Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PTA Ortho > Lumbar, SI, Cervical and TMJ > Flashcards

Lumbar, SI, Cervical and TMJ Flashcards

1
Q

What do spinal curves do and what are they

A

give spinal column 10x more strength
provide shock absorption and balance of COG

Lumbar and cervical-lordosis
Thoracic and sacrum-kyphotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

vertebral weight

A

major weight bearing structure

handles compressive loading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

vertebral arch

A 
**Posterior**
pedicles
transverse process
articular process
articular facet
lamina
spinous process
  • attachment site for muscles and ligaments
  • forms ossseous ring that is vertebral canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

facet joints

A

synovial joints
different orientation in the cervical, thoracic and lumbar spine

FUNCTIONS:
guides movement
limits movement
handles 20-30% of compressive loads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

pedicle

A

connects vertebral body to lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

laminae

A

connect pedicle to the spinous process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

transverse process and spinous process

A

serve as ligament and muscle insertion sites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

anterior longitudinal ligament

A

attaches to anterior vertebral bodies and discs

helps limit extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

posterior longitudinal ligament

A

attaches to posterior vertebral bodiesand discs

helps to limit flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ligamentum flavum

A

helps to limit flexion

forms anterior portion of facet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

interspinous ligament

A

between the spinous processes

helps to limit flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

intertransverse ligament

A

between transverse processes

helps to limit sidebending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

supraspinous ligament

A

between tips of the spinous processes

helps to limit flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

annulus fibrosis

A

made up of dense layers of collagen fibers and fibrocartilage
fiber orientation changes obliquely from layer to layer giving it tensile strength to resist compression, twisting and bending

fibers of the innermost layer blend with nucleus pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

nucleus pulposus

A

gelatinous mass located centrally in disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nerve roots

A

exits below the corresponding vertebral body
spinal cord ends between vertebrae L1 and 2 and extends as Cauda Equina

disc pathology usually affects nerve root below

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

dermatomes

A

sensory nerve root distribution

L1-groin
L2-lateral and upper thigh
L3-lateral mid, anterior lower thigh and medial knee
L4-lateral knee, medial lower leg, 1st toe
L5-lateral lower and posterior leg, dorsal foot, 2-4 toes and plantar of 1st toe
S1- lateral foot, plantar foot 2-5 and mid posterior leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Myotomes

A

motor nerve root distribution

L1-2: hip flexion
L3- knee extension
L4- ankle dorsiflexion
L5- 1st toe extension
S1- ankle plantar flexion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Flexion disc movement

A

anterior portion of the disc is compressed and nucleus pulposus moves POSTERIORLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Extension disc movement

A

posterior portion of disc is compressed and nucleus pulposus moves ANTERIORLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lateral Flexion disc movement

A

nucleus proplsus moves away from the compression= opposite the direction of the bend

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

disc lesion causes

A

wear and tear of annular fibers

  • repeated flexion or rotational movements
  • poor circulation to the disc prevents healing of microtears
  • any microtears that do heal are weaker once healed

degenerative changes of nucleus propulsus

  • nucleus becomes more fibrotic over time
  • less water content as disc ages

traumatic rupture of annular fiber

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

protrusion

A

annulus bulges but nucleus is contained within the annulus and supporting structures

only level that can be fixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

extruded

A

nucleus extends through the annulus, beyond confines of posterior longitudinal ligament or above/below disc space, still in contact with the disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

sequestered

A

nucleus extends through annulus, separated from the disc and moved away from the prolapsed area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

disc hernitation

A

onset usually between 20-55 y.o
most common at L4-5 and L5-S1
usually psoterior lateral protrusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

clinical sx of posterior lateral protrusion

A

pain arise when protrusion of disc applies pressure again other structures

pain tends to increase with sitting, forward bending, coughing, straining, attempting to stand after being in forward flexion position

symptoms tend to be better with walking

may see decrease in lumbar lordosis and lateral shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Neurological signs of protrusion

A

radiation of pain down the leg
paresthesia or sensory loss in dermatomal pattern
muscle weakness in myotomal pattern
reduced reflexes

RED LIGHT:
loss of bowel/bladder control-there may be spinal cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Slump Test

