Introduction to Spinal Orthoses (QUIZ 4) Flashcards
What are the ISO Nomenclatures for Orthoses?
Categorize
Describe
Specify
Determine
Categorize
by body segment encompassed
Describe
Individual factors affecting perscription
Specify
Clinical objectives of treatment
Determine
Design elements (interface, articulations, structural components, cosmetic elements)
C7
vertebra prominens
T2
Superior angle of scapula
sternoclavicular joint
jugular notch
T4
Sternal angle of louis
T3
Scapular spine
menubrium
T7
Inferior angle of scapula
T9
Xiphoid process
L2-3
lower costal margin
L4
iliac crest
S2
PSIS, ASIS
Spinal Orthoses Hypothesized Mechanisms of Action
Motion Control
Decreased Loading
Enhanced Proprioception
other (warmth, placebo, etc)
Motion Control
Can be gross or segmental
end point control
3 point pressure systems
total contact
Decreased loading
increased abdominal pressure
skeletal alignment
enhanced proprioception
avoid abnormal postures
kinesthetic reminder to withdraw
Euler’s Buckling Theory In order to most stable
Fixed - Free
Pivot - Pivot
Fixed - Pivot
Fixed - Fixed
Basic Spinal Biomechanics
Compressive Loading
follower load theory
functional spinal unit
denis 3 column theory
What is Primarily Compressive Loads caused by
gravity
external forces & moments
muscle tension
What is primarily compressive loads resisted by
boney structure
ligaments & tendons
Muscles
Follower Load Theory
co-activation of trunk muscles could alter the direction of internal forces to follow the curve of the spine
muscle dysfunction can result in internal shear forces
muscle strengthening may be useful
What are two functional spinal units
1) 2 vertebral bodies + intervertebral disk, facet joints & ligaments
2) 3 joint complex: cartilaginous disk + 2 synovial disks
Anterior column
ALL, anterior 2/3 of body
middle column
post 1/3 body, PLL
Posterior column
all structures posterior to PLL
one column injury is?
stable
two column injury is?
unstable
three column injury is?
invariably unstable