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Osteopathy Term 2 > osteopathic Skills 1 (ROM/Restrictive factors) > Flashcards

osteopathic Skills 1 (ROM/Restrictive factors) Flashcards

1
Q

What is the available AROM for the cervical spine?
Flex, Ext, Rot, S/bending
What is the orientation of the facets?
Which plane do they reside within?

A

Flex 80-90
Ext 7
Rot 20 to 45
S/bending 70 to 90

45 degree coronal (C2 to C7)
C1 transverse

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2
Q

Which muscles Flex the cervical spine?

A

Anterior scalene
Longus colli
Longus capitis
SCM

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3
Q

What are the limiting factors to flexion of the cervical spine?

Apprehension 
Ligamentous
Structural 
Joint capsule
Opposing muscles
A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Adipose tissue – Generating soft end feel

Muscular (Opposing muscles of extension)
Upper fibers of the trapezius 
Levator scapulae 
Splenius cervicis and Splenius capitis 
Semispinalis and spinalis capitis 
Cervicis portion of erector spinae
Sub-occipitals 
Ligamentous:
Nuchal ligament 
Interspinous Ligaments 
Ligamentum flavum 
Posterior longitudinal ligament

Joint Capsule
Posterior stretch of zygapophyseal joint
(stretching the capsule)

Structural
Posterior intervertebral joint opens
Anterior intervertebral joint closes

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4
Q

Which muscles Extend the cervical spine?

A 
Upper fibers of the trapezius 
Levator scapulae 
Splenius cervicis and Splenius capitis 
Semispinalis and spinalis capitis 
Cervicis portion of erector spinae
Sub-occipitals
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5
Q

What are the limiting factors to extension of the cervical spine?

Apprehension 
Ligamentous
Structural 
Joint capsule
Opposing muscles
A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Ligamentous
Anterior longitudinal ligament

Structural
Sp’s come together (kissing syndrome)

Anterior facet capsule will stretch
Posterior intervertebral joint closes
Anterior intervertebral joint opens

Muscles of flexion (e.g. scalene)
Platysma 
Anterior scalene 
Longus colli 
Longus capitis 
SCM
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6
Q

Which muscles side bend the cervical spine?

A 
SCM (Same side)
Longus colli and capitis (SS)
Trapezius (SS)
Splenius capitis and cervicis (SS)
Intertransversarii 
Levator scapulae 
Scalenes
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7
Q

What are the limiting factors to side bending of the cervical spine?

Apprehension 
Ligamentous
Structural 
Joint capsule
Opposing muscles 
Joint mechanics
A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Ligamentous 
Intertransverse ligament (joint TP to TP)

Opposing side bending muscles

Structural
Stretch of capsule on contralateral side
(joint opens)
Compression of capsule on ipsilateral side
(joint closes)

Mechanics
Side bending and rotation coupled to the same side

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8
Q

Which muscles rotate the head and neck?

A 
Splenius capitis and cervicis (SS)
SCM (OS)
Scalenese anterior (OS)
Longus colli (OS)
Rotatores (OS)
Multifidi (OS)
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9
Q

What are the limiting factors to rotation of the cervical spine?

Apprehension 
Ligamentous
Structural 
Joint capsule
Opposing muscles (2 suboccital muscles)
Joint mechanics
A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Ligamentous
Apical/ Alar ligaments (Odontoid processs)

Joint Mechanics
Rotation and side bending are coupled to the ipsilateral side (type 2 mechanics)

Opposing muscles of rotation 
Rectus Capitis posterior major
Obliquus capitis superior
SCM
Trapezius 
Splenius capitis and cervicis (SS)
Intertransversarii 
Levator scapulae 
Scalenes

Structural
Stretch of capsule on contralateral side
(joint opens)
Compression of capsule on ipsilateral side
(joint closes)

Mechanics
Side bending and rotation coupled to the same side

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10
Q

What is the Origin (2), insertion (2), action and nerve innervation of the SCM?

Which condition effects the SCM during infancy?

A

Origin
Sternal head: superior part of anterior surface of manubrium
Clavicular head: superior surface of medial third of the clavicle

Insertion
Lateral surface of mastoid process of the temporal bone, Lateral half of superior nuchal line of the occipital bone

Action
Contralateral
Rotation

Ipsilateral
Side Bending

Bilateral
Flexion

Nerve innervation
Accessory nerve (CN XI)
cervical plexus (C2-C3)

Pathology
torticollis

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11
Q

What is the Origin, insertion, action and nerve innervation of the Trapezius?

