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Spine Flashcards

1
Q

C3 - C7 facet orientation

A

45 degree angle

From C3 to C7 orientation changes from medial to lateral in frontal plane (happens around C5/C6)

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2
Q

OA and AA motion

A

OA: FLEX/EXT — (rot/SB OPP)

AA: ROT only

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3
Q

C3 - C7 coupling

A

SB and ROT SAME

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4
Q

Tectorial membrane
Location
Test

A

Continuation of PLL (C2 to occiput)

Grab occiput and pull into flexion and distraction

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5
Q

Alar ligament
Location
Test

A

lateral sides of dens to lateral margins of foramen mag

Stabilize C2 and LF head

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6
Q

Transverse ligament
Location
Test

A

Occipital tubercles to lateral masses of C1

Stabilize C2 and extend backward (sharp purser)

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7
Q 
C3 - C7 
Facet closing (LF vs. Rot)
A

Ipsilateral facet closes with LF

Contralateral facet closes with Rot

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8
Q

Motion changes throughout cervical

A

Flex/Ext stays same as descend
LF decreases from C3-C7
Rot same C3-C7

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9
Q

Scalenes

A

Ant - flex, LF toward, rot away (TP C3-6 to 1st rib)
Mid - flex, LF (TP C2-7 to 1st rib)
Post - flex, LF toward, rot toward (TP C5-7 to 2nd rib)

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10
Q

Semispinalis mm

A

Ipsilateral LF, Contralateral Rot, Extension

Go from TP to SP

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11
Q

Splenius mm

A

Go from SP to TP

Ipsilateral LF and Ipsilateral Rot, Extension

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12
Q

Rim lesion

A

Horizontal anterior tear in annulus without tearing ALL

Difficulty lifting head off pillow

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13
Q

Diagnostics for radiculopathy (4 criteria)

A

Pos neurodynamics
Cervical rot less than 60 deg
Distraction test pos
Spurling test pos

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14
Q

Spurling test

A

Spurling/Compression test
Can just do compression
Or add LF/Ext = spurling
Positive - IVH, nn root impingement

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15
Q

VBI

A

5 Ds And 3 Ns
Dysarthria, Dizzy, Dysphagia, Diplopia, Drop attacks
Ataxia
Nausea, Nystagmus, Numbness

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16
Q

Disc herniation - cervical - most common at

A

C6

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17
Q

Thoracic facet orientation

A

Lateral to medial as move from T1 to T12 (change at about T6/T7)
60 degrees

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18
Q

Movement change as go down thoracic

A

Flex/Ext inc slightly as you descend
LF is minimal throughout
Rot is minimal throughout but dec at T9-T12

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19
Q

Ribs and thoracic vertebrae

A

T2-T9 have demifacets for ribs

T1, T10-T12 have complete rib facets

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20
Q

Ratio of disc height to body height reflect

A

MOBILITY

Body height increases as descend thoracic and mobility increases

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21
Q

Upper thoracic rotation R causes in what rib movement

A

L rib moves ant and medially

R rib moves post and lateral

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22
Q

Thoracic SP - rules of 3

A

T1-T3 = SP is at level of same vertebral body (T12 too)

T4-T6 = At disc below (T11 too)

T6-T9 = At vertebrae body below (T10 too)

