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Clinical Practice > Posture > Flashcards

Posture Flashcards

1
Q

What is the key to preventing or correcting musculoskeletal pain?

A

Maintaining or restoring precise movement of specific segments

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2
Q

How can stress be beneficial to tissues?

A

Stress on components is necessary for optimal health. Graded stress can improve strength of the involved tissue.

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3
Q

What does optimal stress lead to?

A

Optimal stress leads to healthy adaptation and optimal performance.

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4
Q

What can abnormal stress lead to?

A

Abnormal stress leads to degenerative changes, microtrauma, macrotrauma, and then movement impairment.

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5
Q

A patient continues moving in bad alignment. What may be the result?

A

Injury. Lengthened or shortened structures change the length tension relationship of muscles. This takes them out of an optimal pull and will change how your body recruits the muscles.

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6
Q

If a patient has optimal muscle length, strength, and motor recruitment patterns, what are they promoting?

A

They are producing and maintaining alignment, balance, and health via optimal motor performance.

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7
Q

A patient continually, sits with their shoulders hunched and back slouched. What does sustained posture cause?

A

Repeated movements and sustained postures alter tissue characteristics, which eventually change the pattern of movement.

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8
Q

If a patient stands in hyperextension all the time, what happens?

A

The tibia and fibula can bow. Tissues adapt to our posture. This doesn’t just apply to muscles and ligaments. There can be bony changes too.

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9
Q

What does DSM stand for?

A

Directional susceptibility to movement

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10
Q

Changes in soft tissues induced by repeated movements and sustained postures eventually cause…?

A

This can cause a joint to develop a susceptibility to movement in a specific anatomic direction.

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11
Q

What does altered susceptibility of a joint to motion increase?

A

It increases the frequency of accessory and physiologic movements which can cause tissue damage and pain.

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12
Q

Stability = ?

A

Stability = ability to maintain COM in BOS

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13
Q

Are we inherently stable or unstable?

A

We are inherently unstable.

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14
Q

What three subsystems maintain postural stability?

A

Passive, active, and neural control.

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15
Q

Which system is like guidewires and what is it made up of?

A

The passive structures act like guide wires. It is made up of ligaments and bones. They provide stability in the motions they resist.

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16
Q

What are the two components of active structures?

A

Global muscles and core (local) muscles

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17
Q

What are global muscles?

A

Global muscles are multi-segmental. They respond to external loads that shift the COM. Global muscles have direction specific responses.

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18
Q

What are core (local) muscles?

A

Core muscles have segmental attachments. They provide dynamic support to individual segments to prevent stress on passive structures. They do not have direction specific responses.

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19
Q

True or false, global muscles control a whole portion and do not have directional responses?

A

False!

Global muscles DO control a whole portion. They DO have directional responses.

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20
Q

True or false, core muscles control a single segment within a portion?

A

True!

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21
Q

There is a greater percentage of type I fibers in back muscles. What does this indicate about the function of these muscles?

A

It indicates that the back muscles are constantly firing at a low activation because they have to work to fight gravity all day long.

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22
Q

What is a feed forward response?

A

A feed forward response is muscle activation and hormonal responses that occur before an activity is started.

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23
Q

How does the CNS use feed forward control?

A

It activates postural responses before moving an extremity. Muscles are recruited from deep to superficial and then the extremity movers.

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24
Q

Where do patients with low back pain show delayed recruitment?

A

They have delayed recruitment of deep core stabilizers with movement. They also show delayed recruitment of global muscles specific to direction of movement.

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25
Q

True or false, patients with low back pain do not activate their rectus abdominus like they should?

A

False! Patients with low back pain tend to not have the TA kick in like it should.

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26
Q

What do small adaptations in stabilizing muscles support?

A

They support against continuously fluctuating forces.

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27
Q

Global muscles are being recruited to help control activity. What is happening?

A

Fatigue. Repetitive motions and perturbations increasingly require global and muscles to control activity.

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28
Q

What else can fatigue cause?

