Final Exam Prep Flashcards
What is traction?
-A force applied to separate two joint surfaces and elongate surrounding tissue
-Distraction
What is medical traction? What is it used for?
-Continuous and static traction
-Used to promote reduction and immobilization following trauma
What is spinal traction?
-Encourages separation and/or movement within the spine between individual segments
-Can be applied manually or mechanically
-Can be continuous or intermittent
What are the grades of manual traction?
-Grade I
-Grade II
-Grade III
What are manual traction characteristics?
-Oscillatory
-Progressive
-Positional
How did Kaltenborn describe traction to a joint?
-With use of three-dimensional traction, which described traction that has been positioned with respect to cardinal planes of motion
-Ex: painful joint positioned into pain-free range
-Ex: hip was positioned in flexion and abduction
What can traction do to different types of tissues?
-Stretches soft tissue
-Relaxes muscles
-Mobilizes joints
-Separates joint surfaces
-Reduces protrusion of nuclear disc material
What must occur in order to have true distraction?
A force strong enough must be applied to elongate the surrounding tissue and allow the joint surfaces to separate
What percentage of a patients body weight is required to increase the length of the lumbar spine?
30-50%
What percentage of a patients body weight is required to increase the length of the cervical spine?
7%
What pathologies are treated with traction?
-Nerve impingement
-Disc herniation/prolapse
-Joint hypomobility
-Arthritic conditions of facet joints
-Muscle spasm
-Generalized joint pain
What tissues are affected by spinal traction?
-Ligaments
-Intervertebral discs
-Facet joints
-Muscles
-Nerves
What does ligament deformation allow for?
It allows spinal vertebrae to temporarily move apart
How does traction affect ligaments?
-Ligaments can be contracted or shortened by injury or chronic postural problems
-Traction encourages adaptive changes in length and strength
-Places pressure on structures within the ligamentous complex (proprioceptive nerves)
-Activation of proprioceptive fibers provide a gating mechanism similar to TENS
What is the function of normal intervertebral discs?
-Act to dissipate compressive forces within the spine
-Internal pressure increase, but nucleus pulposus does not move out with change in weight bearing forces
-80% of compressive load in spine is taken up by the disc
What happens to the intervertebral discs when they are herniated?
-Lose fullness, which moves vertebrae closer together
-Annular fibers bulge
-Nucleus shifts according to fluid-dynamic principles (path of least resistance if annulus is damaged)
How does traction help treat intervertebral disc abnormality?
-Decreases central pressure
-Return of nucleus to central position
-Tension on annulus fibrosus and ligaments surrounding disc (helps to push disc material more centrally)
-Movement of structures relieves pain if pressure is on vascular or nervous tissues
-Allows for improved fluid exchange within disc and spinal canal
-Possible reduction of disc herniation
How does traction affect the facet joints?
-Traction separates joint surfaces up to 1-2mm
-Decompresses articular cartilage, increasing synovial fluid exchange to the cartilage
-Stimulates proprioceptive nerves at the facet joint capsules
What type of traction is best if you are trying to promote fluid movement?
Intermittent traction, because traction, then release will move the fluid around
How does traction affect muscles?
-Decrease in spinal musculature EMG from 1-10 minutes of traction
-Increased muscle EMG from 10-15 minutes of traction
-For muscle tone, use high load, continuous traction less than 10 minutes
What can pressure on nerves be from?
-Bulging disc material
-Irritated facet joints
-Bone spurs
-Narrowed intervertebral foramen
How does traction affect the nerves?
-Can decrease pressure on the nerve
-Can increase blood flow to the nerve, decreasing edema and allowing return to normal function if there is no permanent damage
What are indications for traction?
-Nerve root impingement
-Disc herniation
-Spondylolysthesis
-Osteophyte formation
-Degenerative joint disease (arthritis)
-Sub acute sprain
-Joint hypomobility
-Discogenic pain
-Muscle spasm or guarding
-Muscle strain
-Ligament or connective tissue contractures
What are contraindications for traction?
-Acute sprains or strains
-Acute inflammation
-Fractures
-Joint instability
-Tumors
-Bone disease
-Osteoporosis
-Infections in bones/joints
-Vascular conditions
-Pregnancy (loose ligaments)
-Cardiac or pulmonary problems (because strap around chest can compress chest)