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Spine Flashcards

1
Q

How many vertebrae are in the Cervical, Thoracic, Lumbar, Sacral and Coccyx Spine?

A 
C = 7
T = 12
L = 5
S = 5 fused together
C = 4
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2
Q

How many Cervical Nerve Roots are there?

A

8 nerve roots

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3
Q

What is the function of the Annulus of the Intervertebral Disc?

A

STABILITY, movement between vertebral bodies, LIMITED shock absorption

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4
Q

What is the function of the Nucleus Pulposus of the Intervertebral Disc?

A

Transmits forces, equalizes stress and PROMOTES movement and SHOCK ABSORPTION

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5
Q

Do the Intervertebral Discs have good blood supply?

A

No, they are largely avascular and a neural so are limited in healing

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6
Q

Define Posture

A

A position or attitude of the body, the relative arrangement of body parts for a specific activity or a characteristic manner of bearing ones body.

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7
Q

Where is the COG in relation to the Atlanto-Occipital Joint?

What provides Stability?

A
  • Anterior as posterior muscles contract

- Posterior cervical muscles

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8
Q

Where is the COG in relation to the Trunk?

What provides Stability?

A
  • Goes through the bodies of the bodies of the cervical and lumbar vertebras.
  • Erector spinae muscles
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9
Q

Where is the COG in relation to the Hip?

What provides Stability?

A
  • Usually goes through the Hip but varies with body movement
  • If Posterior = Iliopsoas tension
  • If Relaxed = Iliofemoral ligament (Y)
  • If Anterior = Hip extensors
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10
Q

Where is the COG in relation to the Knee?

What provides Stability?

A
  • Anterior to joint keeping the knee in extension

- ACL, posterior capsule, tension on hamstrings, soleus

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11
Q

Where is the COG in relation to the Ankle?

What provides Stability?

A
  • Anterior to the joint which causes the tibia to rotate forward on ankle
  • Plantarflexors (primarily soleus)
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12
Q

What is the function of the Anterior Pillars of the Spine?

A

They are the vertebral bodies and discs that provide weight bearing and shock absorption

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13
Q

What is the function of the Posterior Pillars of the Spine?

A

They are the articular processes and facet joints, vertebral arches, transverse process and central spinous processes that provide gliding for movement and stability

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14
Q

What type of muscles are Global and Core?

Which are Superficial and Deep?

A

Global = Fast Twitch Type 2, Superficial

Core = Slow Twitch Type 1, Deep

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15
Q

Describe Global Muscles

A
  • Respond to external loads

- Provide overall stability but cannot control mulitsegmental instabilities

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16
Q

Describe Core Muscles

A
  • Segmental attachments
  • Dynamic support
  • Help maintain each segment in stable position to reduce stress
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17
Q

Anterior Curves are also known as?

Posterior Curves are also known as?

A 
Anterior = Lordosis (Cervical & Lumbar)
Posterior = Kyphosis (Thoracic & Sacral)
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18
Q

Describe Lordotic Posture

A

Increased lumbosarcral angle to about 40*

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19
Q

Describe Relaxed “Sway Back” Posture

A

Pelvis shifts anteriorly as Thoracic shifts posteriorly

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20
Q

Describe Flat Low Back Posture

A

Decreased lumbosacral angle and lumbar lordosis with hip ext and posterior pelvic tilt

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21
Q

Your patient demonstrates a flat low back posture. Which muscle would NOT need to be stretched?

A

Hip Flexors

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22
Q

Which side do you name Scoliosis for?

A

The side of CONVEXITY

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23
Q

If you patient has right thoracic scoliosis what is the appropriate stretch for them?

