Chapter 5 Flashcards
What is the most crucial question a chiro must resolve?
Which vertebra is the cause
What aspects make up a subluxation?
May have misalignment but must have nerve involvement causing physiological and pathological conditions
Can subluxation be determined by film analysis?
NO
What are the 2 main functions of the spinal column?
Protection and support
What gives the spinal column flexibility?
Its segmentation into 24 vertebral units
What is the most important ligament of the spine?
IVD
What type of movement occurs at the IVD/vertebra junction?
Amphiarthrodial movement
What type of articulation is present at this joint?
Symphysis articulations
What is the most important purpose of the disc?
Provide flexibility while limiting the amount of displacement
What holds the nucleus in the center of the disc?
Annulus fibrosus
Define optimal relationship in reference to the spine, what allows this to occur?
When all aspects of the vertebral body are in line with subjacent vertebra forming parallel discs.
The nucleus acting as a pivotal ball
To determine misalignment of the vertebra what position must the spine be in?
Standing erect position
What allows for 2 degree curvatures of the spine?
Difference in thickness at the anterior and posterior borders of the discs
What might alter optimal relationships of vertebrae?
Abnormal weight distribution, congenital malformations, subluxations and their effects
Describe the process of effects of trauma on the spine
Trauma causes shifting of the vertebra, shifting forces the nucleus against the annulus, the annuls is stretched beyond its limits resulting in deranged fibers, tissue damage leads to inflammation and edema causing disc protrusion, protrusion causes compression of neural structures within the canal or IVF, thus causing nerve pressure and dysfunction
What is a subluxation a disorder of?
Disc
Do posterior articular processes have anything to do with subluxaton?
No
What allows for inferiority of the vertebra?
As the vertebra slips backwards it pushes the nucleus forward and allows the posterior part of the body to drop inferior
Describe the stages of disc degeneration
D1= swollen disc, entire disc is thick and swollen (less movement than D5) D2= disc thin at posterior, space at posterior aspect of disc is diminished and beyond acute stage (cutaneous is oily) D3= disc very thin at posterior, extremely wedged and at chronic state D4= total disc thin, thickness is observably diminished to about 2/3 original height D5= total disc very thin, decreased to about 1/3 and severe damage to the vertebra above, will have movement at end fall D6= total disc extremely thin, entire disc space greatly diminished from 2/3 to totally reduced, difficult to fix
Why is the IVF more apt to experience effects of disc bulging? What is the protrusion made of (disc edema)?
Because the ALL and PLL somewhat restrain anterior and posterior protrusion
Protrusion made of edema resulting from displaced nucleus
What 3 reduce motion of the vertebra?
Nucleus displacement toward periphery, edema, adhesions
Where can hypermobility be found?
Above or below the fixation because the rest of the vertebra have to make up for the fixation
Indications of compensation post and pre x ray?
-
Why does a bone compensate or why does compensation occur?
To maintain equilibrium of the body
What happens when subluxation is corrected?
The compensation will change its misalignment to accommodate to the subluxation as it is in the correction process
Why are compensating vertebra moveable?
Because their nuclei are intact
Why is the mechanical system not reliable?
Because of different anatomical and physiological variables such as malformation must be taken into consideration
How does subluxation occur without a disc?
-
Purpose of lateral and A-P film?
The lateral film determines which vertebra is responsible and the A-P tells how to correct it
