PTI Lec 7&8 Flashcards
Intimately related with
reflex systems associated with stab of the head and eyes,vestibular fn & proprioceptive systems
Distributes load from
head and upper limbs while maintaining mechanical stability of thehead-neck system
Will lead to
- Pain Because of the trigeminal nerve.
- Dizziness Mixed messages, the vestibular and theoccular, and the propioception, all give mixedmessages.
- Unsteadiness Vertebral arteries can also be affected.
- Difficulty swallowing
Ligamentous systems
20% of stability
End range control
Muscular System
80% of stability
Mid range control
More often used
Must work harder if lig. Injury
Superficial
Scalenes Sternocleidomastoid (Upper trap) Sudden movement. Function – Maintaining Equilibrium of external forces so that the load transmitted to the spinalsegments can be controlled by deep muscles
These are the tripple S
Deep
Longus Coli
Multifidi
in wiplash, need to trainthis muscle, the longus coli.
Function
– Create cervical column to support the cervical spine Segmental control.
Synergy
grouping a set of muscles to accomplish a task
•CNS controls a synergy pattern vs individual ms
•Based on direction, spine position, posture and moment arm
Superficial vs Deep cervical spine synergy
•Balance of stability and mobility
•Further divided by direction ie. neck
flexor synergy
Cervicoscapularsynergy
•Relation of the scapula duringcervical spine
motions
Balance between deep neck & superficial (sf) extensor synergy
Deep = multifidi,
semispinalis cervicis, and the longus coli
• Sf = semispinalis capitisand splenius capitis and the SCM.
The cervicis of the splenius is deep and the capitis of splenius is superficial.
The cap is super
The cer is deep
A is before c.
Function of the thoracic
` Accommodates the expansion and recoil of
the lungs
` Provide a stable base for the head and neck ` Provide a stable platform for shoulder girdle attachment and movement
` Required to perform associated movements along with neck, lumbar, and shoulder movement
` Absorb shock from the extremities
Disruption of the thoracic function
` Affects breathing pattern ` Can lead to cramps with running ` Disrupt Cervical movement ` Affect Shoulder function (can lead to impingement) ` Impair shock absorption placing increasedstress to other joints
These are all the things that we did say was.
To aupport the head, to absorb shock, to allow for breathing, and to allow for the connection of the UE to the body,
There are muscle that attach to the upper ribs, and so
the function if the thoracs affects the cervicals. There aredeep muscles which we are not sure what they do. The
intercostals can stablize the thorax, the ribs need a little
bit of back up during breathing, because both the
intercostals are activated while we are breathing.
Stability of each level of the thorax.
Multifidi are also deep muscles.
.
Superficial erector
spinae
` Serratus posterior
◦ Superior Attaches to the rib cage.◦
inferior
` Latissimus DorsiMultifidus
` Rotatores
` Semispinalis Thoracis
Posture Boyling Observe
–Cervical spine
–Thoracic spine
–Scapula
Forward Head Posture• What is effected?
– Tight deep sub-occipital, which gives you the upper cervical extension
– Elongated Longus coli, which gives you not a real lower cervocal flexion, but rather wes ee that there is the lower cervical stretch.
Orientation of Scapula
Superior angles lies level with
T2 or T3 SP
Inferior angle
T7-T9
Sit with slight _______ rotation
upward
Medial border _______ against ribs
flat
You want the slight upper rotation, so that the GHcan rest there, also to not have muscles
compensate, it could be the levator scapula, it
brings it into a downward rotation, and so we
need to teach how to use their upper rotation, to
relax those muscles.
.
Seratus anterior and upper and lower trap, they will allow the
upper roation, they will hold the resting position.
What to look for during an assessment:
Give, deviations, active equals passive. ◦ Does active equal passive? ◦ Is there a give? ◦ Is there a deviation? ` Looking for optimal pattern of movement initiated with deep mm. ` Looking for smooth even spinal curve Shared distribution.
Everytime you cue and you see an improvement, what would you do next?
Assess the area that was cued and got better.
The whole point that it got better with cuing is huge, it just means that they do not know how to do the job. Alot of people have the strength and ROM and flexibility to perform a back flip, but why can’t they? Becaue they have not been taipught how to do it.
From neutral to extension we are lengthening the moment arm of the superficial cervical muscles, the SCM and the Scalenes.
So the deep muscles, the multifidi, the longus coli are to need to work harder to eccentricaly release the neck backwards, and if these deep muscles, which are our only muscles that would work at this position, are weak, then we are to not want to extend our neck.
.
Compensation for side bending of the neck?
Shoulder hike, because they will have had brought their ear to their shoulder one way or another.
But the slides does not say this, why not?
By the side bending, oes the pt move the ______ and _______ cervical.
Upper and lower.
A thoracic extension give is more likely in the…
lower portion(approx T10-L1)
Which area do you think will go into extension? The upper thoracic or the lower thoracic? Which area do you feel is falling backwards?
Thats right, the lower thoracic, the area that is starting to become lordodic and transitioning to the lumbar spine.
A thoracic flexion give is more likely in the…
in the upper portion (around T4)¾If see a flexion “give” then it is deficient posterior muscles
¾A lateral thoracic give will look like
scoliosis
¾If see a lateral bending “give” then deficient lateral muscles
¾If see a rotation “give” then it is deficient
rotator muscles
There is the possibility to go and make the assessment the motor control treat by having the patient move in the pattern of the assessment to the point where they deviate and then do this for two minutes or ten seconds for ten times.
.
Depression: lower trap
So if these do not work, it will show itself as…
in cases of anterior tilted position
Protraction: serratus anteriory Indicated if
medial border wingingy
Indicated if dumped scap