A

Forces will be increasingly shifted to passive structures causing mechanical stress.
Injury is more likely to occur.

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29
Q

Exaggerated spinal curves could be the result of…?

A

Could be caused by impaired postural support from trunk muscles.

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30
Q

If a spinal curve is exaggerated, increased stress will be put on
A. Passive Structures
B. Active Structures

A

B. Passive structures

Continued end-range loading causes strain leaving the supporting tissues vulnerable to injury

31
Q

Where is the line of gravity aligned in ideal posture?

A

The body segments are aligned vertically with the LOG as close to possible to joint axes.

32
Q

When the line of gravity does not pass through the joint axis…

A

the torque must be balanced by an opposing torque.

33
Q

Torque of bad posture is balanced by what?

A

Passive ligamentous tension and minimal muscle activity

34
Q

True or False

In ideal posture, compression forces are dissipated by muscular activity.

A

False

Compression forces are optimally distributed over weight-bearing surfaces.

35
Q

What does ideal posture take tension off of?

A

Ligaments and muscles. It places minimal tension on ligaments and muscles.

36
Q

True or false

There are two types of Vladimir Janda’s Syndrome?

A

True!

  1. Lower crossed syndrome
  2. Upper crossed syndrome
37
Q

What muscles are weak in lower crossed syndrome?

A

Abdominals and gluteus maximus.

38
Q

What muscles are tight in lower crossed syndrome?

A

Erector spinae and iliopsoas.

39
Q

True or False

Lower crossed syndrome can result in a posterior pelvic tilt, hip extension, and a flat lumbar spine.

A

False

Lower crossed syndrome can result in an anterior pelvic tilt, increased hip flexion, and a compensatory hyperlordosis.

40
Q

What muscles are tight in upper crossed syndrome?

A

Cervical extensors and pectorals.

41
Q

What muscles are weak in upper crossed syndrome?

A

Cervical flexors and scapular retractors.

42
Q

What other pathologies can arise from upper crossed syndrome?

A

It can cause forward head posture, increase cervical lordosis, and increase thoracic kyphosis.

43
Q

A patient comes in with back and neck pain. You want to look at their posture. How would you examine it?

A
  1. Examine the patient in various postures depending on the affected area
  2. ROM testing
  3. MMT
44
Q

You start examining the patient’s posture in standing. What other positions might you examine?

A

Look at posture in sitting, squatting, SLS, supine/prone etc.
Look at the patient in multiple planes (front, back, and side)
Look for equal distribution of weight
Compare what you see to the norm

45
Q

In ideal alignment, where is the head?

A

In a neutral position.

46
Q

True or False

In ideal alignment, the cervical spine is slightly convex posteriorly?

A

False

The cervical spine has a normal curve and is slightly convex anteriorly

47
Q

Where are the scapula in ideal alignment?

A

Flat against the upper back

48
Q

Which direction is the thoracic spine convex during ideal alignment?

A

It should be slightly convex posteriorly.

49
Q

In ideal alignment, is the lumbar spine slightly convex anteriorly or posteriorly?

A

Anteriorly.

50
Q

In ideal alignment, is the pelvis
A. Anteriorly tilted
B. Posteriorly tilted
C. Neutral

A

C. Neutral

The ASIS should be in the same vertical plane as symphysis pubis.

51
Q

How are the knees positioned in ideal alignment?

A

They should be neither flexed nor hyperextended.

52
Q

At what angle is the ankle during ideal alignment?

A

At a right angle. The ankle should be in a neutral position. The leg vertical at right angle to sole of foot.

53
Q

At the head, what structures does the line of gravity pass through?

A

The line of gravity passes through the external auditory meatus. It runs posterior to the coronal suture and through the odontoid process.

54
Q

The gravitational moment of the head is…
A. Flexion
B. Extension

A

A. Flexion

Resisted by ligamentum nuchae, posterior longitudinal ligament, tectorial membrane, and neck extensors.

55
Q

At the hips, is the line from the symphysis pubis to ASIS
A. Anterior
B. Vertical
C. Posterior

A

B. Vertical

Hip is in neutral, and there shouldn’t be an anterior or posterior pelvic tilt.

