Fryettes

Question 1

Simple physiologic motion of the spine is comprised of three cardinal motions:

Answer 1

I.Rotation
II.Side-bending
III.Flexion/Extension/Neutral

Question 2

Rotation:

Answer 2

Transverse (Horizontal) Plane; Vertical Axis

Question 3

Side-bending:

Answer 3

Coronal (Frontal) Plane; Anterior-Posterior Axis

Question 4

Flexion/Extension:

Answer 4

Sagittal Plane; Transverse Axis

Question 5

Neutral

Answer 5

• Neutral:The point of balance of an articular surface from which all the motions physiologic to that articulation may take place2.
• NOTE:Neutral is not a single point, but rather a RANGE in which the weight of the trunk is borne on the vertebral bodies and discs3.

Question 6

Non-Neutral

Answer 6

Flexion(Forward Bending) or Extension(Backward Bending) beyond the neutral range, engaging the facet (zygapophysial) joints.

Question 7

Motion of What Exactly?

Answer 7

General spinal motion occurs at the level of the vertebral unit.
•Vertebral Unit: Two adjacent vertebrae (vertebral segments) and their associated arthrodial, ligamentous, muscular, vascular, neural and lymphatic elements2.

Question 8

Anterior Segment

Answer 8

Structure:
•Vertebral Bodies
•Vertebral Discs
•Longitudinal Ligaments*

Function:
•Load Bearing

Question 9

Posterior Segment

Answer 9

Structure:
•Vertebral Arches
•Facet (Zygapophysial) Joints
•Transverse Processes
•Spinous Processes
•Ligaments*

Function:
•Guide and Limit Motion

Question 10

Conventions

Answer 10

• Vertebral Units are named for the superior member (vertebrae) of the unit.
• All spinal and vertebral movements are described in relation to the motions of their anterior and superior surfaces.

Question 11

Fryette’s Principles:Complex Physiologic Motion

I.

Answer 11

In the NEUTRALrange, side-bending and rotation are coupled in OPPOSITEdirections = Type I Mechanics

Question 12

Fryette’s Principles:Complex Physiologic Motion

II.

Answer 12

In sufficient flexion or extension (NON-NEUTRAL), side-bending and rotation are coupled in the SAMEdirection = Type II Mechanics

Question 13

Fryette’s Principles:Complex Physiologic Motion

III.

Answer 13

Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion.

Question 14

Fryette’s Principles (I and II) apply only to

Answer 14

thoracic and lumbar vertebrae.

Question 15

Fryette’s 1stPrinciple

Answer 15

Principal I
In neutral position:
Side-bending and rotation occur in opposite directions.

Neutral(Type I) Mechanics
When the spine is in a neutral position and side-bending is introduced, the bodies of the vertebrae will rotate toward the convexity2.

Question 16

Fryette’s 2ndPrinciple

Answer 16

Principle II
In Non-Neutral Position (flexed or extended):
Rotation and side-bending are to the same side.

Non-Neutral (Type II) Mechanics
When the spine is either forward or backward bent and side-bending is introduced, the vertebrae will rotate toward the concavity2.

Question 17

Flexion

Answer 17

Forward or anterior bending in the sagittal plane around a transverse axis (past the neutral range).

Question 18

Extension

Answer 18

Backward or posterior bending in the sagittal plane around a transverse axis (past the neutral range).

Question 19

Fryette’s 3rdPrinciple

Answer 19

Principle III
When motion occurs in any one plane within a joint, the motion in all other planes of that joint will be influenced.

Note: Fryette’s third principle applies to cervical, thoracic and lumbar vertebrae.

Question 20

From Physiologic Motion to Somatic Dysfunction

Answer 20

•When complex physiologic Type I or Type II mechanics of a vertebral unit are restricted in any plane of motion, we have somatic dysfunction. (Remember Principle III?)

–A dysfunction exists when the spine is placed in a neutral position and a spinal segment or group is not in neutral (i.e. its motionor landmarksare asymmetric).

Question 21

Arthrodial (Joint) Restriction

Answer 21

–Thin Layer Adherence at Facet Joints

•Maintained by muscle hypertonicity

Question 22

Muscular Restriction

Answer 22

–Longer paraspinal musclesmaintain Type I dysfunctions
•Often postural compensation/chronic process
–Short paraspinal musclesmaintain Type II dysfunctions
•Often acute process

Question 23

Fascial and Ligamentous Restriction

Answer 23

–Fibrosis/scarring/inflammation can shorten fascia and ligaments associated with paraspinal muscles

Question 24

Edema

Answer 24

–Interstitial fluid distends, stretches, and restricts tissues, causing motion restriction

Question 25

A GROUP of vertebrae stuck in

Answer 25

Type I Mechanics. –Example: L1-4 sidebent right and rotated left and not improving with flexion or extension. –Often a postural compensation/chronic process maintained by long paraspinal muscles

Question 26

Long Paraspinals:Type I Dysfunctions

Answer 26

Intermediate: Serratus posterior superior & inferior ``` Deep: Splenius Erector Spinae: Spinalis Longissimus Iliocostalis ```

Question 27

A SINGLE vertebrae stuck in

Answer 27

Type II Mechanics –Example T7 is flexed and sidebent and rotated to the left –Often an acute process maintained by short paraspinal muscles

Question 28

Short Paraspinals:Type II dysfunctions

Answer 28

``` Deep Muscles of the Back: Transversospinal group Semispinalis Multifidus Rotatores Intersegmental Muscles Interspinalis Intertransversarii Levatorcostarum ```

Question 29

The rule of threes

Answer 29

Distance Spinous process is below transverse processes ``` 1-3 are the same level 4-6 are 1/2" inferior 7-9 are 1" inferior 10 is 1" inferior 11 is 1/2" inferior 12 is the same level ```

Question 30

Superior Scapular Border =

Answer 30

T2 SP

Question 31

Scapular spine =

Answer 31

T3 SP

Question 32

Scapular Angle =

Answer 32

T7 SP

Question 33

Iliac Crests

Answer 33

L4 SP

Question 34

Somatic dysfunctions are named for the direction of

Answer 34

ease (freer motion), NOT for the direction of restriction

Question 35

Whichever direction motion is restricted, the somatic dysfunction is in the

Answer 35

opposite direction. –Example: If a vertebra is “restricted in right rotation,” we know that it is rotated left. –This will hold true for any direction tacked on to the end of this phrase.