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Sophia's OS Stuff > Lumbar, Thoracic, Ribs, Vertebra Mechanics (for CPA 3) > Flashcards

Lumbar, Thoracic, Ribs, Vertebra Mechanics (for CPA 3) Flashcards

1
Q

In what parts of the spine are there kyphoses? Lordoses?

A

thoracic and sacral kyphoses cervical and lumbar lordoses

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2
Q

How are the cervical superior facets oriented?

A

BUM backward, upward, medial

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3
Q

How are the thoracic superior facets oriented?

A

BUL backward, upward, lateral

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4
Q

How are the lumbar superior facets oriented?

A

BM backward, medial

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5
Q

What are the 5 spinal ligaments you should know?

A

anterior longitudinal ligament posterior longitudinal ligament ligamentum flava interspinous ligaments intertransverse ligaments

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6
Q

What does the posterior longitudinal ligament connect?

A

posterior aspect of the vertebral bodies

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7
Q

What does the ligamentum flava connect?

A

the laminae of adjacent vertebra

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8
Q

What does the iliolumbar ligament connect?

A

the transverse processes of lumbar vertebrae and the ilium

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9
Q

How is excessive or restricted motion named?

A

in reference to the vertebra above in a functional vertebral unit (excess motion of L2 is motion of L2 on L3)

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10
Q

When were Fryette’s principles published?

A

1918 = first 2 principles of spinal motion

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11
Q

What are type one mechanics?

A

TONGO Type One Neutral Grouped vertebra Opposite sidebending and rotation

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12
Q

What are type two mechanics?

A

TTOSS Type Two nOt neutral Single segment Same direction

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13
Q

What is Fryette’s third principle?

A

initiating movement of a vertebral segment in any plane of motion will modify the mvnt in other planes of motion

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14
Q

For which parts of the spine are Fryette’s first two principles applicable?

A

thoracic and lumbar spine only

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15
Q

What spinal landmarks are at the level of the spine of the scapula?

A

T3 spinous and transverse processes

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16
Q

What spinal landmarks are at the level of the inferior angle of the scapula?

A

spinous process of T7 transverse process of T8

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17
Q

What spinal landmark is at the level of the iliac crest?

A

L4

18
Q

Seated Articulatory, T1-T6 (Type 2 SD)

Dx: T2 ESlRl

A

seated behind or next to pt

put thumb pad on lateral aspect of TP of level w/ SD

put pt into Flexion, Sr Rr

articulate until no restricted motion is perceived

reevaluate

19
Q

ME, seated T1-6 (type 2 SD)

Dx: T3 ERrSr

A

monitor T3 TPs using pads of thumb and index finger of one hand and middle finger pad to monitor TP of T4

other hand on pt’s head –> induce flexion - if T4 begins to move, too much flexion induced

induce sidebending and rotation to RB

MET 3-5 sec 3-5 times then recheck

20
Q

ME, seated T1-6 (type I SD

Dx: T1-3 NRlSr

A

monitors T2 TPs and TP of T3 (claw hand)

other hand on pt’s head

induce left sidebending - if T3 begins to move, too much motion was induced

induce left rotation

ME 3-5 sec 3-5 times then recheck

21
Q

For lower thoracic techniques, how do you position the patient?

A

have them put one hand on back of neck and then grasp the elbow with other hand

22
Q

How do you position yourself for type 1 lower thoracic SD?

A

make sure you stand on side opposite of pt’s hand thats on their neck

loop arm under armpit = over 1 bicep!

induce sidebending and rotation pushing away from you

23
Q

How do you position yourself while doing a lower thoracic type 2 direct technique?

A

stand on opposite side which pt has hand on back of neck

over 2 biceps –> induce sidebending and rotation pulling toward you (will be same side)

24
Q

ME, seated - Lower Thoracic SD (type 1)

Dx: T8-10 NRrSl

A

Pt seated on table w/ ipsilateral hand to the PTP behind their neck and holding elbow w/ other hand

monitor T9 TPs and TP of T10 using claw hand

hand under armpit and over 1 bicep

induce Rl and Sr by pushing away from you

ME 3-5 sec 3-5 times

25
Q

ME, seated - lower thoracic SD (type 2 SD)

Dx: T7 ERrSr

A

Put pt in position w/ R hand on back of neck and grasping that elbow

monitor T7 TPs and T8 TP w claw hand

put arm over both biceps and induce left sidebending toward physician and left rotation

ME 3-5 sec 3-5 times

26
Q

ART, seated - lower thoracic SD

extension type 2 SD

A

pt sits on table w/ arms folded across chest

physician stands behind/beside pt with arm over pt’s shoulder and hand on opposite shoulder

stabilize T10 TPs w/ thumb and index finger

flex thorax into RB to level of the stabilizing hand

induce ART motion until improvement

27
Q

ART, seated - lower thoracic SD

flexion type 2 SD

A

pt sits w/ arms folded across chest

physician sits beside pt w/ arm across chest; hand on opposite shoulder

stabilize T10 TPs and use this hand as a fulcrum

extend thorax and induce ART motion through RB

28
Q

Articulatory thoracic sidemending, prone

A

stand on contralateral side to PTP

place caudad hand on posterior ptp, fingers facing cephalad

cephalad hand insilateral w/ fingers facing caudal

downward pressure to articulate spine

exert longitudinal force w/ both hands to carry affected segment thru restrictive barrier

