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Semester 3 PM Exam 1 > Cervical Spinal Stability > Flashcards

Cervical Spinal Stability Flashcards

1
Q

Spinal stability involves

A

intricate interrelationship btw muscles and the joints upon which they act w/o strain or injury to involved tissues

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2
Q

Define clinical instability

A

A significant decrease in the capacity of the stabilizing system of the spine to maintain the intervertebral neutral zones w/in physio limits resulting in pain and disability

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3
Q

Panjabi model - Active

A

muscles

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4
Q

Panjabi model - passive

A

ligaments

bone

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5
Q

Panjabi model - neural

A

ligaments can be neural from proprioception component

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6
Q

Neutral zone =

A

a zone of high flexibility around the neutral position of the spinal segments
Segmental physiological motion occurs around this area

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7
Q

Neutral zone - trauma can

A

increase the size of it

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8
Q

Neutral zone - immobility can

A

decrease the size of it

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9
Q

Control of motion in the neutral zone is related to

A

spinal stability
Nothing is stopping you in the neutral zone - muscle just have to help you actively control the motion in the neutral zone

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10
Q

Neutral zone is located

A

midway btw flex and ext

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11
Q

Global muscles are defined as the muscles

A

that act on the trunk and spine without being directly attached to it

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12
Q

Global muscles - description

A

Large torque producing muscles
Remote from the spine - no direct segmental influence
Provide general trunk stability
Minimize effects of external loads

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13
Q

Global muscles include

A 
Upper Trap 
SCM
Serratus Ant
Lev Scap
Pectoralis
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14
Q

Local muscle system

A

Deep anatomically linked to individual vertebrae
Privide segmental stability
Control the neutral zone

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15
Q

Local muscle system - postural function

A

provide stiffness effect on spine for stability with limb movement
Dec in function –> intersegmental microtrauma

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16
Q

Local Muscles - list them

A

Middle and lower trap
Deep neck flexors - Rectus cap ant and lat
- Longus colli
- Longus capitis

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17
Q

Stability dysfunction

A

The failure of the movement system under low load testing

Trouble firing TA in neutral spine

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18
Q

Strength dysfunction

A

the failure of the movement system under high load testing

cant do supine to sit

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19
Q

Muscle Imbalance - tight or over activity

A

These muscles arent necessarily always tight - just need to relax them - so stretching wont always help - need to relax

20
Q

Imbalance - mm tight or over activity

A 
Subocipital extensors
Lev Scap
Pecs
SCM
Upper trap
Scalenes
21
Q

Imbalance - inhibition or weakness

A

Sometimes it is true muscle weakness but sometimes the muscle is inhibited

22
Q

Imbalance - mm inhibition or weakness

A

Deep cervical flexors
Serratus ant
Middle trap
Lower trap

23
Q

Limited deep neck flexor muscle control in subjects with

A

chronic neck pain, cervicogenic headache, WAD

24
Q

Impaired SA, MT, LT strength in people with

A

chronic neck pain

25
Q

Subjective info

A 
Trauma
WAD
Heavy head
Inconsistent symptoms
Clicking/clunking
Chronic neck pain
Cervicogenic headache
RA
Downs syndrome
Klippel Feil
26
Q

Objective exam

A 
Deep neck flexor muscle test
Cervical extensor coordination/endurance
Scapular muscle strength
Muscle length
Proprioceptive testing
27
Q

Cervical flexion and endurance test

A

Cover in lab?

28
Q

Impairments

A

Strength, endurance and coordination deficits of DNF muscles, SA, MT, LT
Impaired flexibility of global mm
Mid range pain with neck ROM that worsense at end range
Neck and neck related UE pain
Cervical instability may be present

29
Q

Deep neck flexors

A

Limited strength/delayed activation

  • WAD
  • Cervicogenic headaches
  • Chronic neck pain
30
Q

Deep neck flexors - limited strength/delayed activation - what are substitution strategies

A

SCM

Scalene

31
Q

Proprioception

A

Joint position sense
Balance
Eye movement control
Postural control impairements with vestibular dysfunction, head injury, WAD, impaired afferent output

32
Q

Assessment and management of proprioception in cervical disroders is analogous to

A

lower limb prop training following ankle or knee injury

33
Q

Intervention

A

Coordination, strengthening, endurance exercises
Proprioceptive training
Stretching
Patient education

34
Q

Principles of stability rehab - progression

A

Control of neutral
Retrain Dynamic Control
Rehab global stabilizers through range
Lengthen or inhibit overactive muscles

35
Q

DNF - Pain and DNF exercises in patients with neck pain

A

Pain pressure threshold increases immediately after DNF exercises

36
Q

DNF exercises can do what for those with neck pain

A

Dec pain, inc strength, inc ROM, improve function in thsoe with neck pain, WAD, headache

37
Q

Progression for ex

A

Isolate LMS
Train LMS
Train LMS functionally

38
Q

Progression - Isolate LMS

A

Co activation
Controlled breathing
Neutral/vary positon

39
Q

Progression - train LMS control

A

postural

co-activation with limb load

40
Q

Progression - train LMS functionally

A

Balance

Resistance, weighted balls, swiss ball

41
Q

Proprioceptive exercises -

A

Head repositioning
Occulomotor
Eye/head coordination

42
Q

Proprioceptive exercises - Head repositioning

A

Eyes open and then eyes closed

Vary position

43
Q

Proprioceptive exercises - Occulomotor exercises

A

Eye movement wth head stationary

Progress to movement of head with visual fixation

44
Q

Proprioceptive exercises - Eye/head coordination exercises

A

Rotate head/eyes same direction
Progress to find target with eyes first, then head
Progress to head and eyes moving in opp directions

45
Q

Proprioceptive exercises - function

A

Inc joint position sense
Dec neck pain
Improve functional outcomes

Semester 3 PM Exam 1 (2 decks)

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