Lumbar and thoracic spine Flashcards
Non-neutral dysfunctions of the spine
ERS and FRS
ERS is assessed for in which position?
Flexed
FRS is assessed for in which position?
Extended
Possible dysfunctions of the spine
ERS, FRS, NRS, bilaterally flexed or extended
How many segments in a row must be the same in an NRS?
3
MOI in ERS and FRS
Transversopsinalis, primarily multifidi
MOI in NRS
Erector spinae and transversospinalis
In an ERS dysfunction, where is the MOI found?
On the same side and below the dysfunction.
In an FRS dysfunction, which side is the prominent TP on?
The opposite side from the dysfunction
Where is the MOI found in an FRS dysfunction?
On the same side as the dysfunction, above the dysfunction.
In an ERS dysfunction, which side is the prominent TP on?
The same side as the the ERS.
Where is the SP of L4 located?
Medial to the PSIS
Where is the SP of T6 located?
In line with the inferior angles of the scapula
How are rib restrictions named?
As inhalation or exhalation restrictions.
How is rib assessment done?
By monitoring quiet and forced breathing in 4 positions.
Most rib dysfunctions are caused by what?
Thoracic dysfunctions
Which tests should be performed in the standing position for patients with low back pain?
Plumb line, standing flexion and ROM
Which tests should be performed in the seated position for patients with low back pain?
Slump, seated flexion, lumbar and thoracic ROM and TP assessments
Which tests should be performed in the supine position for patients with low back pain?
SLWL, ASIS, adductors
Which tests should be performed in the prone position for patients with low back pain?
Sacral sulcus and ILA
What order should motions be applied in order to pre-stretch for an IIT for ERS or FRS
Flex, side bend then rotate
Which actions should be used to pre-stretch during an IIT treatment of an NRS?
Side bending then rotation
Patient effort in an IIT for ERS dysfunction
Side bending
Patient effort in an IIT for FRS dysfunction
Rotation
Patient effort in an IIT for NRS dysfunction
Alternate between side bending and rotation
How can IITs be performed in the upper thoracic region?
By using the head
How should the IIT for an upper thoracic dysfunction be set up?
Head is first rotated, then side bent and flexed at the same time.
Why don’t static stretches usually help with spine issues?
The discs are avascular and need the skeletal muscle pump for nourishment
In what position is a lumbar or lower thoracic multifidi treated?
Lateral recumbent, on the top side. Patient rolls backwards towards you to streth.
In what position is an upper thoracic multifidi treated?
Lateral recumbent, on the bottom side. Patient rolls forwards away from you to stretch.
In what position are the intercostals best treated?
Lateral recumbent
In what position is the serratus anterior best treated?
Lateral recumbent
In what position is the pec minor best treated?
Supine
In what position is the external oblique best treated?
Lateral recumbent
In what position is the internal oblique best treated?
Supine as in abdominal massage
Muscles of involvement in rib dysfunctions
Intercostals, serratus anterior, pectoralis minor, obliques, scalenes and quadratus lumborum
Muscles which can cause an inhalation restriction at position one
Upper serratus anterior and the intercostals
Muscles which can cause an exhalation restriction at position one
Scalenes, intercostals and possibly the SCM and subclavius
Muscles which can cause an inhalation restriction at position two
Serratus anterior, obliques and intercostals.
Muscles which can cause an exhalation restriction at position two
Pectoralis minor and intercostals
Muscles which can cause an inhalation restrction at position 3
Obliques, rectus abdominis and intercostals
Muscles which can cause an exhalation restriction at position 3
Lower serratus anterior and intercostals
Muscles which can cause an inhalation restriction at postion 4
Quadratus lumborum
Muscles which can cause an exhalation restriction at position 4
Quadratus lumborum
Key rib
The last rib in a restricted group
Ribs which are torsioned up cause what type of restriction?
Exhalation
Ribs which are torsioned down cause what type of restriction?
Inhalation
In an ERSrt, which way are the right ribs torsioned?
The right ribs are torsioned up
In an NRSrt, which way are the right ribs torsioned?
Because the rotation is left, the the right ribs are rotated down.