A

suggest compression from sciatic nerve from herniated disc

patient short sitting with neck flexed
knee passively extended

+pain or increase in symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

straight leg raise test

A

suggests sciatic nerve compression from herniated disc

patient supine
therapist passively raises straight leg

+ pain in back of leg or increased parathesia

**may further increase neural tension stretch by passively DF and actively flexing neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

rehabilitative management of disc lesions

A

supportive modalities for pain, traction
ROM to promote centralization- 1st goal before moving onto full program

correct lateral shift

emphasize extension to mechanically minimize disc protrusion

increase lumbar and LE flexibility

increase strength

increase cardiovascular fitness

improve posture

education on anatomy and prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

facet joint impingement

A

meniscus of the facet capsule beecoems entrapped, impinged or stresed

Cause:
sudden or unusual movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

signs of facet joint impingement

A

onset begins with unusual movement
loss of spinal mobility-back has locked up
pain with spinal motion
muscle guarding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

rehab for facet joint syndrome

A

manual or mechanical traction
mobilization techniques
treatment of muscle spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Lumbar spinal stenosis/foraminal stenosis

A

narrowing of spinal canal-constricts and compresses nerve roots/cauda equina

degenerative and bone spurs

Cause:
degenerative arthritic changes
repeated stress to the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

clinical signs of stenosis

A

pain in back ro neck
radiular pain, parathesia, weakness, impaired sensastion, diminished reflexes

symptoms frequently increased with extension

usually progressive

can cause patient to fall due to LE wekaness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

rehab for stenosis

A

posture education to decrease pinching

flexibility and stretching

patient may have impaired LE strength-gait training, balance training, safety education and LE strengthening may be necessary

steroid injections

may need surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Ankylosing spondylitis

A

inflammatory disease that causes joint sclerosis and ligament ossification

  • gradual ankylosing of the spine, SI joints, hips and costovertebral joints
  • symptoms begin in early adulthood-PROGRESSIVE

affects men more frequently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Signs of ankylosisng SPONDI

A

flat lumbar spine
severe kyphosis in thoracic and cervical spine
increase hip flexion
Bamboo spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

rehab management for ankylosing

A 
patients must faithfully exercise the rest of their lives
avoid flexion activities 
promote extension
posture education
positioning 
deep breathing exercise 
extremity flexibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

spondylosis

A

degenerative joint disease/OA of the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

spondylolysis

A

bony defect in the pars interarticularis-fracture
BUT STILL INTACT

between superior and inferior facets

no abnormal spinal movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

spondylolisthesis

A

bony defect in pars interarticularis
forward slipping of one vertebral segment on the one below it

superior vertebrae slides anterior on the inferior vertebrae

most common at L5-S1

deined by amount of forward displacement of superior vertebrae over inferior vertebrae

ACTUAL FRACTURE

inferior facet, spinous process do not move
*superior and rest of vertebrae shifts forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

possible causes of spondylolisthesis

A

congenital malformation of spinal arch

fracture due traumatic injury
degenerative changes

45
Q

Signs of spondylolisthesis

A

pain/neuro signs symptoms
aggravated symptoms with extension activities
symptoms with prolonged standing and walking
relieve pain with lying down

46
Q

spobdylolisthese rehab management

A

Less severe:

  • pt. education-avoid progression of slippage
  • neutral alignment
  • lumbar stabilization exercises

Severe:
-requires surgical fusion

47
Q

Compression fractures

A

cause:

  • Osteoporosis
  • trauma
  • prolonged steroid use

Signs:

  • diagnosis by xray
  • pain at fracture site
  • neurological signs
48
Q

rehab for compression fractures

A

pain control
in severe osteoporosis cases-more fractures can occur while its attempting to heal

avoid flexion motions
rotation with caution
gentle stabilization
increase mobility-wolf's law
kyphoplasty
49
Q

Spinal fusion surgery

A

one or more vertebral segments of column are sugically fixated or fused to prevent movement

fusion can be internal fixation or bone graphs

surgical approach may be from anterior or posterior

50
Q

rehab for spinal fusion

A

follow protocol

pt. will initially be splinted or braced

focus on returning to independent functional mobility level with transfers, gait and stairs

log roll tecnique should be taught for bed mobility

scar mobs

muscle flexibility program

trunk stabilization

endurance program

generalized whole body conditioning

51
Q

Laminectomy surgery

A

lamina is cut into to gain access to herniated disc

herniated material removed

52
Q

rehab for laminectomy

A 
follow protocol
functional mobility training
posture and boddy mechanic training
joint mobilization 
scar mobs
spinal ROM
UE/LE flexibility
trunk and UE/LE strengthening
endurance 
over all conditioning
53
Q

