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SPINE/MARCIE > CSPINE, TSPINE, TMJ > Flashcards

CSPINE, TSPINE, TMJ Flashcards

1
Q

typically, where is referred non radicular px in relation to Cspine

A

surrounding the medial border of scap (C3/4 starts at sup angle, then count all the way around and C7/T1 are at inf angle)

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2
Q

cap like HA is referred/non rad px from C

A

5 or 6 disc

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3
Q

in C spine, protrusion appears with what sx

A

arm pain in partial dermatome pattern

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4
Q

in C spine, prolapse appears with what sx

A

arm pain is worse than the back pain, follows dermatome pattern

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5
Q

in C spine, extrusion presents with what sx

A

arm pain worse than back pain, poly dermatome pattern

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6
Q

with severe HA, you have to R/O

A

ischemic (blood supply) issues

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7
Q

if you have a case that none of your tests are conclusive and they have neuro sx, you may need to refer out for

A

tumor

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8
Q

nerve root pain usually exists at what segment

A

if it’s C3-C4 it will exist at C4

meaning the lower segment

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9
Q

C2/C3 radicular px is where

A

side of head or neck (ant/lat)

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10
Q

C3/C4 radicular px is where

A

above the upper trap (C4 is supraclavicular)

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11
Q

C4-C5 radicular px is where

A

lateral arm

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12
Q

C5-C6 radicular px is where

A

thumb

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13
Q

C6-C7 radicular px is where

A

middle finger

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14
Q

C7-T1 radicular px is where

A

hypothenar and 5th finger

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15
Q

where is facet px for C3-C4

A

side of neck

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16
Q

where is facet px for C4-C5

A

side of lower neck

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17
Q

where is facet px for C5-C6

A

entire upper shoulder area

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18
Q

where is facet px for C6-C7

A

entire scapula

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19
Q

where is facet px for C2-C3

A

around ear (behind ear)

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20
Q

bilateral neck pain sx (but one side worse) spreading to medial scapula (staying around c spine)

A

DDD of Cspine

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21
Q

bilateral neck pain Sx (but one side worse) spreading to medial scapula, also having lateral neck px or shoulder px or post back px (around scapula)

A

DDD of C spine with possible DDD of facet

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22
Q

differentiate btwn clowards sign and disc with nerve root involvment (body chart)

A

clowards is just referred px (non neural or non radiating), nerve root involvement also has stiffness and px in the neck as well as neural sx in the arm

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23
Q

Deep unilateral neck pain with stiffness, then sharp or deep px somewhere around medial scapula

A

discogenic (IDD/EDD) (there is an issue within the disc but it’s contained and not radicular px)

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24
Q

clowards sign (disc referral) is or is not radicular

A

is not - referred from disc only

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25
Q

neck pain, arm pain, bilateral, multiple dermatome patterns, extension hurts so they come in flexed, sensory and motor loss, neuro tests pos probable diminished reflexes (all describe)

A

cervical stenosis

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26
Q

simultaneous NT is bad, think

A

cord issues

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27
Q

body chart with ear dot

A

00-01 facet

02-03 disc

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28
Q

temporal band body chart would be __ or __

A

01-02 or 02-03 facet

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29
Q

whole head px is what body chart

A

T4

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30
Q

what 6 areas can 02-03 facet body chart px be

A 
eye socket
jaw
temporal band
occipital area (coming up and around to eye)
ant neck
behind ear (post, medial cranium)
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31
Q

If it’s just a scapular dot, what test must you do

A

modified spurling towards pxful side
(retraction/extension/ipsi SB/ipsi rotation)

this puts load on the post/lat disc

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32
Q

which levels of facet do you do testing with pro/retraction

A

00-01
01-02

other ones you do rot, then ipsi sb

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33
Q

what are some differences btwn Cspine and Lspine (IVJ)

A

the intervertebral joint takes less load in the Cspine and the vertebral body is smaller. also, the load is 50/50 btwn the facet and the IVJ.

