Introduction to Spine

Question 1

List 4 differences between the appendicular and axillary skeleton

Answer 1

1. The axial system is the stable base upon which all extremity movement occurs.
2. The CNS is housed by the axial system.
3. The PNS is housed by the appendicular system.
4. Movement can be isolated on one side in the appendicular spine, but not in the axial spine.

Question 2

Spondylolisthesis is common among ______ with back pain.

Answer 2

Younger patients

Question 3

Spinal stenosis is common among ______ with back pain.

Answer 3

Older patients

Question 4

What is definite instability?

Answer 4

Defined as exceeding 4 to 5 mm difference on flexion-extension radiographs

Question 5

True or False: The appendicular system is inherently more complicated than the axillary system.

Answer 5

FALSE

The axillary system is inherently more complicated than the appendicular system

Question 6

What two process tend to be less accurate when examining the spine?

Answer 6

1. Patient histories

2. Examination procedures

Question 7

_____ is more likely to cause joint movement in the spine than in the extremities

Answer 7

Resisted isometric testing

Question 8

List 2 examples of classification systems used to classify patients in a way other than by diagnosis.

Answer 8

1. McKenzie Method

2. Treatment Based Classification

Question 9

Motion in the ______ plane is described as _____ and _____ rather than flexion and extension.

Answer 9

1. Sagittal Plane
2. Forward bending
3. Backward bending

Question 10

Flexion usually refers to movement producing a _____ angle and extension usually refers to movement producing an ______ angle.

Answer 10

1. Closing angle

2. Opening angle

Question 11

In the cervical and lumbar spine, flexion produces an ______ angle, and extension produces a _____ angle.

Answer 11

flexion = opening angle
extension = closing angle

Question 12

What is a motion segment?

Answer 12

The space between two vertebrae.

Question 13

Movement at a motion segment is usually referred to as motion at the ______ on the ______, regardless of which vertebra is actually moving.

Answer 13

Motion at the TOP vertebral body on the BOTTOM vertebral body.

Question 14

If motion at T4 is being discussed, this refers to motion of ____ on ____.

Answer 14

T4 on T5

Question 15

What part of the spine can the PT observe moving when looking at the patient from behind?

Answer 15

Spinous processes

Question 16

When the patient rotates, the spinous processes will move in the direction ____ the direction of the vertebral bodies and the osteokinematic motion that is occurring

Answer 16

Opposite

Question 17

if a patient is rotating right, the vertebral body rotates _____, and the spinous process moves toward the _____.

Answer 17

Vertebral body rotates right (same direction)

Spinous process rotates left (opposite direction)

Question 18

How does recruitment typically occur when movement is initiated at the spine?

Answer 18

SEGMENTALLY

** For example, if a patient rotates his/her neck to the left, movement occurs first at C1, then at C2, then at C3 etc. **

Question 19

If a patient rotates his/her hips to the left while keeping the trunk forward, motion occurs first at ___, than at ___, then at ___, then at ___ etc.

Answer 19

S1
L5
L4
L3

Question 20

What kind of joints are the facet joints of the spine? What direction do they move in?

Answer 20

1. Plane Joints

2. Move in the direction of the osteokinematic motion

Question 21

True or False: Convex/concave rules are important in understanding spinal motion.

Answer 21

FALSE

Movement occurs in the direction osteokinematic motion

Question 22

What is an opening restriction?

Answer 22

Restrictions in flexion / forward bending are accompanied by a decrease in the opening angle

Question 23

What is a closing restriction?

Answer 23

Restrictions in extension / backward bending are accompanied by a decrease in the closing angle

Question 24

Opening/closing restrictions are best visualized by looking at the _____ joints.

Answer 24

facet joints