A

Heel sit, patient laterally bends to the right

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24
Q

Describe Forward Head Posture

A
  • Increased flex of lower cervical and upper thoracic regions
  • Increased ext of occiput on atlas and upper cervical vertebrae
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25
Describe Flat Neck?
- Decreased cervical lordosis | - Increased flex of occiput on atlas
26
What muscles are involved in Muscle Sprains of the Cervical Spine?
Sterno, trapezius, scalenes, erector spinae, rhomboids, and levator scapulae
27
For muscle sprains what is the key factor to avoid during rehab?
Avoid the mechanism of injury
28
Muscles involved in MVA with HyperEXT
Tearing of the Sterno, logissimus coli, anterior longitudinal ligament
29
Muscles involve in MVA with HyperFLEX
Tearing of posterior cervical muscles, ligamentum nuchae, posterior longitudinal ligament
30
What is Cervical Radiculopathy? What Causes it? Goals of treatment?
- Mechanical compression or inflammation of a nerve root that causes neurological symptoms into upper extremities - Caused by disc herniation, spondylosis, osteophytes (bone spurs) - Relieve symptoms, reduce pain/swelling, control muscle spasms, centralize symptoms
31
How to treat Disc Herniation
Gradually strengthen directions that relieve pain and avoid those that make pain worse
32
What is Cervical Spondylosis? Age group? Treatment?
- Chronic disc disease from wear and tear that leads to degeneration of bones - Mostly in men ages 40-50 in C5-C6 or C6-C7 - Treatment: Thermal or Electrical modalities - Traction - Flex exercise (bc usually pain with ext) and axial rotation - Functional AROM exercises - Cervical isometrics - Education on posture exercises, flexibility and stability
33
What needs to be strengthened in patients that suffer from Headaches?
Scapula and deep neck flexors
34
What causes Thoracic Outlet Syndrome of the cervical spine? Treatment?
Compression of vascular and or neurological tissues as they exit the superior triangle opening of thorax - Causes: cervical rib, shortened anterior scalene, malunion of clavicle and first rib or tight pectoral muscles - Treatment: posture education, stretching ant scalene and pecs, strengthening scap retraction, thoracic ext, rowing, educate on protection or possible surgery
35
How do you exercise the Deep Neck Flexors?
Chin Tucks = craniocervical flexion Supine (Easy) Sitting or Standing Prone Add in another movement like walking or squats (Hard)
36
What cues would you give a pt to activate the cervical core muscles?
Head flexion and slight flattening of the cervical lordosis
37
Which side of the Scoliosis curve do pt have ligament strains and which side mobility impairments?
Ligament strains = ConVEXity Impairments = ConCAVE
38
What is the treatment for Scoliosis?
``` Strengthening muscles on convex side Stretch muscles on concave side Trunk elongation exercises Bracing Correct Leg Length Discrepancy Surgery for curves over 5-60* ```
39
Which level is the most rare disc injury to occur?
Thoracic because of the articulation with the rib cage adds more support
40
What are treatments for Disc Injuries?
Analgesics, modalities, epidural injections, surgery if severe, bracing, progress AROM, strengthening, endurance activities, return to function with limitations specific to fusion
41
What are treatments for Thoracic Kyphosis?
Posture awareness, strengthen scapular retractors, stretch anterior shoulders, breathing exercises
42
How much money do back related problems cost the US in one year?
$7.2 - $40 billion
43
What ares have better outcomes for pts that seek treatment with in the first 6 weeks of lower back pain?
- disability - general health - mental health - social function - vitality - anxiety - depression
44
What gets SPRAINED the most common in the lumbar spine?
Posterior Ligaments and Joint capsule and Supraspinouse
45
What are the 4 phases of recovery in Lumbar Spine Sprains?
- Max: Healing and pain control - Mod: Initiation of movement - Min: Return to normal activities - Prevention on re-injury
46
Intradiscal Pressure (Body weight)
``` Supine 25% Supine with knees flexed 35% Side lying 75% Seated in a flexed position 85% Standing 100% Standing with forward flexion 150% Bending forward in flexed posture and lifting 275% ```
47
Define Herniation
Any change in shape of annulus , bulges beyond normal perimeter
48
What are the pain types of Lumbar Disc Injuries
- Viscerogenic: kidneys - not aggravated by activity or relieved by rest - Neurogenic: neurofibromas, cysts, tumors of nerve roots - Vascular: peripheral vascular disease - Spondylogenic: direct pain in soft tissues of spine - aggravated by activity and relieved by rest
49
Herniation Define: Protrusion, Extrusion and Sequestration
Protrusion: nuclear material contained by outer layers of annulus Extrusion: extension of nuclear material beyond confines of posterior longitudinal ligament but still in contact with disc Seq: extruded nucleus separated from disk, moved away from prolapsed area
50
What is Spinal Stenosis? Symptoms?
Narrowing of spinal canal, constricts and compresses nerve roots -Symptoms: radicular ache into thigh and calf parasthesia into lower extremity, disturbances in motor function
51
What relieves pain of Spinal Stenosis?
Flexion | Ext worsens pain
52
What is Lumbar Spondylolysis?
Bony defect in pars interarticularus of posterior elements of spine
53
What is Lumbar Spondylolisthesis?
Forward slippage of one superior vert over the inferior art as a result of instability caused by the bilateral defect in pars interarticularis
54
Spondylolisthesis (Grades I - IV)
I: 0-25% II: 26-50% III: 51-75% IV: 76-100%
55
Define Ankylosing Spondylitis
Arthritic condition of the spine in which ossification of anterior and posterior longitudinal ligament and facet going eventually occurs "Bamboo Spine" Joint eventually fuse together
56
Treatments for Bamboo Spine
``` Posture edu (avoid flex) Ext Bias segment and global stabilization ```
57
What is treatment for the Lumbar Spine?
``` Patient edu Pain management Restore mobility/flexibility Restore Stability Restore Function ```
58
Phase time frames for lumbar spine?
Max 4 weeks Mod 4-12 weeks Min 12 + weeks
59
Which injuries are Ext Bias of the spine?
Posterior/Posteriorlateral disc lesion
60
Which injuries are Flex Bias of the spine?
Spinal Stenosis Spondylosis Spondyloloisthesis
61
Which injuries are NWB of the spine?
Lying Down Traction Aquatic therapy best

Therapeutic Exercise (5 decks)

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