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34
Q

facets in the Cspine are arranged how

A

frontal plane, 45 degrees (facilitates rotation)

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35
Q

difference in discs of cspine and Lspine

A

the cspine discs degenerate quicker
the cspine discs nucleus and annulous blend
there is no disc at co/c1 and c1/c2

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36
Q

UVJ only occurs after

A

WB has occured, we aren’t born with it (it gets stronger and stiffer as we walk)

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37
Q

Vert A goes in the

A

transverse foramen

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38
Q

where spinal N exits in Cspine

A

foramenal gutter (aka IV foramen)

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39
Q

in the facet joint of Cspine, the capsule is strongest where

A

stronger ant, weaker post

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40
Q

where is there more degeneration upper or lower cspine

A

lower

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41
Q

C spine nerve roots exist where

A

above the vertebrae (they are named by their level)

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42
Q

compression on nerve root can be either ant or post, if it is ant it is dt ___ if it is post it is dt

A

ant - HNP

post- articular surface or ligg

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43
Q

in c spine, with flexion there is increased load on the

A

disc (for C spine not upper)

decreased load on facet

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44
Q

in c spine, with extension there is increased load on the

A

facet

decreased load on disc

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45
Q

retraction of the neck is flexed ___ spine and ext ___ spine

A

flexing the upper and ext the lower

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46
Q

with rotation, the facet of the side you are rotating towards is __ and the opp side is __

A

closing, opening

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47
Q

in c spine, SB and rotation are ____, which is opp of lumbar

A

coupled (ipsi)

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48
Q

in combined mvmt of cspine, SB and Rot are

A

contra (remember combined means not natural)

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49
Q

how to test the ventral capsule (00-02)

A 
they are seated
protract with post cranial tilt 
you L grip and scoop hand 
rotate towards your body and take a big breath (SB away)
Your L grip is at C1/C2
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50
Q

how to test dorsal capsule

A

seated
retract with ant cranial tilt
rotate away
SB towards

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51
Q

for facet issues, if you are doing traction and they have px, what can you do

A

rotate them away to open the facet

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52
Q

when you are doing cervical traction of the c spine (not upper) explain your placement of hands and body

A

use first finger of cradle hand to stabalize the segment (left)
other hand is on top of that hand (right)
you lean in towards the stabalizing hand side so that your armpit area is on their forehead (stabalizing hand is the armpit side)
you do a slight distraction with your other hand

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53
Q

when a pt sidebends to one side, that side ___ glides or ___

A

that side down glides or closes (other side opens)

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54
Q

local pain could be (cspine)

A

facet, non neuro disc, UVJ, ligg, muscle

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55
Q

cap HA px is usually

A

referred, non radicular C5-C6

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56
Q

main sx of DDD, DJD

A

limited ROM (rot and sb) PAs are stiff, flexion may be limited too

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57
Q

with discogenic c spine issues, what motion is most pxful

A

flexion

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58
Q

why (general) would you do PIVMS

A

unilateral sx

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59
Q

with a rotational PIVM, how to choose which way to rot

A

rotate away from pxful side (for tx)

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60
Q

main difference btwn seated distraction and supine traction is

A

seated distraction is for 00 -01/02 only

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61
Q

if you are doing unilateral PAs and you have them rotate to the side you are working on, and rotation in general is stiff for them. what may this indicate

A

01-02 issue

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62
Q

vascular, fat filled intra articular tissue that acts as a space filler in the facet jt

A

meniscoid

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63
Q

functions of UVJ

A

protect disc from lateral prolapse
aid in flexion and ext
reduce SB

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64
Q

what joint wears out the quickest

A

UVJ (you will hear crepitus)

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65
Q

what ligg helps control motion (most) in c spine, if weak then central prolapse can occur

A

PLL

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66
Q

largest nerve root

A

C7

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67
Q

axis of rotation in upper C spine is

A

away from disc (more translation)

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68
Q

axis of rotation of lower C spine is

A

tight to the disc

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69
Q

with DDD (spondylosis) there is increased load on

A

facet and UVJ bc they pick up the slack

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70
Q

B sx of deep ache in neck. One side greater issue. May have some medial scapula aching. dx?

A

DDD

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71
Q

with disc/nerve root involvement, if there is immediate sharp shooting px in the arm, think ___

A

DRG

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72
Q

with disc/nerve root involvment, if there is sx that start in the neck and progress to the arm, think ___

A

actual nerve root itself

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73
Q

with nerve root irritation or neuro claudication, if the sx are worse distally it’s a ___ issue

A

chronic, if sx are worse proximally it’s acute

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74
Q

neck and arm px that is bilateral, with many segments of derma/myotome issues you have to rule out

A

stenosis

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75
Q

UVJ is ___ px

A

local unilateral

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76
Q

facet joint issue is ___ px

A

local unilateral

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77
Q

lateral neck, local (unilateral) px…think ____

A

C3-C5 facet

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78
Q

with nerve root involvement of c spine, what motions are very pxful and limited

A

ext and SB rotation towards

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79
Q

central stenosis px, what motion is worse

A

ext

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80
Q

facet, there is more px with ____ vs ____

A

more px with standing vs sitting

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81
Q

px with turning head to look over shoulder, think

A

facet

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82
Q

with nerve root irritation, what motion feels good (cspine)

A

flexion of spine

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83
Q

list myotomes and actions of c spine

A

C1— cervical flexion
C2— cervical extension AND resisted cervical spine rotation
C3—cervical lateral flexion - SB
C4—shoulder shrug
C5—Deltoids
C6—Biceps; resist elbow flexion with wrist supinated
C6—ECRL; Thumb up,elbow flexed, resist wrist extension/ radial deviation
C7—Triceps; resist elbow extension with wrist in neutral
C7—Wrist flexion
C8—EPL; thumb extension
C8—Flexor digitorum profundus; DIP flexion

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84
Q

reflexes for C spine

A

Biceps (C5-6)
Brachioradialis (C6)
Triceps (C7)

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85
Q

dermatomes for c spine

A 
C2—side of head 
C3—anterior and lateral neck 
C4—supraclavicular area—over trap 
C5—lateral arm 
C6—pad of thumb 
C7—middle finger 
C8—hyperthenar eminence and fifth finger 
T1—medial forearm
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86
Q

what AROM will be limited with EDD/IDD

A

flexion

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87
Q

congenital shortening of the SCM usually under 12 yrs of age

A

torticollis

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88
Q

axns of SCM

A

flexion and contra rotation

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89
Q

axns of scalenes

A

flexion, contra rotation, ipsi SB

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90
Q

how to rule out muscle tightness vs true neural tension in the upper ext neuro test

A

have them flex neck towards test side, if that decreases sx then it is prob not neural

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91
Q

scalene length test (explain)

A

they are supine, rest their head in your hand, other hand goes parallel (runs 1st finger right on the side of the neck until you hit the shoulder) go just slightly lateral to your landing spot and that should be the 1st rib. SB away and feel when the first rib raises, shouldn’t happen right away.

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92
Q

how to length test upper trap

A

supine, cradle head, push down on shoulder of test side, SB head away and rotate towards

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93
Q

how to length test levator scap

A

supine, cradle head, push down on shoulder of test side, SB head away, and rotate away

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94
Q

the “yes” joint

A

OA

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95
Q

primary stabalizers of UCS

A

ligg

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96
Q

sx of vertebral A issues

A

dizziness, tinnitus, nystagmus, NV

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97
Q

ON

A

occipital neuralgia (enrapment of nerve)

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98
Q

HA like no other, rule out

A

CAD (cervical artery dysfunction)

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99
Q

what motions may create sx from CA dysfunction

A

rotation and extension (contra side rotation)

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100
Q

how to rule in CAD

A

do cranial nerve exam and go by their sx, don’t do the old position testing

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101
Q

one of the most common causes of ICA trauma

A

the sink at the hairdressers

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102
Q

Main types of HA

then 3 main subtypes of one of them

A

Vascular: migraine, cluster, tension

Cervicogenic - typically isn’t just a HA (has specific referred px locations - T4, C5/6)

103
Q

vagal nerve ischemia sx

A

NV

104
Q

only type of HA that has B sx

A

tension

105
Q

posture of most UCS pathos

A

foreward head

106
Q

what motions will you assess with UCS issues of 00-02

A

protraction and retraction

107
Q

What motion will you assess if you suspect UCS disc patho

A

flexion

108
Q

what palpation will you do for any facet issue

A

unilateral PA

109
Q

what motion is often the most damaging with WAD

A

whiplash associated disorder = extension

110
Q

how to do a gross assessment of the dorsal capsules of UCS

A

retract and flexion

111
Q

how to do a gross assessment of the ventral capsules of the UCS

A

protract and extend

112
Q

protraction/retraction with SB vs protraction with rotation (provocation tests)

A

If you just do protraction with SB you are trying to rule in 00-01 facet (you SB to right and left)

if you just do protraction with rotation you are trying to rule in 01-02 facet (you rotate right and left)

113
Q

How to test 02-03 facet

A

Rotate with SB (rotate towards side of px)

ipsi SB vs contra SB (capsule vs articular surfaces)

114
Q

SB then rotation tests what

A

UVJ
ipsi rotation is capsule
contra rotation is art surfaces

115
Q

Rotation then SB tests what

A

facet

116
Q

Biceps reflex is what segment

A

C5-C6

117
Q

Brachioradialis reflex is what segment

A

C6

118
Q

Triceps reflex is what segment

A

C7

119
Q

what motion will be pxful with nerve root involvment

A

extenstion

120
Q

if you suspect IDD/EDD of cspine what test could you do

A

they AROM protract, Extension, SB ipsi and rotate ipsi

121
Q

for the UCS provocation tests, explain how to test ventral vs dorsal and 00-01 vs 01-02

Remember, this is different than Sue’s rotation mobilization tx

A

ventral: protract
dorsal: retract
OO-01: SB
01-02: rotation

122
Q

when you would you do the UCS provocation tests

A

when you suspect facet issues anywhere btwn 00-02

123
Q

Explain Sue’s UCS rotation (mobilization of 00-02) tx for ventral capsule

A

this is a tx
This one is for 00-02 only
seated, lumbrical grip, scoop hand under their occiput, your scoop hand arm is in front of pts face, have them post cranial tilt and protract, rotate towards you, and SB away

124
Q

Explain Sue’s UCS rotation mobilization of 00-02 tx for dorsal capsule

A

for 00-02 only
seated, lumbrical grip, scoop hand under their occiput, have them ant cranial tilt and retract, rotate away and SB towards (this is a tx)

125
Q

So UCS seated rotation for ventral details

A

P
P
RT
SBA

126
Q

CS not UCS seated SB PIVM (explain)

A

palpate pretty low under the ear for the transverse process. Grip around post part of neck and feel with 1st and 2nd finger as you use other hand (on top of their head) to SB towards side you are palpating. You are feeling for restrictions.

127
Q

if protraction is an issue, what should be a go to tx

A

tiny yes’s (for 00-01)

128
Q

how to stretch the SCM

A

drop head of table down

extend the neck and rot away

129
Q

the seated distractions (breathing one) is only for what segments

A

00-02

130
Q

How would you do a PIVM for SB while supine (for CS not UCS)

A

Marcies way: have them supine, use your index finger to locate the segment. then with other hand (test side) locate the joint line, SB away from joint line hand to feel if it opens, compare sides. (do the same for rotation= those are rotational PIVMS)

131
Q

test you put your fist above their shoulder

A

upper ext tension test

132
Q

explain components of the upper ext tension test

A

90 degrees abd and ER, fully ER them, fully supinate them, extend wrist and fingers, extend elbow and sb away

133
Q

how to test T lig

A

seated
flex neck slightly to find C2
lumbrical grip at C2 (stabalize)
as you push forehead posteriorly

134
Q

how to test alar lig

A

seated
find C2
palpate lateral to C2
as you SB R you plapate to the left of the SP
as you SB L you palpate on the R of the SP

135
Q

explain how to downglide for tx

A

they are supine,
you palpate for the segment and hook your 1st finger
you SB towards and rotate towards that side
slight ext
and your line of force goes to their opp hip

136
Q

explain the 2 ways to do PIVM rotations for C spine (not UCS)

A

Seated - Sue’s way rotate away (pillow)

Supine- Marcie’s scoop way

137
Q

there is no disc at what levels of c spine

A

00-02

138
Q

protraction and retraction are done to test what

A

FACETS of 00-02

139
Q

the whole ventral/dorsal capsule thing only applies to

A

00-02

140
Q

Pain located anterior to the tragus and referring to the ear, the mandible, the eye, or temple is strongly correlated to

A

TMJ pain.

141
Q

what is bruxing

A

grinding or clenching of teeth

142
Q

her stance on treating C spine with TMJ

A

If CS signs and symptoms are not addressed, attempts to treat the TM joint will not be successful

143
Q 
Clicking during opening and closing 
protrusion limited
deviation toward the involved side 
lateral deviation limited toward the uninvolved side. 
palpable crepitus

these all describe what TMJD

A

articular disc displacement

144
Q

list the palpation synovials for TMJD

A 
#1        anterior inferior synovial pain
#2        anterior superior synovial pain
#3        lateral collateral ligament pain
#4        temporomandibular ligament pain
#5        posterior inferior synovial pain
#6        posterior superior synovial pain

ISLTIS

145
Q

list synovials that correspond with stages of articular disc displacement

A

stage 1: synovials 1 and 2

Stage 2: pain with #1, #2, #3 synovials

Stage 3: pain with #3, 5, 6 synovials

Stage 4: pain with #3, #5, #6

146
Q

most common area of px for tmjd

A

pariauricle (around the ear)

147
Q

explain stages of ant displacement tmjd (sx)

A

Stage1: no joint sounds
Stage 2: early opening/ late closing
Stage 3: late opening/ early closing
Stage 4: no joint sounds

148
Q

list the provocation tests for TMJD

A 
#4 Inferoposterior glide – temporomandibular ligament 
#7 Bilaminar zone -Superior movement of condyle on posterior ligament 
#8 Retrodiscal area --from #7, add protrusion (with patient assist)
            - Encroachment of condyle on posterior disc
149
Q

explain provocation tests for TMJD

A

4 -inf/post glide of lower jaw
7- pushing on the mandible (at the curve) and compressing the disc
8 - same as 7 but they protrude jaw

150
Q

Soreness in the jaw in the AM if clenching or bruxing; may be better in AM but worse after eating breakfast

what do you need to rule in/out

A

TMJD

151
Q

pain with palpation and pain with forced biting, what TMJD

A

systemic inflammation

152
Q

Large indentation palpable posterior to condyle when mouth opened, think what patho for TMJD

A

instability/hypermobility

153
Q

what provocation test do you do for hypermobility of TMJD

A

4

154
Q

Behavior of Sx – joint noise – crepitus at the same points in ROM (TMJD)

A

degenerative issue

155
Q

inf facet in C spine are oriented how

A

ant and downward

156
Q

the sup facet of the c spine are oriented how

A

post and upward

157
Q

meniscoids are typically only found in

A

children

158
Q

area of Tspine (segments) with a ton of articulations

A

T2-T9

159
Q

compared to cervical and lumbar, the stability of the Tspine is ___

A

increased - dt the increased articulations and ribs

160
Q

what is lost due to the increased stability of the TSpine

A

ROM

161
Q

functional regions of thoracic spine

A 
CT junction (C7-T3)
mid thoracic spine (T4-T9)
thoracolumbar junction (T10-L1)
162
Q

explain vertebral placement/position in kyphosis of tspine

A

the vertebral bodies and discs are higher post than anteriorly in the Tspine, which increases load ventrally = thoracic kyphosis
(meaning: there is an angle of the orientation of the alignment, higher in the back)