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23
Q

With unilateral should flexion, what happens to thoracic

A

Thoracic extension and ipsilateral rot and LF

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24
Q

Thoracic flex leads to what rib motion

A

Downward rotation

25
Thoracic ext leads to what rib motion
Upward rotation
26
Thoracic rot (R) leads to what rib motion
R rib rotate up | L rib rotate down
27
Thoracic LF (R) leads to what rib motion
Ipsilateral rib down | Contralateral rib up
28
Pump, Bucket, Caliper
``` Pump = 1-6, sagittal, ribs move up and ant with insp Bucket = 7-10, up, back, med with insp Caliper = 8-12, transverse, post/lat with insp ```
29
If rib torsion and thoracic issue - tx what first
THORACIC SPINE
30
Scoliosis
ROTATIONAL DEFORMITY - spine is curved with vetebrae rotated towards side of convexity Rib hump on side of convexity Rib hump ONLY WITH STRUCTURAL!
31
Lumbar facet orientation
90 degrees | Post and med
32
Freyette laws
1 - in NEUTRAL rot and SB occur in OPP 2 - in flex/ext rot and SB occur in SAME 3 - motion introduced in one plane will dec motion in others
33
FRS(L)
F so we know SAME So motion avail - flex, rot L, SB L Restricted in - ext, rot R, SB R So to tx - put in L sl, ext them, rot R and use legs to SB R
34
Motion changes throughout lumbar as descend
Flex/Ext - increase as descend LF - dec at lower Rot - minimal
35
Ferguson's angle
AKA lumbosacral angle Formed by line through superior aspect of scarum and horizontal (lateral view) ``` Hyperlord = more than 45 Hypolord = less than 35 ``` Norm is 35-45
36
Disc herniation rules
C1-8 nerve roots come out ABOVE respective vert (C5 nerve root is between C4 and C5 vert) (C8 nerve root is between C7 and T1 vert) T1-L5 nn roots come out BELOW respective vert (L2 comes out between L2 and L3 vert)
37
Herniated disc at T12/L1 is impinging which nerve
T12!
38
Conus medullaris at what level
L2 | This is where cauda equina begins!
39
L4/L5 disc herniation impinges which nerve?
L5!!! Below L2 and cervical follow same rule - disc herniation will impinge the nn root level named same as the bottom vertebrae L2/L3 will impinge L3 even though L2 comes out at L2/L3 articulation
40
Pt likely to benefit from lumbar stabilization if what
need 3 of 4 Less than 40 yo Pos prone instability test SLR greater than 91 Aberrant movement
41
Tx for instability - pattern
Control NZ - dynamic control - rehab global stabilizers - length/inhibit overactive mm
42
Positive neurodynamic testing
NEED ALL 4 Reproduction of comparable sign Changes in s/s with distal mvmnt of extremity Differences btw sides Positive nn palpation
43
Nerves
``` Femoral = L2 - L4 Sciatic = L4 - S3 Sup peroneal = L5-S1 Deep peroneal = L4-L5 Tibial = S1-S2 ```
44
Stork Standing
For spondylolisthesis Stand on one leg - go into ext If pain on standing leg (+)
45
Standing - What type of motion (SIJ)
Ilium moving on sacrum (iliosacral movement) | Standing forward bend, Gillet test - looking at Innominate dysfunction (long sitting too)
46
Sitting - What type of motion (SJ)
Sacrum moves on fixed ilium (sacroiliac movement) | Seated forward bend and sphinx
47
Nutation
Close packed of SIJ Anterior tilting of sacrum (glides inf and post) Inc lumbar lordosis, occurs with exhalation Sacrum moves ant on ileum
48
Counternutation
Open packed position of SIJ Posterior tilting of sacrum (glides ant and sup) Will decrease lumbar lordosis, occurs with inhalation
49
Sacral torsions - types
Type 1 = Anterior - L on L or R on R | Type 2 = Posterior - R on L or L on R
50
Anterior torsion (L on L example) ``` Deep ___ Prominent ___ Lumbar ext Lumbar lordosis PA on sacrum L5 ```
``` Deep RIGHT Prominent LEFT Lumbar ext EXCESSIVE/NORMAL Lumbar lordosis EXCESSIVE/NORMAL PA on sacrum POSSIBLE L5 SB R, ROT L (follows neutral spine - OPP) ```
51
Posterior torsion (R on L example) ``` Deep ___ Prominent ___ Lumbar ext Lumbar lordosis PA on sacrum L5 ```
``` Deep LEFT Prominent RIGHT Lumbar ext LIMITED Lumbar lordosis FLAT PA on sacrum LIMITED L5 SB L, ROT L ```
52
Thigh thrust
Put thenar on pt sacrum (med to PSIS) Flex hip to 90 and adduct in Apply shear pressure through femur Pos if butt pain (SIJ)
53
Gaenslen
Fully flex hip.knee on affected while keeping other in full ext Pos if LBP or butt pain - Hip flex causes post inominate rot
54
Sacral thrust
PA over sacrum
55
What would indicate SIJ issue
3/5 of provocation tests SIJ comp/distraction Gaenslens Thigh thrust Sacral thrust
56
Standing FBT
SIJ hypomobility if one PSIS elevates higher than other
57
Seated FBT
SIJ hypomobility if PSIS that was lower is higher with forward bend
58
Gillet
Standing - palpate S2 and PSIS on one side | When flex that hip - if PSIS does not move inf = hypomobility
59
Long sitting test
For leg length vs. pelvic rotation pos for post rotation if shorter leg in supine becomes longer in sitting OPP would happen for ant rotated innominate

Reminders! (22 decks)

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