Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PTA - Pathology > PTA135-Unit5-Spine > Flashcards

PTA135-Unit5-Spine Flashcards

1
Q

relate the difference between Correct and Faulty Posture

A

correct - the position in which minimal stress is applied to each joint
faulty - any position that increases the stress to the joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe Ideal Standing Postural Alignment

A

Sagittal view, the plumb line:
• Passes through the ear lobe, the bodies of the C-spine vertebrae, the tip of the shoulder
• Midway through the thorax, through the bodies of the lumbar vertebrae
• Slightly posterior/midpoint to the hip joint
• Slightly anterior/midpoint to the axis of the knee joint
• Just anterior to the lateral malleolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

identify the characteristics of Normal Sitting Posture

A 
“neutral” – 90-90-90
•	ears over shoulders
•	Shoulders relaxed
•	Wrists straight
•	Elbows kept close to the body
•	Natural curve to lower back maintained
•	Feet resting on the floor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how to Instruct a Patient on the mechanics of lifting

A

use the Five L’s of Lifting
- When you lift, make sure you stand close to the object you are lifting (lever) with a wide stance and feet firmly on the ground. Bend at the knees and hips and make sure you lift with your legs and not with your back (lordosis). Make sure you do not pick up anything that is too heavy for you. Keep the load (what you are lifting) as close to your body throughout the lift as possible. Make sure you breathe when you lift, do not hold your breath. (Lungs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

name the 5 L’s of Lifting

A 
Load
Lever
Lordosis
Legs
Lungs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

explain the Load of lifting

A

The amount of weight to be hoisted should be appropriate for the task and for the individual attempting to lift it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

explain the Lever of lifting

A

Keep the object as close to the body as is functionally possible throughout the lift
• Holding an object away from the body increases the spinal compressive forces 10x
o a 5 lb. dumbbell away from the body, feels like 50 lbs. of pressure on the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

explain the Lordosis of lifting

A

Maintain a normal anatomic lordotic curve (normal inward curve of lower back) while lifting any object

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

explain the Legs of lifting

A

Instruct individuals to lift with their legs and not with their back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

explain the Lungs of lifting

A

Use proper breathing techniques during lifting. Valsalva maneuver (closed glottis during attempted expiration) should be AVOIDED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

discuss Body Mechanics

A

All these L’s together comprise proper body mechanics.
“Body mechanics refers to the way we move during every day activities. Good body mechanics may be able to prevent or correct problems with posture (the way you stand, sit, or lie.) Good body mechanics may also protect your body, especially your back, from pain and injury. Using good body mechanics is important for everyone.” (http://www.drugs.com/cg/using-good-body-mechanics.html)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe Peripheralization

A
  • Radicular pain symptoms are experienced further down the leg.
  • Do not want!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe Centralization

A
  • Radicular pain symptoms are made to move away from the periphery and toward the mid-line of the spine
  • As a result of the performance of certain repeated movements or the adoption of certain positions
  • Good! Yay!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

1) Effect on the nucleus pulposus with positional change from flexion into extension

A

The nucleus moves anteriorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

2) Effect on the nucleus pulposus with positional change from extension into flexion

A

The nucleus moves posteriorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

rehab for Lumbar Spine Ligament Sprain

A
  • Treatment parallels that of muscular strains
  • Managed similarly to muscle strains
  • Individualized treatment based on each patient’s impairments
  • Emphasize protecting the spine from unwanted forces and positions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

rehab for Lumbar Spine Muscle Strain

A
  • Individualized for patient’s impairments
  • Address pain and inflammation
  • Specific stabilization and back strengthening exercises
  • Flexibility in hips and lower extremity
  • Cardiorespiratory conditioning
  • Patient education!! Prevent reinjury!!
  • Emphasize protecting the spine from unwanted forces and positions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

define Ergonomics

A

a quantifiable system of job or ADL modification[ or redesign that allows for continued productivity while reducing work-related physical stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

define Functional Capacity Evaluation

A

FCE
• Mimics the work environment for improved training, similar to “Back School”
• A group of physical and functional tests administered to a recovering patient before he or she returns to the job.
• An FCE can also be used as a screening tool to acquire data related to pre-employment risk assessment and management of back injuries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

MOI of muscle strains of cervical spine

A
  • Common among young athletes
  • In association with motor vehicle accidents with flexion-extension, later flexion and acceleration-deceleration “whiplash” type injuries
  • Falls
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Muscles most often involved in muscle strain of cervical spine

