Lecture 02 Spinal Mechanics Fryettes Principals Flashcards
Somatic dysfunction
Impaired altered function of related components of somatic system: skeletal, arthrodial, myofascial, musculature, lymph, neural
3 ways to evaluate for somatic dysfunction
- Compare active and passive ROM
- Compare R and L
- Consider quality of motion
What is flexion
-decrease angle between bones of a joint
What is extension
-increase angle between bones of a joint
What motion are vertebrae capable of
- flexion
- extension
- rotation
- side bending
How do you perform a segmental exam on a patient?
- pt prone/seated
- anteriorly compress R TP–> load and spring–> induces L rotation
- repeat for L TP–> induce R rotation
- repeat w/flexion and extension and compare to neutral
What is a SD called when vertebrae will NOT rotate RIGHT
- push on L TP and will not rotate right
- restricted motion to the RIGHT
- notice hard end feel when pushing on LEFT TP= L PTP
- live sin the left (wont go right)= ROTATED LEFT SD
Fryettes 1st principal
-when thoracic and lumbar spine is in NEUTRAL position coupled motions of side bending and rotation for a GROUP of vertebrae are such that side ending and rotation occur in OPPOSITE directions (rotation toward convexity)
Type I mechanics/SD
- found in NEUTRAL
- T1-L5
- rotation toward convexity
- found at OA joint
- sidebending and rotation opposite directions
What is TONGO?
-used to dx type 1 SD
-T= type
-O= one
_N= neutral
-G= grouped curve
-O= opposite (side bend and rotation)
Fryettes principle 2
- when thoracic and lumbar spine is sufficiently forward or backward bent (NON-neutral) the coupled motions of sidebending and rotation in a SINGLE vertebral unit occur in the SAME direction
- rotation and sidebending to same side
Type II mechanics/SD
- found in flexion/extension (non-neutral)
- rotation toward concavity
- rotation and side bend in same side
- rapid onset: trauma, sudden movement, unusual position
Atypical Cervical SD
- OA joint–> MODIFIED type I motion
- evaluate in NEUTRAL
- motion is coupled= always get some rotation if head side bent and always get some side bending if head is rotated
Cervical SD
- C2-C7 (typical cervical vertebra)
- check segment flexion, extension, neutral
- usually side bending and rotation to the SAME side (TYPE II)
- compensatory changes from other segments can lead to SB and rotation to opposite sides
T1-3NRRSL
- TYPE I SD
- T1-3 (group)
- Neutral
- Rotated Right
- Side bent Left
- restriction to rotating L and side binding R