A 
Origin 
Superior nuchal line
External occipital protuberance
Nuchal ligament
Spinous processes of vertebrae C7-T12

Insertion
Lateral one-third of the clavicle
Acromion process
Spine of scapula

Nerve
accessory nerve (motor)
cervical spinal nerves C3 and C4

Action
Rotation
Retraction, elevation, and depression of scapula
Upward rotation of the scapula

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12
Q

What is the Origin, insertion, action and nerve innervation of the Splenius capitis?

A

Origin
Nuchal ligament and spinous process of C7-T3

Insertion
Mastoid process of temporal and occipital bone

Action
Extend, rotate, and laterally flex the head

Nerve Innervation
Cervical plexus C3,4

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13
Q

What is the Origin, insertion, action and nerve innervation of the Splenius cervicis?

A

Origin
Spinous processes of T3-T6

Insertion
Transverse processes of C1-C3

Action
Bilaterally: Extend the head & neck, Unilaterally: Lateral flexion to the same side, Rotation to the same side.

Nerve Innervation
Posterior rami of lower cervical nerves

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14
Q

What is the Origin, insertion, action and nerve innervation of the Levator scapulae?

A

Origin
Posterior tubercles of transverse processes of C1 - C4 vertebrae

Insertion
Superior Angle of the scapula

Action
Elevates scapula and tilts its glenoid cavity inferiorly by downwardly rotating the scapula
Side bends/rotates to the ipsilateral side
Bi laterally extends the neck

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15
Q

What is the Origin, insertion, action and nerve innervation of the sub occipital muscles?

  1. Rectus capitis posterior major muscle
  2. Rectus capitis posterior minor muscle
  3. Obliquus capitis superior muscle
  4. Obliquus capitis inferior muscle
A
  • All muscles innervated by the nerve to the sub occipitals, C1*
1. Rectus capitis posterior major muscle
Origin	
Spinous process of the axis (C2)
Insertion	
Inferior nuchal line of the occipital bone
  1. Rectus capitis posterior minor muscle
    Origin
    Posterior tubercle on the posterior arch of the atlas
    Insertion
    Medial part of the inferior nuchal line of the occipital bone and the surface between it and the foramen magnum
3. Obliquus capitis superior muscle
Origin	
Lateral mass of atlas (TP)
Insertion
Lateral half of the inferior nuchal line
4. Obliquus capitis inferior muscle
Origin	
spinous process of the axis
Insertion	
lateral mass of atlas
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16
Q

What is the available AROM for the thoracic spine?
Flex, Ext, Rot, S/bending
What is the orientation of the facets?
Which plane do they reside within?

A

60 degree orientation within coronal plane

Flexion 20 to 45
Extension 25 to 45
Rotation 35 to 50
S/bending 20 to 40

17
Q

Which factors contribute to thoracic flexion?

A 
Gravity 
Psoas contracting eccentrically 
Rectus abdominis 
Internal oblique 
External oblique
18
Q

What are the limiting factors of the thoacic spine flexion?

Apprehension 
Ligamentous
Structural 
Joint capsule
Opposing muscles
Joint mechanics
A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Structural 
Visceral 
Adipose Tissue 
Posterior stretch of facet joint capsule 
(Joint opening) 
Facet opening closing
Sternum 
Ribs 
Ligamentous
Posterior longitudinal ligament
Ligamentum flavum 
Interspinous ligament 
Supraspinous ligament

Opposing muscles
Muscles of the back (erector spinae )
Quadratus Lumborum

19
Q

Which muscles produce extension of the thoracic spine?

A 
Serratus posterior inferior 
Quadratus lumborum 
Erector spinae muscles (superficial and deep)
Interspinalis 
Intertransversarrii
20
Q

What are the limiting factors of the thoacic spine extension?

Apprehension 
Ligamentous
Structural 
Joint capsule
Opposing muscles *think muscles of respiration*
A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Structural
Anterior facet capsule will stretch (joint will open)
Posterior facet capsule (joint will close)
Orientation of the facets (they start to pinch at the lower pole)
Spinous processes overlap (compressing together)
Compression of the ribs

Ligamentous
Anterior longitudinal ligament

Muscles 
*INTERCOSTALS*
Psoas contracting eccentrically 
Rectus abdominis 
Internal oblique 
External oblique
21
Q

Which muscles produce rotation of the thoracic spine?