163
Q

typical vs atypical vertebrae Tspine

A

typical- segments T2-T9

atypical- segments T1, T10 - T12

164
Q

each typical Tspine vertebrae articulates with what (that the atypicals dont)

A

ribs

the typicals have 2 pairs of demi facets

165
Q

explain articulation of ribs with T spine level, for typical vertebrae

A

each rib will articulate with it’s corresponding vertebral segement and then also the segment above.
rib 2 articulates with T1 and T2
rib 3 articulates with T2 and T3
(the atypical’s don’t follow this rule)

166
Q

ratio of disc ht of Tspine, C spine, L spine (compared to the vert body ht)

A

Lspine 1:3
Tspine is 1:5
(cspine is 2:5)
disc height vs vert body ht

Ratio between the vertebral body height and the disk height will dictate the mobility between the vertebra –
Highest ratio in cervical region allows for motion
Lowest ratio in thoracic region limits motion

167
Q

with a protrusion in the Tspine, what part of the disc protrudes

A

typically annulus is the protruding part bc nucleus is so small

168
Q

main lig of Tspine

A

ALL

169
Q

spinal canal in tspine is largest at what areas

A

CT juncton

thoracolumbar junction

170
Q

explain orientation of transverse processess in Tspine

A

T1-T3 the TP’s are directly lateral to their corresponding segments
T4-T9 they are superior to the SP

171
Q

explain the finger width rule for t spine palpation

A

(1) T1/T2: 1 finger cranial to SP
(2) T3/4: 2 fingers cranial to SP
(3) T5-T8: 3 fingers cranial to SP
(4) T9-T10: 2 fingers cranial to SP
(5) T11-T12: 1 finger cranial to SP

172
Q

Rib articulation: The costovertebral joint (CVJ) is formed by what 3 things

A

the articulation between the head of the rib, the intervertebral disc and the vertebral body at the same level and the level above

173
Q

3 main parts to ribs (anteriorly)

A

manubrium
sternum
Costo cartilige

174
Q

ribs ___-____ are typical

A

3-9

they have 2 articular facets to art with the vert body above AND below

175
Q

atypical ribs include

A

1,2
10-12
these only articulate with one vertebra via 1 facet (their own corresponding level)

176
Q

true vs false ribs (list segments and describe differences)

A

true ribs: 1-7 (they attach directly to chest plate)

false ribs: 8-12 (they blend with the costo cart)

177
Q

mvmt of ribs during breathing

A

(1) Upper ribs: pump

(2) Lower ribs: bucket

178
Q

2 main joints of articulation of the ribs with the tspine vertebrae

A

costovertebral

costotransverse

179
Q

explain orientation of the facets in upper, mid and lower t spine

A

60
90
0
coronal

180
Q

Tspine flexion, ribs rotate___

Tspine ext, ribs rotate___

A

ant

post

181
Q

one way to implicate ribs as the source of px

A

SB to side of px and have them inspire big

182
Q

how can body misinterpret an issue in the lungs as a Tspine issue

A

message sent to DRG (sympathetic afferent), message goes to brain; brain tells T2-T5 that they have pain in this region because the afferents from the lungs converged with somatic afferents and traveled together to the brain. Brain tricks the body and has pain in TS rather than in the organ.

183
Q

armpit px is often what

A

referred T2

184
Q

whole head px with temporal dot is often what

A

referred T4

185
Q

right UQ px (big circle on upper right chest and shoulder) is often what

A

referred T9

186
Q

lower abd dot is often what

A

referred T11/12 or L4

187
Q

groin px (line at groin region, under crease) is often what

A

T12 or L1

188
Q

neural sx that go to medial aspect of upper arm and medial elbow area is often (radicular)

A

T2 nerve root

189
Q

single line under inf border of scapula is often (radicular px)

A

T8 nerve root

190
Q

which c spine facet px is over the entire scapula

A

C6-C7

191
Q

where does T2-T3 facet px occur

A

under the scapular spine

(then count all other segments of Tspine as you advance down the back, ending above the iliac crest for T10-T11_

192
Q

if the Tspine facet area of px is at mid spine and then lateral on the iliac crest it is

A

T9-10

193
Q

herniation of disc substance through cartilaginous plate of disc into body of the adjacent vertebra

A

schmorles nodes

194
Q

Compression syndrome involving the subclavian artery or vein and/ or brachial plexus as it passes from neck to axilla (an upper rib dysfunction)

A

TOS

195
Q

is T4 syndrome radicular px

A

no

it is referred non radicular

196
Q

sharp, stabbins, severe burning along intercostals describe what patho of Tspine

A

nerve root issue

197
Q

what motions create sx for flattened upper TS disorder

A

pain with loaded ext,

will have limited flexion capability- so make sure to observe

198
Q

pulling and pushing activities are agg factors for what tspine disorders

A

general hypomobility and T4 syndrome

199
Q

if you suspect general hypomobility of tspine, other than doing pushing/pulling what else should you have them to do

A

sustained flex or extension to see if they can hold it

200
Q

thoracic disc agg factors

A

prolonged sitting
physical labor
rotation (remember-tspine disc issues are different agg factors than any other part of the spine)

201
Q

what hx is often common with general hypomobility of tspine

A

work hx of prolonged positions (ex: desk jobs or surgeons )

202
Q

with general hypomobility of tspine, what goes on with their UE movement

A

UE mvmt is limited and usually are muscle imbalances

203
Q

T4 syndrome is thought to maybe be caused by

A

a sympathetic reaction to a hypomobile segment

204
Q

big issue with flat upper tspine dysfunction

A

they are resistant to tx

205
Q

what posture accompanies general hypomobilty

A

kyphosis

206
Q

what posture accompanies t4 syndrome

A

forward head, kyphosis, protracted shoulders

207
Q

generalized disc issue will have what posture

A

increased tspine kyphosis

208
Q

the only t spine pathology that would have a pos beevor sign

A

nerve root involvement

209
Q

explain beevors sign

A

have them do a sit up or SLR and watch their umbilicus, if it goes to one side and not up or down, it’s pos.for weakness or lack of neural connection on the side opp of the deviation

210
Q

the only t spine pathos that would have pos neural tests

A

disc or nerve root

hypomobility or t4 syndrome might have neural tension, but not true neural sx with pos neural tests

211
Q

hypomobility of tspine can have what 3 px generators

A

facet
disc
rib

212
Q

general hypomobility, what ROM test will you always do

A

UE motions

213
Q

what ROM tests

would you do for tspine disc

A

TS rotation
flexion
Flexion with inhalation

214
Q

what ROM testing will you do for tspine nerve root involvement

A

rotation
SB
(it’s different than cervical)

215
Q

when might you do babinskis and what is pos test

A

if they have B N/T or neuro sx

pos is when the GT extends

216
Q

landmarks for t spine

A

spine of scapula is t4

inf angle of scapula is t8

217
Q

does flattened tspine always accompany hypomobility and visa versa

A

no, you can have the same body chart for either, but look at the spine to determine whether it is flat or kyphotic. it may be flat with hypomobility, or just hypomobility

218
Q

HA with glove like distribution of px into the hand, think

A

T4 syndrome

219
Q

trunk movements bothersome, think what part of the spine

A

mid to low tspine

220
Q

if you suspect facet issue in tspine, what motions should you do (handprint px)

A

flexion with rot/sb
(closing the joint)
then take them prone and do pavms

221
Q

thumbprint px is typically (in tspine)

A

CTJ

222
Q

nocturnal UE px with “pins and needles” may be

A

upper rib issue

223
Q

where is CTJ or CVJ often located (pain)

A

local px 3 cm from rib articulation at TP

224
Q

vague epigastric px, increased px after eating, cannot lean against lower ribs

A

slipped rib (costal arch syndrome)

225
Q

if you suspect any form of rib pathology, what tests would you do

A

ROM:seated SB with deep breath
Lindgrens for rib 1 (PROM cervical rotate away from test side, then contra SB)
Spring test

226
Q

with any Tspine suspected patho, always check

A

shoulder ROM

227
Q

Rotation pxful (tspine) what pathos most likely

A

neural sx: disc with nerve root

non neural sx: facet or disc

228
Q

sensation tests location for tspine

A

T8: area just below xiphoid process
T10: the umbilicus
T12: lower abdominal region, level with ASIS

229
Q

reflex testing tspine

A

observe umbilicus with a cough (does it move in a normal pattern-not diagonal)
Flower pedals drawing with reflex hammer

230
Q

motor testing for tspine (myotome)

A

resist sit up, then diagonal sit ups

231
Q

with tspine disc issue (general) what motion with inspriation hurts

A

ext plus inspiration

232
Q

in tspine, the flexion or ext with sb/rot implicates

A

facet issue

233
Q

in tspine, pure rotation by itself impicates

A

disc or possibly facet too

234
Q

Inflammation of the costochondral cartilage

A

Tietze’s (costochondritis)

235
Q

disc slides medially during opening (no pain) describes what phase of disc displacement of TMJD

A

phase 1

236
Q

bilaminar tissues lengthen allowing disc to migrate med. and ant. Reciprocal clicking starts. describes what phase of TMJD

A

2

237
Q

Post. Lig. overstretched completely
Disc deformed
Mandibular head deforms
describes what phase of TMJD

A

IV - most severe

238
Q

symptoms of ischemia (CAD)

A 
5 d's
3 N's
1 a
dizziness, diplopia, dysarthria, dysphagia, drop attaack
nausea, numbness, nystagmus
ataxia
239
Q

which thoracic spine dysfunction is closely related to occupations that use their hands in a manner that the shoulder is not really flexed (hands at waist level)

A

hypomobility

240
Q

what should be the focus of therex tx for T4 syndrome pts

A

pulling the scap back

scap pinches or all 4s exs

241
Q

5 nerve tests for T spine

A 
Dermatomes
Beevors
ULNT
Myotomes
Slump
242
Q

for tspine, disc and disc with nerve root involvement, this motion is always pxful

A

rotation

243
Q

tmj body chart can also look like what body chart

A

01-02 facet

244
Q

in the LUMBAR spine, what motions are coupled but contra

A

SB and rot are contra/coupled

245
Q

the Lspine facilitates what motion more compared to Cspine

A

lspine facilitates flexion/ext more

cspine falitates rotation more

246
Q

In the C spine, the disc is taller on the ___ side

A

ant

247
Q

only part of spine with UVJ

A

CSpine

248
Q

Cspine , what motions are coupled

A

SB and rotation (ipsi)

249
Q

education for suspected TMJD

A

limit hard foods
limit over opening
modify sleep position
limit parafuncitional activities
Avoid foods that require excessive opening of the mouth (e.g. hamburgers).
Avoid eating hard foods. Do not bite into ice.
When yawning, place and hold your tongue against the roof of your mouth.
Avoid clenching your teeth, as when chewing gum.
Sleep with one pillow.
Maintain correct sitting posture.

250
Q

how to describe ex for TMJD

A

Restore cervical lordosis and strengthen in that position;

251
Q

if you suspect UCS facet, you must do what tests, and then what tx would you want to do

A

You stand on opp side of px
after reg ROM, do the provocation tests (pro/ret)
then for dorsal do seated pivm (DAT-dorsal, rotate away from you, sb towards you) or for ventral do seated pivm (VTA) ventral- rotate head towards you and SB away

252
Q

right rotation and left sb (of UCS) at occiput results in what

A

all vertebrae from c2 down to rotate right and sb right

253
Q

UCS innervation

A

dorsal and ventral rami of 1-3

254
Q

explain cervicogenic HA

A

these cause specific referred px, (not like vasculo HAs that typically stay in/around the head)

SPINE/MARCIE (3 decks)

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