Crossed Syndromes & Biopsychosocial Model

Question 1

In upper crossed syndrome, cervical flexors are…

Answer 1

under-activated (weak)

Question 2

In upper crossed syndrome, sub-occipitals, upper trapezius, and levator scapulae are…

Answer 2

over-activated (tight)

Question 3

In upper crossed syndrome, pectoralis is…

Answer 3

over-activated (tight)

Question 4

In upper crossed syndrome, rhomboids, mid and lower trapezius, and serratus anterior are…

Answer 4

under-activated (weak)

Question 5

If anterior stabilizer and head/neck extensors are hypertonic, while posterior stabilizer and deep neck flexors are hypotonic, what is suspected?

Answer 5

Upper crossed syndrome

Question 6

What are postural distortions of upper crossed syndrome?

Answer 6

• Forward head carriage, often with C0/C1 hyperextension
• Forward drawn or rounded shoulders
• Increased interscapular distance (bilateral abduction), often with scapular winging

Question 7

What other body system might be affected by upper crossed syndrome?

Answer 7

Respiratory

Question 8

In lower crossed syndrome, abdominals are…

Answer 8

under activated (weak)

Question 9

In lower cross syndrome, thoraco-lumbar extensors are…

Answer 9

over-activated (tight)

Question 10

In lower cross syndrome, hip flexors (iliopsoas and rectus femoris) are…

Answer 10

over-activated (tight)

Question 11

In lower cross syndrome, gluteals are…

Answer 11

under-activated (weak)

Question 12

If there is imbalanced resting muscle tone between trunk flexors and extensors, and hip joint flexors and extensors, what is suspected?

Answer 12

Lower crossed syndrome

Question 13

Imbalance related to lower crossed syndrome can impact…

Answer 13

standing posture, gait, bending are/or twisting activities

Question 14

Which syndrome’s imbalance causes altered load distribution to the lumbar facets?

Answer 14

Lower crossed syndrome (especially to L4/5, L5/S1 facets)

Question 15

Substitution of overactive trunk extensors for underactive hip extensors stresses… potentially causing…

Answer 15

stresses the lumbo-sacral joint potentially causing instability and pain

Question 16

What is the presentation of lower crossed syndrome?

Answer 16

• Anterior pelvic tilt (can be asymmetrical)
• Hyperlordotic lumbar spine
• Hyperextended knee joints
• Valgus stress at ankles (pronated feet, loss of plantar arch)

Question 17

What is a kinetic chain?

Answer 17

A combination of several successively arranged joints constituting a complex motor unit (referring to the extemities)

Question 18

What are the two types of kinetic chain?

Answer 18

Open: the terminal segment is freely moveable
Closed: the terminal segment is fixed or meets considerable resistance

Question 19

In the biopsychosocial model venn diagram, biological, psychological, and social factors overlap to contribute to…

Answer 19

pain

Question 20

What are four somatic factors to the biological aspect of the BPS model?

Answer 20

1. Disc derangement (contained/uncontained lesion)
2. Joint dysfunction
3. Radiculopathy
4. Myofascial pain (trigger points)

Question 21

What are three neurophysiological factors of the biological aspect of the BPS model?

Answer 21

1. Instability, dynamic and passive
2. Nociceptive system sensitization
3. Systemic inflammation

Question 22

Fear, catastrophizing, and passive coping are all factors of what aspect of the BPS model?

Answer 22

Psychological

Question 23

Poor self-efficacy, depression, and hypervigilance are all factors of what aspect of the BPS model?

Answer 23

Psychological

Question 24

What are the factors of the social aspect of the BPS model?

Answer 24

The context in which all else occurs:
* Work
* Needless disability
* Home life
* Social support
* Litigation