sacrum

A

wedge shaped

suspending by strong ligaments

54
Q

innominate

A

ilium, ischium and pubis is one unit

during functional activities the 2 can move in different directions

look at pelvis in halves

55
Q

Posterior Pelvic Tilt

A

ilium rotates posteriorly bilaterally

both innominates move as one unit

sacrum moves anteriorly 2-4 degrees

56
Q

posterior pelvic tilt in standing

A

both ASIS move upwardly and posteriorly

rectus ab-pulls anteriorly

glute max and hamstring-pull down posteriorly

57
Q

posterior pelvic tilt in gait

A

2 ilium/innominates do not move in same direction

stance-
femur in contact with ground
stance innominate rotates posteriorly 2-4 degrees 
NUTATION
Sacrum is table
58
Q

Anterior pelvic tilt

A

ilium rotated anteriorly

59
Q

anterior pelvic tilt in standing

A

both asis move downward/anteriorly

erector spinae-pulls up posteriorly
iliopsoas and sartorius pull downward anteriorly

swing phase-foot is off the ground

ilium do not move in the same direction

Counternutation

60
Q

SI dysfunction:

Anterior Rotated Innominate

A

ASIS moves downward

Pubic symphasis moves downward

iliac crest downward

PSIS upward

Ischial tubs upward

supine to sit - leg appears shorten

tight iliospoas and quads

legnthened and weak glutes and hamstrings

61
Q

Causes of anterior rotation

A

baseball or golf swing

knee to dashboard injury

forceful diagnoal PNF pattern

repeated PNF pattern

62
Q

rehab for anterior rotation

A

muscle stretching-iliospoas and quads

strenghten: glutes and hamstrings

modalities

strengthen general core

SI Belt may be option

63
Q

Posterior rotation SI dsyfunction

A 
ASIS upward
pubic symphasis upward
iliac crest upward
ischial tubs downward 
supine to sit test-lg appears to lengthen 
tight glutes and hamstrings
lengthened  and weak hip flexors
64
Q

causes of posterior rotation

A

repeated unilateral stance
fall on ischial tuberosity
vertical thrust on to extended leg
lifting in forward bent position with knees locked

65
Q

rehab for posterior rotation

A

stretch-glutes and hamstrings

strengthen-iliopsoas and quads

modalities
strengthen general core
SI belt for stabilization

66
Q

Palpation for eval of SI joint

A 
ASIS
PSIS
ischial tub
iliac crest
greater trochanter
sacrum
67
Q

SI standing forward flexion test

A

patient stands away from therapist

palpates PSIS

pt. flexes forward

any assymetrical motion may be from SI dysfunction

68
Q

Supine to Sit SI test

A

patient lies supine with knees extended

therapist palpates medial malleolus-equal

patient flexes forward into long sitting

If malleolus changes position=+ sign

69
Q

In sitting if patient leg appears:

A

short=innominate may be anteriorly rotated on that side

Long=innominate may be posteriorly rotated on that side

70
Q

Cervical certebra alignement degrees

A

45

71
Q

Atlanto-occiptal joint

A

flexion/ext= 15-20 degrees

atlas has no vertebral body

72
Q

Atlanto=axial joint C1-2

A

ondontoid process C2

rotation 45-50 degrees

73
Q

vertebral artery

A

along each side of cervical spine

canal for vertebral artery is transverse foramen

74
Q

7 cervical vertebrae and 8 cervical nerves

A

cervical nerve is ABOVE corresponding vertebrae for C1-C7

Occiput and C1= c1 nerve root
between c4-c5=C5 nerve root

C7-T1=C8 nerve root

Naming switches at T1-T2
thoracic nerves are below vertebrae

75
Q

motion of cervical spine

A

flex/ext
rotation: superior vert. rotates on inf.
lateral flexion

76
Q

Lateral flexion to R closes what?

A

closes R intervertebrae and opens left side

77
Q

When rotation and lateral flexion occur at the same time:

A

closing on intervertbrae forament follows lateral flexion

78
Q

Reflexes

A

C5-bicep
C6-brachioradialis
C7-triceps

79
Q

sternocliedomastoid

A

mastoid process to clavicle and sternum

lateral flexion to same side

rotation to opp. side

80
Q

scalenes

A

transverese process of c. vertabrae to 1st and 2nd rib

lateral neck flexion

81
Q

levator scap

A

stransverese process of c2-c4 to superior angle of scap

downward rotation and elevation of scap

82
Q

upper trap

A

occiput and spinous process of cerv. vertebrae to clavicle and spine of scap

upward rotation and elevation of scapula

83
Q

force inspiration muscles

A

levator scap

upper trap

84
Q

deep breathing and chest breathing muscles

A

sternocleidomastoid

scalenes

85
Q

neck and head positioning /posture

A

muscles in neck act as stabilizers

posture of the whole body will affect he positioning/posture of head

as head moves forward the lever arm in neck increases and increases the weight of the head