reassess

29
Q

ART, seated - lower thoracic sidebending SD

A

Doc stands or sits behind and beside pt who is seated w/ arms folded across the chest

thenar eminence at TP of dysfunctional vertebra on ipsilateral side to doc

doc induces sidebending force by pressing downward w/ axilla while also pressing medially w/ thenar eminence

hold 1-2 sec, then return to neutral

repeat rhythmically until motion is improved

30
Q

ART, seated - lower thoracic rotation SD

A

doc stands or sits behind and beside pt who has arms folded across chest

doc has arm over pt’s shoulder w/ hand on opposite shoulder

thenar eminence at TP of dysfunctional vertebra on contralateral side to doc

induce rotation by pulling shoulder anterior and pressing anteriorly w/ thenar eminence

hold 1-2 sec then return to neutral; repeat until motion improved

31
Q

MET/ART lumbar seated treatment (type 1 SD)

Dx L1-3 NRrSl

A

Pt sits w/ ipsilateral hand to PTP clasped behind neck and holding elbow w/ other hand

physician places hand over one bicep (standing on side contralateral to PTP)

monitor L2 TPs and TP of L3

rotate pt left and sidebend right

do MET or ART

32
Q

MET/ART lumbar seated treatment (type 2 SD)

Dx L2 ERrSr

A

pt’s hand ipsilateral to PTP on back of neck

physician stands contralateral to PTP

physician monitors L2 TPs and TP of L3

rotate left and sidebend left (too far if motion felt at L3)

MET or ART

33
Q

Seated Lumbar ART sidebending SD

A

Pt seated w/ hands across chest

physician with arm across chest and 1 hand on contralateral shoulder

thenar eminence at TP of dysfunctional vertebra on ipsilateral side of operator

induce sidebending by pressing downward w/ axilla while pressing laterally w/ thenar eminence

34
Q

Seated lumbar ART

rotation somatic dysfunction

A

Operator stands on contralateral side to PTP (if rotated right, stand on left side)

hand on opposite shoulder and thenar eminence on TP of dysfunctional vertebra contralateral to operator

induce rotation

ART

35
Q

Lumbar long lever/sidebending ME treatment (type 1 SD)

Dx: L3-5 N RrSl

A

mnemonic: NUDR

Neutral dysfunction, ptp Up, pt force Down, lateral Recumbent

pt right lateral recumbent (right side up), induce R sidebending by lifting ankles and monitoring at apex of curve w/ cephalad hand

should be facing pt –> they will pull down

MET

36
Q

Lumbar ART sidebending, lateral recumbent sidebending dysfunction

A

put side of somatic dysfunction facing table (so you can sidebend pt opposite way)

face pt and stabilize the superior (dysfunctional) vertebra while pulling up bent ankles to induce sidebending

ART

37
Q

Lumbar long lever/sidebending ME treatment (type 2 SD)

Dx: ERrSr

A

SUUE

modified Sims. ptp Up. pt force Up. Extension sd.

pt lateral recumbent w/ right side up and pt’s torso rotated to to the table

facing pt w cephalad hand monitoring dysfunction

flex hips and knees, engaging flexion barrier

drop pt’s legs off table and push down ankles to engage sidebending barrier

pt will raise ankles up against operator’s counter-resistance

38
Q

Lumbar long lever/sidebending ME treatment (type 2 SD)

Flexed

Dx: L4 FRlSl

A

mnemonic: FDDR

Flexed dysfunction, ptp Down, pt force Down, lateral Recumbent

pt LR w/ disfunctional side (left) on table

torso rotated back right; monitor at dysfunction w/ caudal hand

straighten bottom leg, engaging extension barrier

engage SD by lifting top ankle –> instruct pt to pull toward floor w/ ankle = MET

39
Q

Lumbar long restrictor/rotation MET (type 1 SD)

Dx: L3-5 N RrSl

A

Pt lateral recumment w/ ptp down

caudal hand or thigh flexes pt’s knees and hips; top leg lowered off edge of table –> left rotation

put caudal hand now to monitor dysfunctional segment

use cephalad hand to move pt’s top shoulder posteriorly

option 1: pt pushes top shoulder forward against resistance

option 2: pt pulls hip posteriorly and cephalad against resistance

40
Q

Lumbar long restrictor/rotation MET (type 2 SD)

extended

Dx: L4 ERrSr

Tx: L4 FRlSl

A

Pt lateral recumbent, PTP down; physician facing pt

caudal hand or thigh flexes pt’s knees and hips and monitor w/ cephalad hand; flex top hip until motion is felt to flex

put pt’s top foot behind bottom knee

switch monitoring hands. use cephalad hand to move pt’s top shoulder posteriorly until caudal hand detects rotation

Option 1: pt pushes top shoulder forward agianst resistance

option 2: pt pulls hip posteriorly and cephalad against doc’s resistance

41
Q

Lumbar Long Restrictor/Rotation MET (type 2 SD)

Flexed

Dx: L4 FRrSr

Tx: L4 ERlSl

A

pt lateral recumbent, PTP down. Dr facing the pt

caudal hand or thigh flexes pt’s knees and hips while cephalad hand monitors segment. flex hip until motion is felt at inferior segment

switch monitoring hands. Use cephalad hand to move shoulder posteriorly until caudal hand detects motion. Extend torso to feel motion at finger and thumb

option 1: pt pushes shoulder against resistance

option 2: pt pulls hip posteriorly and cephalad against resistance

Sophia's OS Stuff (7 decks)

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