Physiologic Motion Of The Spine

Question 1

Typical cervical vertebrae movement

Answer 1

Along the coronal plan

• Backward, Upward, Medial (BUM)

Question 2

Typical thoracic vertebrae movement

Answer 2

Along the coronal plane

Backwards, Upwards, Lateral (BUL)

Question 3

Typical Lumbar vertebrae movements

Answer 3

Along the sagittal plane

Backwards, medial (BM)

Question 4

Reasons why ROM is limited

Answer 4

Thickness, elasticity and compressibility of discs

Shape and orientation of the zygapophysial joints

Tension in the articular capsules of facet joints

Resistance of back muscles and ligaments

Question 5

Sagittal rotation movements

Answer 5

Flexion and extension

Question 6

Coronal rotation movements

Answer 6

Sidebending left and right

Question 7

Horizontal rotation movements

Answer 7

Rotation left and right

Question 8

Transverse process specific to rotation

Answer 8

Rotated right:

• right transverse process will be posterior
• left transverse process will be anterior

Rotated left:

• right transverse process will be anterior
• left transverse process will be posterior

rotation is respect to the vertebrae body movement

Question 9

Principle 1 characteristics

Answer 9

Generally refers to a group of vertebral segments (typically 3)

Rotation and side-bending are OPPOSITE

• sidebending occurs first
• rotation occurs along the side of convexity

No extreme flexion or extension

Causes discomfort but not pain and is usually chronic

Because sidebending occurs first, the nomenclature is N(sidebending)(rotation)

Question 10

Principle 2 characteristics

Answer 10

Refers to single superior vertebral segment/ vertebral unit

Segmented vertebrae does not return to neutral and remains flexed or extended when the patient returns to neutral

Includes flexion or extension of the segmented
- induces same sidebending and rotation of the segment

Commonly causes a acute pain and short restrictor muscles are affected

Nomenclature goes (flexion/extension)(rotation)(sidebending)

Question 11

Principle 3 characteristics

Answer 11

Initiating motion of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion

THERE IS NO TYPE 3 SOMATIC DYSFUNCTION

Question 12

Rules of 3 in thoracic spine

Answer 12

T1,2,3 and 12 =. Tip of each spinous process is at the same level as the transverse process of the same vertebrae

T 4,5,6 and 11 = tip of each spinous process is about 1/2 way between the transverse process of the same vertebrae and the one directly below

T7,8,9,10 = tip of each spinous process is at least one level below the same corresponding vertebrae and at the level of the vertebrae directly below it

Question 13

Thoracic Spinous process special locations

Answer 13

T3 = scapular spine

T7 = inferior scapula angle

T12 = Twelfth rib

L4 = iliac crest

Xyphoid process = T9

Umbilicus = L3-L5

Question 14

Cervical spine specifics

Answer 14

OA spinal segments

• named similar to type 1
• sidebending and rotation to opposite direction
• can be neutral, flexed or extended

AA spinal segments (C1/C2)
- only has rotational mechanics

C2-C7 spinal segments

• named similar to type 2
• rotation and sidebending occur to the same direction a
• can be neutral, flexed or extended

Question 15

Flexion and extension plane and axis of motion

Answer 15

Sagittal plane and transverse axis

Question 16

Motion of rotation along a plane and axis

Answer 16

Transverse plane

Vertical axis

Question 17

Sidebbending along a plane and axis

Answer 17

Coronal/frontal plane

A-P axis

Question 18

Tri-planar diagnosis upper thoracic spine

Answer 18

Tart 1st

• heat
• psuedomotor findings
• red reflex
• tissue abnormalities

Assess motion of the transverse processes (rotation first)

• determine any restriction of motion one way or the other first
• document the somatic dysfunction
• have the patient flex forward and extend to determine if the somatic dysfunction approves
• have the patient side bend and determine if the somatic dysfunction approves

Determine the somatic dysfunction in all 3 planes of motion and write the nomenclature