56
Q

In correct posture, where does the line of gravity pass through the hip?

A

It should pass slightly posterior to the hip joint.

57
Q

The gravitational moment at the hip is in…
A. Flexion
B. Extension

A

B. Extension

Extension moment on hip joint.

58
Q

What muscles and ligaments resist hip extension?

A

Iliopsoas may be active in standing to resist hip extension. Iliofemoral, ischiofemoral, and pubofemoral ligaments resist hip extension.

59
Q

Where does the line of gravity pass through the knee?

A

It passes slightly anterior to the midline of the knee, posterior to the patella.

60
Q

The gravitational moment at the knee is…
A. Flexion
B. Extension

A

There is an extension moment.

61
Q

A patient is standing with their knees extended. What prevents them from hyperextending?

A

Hyperextension is prevented by posterior joint capsule and ligaments.

62
Q

A patient is standing for multiple hours at a concert. Would it be normal for them to report quad soreness and fatigue?

A

Maybe a little, but there is little or no muscle activity needed to maintain extension in optimal posture.

63
Q

What are the characteristics of a kyphotic posture?

A
  • forward head
  • hyperextended cervical spine
  • abducted scapulae
  • kyphosis in thoracic spine
  • lordosis of lumbar spine
  • anterior tilt in pelvis
  • flexion at hips
  • slightly hyperextended knees
  • slight plantar flexion because of backward inclination of the leg
64
Q

What are the characteristics of a lordotic posture:

A
  • head is in a neutral position
  • cervical spine has a normal curve (slightly anterior)
  • thoracic spine has a normal curve (slightly posterior)
  • hyperextension in the lumbar spine
  • anterior tilt in the pelvis
  • slightly hyperextended knees
  • slightly plantar flexed ankles
65
Q

What are the characteristics of a flat back posture?

A
  • head forward
  • cervical spine slightly extended
  • thoracic spine: upper part, increased flexion; lower part, straight
  • lumbar spine is flexed (straight)
  • posterior tilt in pelvis
  • hip joints extended
  • slight plantar flexion in the ankle
66
Q

What are the characteristics of sway-back posture?

A
  • head forward
  • cervical spine slightly extended
  • thoracic spine increased flexion (long kyphosis) with posterior displacement of the upper trunk
  • lumbar spine flexion (flattening) of the lower lumbar area
  • posterior tilt of pelvis
  • hyperextended hips with anterior displacement of pelvis
  • hyperextended knees
  • neutral ankle joints. Knee hyperextension usually results in plantar flexion of the ankle joint, but that does not occur here because of anterior deviation of the pelvis and thighs
67
Q

True or False

Scoliosis is a lateral extension and rotational deformity

A

False

Scoliosis is a lateral flexion and rotational deformity

68
Q

Is idiopathic scoliosis structural or functional?

A

Structural

69
Q

When does functional scoliosis occur?

A

Functional scoliosis is a secondary adaptation to behavioral habits, leg length discrepancy or other issues

70
Q

How is a scoliosis named?

A

It is named by the side of convexity and location. If there is more than one curve, the superior segment is named first.

71
Q

How many of the 10% of adolescents in the US with scoliosis will need intervention?

A

1/4 of them will need intervention.

72
Q

What are some hallmarks of scoliosis?

A
  • head not centered over body
  • one shoulder higher
  • one shoulder-blade higher and possibly more prominent
  • spine obviously curved
  • unequal gaps between the arms and the trunk
  • one hip more prominent
73
Q

How do you tell the difference between a structural and functional scoliosis?

A

Perform a forward bending test.
With structural, you will see a prominence in forward bending.
With functional, you will not see a prominence in forward bending.

74
Q

What is one way you can determine if muscles are weak?

A

Look at their muscle mass distribution. If someone has large hamstrings and a flat butt, they aren’t using their glute max as much. They are probably overusing their erector spinae.

Clinical Practice (19 decks)

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