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PCE - Neuromusculoskeletal > Spinal Abnormalities > Flashcards

Spinal Abnormalities Flashcards

1
Q

Plumb line surface landmarks

A
  • Ear lobe
  • Shoulder joint
  • Midway of the trunk
  • Greater trochanter
  • slightly ant to knee joint
  • slightly ant to ankle joint
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2
Q

What are the structural changes in exagerrated lumbar lordosis

A
  • Lordosis
  • ANterior pelvic tilt
  • hip flexion
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3
Q

What are the structural changes in sway back

A
  • Pelvis shifted forward in relation to thorax
  • Increased lumbar lordosis
  • Thoracic kyphosis
  • hip extension
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4
Q

What muscles are short and strong in sway back

A

Hamstrings

Upper fibers of IO

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5
Q

What muscles are strong but not short in sway back

A

lumbar erector spinae

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6
Q

What muscles are long and weak in sway back

A
  • One joint hip flexors
  • External oblique
  • Upper back extensors
  • Need flexors
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7
Q

What are potential sources of dysfunction in sway back

A
  • Stretch iliofemoral lig
  • hip joint dysfunction
  • Lumbar lordosis/thoracic kyphosis/HFP
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8
Q

What are the structural changes in Flat back

A

Decreased lumbar lordosis + posterior pelvic tilt

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9
Q

What muscles are short and strong in flat back

A

Hamstrings and often abdominals

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10
Q

What muscles are long and weak in flat back

A

one joint hip flexors

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11
Q

Possible causes of flat back?

A

Poor postural habit, poor ergonomics

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12
Q

Possible sources of dysfunction for flat back

A
  • short abdominals/hip extensors
  • long and weak lumbar extensors
  • loss of normal lumbar curve (reduced capacity for shock absorption)
  • stretched PLL and lumbar erectors, compressed anterior disc
  • altered respiration
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13
Q

What muscles are short and strong in HFP

A

Lev scap
SCM
Scalenes
Suboccipitals

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14
Q

What muscles are long and weak in HFP

A
  • Deep neck flexors

- Erector spinae

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15
Q

Types of scoliosis

A
  • idiopathic
  • Congenital - vertebral deformities
  • neuromuscular - second to other conditions
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16
Q

Scoliosis S&S

A
  • Decreased nerve conduction - myo, demas, reflexes

- Decreased nerve mobility - SLR, slump

17
Q

Scoliosis Ax

A
  • Forward bend test
  • muscle imbalance
  • Decreased proprioception
18
Q

Scoliosis Rx

A
  • Posture
  • Stretch and strengthen
  • CV training (decreases pain)
  • If severe - bracing + surgery
19
Q

Postural back pain caused by ____

A

tissue creep

20
Q

Postural dysfunction S&S

A

i. pain increases w/ sitting or prolonged postures
ii. poor posture/ergonomic set up
iii. pain not specifically caused by FLEX or EXT
iv. NO neurological s/s
v. better in AM, worse as the day goes on
vi. associated w/ decreased fitness

21
Q

Postural dysfunction Rx

A 
Correct!!!
	posture and ergonomics
	muscle imbalances
	fitness issues
	spinal supports (obus forme)
	education on posture + rest/activity/breaks
22
Q

What are the general risk factors for MSK Injury due to workplace ergonomics

A
  • Repetitive, labor intensive work
  • Young ( < 30 yrs)
  • First 5 years of practice
  • Responding to unexpected movement
  • Failure to take rest breaks
  • Inadequate training re: injury prevention
23
Q

What are the WorkSafe BC Ergonomic recommendations

A

o Forearms horizontal, elbows at 90° (or slightly greater) with shoulders/upper arms relaxed
o Wrists neutral (straight) with hands on keyboard or mouse
o Head upright over shoulders, eyes looking slightly downward (~30° with screen 64-75 cm from the floor)
 Top of line of text should be at eye level
 Arms length between your eyes and the screen
o Backrest supporting lower back, pelvis, and the natural curve of your spine (90-110° tilt, minimum 45 cm tall)
o Thighs resting horizontally with a 90-110° angle at the hips (seat height 38-51 cm)
o Feet fully supported by the floor or a footrest with an adjustable slope (10-20°)

24
Q

What are the two components of a disc? Which has pain fibers?

A 
Nucleus pulposis (inner) 
Annulus  fibrosis (outer)

Annulus has pain fibers

25
Q

What is the healing time for a disc lesion

A

3 months for ligaments to heal

26
Q

Disc lesion S&S

A
  • Central back pain +/- leg pain
  • +/- lateral shift (name relative to shoulders)
  • loss of normal lordosis - flat back - muscle supporting EXT
27
Q

Disc lesions Rx

A 
	centralize pain, radiate 
	correct shift
	support lordosis
	posture education
	avoid flexion postures with time 
	traction (gentle!)
	correct: muscle balance, posture, ergonomics
28
Q

Stenosis - Causes:

A

Swelling
Disc
Osteophyte
Bony change

29
Q

Stenosis - S&S:

A
  • Bilateral radiation: legs/feet

- X-ray changes: bony hypertrophy, DDD, spurs

30
Q

Stenosis - Rx:

A

 posture avoidance, correct muscle imbalances (core, hamstrings)

31
Q

Spondylolisthesis S&S:

A
  • central low back pain +/- referred pain
  • weak abdominal muscles
  • +/- tight hamstrings
  • Agg: Ext
  • Ease: Flex
32
Q

Spondylolisthesis Rx:

A
  • address lower quadrant muscle imbalance
  • abdominal strengthening
  • biomechanical counseling
  • avoid HYPEREXT activities

PCE - Neuromusculoskeletal (8 decks)

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