A
  • Upper trapezius
  • Levator scapulae
  • Scalenes
  • Sternocleidomastoid (SCM)
  • Spinal erectors
  • Rhomboids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

rehab for Cervical Strain

A
  • Similar to treatment of lumbar strains
  • Address pain and its causes
  • AVOID the direction of the strain initially
  • After inflammation and pain decrease, isometric contractions in all planes
  • Progress to cervical stabilization strengthening
  • Postural strengthening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

cause of Cervical Spondylosis

A

Chronic degenerative disc

- “wear and tear on the weight bearing structures of the cervical spine”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

most common cervical segments involved in cervical spondylosis

A

C5-C6

C6-C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

rehab for Cervical Spondylosis

A

• Address pain (NSAIDs)
• Avoid aggravating positions
• Semi-rigid cervical collar for some
◦ hopefully short term
• Axial Extension-retraction exercises are effective for patients who drive pain relief from extension
• Flexion-type activities are reserved for patients who obtain pain relief from cervical flexion
• Mechanical or manual cervical traction
• Cervical mobilizations (by the PT, of course)
• Isometric cervical spine exercises
• Posture mechanics, flexibility exercises, and strengthening activities
• Patient Education:
◦ Move on a regular basis
◦ Stretch throughout the day
◦ Posture – good sitting posture, ergonomics
◦ Sleep
- one pillow under head in supine
- pillow between knees and two pillows under head in sidelying
- Neutral spine top to bottom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

name the 2 layers of an intervertebral disc

A
  • Annulus

- Nucleus Pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

describe Annulus

A

– outer wall
• 12-18 concentrically arranged rings of fibroelastic cartilage
• No blood supply, cannot heal itself
• Anueral (gets nutrients from movement) except outer fibers
• Provides stability and withstand tension-torsional forces and bending

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

describe Nucleus Pulposus

A

– water binding mucopolysaccharide gel
• Transmits forces
• Equalizes stress
• Promotes movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is important about Intervertebral Discs

A

They provide stability between vertebral bodies, permit movement within each vertebral segment and transmit motion.

30
Q

name 3 categories of Herniated Nucleus Pulposus (HNP)

A
  • protruded disc (disc protrusion)
  • extruded disc
  • sequestrated disc
31
Q

define Disc Protrusion

A
  • usually posterior or lateral

- the nucleus bulges against INTACT ANNULUS

32
Q

define Extruded Disc

A

– nucleus extends thru the annulus, but the nuclear material remains confined by the posterior longitudinal ligament

33
Q

define Sequestrated Disc

A

– the nucleus is free within the spinal canal

34
Q

general rehab for HNP

A

Conservative management
• Decide what motions improve symptoms (extension?)
• Teach proper body mechanics
• General physical conditioning
• Stabilization exercises
• Safe lifting principles into their ADL’s

35
Q

the significance of the Straight Leg Test

A
  • Tests the Sciatic Nerve
  • is considered positive if the radicular pain is increased
  • the opposite leg is tested in the same manner
36
Q

the significance of the Femoral Neural Tension Sign

A
  • Tests the Femoral Nerve
  • do for a paitent with anterior radiating thigh pain
  • positive only if anterior thigh pain increasese
  • negative if there is back pain
  • Position = prone w/affected leg flexed to 90 and passively extend hip
37
Q

define Neural Tension

A

positioning of the spine and extremities can put a stretch on peripheral nerves, thus affecting the perception of pain, causing radicular symptoms

38
Q

the 4 phases of lumbar strain or sprain rehab

A 
Phase I – Pain, edema control, early healing             
Phase II – mobilization
       •	early active and passive motion
       •	Flexibility
Phase III - prevention of re-injury
       •	spinal stabilization techniques
       •	continuing education 
Phase IV – Return to normalized activity
       •	Work, sports
       •	More challenging exercises and activities
39
Q

define Spinal Stenosis

A
  • the narrowing of the spinal canal

- constricts and compresses nerve roots

40
Q

the 3 symptoms of Spinal Stenosis

A
  • radiating ache into lower extremity
  • paresthesia into lower extremity
  • disturbance in motor function
41
Q

define Paresthesia

A

a sensation of pricking, tingling, or creeping on the skin that has no objective cause

42
Q

Most Common Cause of Spinal Stenosis?

A

degenerative arthritic changes

43
Q

Management of Spinal Stenosis?

A
  • flexion exercises
  • encourage slightly forward trunk positions
  • encourage a general exercise program
  • partial direct and oblique sit-ups
  • body mechanics education (lifting, sitting and sleeping postures)
44
Q

define Spondylosis

A

degeneration in spine

45
Q

define Spondylolysis

A
  • bony defect in the pars interarticularis (part of the lamina btw inferior and superior facets)
  • usually occurs at L4-L5 and L5-S1
46
Q

define Spondylolisthesis

A
  • forward slippage of one superior vertebra over an inferior one (caused by unstable fractures)
  • most common L4-L5
47
Q

5 Types of Spondylolisthesis

A

Type I - congenital or dysplastic (common in kids)
Type II - mechanical stress/microtrauma (ages 5-50)
Type III - degenerative/loss of stability (elderly)
Type IV - traumatic w/fratcure (young and active)
Type V - pathologic, bone tumors affect the pars

48
Q

4 Grades of Spondylolisthesis

A

Grade I - 0-25%
Grade II - 25-50%
Grade III - 50-75%
Grade IV - 75-100%

49
Q

Spondylolisthesis, Grade I

A
  • treatment is preventing progression
  • avoid extension and vertical loading
  • abdominal strengthening /stabilization
  • stretching for trunk and LE
50
Q

Spondylolisthesis, Grade II

A
  • address the pain and spasms (ice, heat, NSAIDS)
  • avoid extreme lumbar extension
  • orthosis to create slight flexion
51
Q

Spondylolisthesis, Grade III

A
  • usually treated with surgery

- rehab depends on type of surgery

52
Q

Spondylolisthesis, Grade IV

A
  • surgery for high grade slippage w/neurologic signs (decompression laminectomy and fusion)
  • orthosis until bony fusion
  • gentle ROM for all extremities
  • once bones have healed, abdominal and trunk strengthing, lumbar ROM, general conditions
  • avoid extension because it will push vertebrae forward and cause more slippage
53
Q

manage Vertebral Compression Fracture clinically

A
  • pain relief interventions
  • NSAIDs
  • avoid thoracic or lumbar flexion activities
  • once pain is gone, increase out of bed opportunities and walking
54
Q

define Kyphosis

A
  • Increased posterior convexity
  • Rounded back and protracted scapula
  • Muscles and ligaments are stretched and weakened = PAIN
55
Q

rehab for condition of kyphosis

A
  • Patient education
  • Postural awareness
  • Stretch anterior shoulder and pectorals
  • Strengthen spinal extensors
  • Scapular retraction
56
Q

Idiopathic Scoliosis

A

– unknown, 80% of cases

57
Q

Myopathic Scoliosis

A
  • result of muscle weakness

- osteoporosis, RA, and Spinal TB

58
Q

Osteopathic Scoliosis

A

– result of spinal disease or bony abnormality

59
Q

Neurogenic Scoliosis

A
  • result of CNS disorder

- CP, Polio, MD

60
Q

Functional Scoliosis

A

– Caused by factors other than vertebral involvement
• Poor posture
• Pain
• Leg length discrepancy
• Muscle spasm secondary to HNP or spondylolisthesis
*functional curve will disappear once the cause is treated
*if untreated, can become a fixed structural curve
*once we find why – we treat it and it’ll go away
* different positions you will not see the scoliosis

61
Q

Structural Scoliosis

A 
– a structural scoliosis curve will NOT change or correct with motion or position change
•	Forward flexion test
•	Will still see the curve
•	“Rib-hump”
*you can always see it
62
Q

Medical Treatment for Scoliosis

A

Curves:
• Less than 20 degrees – brace
• Less than 25 degrees – observe and monitor for progression every 4-6 months
• Between 25-45 degrees – spinal orthosis
• Greater than 45 degrees – surgical fusion (Harrington rods)

63
Q

PT treatment for Scoliosis

A

• Exercise does not stop the progression of or correct a structural scoliosis
• Functional Scoliosis
* Stretches for muscles on concave side
* Axial stretching or elongation
* Strengthen muscles on convex side
* General conditioning
* General core and postural strengthening
* Hip extensors and rotators

64
Q

Defince Thoracic Outlet Syndrome

A

TOS – Proximal compression of the
• Subclavian artery
• Subclavian vein
• Brachial plexus

65
Q

TOS caused by:

A

be caused by
• “Cervical rib” (C7 transverse process)
• Shortened or hypertrophied anterior scalene muscle(will squeeze brachial plexus nerve)
• Malunion of clavicle fractures
• Subluxed first thoracic rib/elevated first rib

66
Q

TOS Symptoms:

A
  • Radicular signs – pain, numbness, tingling, weakness

- Skin and temperature changes

67
Q

TOS rehab

A
  • Stretching of involved muscles
  • Strengthening cervical extensors
  • Education about posture
  • Cervical postural correction
  • First rib mobilization
  • Lots of soft tissue work
68
Q

Temporomandibular Joint anatomy

A
  • Synovial, condylar, and hinge-type joint
  • fibrocartilaginous surfaces vs hyaline cartilage and an articular disc (also called a meniscus).
  • The articular disc completely divides each joint into two cavities
  • Consider both sides when assessing.
69
Q

TMJ upper jaw movement

A
  • Gliding
  • Translation
  • Sliding
70
Q

TMJ lower jaw movement

A

rotation or

hinge movement

71
Q

TMJ disorder Etiology

A
  • Missing teeth
  • Overbite
  • Malocclusion faulty bite (deviation from normal)
  • Trauma
  • Bell’s palsy
72
Q

TMJ disorder Treatment

A
  • Stress and pain reduction techniques
  • Avoidance of movements that cause symptoms (yawning, singing, and chewing gum)
  • Gently stretching or massage to the muscles – Pt education in how to perform these and to perform relaxation of the TMJ muscles
  • Resisted isometric movements in all directions
  • Joint mobilizations as indicated
  • Night mouth sploint to place jow in resting position to reduce “clenching” of teeth
  • Maybe surgery

PTA - Pathology (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions