Module 3

Question 1

Two adjacent vertebrae, their joints, and the intervertebral disc between are called a __________.

Answer 1

Vertebral unit

Question 2

T/F
The vertebral unit is given the name of the superior member of the unit. Ex. Motion or somatic dysfunction of C2 means C2 on C3.

Answer 2

True

Question 3

T/F
The passive range of motion is the degree of joint motion allowed when someone other than the patient puts the joint through its range of motion. (pt is passive)

Answer 3

True

Question 4

Impaired or altered function of the body framework, skeletal, arthrodial, myofascial, and its related elements, is called…..

Answer 4

somatic dysfunction

Question 5

Name and describe the 4 types of barriers.

Answer 5

Anatomic - due to structure
Physiologic - functional limits within anatomic range of motion. Soft tissue tension accumulation which limits the voluntary motion of an articulation.
Pathologic - functional limit within anatomic range of motion which abnormally diminishes the normal physiologic range. May be assoc. with somatic dysfunction.
Restrictive - (used only by some physicians in place of pathologic barrier) - means the same thing. More accurate and descriptive for barrier of somatic dysfunction.

Question 6

T/F

The Occipitoatlantal Joint side-bends and rotates to the same side

Answer 6

False. This would only occur in severe trauma.

It normally side-bends in one direction and rotate to the other during multiple plane motion

Question 7

T/F
The Atlantoaxial Joint’s normal motions include rotation 45 degrees in each direction, side-bending, forward bending, and backward bending.

Answer 7

False
The Atlantoaxial Joint’s normal motions include rotation 45 degrees in each direction- clinically there is NO side-bending, forward bending, and backward bending.

Question 8

T/F

The normal AA joint motion is responsible for 50% of the full range of cervical rotation.

Answer 8

True

Question 9

Why we do assess patient active before patient passive?

Answer 9

safety

Question 10

Name the differences between anatomical, physiological and restrictive barrier.

Answer 10

Anatomical Barrier: motion that exceeds this barrier will disrupt and/or dislocate the joint and/or tear or fracture the joint components.

Physiologic Barrier: functional limits within the anatomic range of motion. Soft tissue tension can limit the voluntary motion. Further motion can be made toward the anatomic barrier, passively.

Restrictive Barrier (pathologic barrier): Functional limits within the anatomic range of motion, which normally diminishes the normal physiologic range. May be associated with somatic dysfunction.

Question 11

What are the superior and inferior divisions of the cervical spine?

Answer 11

superior - occiput, C1, C2, OA/AA

inferior - C2 - C7

Question 12

T/F
It is normal to have SBR to the same side throughout the vertebral column.
???????

Answer 12

False.

Cervical spine with SBR to the same side is only due to serve trauma, congenital or developmental anomalies.

Question 13

T/F

The OA joint accounts for 50% of cervical rotation.

Answer 13

False
The AA (C1 on C2) accounts for 50% of cervical rotation

Question 14

When a spinal diagnosis does not fall into the Fryette Mechanical Theory, what is this called?

Answer 14

Spinal dysfunction

Question 15

When motion occurs in any one plane within a joint, the motion of all other planes of that joint will be influenced. Which law is this?

Answer 15

Nelson’s 3rd Law.

Question 16

Explain the Rule of 3’s.

Answer 16

1T1-3, T4-6, T7-9 & T10-12

• Important for palpation – gives approximation location of thoracic TVPs in relation to the SPs
• The SPs are easier to find – use these as a bony landmark
• T1-T10 TVPs contain costotransverse synovial joints with the ribs of its number except T11 and T12
• Superior articular facets face:
• Cervical: BUM
• Thoracic: BUL – ribs restrict
coronal motion / sternum
• Lumbar: BM

Question 17

What forms the functional cervicothoracic diaphragm?

Answer 17

Sibson’s fascia

Question 18

Name the boundaries of the superior and inferior thoracic outlets.

Answer 18

superior - clavicles, 1st ribs and scapula

inferior - boundary of thorax closed by abdominal diaphragm (xiphoid process, lower 6 ribs, L1-2-3)

Question 19

Which ribs have a motion that is a combination of pump handle and bucket handle?

Answer 19

Ribs 4 5 6

Question 20

Name the motions of all of the ribs.
ribs 1-3
ribs 4-6 
ribs 7-10 
ribs 11&12

Answer 20

1-3 - pump handle
4-6 combination pump handle and bucket handle
7-10 - bucket handle
11-12 pincer

Question 21

Explain the pump handle movement and the bucket handle movement.

Answer 21

pump handle - elevation of ribs - increase in antero-posterior diameter of thoracic cavity

Bucket handle - elevation of ribs - increase in lateral diameter of thoracic cavity

Question 22

Which ribs have atypical rib motions?

Answer 22

Ribs 1, 11 and 12

rib 1 - attached to sternum with synchondrosis therefore anterior end does not move well; no definite motion about an AP/transverse axis

Ribs 11 & 12: no anterior attachment; can be pulled up/down via muscle attachment; pincer motion

Question 23

Which ribs have typical rib motions? Which axis do they move around?

Answer 23

2-10
AP/Longitudinal Axis - buckle handle
• Axis passes thru posterior tubercle & anterior end of rib

Transverse Axis - pump handle
• Axis passes thru posterior tubercle & head of the rib

• Inhalation: “posterior angle” of rib moves inferior & anterior end moves superior
• Changes in the superior & inferior edges of a rib occur at this axis during respiration and can be best palpated