Board review Flashcards
definition: SD
impaired or altered function of ANY part of the soma - skeletal, myofascial, and its related vascular, lymphatic, and neural elements
SDs are diagnosed via __________
palpation
SDs are always named for _______________
freedom of motion
TART
tenderness
asymmetry
restricted ROM
tissue texture changes
how many of TART are required for diagnosis of a SD?
1 out of 4*
*if one is tenderness, then need a total of 3
definition: elastic deformation
tissue can return to its resting state after being deformed - it resists staying transformed (aka elasticity)
definition: hysteresis
- to lag or come behind
- the time between elasticity and creep
definition: creep
- the capacity of fascia and other tissues to lengthen when subjected to a constant tension load resulting in LESS RESISTANCE to a second load application
- with slow, longer lasting stress, the tissue will eventually lose its elastic qualities and not bounce back
definition: vertebral unit
two adjacent vertebrae with their associated IV disc, arthroidal, ligamentous, muscular, vascular, lymphatic, and neural elements
features of a type I SD
- neutral
- long restrictors
- several segments
- sidebending / rotation to OPPOSITE sides
- rotation into the convexity of the curve
- postural
features of a type II SD
- sufficiently flexed / extended
- short restrictors
- 1 segment
- sidebending / rotation to SAME side
- rotation into the CONCAVITY of the curve
- traumatic
facet orientation? what are these in reference to?
- cervicals: BUM
- thoracics: BUL
- lumbar: BUM
- in reference to how the superior articular facets are positioned
gravitational plumb line
- posterior to apex of coronal suture
- external auditory meatus
- bodies of most cervical vertebrae
- shoulder joint
- bodies of lumbar vertebrae
- posterior to axis of hip joint
- anterior to axis of knee joint
- anterior to lateral malleolus
what are the phases of the walking cycle?
- stance phase: when foot is planted on ground (60%)
- swing phase: when foot moves forward (40%)
definition: CCP
- a series of functional, near-physiologic, alternating body torsions which are maintained by muscle and fascia
- these torsions involve body areas where the potential for motion is greatest
- the potential for motion is greatest at the FOUR transitional areas of the body
- CCP is a fascial strain pattern
12 findings of CCP
- C2 is rotated and side-bent to the left.
- The head side-bends to the right.
- T1 rotates and side-bends to the right (flexed or extended).
- The right infraclavicular area is concave and easily compressible.
- T2-6 are neutral, side-bent left and rotated right.
- The lower thoracic area shifts to the left better than to the right.
- The pelvis rolls to the right better than to the left.
- The left iliac crest is superior (more cephalad).
- The pelvis torsions to the left (posterior left/anterior right innominate rotation).
- The sacrum torsions to the left (left-on-left forward sacral torsion).
- The left arm is short.
- The left leg is long and the right leg is externally rotated.
what is the VFIRST acronym for? what are the components?
- red flags for serious health problems / issues
- Vascular
- Fracture
- Infection
- Radicular
- Spinal cord / brain
- Tumor
what is the dalrymple treatment?
lymphatic pump via the feet
definitions:
effleurage
petrisage
tapotement
klapping
- effleurage: stroking movement to move fluids
- petrisage: deep kneading or squeezing to express swelling
- tapotement: striking the belly of a muscle to increase its tone / arterial perfusion
- klapping: striking the skin with cupped hand to loosen material
what are the three types of ME? what are the goals of each?
- isometric: will correct a SD
- isotonic: will strenghten a physiologic weak muscle
- isolytic: will break up adhesions (scarring)
what is concentric contraction ME?
contraction were the origin and insertion of a muscle approximate (isotonic)
what is eccentric contraction ME?
contraction where the origin and insertion of a muscle separate or lengthen (isolytic)
what is the physiologic basis of oculophalogyric reflex (OCGR)?