86
Q

Forward head posture muscles

A 
TIght:
cerv/thoracic extensors
upper trap
levator scap
Ant; sterno,scalenes,pec major and minor

Weak:
scap retractors
-rhomboids
-middle and lower trap

87
Q

cervical disc bulges

A

C4-C5
C5-C6
most common

Causes:
poor posture
heavy lifting
trauma

Clinical Signs:
radiating pain
numbness
tingling
weakness
impaired reflexes
88
Q

Rehab for cervical disc herniation

A 
avoid aggravating positions
manual or mechanical traction
Cervical ROM/gentle stretching
active protraction/retraction
promote centralization
avoid peripheralization
isometric strength/stabilize
pt. education
flexibility of ant. chest wall
thoracic flexibility
UE strength/stabilization
89
Q

Red light= compression of spinal cord

A 
tingling
numbness or burning pain
abnormal pattern of sensation affected
muscle weakness of UE
loss of hand function/coordination
90
Q

whiplash-cervical sprain

A

hyperextension followed by hyperflexion=often followed by 2nd hyperextension

impact is severe it may cause coup or countercoup injuries to the brain

often a component of rotation or lateral flexion as well

91
Q

cervical hyperextension injuries

A

possible injury to sternocleidomastoid muscle, anterior long. ligament or intervertebral disc

pain anterior neck area, shoulders and anterior chest

reduced cervical ROM

92
Q

cervical hyperflexion injuries

A

possible injury to posterior cervical muscles, posterior longitudinal ligament, intervertebral discs

pain posterior neck area, shoulders and upper back

93
Q

rehab for whiplash

A

acute phase: treat the symptoms

progress to AROM, gentle isometrics, cervical posture mechanics

gentle stretching to tight musculature
postural strengthening

94
Q

torticollos-wryneck

A

asymmetrical strength or length of sternocleidomastoid

cause:
congenital
-injury in utero
hemiplegia

clinical presentation:
-cervical sidebending towards affected side and rotation away from affected side

95
Q

rehab management for torticollis

A

stretching tight STM
strengthening supportive muscles
positioning

96
Q

Thoracic Outlet Syndrome

A

blood vessels and nerves are compressed by structures in the thoracic outlet

  • first rib
  • scalenes
  • pectoralis
97
Q

TOS causes

A

poor posture
carrying heavy bag
congenital factors
trauma

98
Q

TOS clinical signs

A 
UE radicular pain
numbness
paresthesia
weakness
discoloration and impaired circulation
99
Q

Tests for TOS

A

roos test
adsons
allen’s

100
Q

rehab for TOS

A

soft tissue stretching
posture
surgery to remove 1st rib

101
Q

rheumatoid arthritis

A

presents special problems because of erosion of bone and ligamentous laxities

can lead to instabilities

risk for atlantoaxial subluxation or C4-C5 and C5-6 dislocations

102
Q

Anatomy of TMJ

A

concave mandibular fossa of temporal bone

convex mandibular condyle of mandible

103
Q

articular disc of TMJ

A

articulates with mandibular condyle and temporal bone

hinge joint that allows some gliding too

104
Q

temporomandibular motions

A 
depression: opening of mouth-40 mm
elevation=closing mouth
protration-bring jaw forward
retraction-bring jaw toward skull
lateral deviation
105
Q

tmj disorder

A

symptoms caused by strain on structures around TMJ

cartilage disc at the joint
muscles of jaw, face and neck
teeth

106
Q

Cause of TMJ: malocclusion of teeth

A

an imbalance between the head, jaw, neck and shoulder girdle

faulty joint mechanics form inlfammation
dislocation of condylar head
contractures
asymmetrical forces 
restricted motion from periods of immobilization
prolonged open mouth position
107
Q

signs of TMJ

A 
biting or chewing dificult or discomfort
clicking sign while chewing or opening mouth
earache
grating sensastion while chewing
headache
jaw pain
loss of ROM
108
Q

rehab for TMJ

A

mouth guards

treat the cause

patient education on posture and proper open/close mouth

NSAIDS

reconstructive surgery

PTA Ortho (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions