus)

Term
Myotome S2 corresponds to which muscular action?
Definition
knee flexion (hamstrings)
Term
Name 5 structures that can compress the spinal cord?
Definition

1. bosses and bars

2. ligamentum flavum

3. disc

4. posterior longitudinal ligament

 

Term
If a patient presents with unlevel greater trochanters and unlevel pelvis in standing then upon sitting presents with both level greater trochanters and pelvis what pathology could contribute to this?
Definition

leg length discrepency

pronated foot

Term
If a patient presents with unlevel pelvis and level greater trochanters in both standing and sitting what pathology could contribute to this?
Definition

-pelvic torsional rotation

-anomaly

-muscular imbalance

-scoliosis

-SI torsion/ rotation

Term
If a patient presents with level greater trochanters and unlevel pelvis in standing then upon sitting presents with both level greater trochanters and pelvis what pathology could contribute to this?
Definition

-avascular necrosis (Legg-Calve Perthes Disease)

-asymmetrical femoral neck angle

-slipped femoral epiphysis

-DJD of hip

Term
In the spine, what do flat areas indicate?
Definition

stiffness

-there will also be an area of compensation that must act as a hinge

Term
What is 'functional motion'?
Definition

motions that are normally performed throughout the day (i.e. FB, BB, trunk rot)

-in fxn'l SB of the neck, the head follows the neck to look in front of the shoulder

Term
what is 'non-functional' motion of the spine?
Definition

this applies to SIDE BENDING

it describes the motions are not normally performed (i.e. neck or trunk SB in the frontal plane)

Term
What is considered the 'mid-cervical' region?
Definition
C2/3----->C6/7
Term
Describe the 'rules of combined motion' concerning SB in the cervical spine
Definition

Fxn'l SB: causes rot to same side in midcervical and subcranial spines (due to facet planes)

non-fxn'l SB: causes rot to same side in the midcervical spine but rotation in the OPPOSITE direction in the subcranial spine

Term
what is considered the 'subcranial' spine?
Definition
C0/1----->C1/2
Term
lumbar and thoracic spine rotation and side bending occur to the ______ side.
Definition
OPPOSITE
Term
rotation and SB always occur to the _____ side in the cervical spine
Definition
SAME
Term
rotation produces SB to the ______ side in the subcranial spine
Definition

OPPOSITE

(rot R and SB L to keep head from cocking)

Term
concerning the subcranial spine, how does the atlas move in relation to the occiput?
Definition

the atlas follows the occiput

(moves posterior in BB, anterior in FB, L in L SB and R in R SB)

Term

What are some symptoms of subcranial instability due to a torn subcranial ligament?

what causes these symptoms?

Definition

trouble speaking and difficulty swallowing

this is due to compression of the hypoglossal nerve

Term
What occurs in midcervical FB?
Definition

-facets translate up and fwd (40% displacement)

-lateral interbody articulations translate anteriorly (more than lumbar spine due to von lushka jnts)

-intervertebral discs bulge anteriorly, flatten posteriorly

-spinal canal lengthens

-canal also narrows but volume remains the SAME

Term
describe the mechanics in mid-cervial BB
Definition

-facets translate down and back

-at end range the facet tilts and gaps superiorly

-lateral interbody joints translate POSTERIORLY

-the spinal canal NARROWS and shortens

-disc and lig flava bulge into the spinal canal

-each vdrtebrae steps back on the one below

Term
you have an elderly woman as a pt with an MD dx of MS due to decreased balance, gait, strength, etc. She presents with forward head posture with her cervical spine in constant extension. What do you think could be causing this and what else do you test to help confirm?
Definition

she may have buckling of the lig flava with calcification or bone spurs causing central stenosis and myelopathy.

you may test babinski and clonus to see CNS pathology

Term
how do the mechanics differ in a healthy disc vs. a nonhealthy disc in BB?
Definition

in a healthy disc the NP translates anteriorly

in a nonhealthy disc the NP follows the last of least resistance sending it further backward

Term
centralization of pain must NOT be associated with __________
Definition
centralizing the NP
Term
Since putting the nucleus back into the disc is not possible, how does BB then relieve pain?
Definition

1.gate control theory: firing of mechanoreceptors in post. annulus and facets will gate pain

2. elevates the H2O content of the disc by repetitive motion (makes it less acidic)

3. mobilizes the facet joints more than FB!

4. promotes circulation flushing away chem irritants

5. relieves the fear of movement

6. neural tension is reduced due to slackening of cauda equina

7. over time the disc protrusion looses proteoglycans and its ability to attract H2O and thus shrinks

 

Term
list characteristics of normal motion
Definition

happens smoothly regardless of speed

relaxation of antagonist

full range-according to body type

pain free

normal strength of muscles

PROM>AROM

Term
what are the characteristics of abnormal motion?
Definition

limited range

unwillingness to move

pain during or at end range

painful arc

compensatory or 'trick' movements

signs of instability (see other card)

Term
in the lumbar spine, if the LEFT facet were limited, what patterns may emerge?
Definition

FB=deviation to the left

BB=deviation to the right

SBR=limited

RL=limited

SBL=free

RR=free

Term
**what is the myofacial pattern of the lumbar and cervical spine?
Definition

lumbar=FB limited all other mvmts are relatively free

cervical=no consistent pattern; depends on muscles involved

Term
how do you know if restrictions in lumbar movements are myofacial or arthrokinematic?
Definition
if upsliding in SB is ok but the spine stays flat in FB its not the facets but erector spinae fascia that is tight
Term
what are the clinical signs of instability?
Definition

1. Hx or demonstration of tissue relaxation/creep

-inability to sit for long periods

-discomfort increases as the day progresses and relieved by mvmt or rest

2. increased muscle tone while standing

3. presence of a 'step' or rotation (spondylolysthesis, retrolisthesis, or spondylolysis)

4. disappearance of muscle tone, step or rotation in prone lying

5. shaking with FB

6. difficulty in coming upright from FB

7. grade 5 or 6 on passive motion palpation

8. radiological evidence of motion studies of FB and BB showing incr. angulation btwn vertebrae and more imprtantly=excessive translation

Term
what are u observing for in lumbar and thoracic movement?
Definition

smooth transition of motion

increase of the thoracic kyphosis

loss of reversal of lumbar lordosis

role of the hip

signs of instability

Term
What are the patterns of restriction of the facet capsular pattern in the cervical spine (T3/4 and up) if the L facet were limited
Definition

FB=possible deviation L

BB=deviate R

SBR=restricted

RR=most restricted

SBL=relatively free

RL=relatively free

Term
describe the mechanics of motion in the cervical spine
Definition

FB=US B

BB=DS B

SBR= DS R, US L

RR= DS R, US L

SBL= DS L, US R

RL=DS L, US R

(SBR and RR are 'coupled motions')

(less consistent than lumbar spine)

Term
functional and nonfunctional SB and ROT are _______in the cervical spine
Definition
the same
Term
what are the boundries of cervical spine?
Definition

T3/4 and above are cervical (no gapping)

T3/4 and below move as lumbar

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