- functional muscle groups are contracted in response to voluntary eye movements on the part of the patient
- these eye movements reflexively affect the CERVICAL and TRUNCAL musculature as the body attempts to follow the lead provided by eye motion
- it can be used to produce very gentle post-isometric relaxation or reciprocal inhibition
what do chapman points represent?
somatic manifestation of a visceral dysfunction
what is responsible for the early tissue changes palpable over the midline collateral sympathetic ganglia?
visceral afferent activity
where is the celiac ganglion located?
right below xiphoid
where is the superior mesenteric ganglion located?
halfway between xiphoid and umbilicus
where is the inferior mesentertic ganglion located?
at umbilicus
what are the collateral ganglia?
- celiac ganglia: T5-9
- superior mesenteric: T10-11
- inferior mesenteric: T12-L2
what is a trigger point?
hypersensitive focus, usually within a taut band of skeletal muscle or in the muscle fascia
what does a trigger point represent?
represents a somatic manifestation of a viscero-somatic, somato-visceral, or somato-somatic reflex
what is the key articulation for cranial?
sphenobasilar synchondrosis (SBS)
what does the sacrum do when the SBS flexes?
moves posterior / superior
what does the sacrum do when the SBS extends?
moves anterior / inferior
what do the cranial midline and paired bones do on inhalation?
- midline: flex
- paired: externally rotate
what do the cranial midline and paired bones do on exhalation?
- midline: extend
- paired: internally rotate
what does cranial flexion do to the transverse diameter of the skull?
increase
what does cranial extension do to the AP diameter of the skull?
increase
what are the 5 components of the primary respiratory mechanism (PRM)?
- inherent motility of the CNS
- fluctuation of the CSF
- mobility of the reciprocal tension membrane (dura)
- articular mobility of the cranial bones
- mobility of the sacrum between the ilia
what cranial bone(s) do you treat for anosmia?
ethmoid
what cranial bone(s) do you treat for tinnitus?
temporals
what cranial bone(s) do you treat for headache?
LOW wing of sphenoid on side of headache
what do you do for a baby with suckling / swallowing difficulties?
treat cranially by decompression of occipital condyles (decompress the condylar parts) - VSD occipital sinus
is there a disc between the occiput and C1? what about C1 and C2?
no (neither)
where do osteophytes typically form in the cervical vertebrae?
uncovertebral joints
coupled motion of rotation and sidebending to the same side occurs at what joint?
zygapophyseal joint
diagnosis of cervical spine is made by evaluating what structures?
posterior articular pillars
spurlings test tests for ___________
nerve root impingement in neural foramina
wallenburg test tests for _____________
vertebral artery insufficiency
which motion is the greatest at the thoracic spine? which is the least?
- rotation
- extension
what is the rules of 3 for spinous processes of the thoracic spine?
- T1-3: horizontal, at level of transverse process
- T4-6: halfway between transverse processes
- T7-9: at level of transverse process one level below
- T10: like T7-9
- T11: like T4-6
- T12: like T1-3
scoliosis is named for the __________ of the curve
convexity
the scapula is more prominent on the (convex / concave) side for scoliosis
convex
scoliosis curvature is measured via x ray using the ________ method
cobb
which lumbar vertebra has the most congenital deformities? what is the most common?
- L5
- facet tropism
what is the batwing deformity?
sacralization of L5
what is ferguson’s angle? when is it increased?
- lumbosacral angle
- increased in any lumbar lordosis
definition: spondylosis
general term for arthritis (degeneration) of spine
definition: spondylitis
inflammation of a vertebra
definition: spondylolysis
- seapration of the pars interarticularis
- oblique views will identify the fracture and is often seen as a ‘collar’ on the neck of the ‘scotty dog’
definition: spondylolisthesis
- forward displacement of one vertebra over another
- most commonly L5 on S1
- graded by % in dividing the sacrum into quarters
what tests evaluate for lumbar nerves?
- heel toe walk (screens L5 nerve root)
- walk on toes (screens S1 nerve root)
what is psoas syndrome?
- unilateral: sidebending to contracted side
- pelvic side shift opposite the contracture
- usually L1 or L2 is in SD
- bilateral: flexed forward when standing, will INCREASE lumbar lordosis when patient is lying supine
what test is used to evaluate for psoas syndrome?
thomas test
what is thomas test used to evaluate?
psoas syndrome
FABER test is used to evaluate for what?
hip vs SI joint dysfunction