A

When the orgin moves towards the insertion, the latissimus dorsi acts as a powerful rotator of the trunk

Rectus abdominis
Internal oblique
External oblique

22
Q

What are the limiting factors of the thoacic spine rotation?

Apprehension
Ligamentous Take into account ligaments of the ribs
Structural
Joint capsule
Opposing muscles think muscles of respiration

A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Spinal mechanics
Type 1 coupled motion
Rotation and side bending to the contralateral side

Ligamentous
Intertransverse ligament
Ligaments surrounding the facet joints will stretch
Ribs
(Radiate ligaments/costotransverse ligament)

Opposing musculature 
Opposing erector spinae muscles 
Rectus abdominis 
Internal oblique 
External oblique 
Quadratus lumborum 
Lats
When the orgin moves towards the insertion, the latissimus dorsi acts as a powerful rotator of the trunk
23
Q

What is the available AROM for the Lumber spine?
Flex, Ext, Rot, S/bending
What is the orientation of the facets?
Which plane do they reside within?

A

Flexion 40 to 60
Extension 25 to 35
Rotation 3 to 18
S/bending 15 to 20

What is the orientation of the facets?
L1 to L4 Sagittal orientation 90 degrees
L5/S1 Coronal orientation 45 degrees

24
Q

Which muscles produce flexion of the lumber spine?

A

Gravity
Rectus abdominis
Abdominal oblique muscles (internal and external)
Psoas major/minor (eccentrically)

25
Q

Which muscles produce extension of the lumber spine?

A

Deep and superficial erector spinae muscles
Intertransversarii
Interspinalis
Quadratus Lumborum

26
Q

Which muscles produce lateral flexion of the lumber spine?

A

Quadratus lumborum
Psoas major
Internal and external obliques
Superficial erector spine

27
Q

Which muscles produce rotation of the lumber spine?

A

Levator costorums
Deep erector spinae muscles
Internal and external oblique

28
Q

Which factors limit flexion of the lumber spine?

A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Adipose tissue/Viscera

Spinal mechanics/orientation
Orientation of the facet joints – stretch at posterior

Ligamentous 
Posterior longitudinal ligament
Supraspinous ligament 
Interspinous ligaments 
Ligamentum flavum

Muscular
Hamsrings
Muscles of extension

Hydration of discs
Presence of intervertebral discs

29
Q

Which factors limit extension of the lumber spine?

A

Psychological apprehension due to eliciting pain

Skin and fascia on opposing side

Adipose tissue/Viscera

Structure
Orientation of the facet joints – joints close posterior and open anterior
Approximation of SP’S
Size of the vertebral bodies

Ligamentous
Anterior longitudinal ligament
Linea alba

intervertebral discs
Disc Hydration

Musculature
Stretch in muscles of flexion

30
Q

Which muscles perform laterally flexion of the lumber spine?

A

Quadratus lumborum
Psoas major
Internal and external obliques
Superficial erector spine

31
Q

Which factors limit rotation of the lumber spine?

A

Structural
Orientation of the facet joints
L1 to L4 adhere to 90 degree sagittal orientation
This limits movement due to the coupled motion of the lumber spine with rotation and side bending being coupled to the contralateral side

Size of the vertebral bodies

Ligamentous
Interspinous ligaments
Intertransverse ligaments

Hydration
Presence of intervertebral discs

Opposing side bending muscles

32
Q

Which muscles perform side bending of the lumber spine?

A

Quadratus lumborum
Psoas major
Internal and external obliques
Superficial erector spine

33
Q

Which factors limit lateral flexion of the lumber spine?

A

Structural
Orientation of the facet joints
L1 to L4 adhere to 90 degree sagittal orientation
This limits movement due to the coupled motion of the lumber spine with rotation and side bending being coupled to the contralateral side

Size of the vertebral bodies

Ligamentous
Intertransverse ligament

Hydration
Presence of intervertebral discs

Musculature
Opposing side bending muscles

34
Q

What is the ROM of the shoulder joint?

A 
Flexion 180
Extension 50
Abduction 180
Adduction 10 to 55
External rotation 80
Internal rotation 60
35
Q

What is the ROM of the elbow joint?

A

Flexion 140/150
Extension 10 to 15
Supination 90
Pronation 90

36
Q

Which ligament restricts supination/pronation of the elbow joint?
Tip begins with a Q.

A

Quadrate ligament

Osteopathy Term 2 (28 decks)

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