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OS Final > DSA: Thoracic and Lumbar Spinal Mechanics > Flashcards

DSA: Thoracic and Lumbar Spinal Mechanics Flashcards

1
Q

What are the important landmarks that the line of gravity passes through?

A
  1. External auditory canal
  2. Head of humerus
  3. L3
  4. Anterior 1/3 of the sacrum
  5. Lateral malleolus
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2
Q

What type of spinal curve does each spinal segment have?

A

cervical and lumbar: lordosis

thoracic and sacral: kyphosis

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3
Q

What are the characteristics of thoracic vertebrae?

A

Body: medium sized, heart shaped, costal facets present

Spinous processes: long, sloped postero-inferiorly

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4
Q

What are the characteristics of lumbar vertebrae?

A

Body: Large, kidney shaped

SP: Short, broad

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5
Q

What makes up a vertebral unit?

A

Two adjacent vertebrae and the associated intervertebral disc

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6
Q

What does the rule of 3’s refer to?

A

Location of the spinous process in relation to the transverse process (for thoracic spine only!)

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7
Q

Apply the rule of 3’s to T1-3

A

Spinous process at the level of the corresponding transverse process

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8
Q

Apply the rule of 3’s to T4-6

A

Spinous process located 1/2 segment below the corresponding transverse process

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9
Q

Apply the rule of 3’s to T7-9

A

Spinous process located 1 full segment below the corresponding transverse process (located at the level of the transverse process of the vertebrae below)

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10
Q

Apply the rule of 3’s to T10-12

A

T10: same as T7-9 (SP one full segment below TP)
T11: same as T4-6 (SP 1/2 segment below TP)
T12: same as T1-3 (SP at same level as TP)

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11
Q

What is the orientation of the superior facets of cervical vertebrae?

A

BUM: Backwards, upwards, medial

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12
Q

What is the orientation of the superior facets of thoracic vertebrae?

A

BUL: Backwards, upwards, lateral

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13
Q

What is the orientation of the superior facets of lumbar vertebrae?

A

BM: Backwards, medial

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14
Q

Describe the location and function of the anterior longitudinal ligament

A
  • covers and connects anterolateral aspects of vertebral bodies and IV disks
  • limits extension
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15
Q

Describe the location and function of the posterior longitudinal ligament

A
  • runs within the vertebral canal along the posterior aspect of the vertebral bodies
  • resists hyperflexion, prevents posterior herniation of the nucleus pulposus
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16
Q

Describe the location of the ligamentum flava

A

-connect the lamina of adjacent vertebrae

17
Q

Describe the location of interspinous ligaments

A

connects adjacent spinous processes

18
Q

Describe the location of the intertransverse ligaments

A

connects adjoining transverse processes

19
Q

What is the action of semispinalis m.?

A

Bilateral: Extends
Unilateral: bends, rotates

20
Q

What is the action of rotatores m.?

A

Bilateral: Extends
Unilateral: rotates

21
Q

What is the action of multifidus m.?

A

Bilateral: Extends
Unilateral: flexes, rotates

22
Q

What are the gross ranges of motion of the lumbar spine?

A

Flexion: 40-90
Extension: 20-45
Sidebending: 15-30
Rotation: 3-18

23
Q

What is coupled motion?

A

Consistent association of a motion along or about one axis, with another motion about or along a 2nd axis

24
Q

What is linkage?

A
  • relationship of joint with surrounding structures
  • by linking multiple structures, increase ROM
  • aka block surrounding structures to evaluate movement of one joint/region
25
Q

How do you name motion of a vertebra?

A

Always references the movement of the anterior/superior surface of vertebra

Excessive motion (or restriction) is in reference to vertebra above in a functional unit (ex. excess motion of L2 is the motion of L2 on L3)

26
Q

Restrictions of motion in the spine can:

A
  • reduce efficiency
  • impair flow of fluids
  • alter nerve function
  • create structural imbalance
27
Q

What is Fryette Type 1 mechanics?

A

TONGO

  • In the neutral range, sidebending and rotation are coupled in opposite directions
  • Rotation is toward the convexity of the spine
  • tends to be a group of vertebra

Only applies to thoracic and lumbar spine

28
Q

What is Fryette Type 2 mechanics?

A
  • In sufficient flexion or extension, sidebending and rotation are coupled in the same direction
  • Rotation is toward the concavity of the spine
  • Tends to be a single vertebra

Only applies to thoracic and lumbar spine

29
Q

How do you name SD of the spine?

A

For where it likes to go

ex. T1-3 N Sr Rl
T1-3 have restrictions sidebending left and rotating right, no improvement in flexion or extension

30
Q

What is fryette’s 3rd principle?

A
  • movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion
  • if motion is restricted in one direction, motion will be restricted in other directions
31
Q

What are some ways to say “R rotation somatic dysfunction”

A
  • PTP on right
  • rotated right
  • hard end feel with rotation to the left
  • hard end feel on the right
  • restricted rotation to the left
  • will not rotate left
  • lives in right rotation
  • held to the right
32
Q

How do you name scoliosis?

A

Toward the convexity

  • levoscoliosis: toward left (obscures heart)
  • dextroscoliosis: toward right (frames the heart)
33
Q

Describe the clinical features of a herniated disk at L4-5

A

Pain: sacroiliac joint, hip, lateral thigh, leg
Numbness: Lateral leg, first 3 toes
Weakness: of dorsiflexion of great toe and foot, difficulty walking on heel
Reflexes: diminished/absent internal hamstring reflex

34
Q

Describe the clinical features of a herniated disk at L5-S1

A

Pain: SI joint, hip, posterolateral thigh, leg to heel
Numbness: back of calf, lateral heel, foot to toe
Weakness: plantar flexion of foot and great toe, difficulty walking on toes
Atrophy: gastrocnemius and soleus
Reflexes: ankle jerk diminished or absent

35
Q

What is sacralization?

A

one or both TP’s of L5 are long and articulate with the sacrum

36
Q

What is lumbarization?

A

failure of S1 to fuse with the rest of the sacrum

37
Q

What levels do you see exit of nerves contributing to sympathetic viscerosomatic reflexes?

A

T1-L2

OS Final (8 decks)

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