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Sports Med 2 > Spine > Flashcards

Spine Flashcards

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1
Q

What percent of CSI come from sports?

A

8%

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2
Q

What is axial loading?

A

Spearing, which occurs when the head and the neck is flexed between 20-30 degrees and serves as the point of contact

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3
Q

What order is the assessment listed?

A

Assess breathing, circulation, pulse, LOC, symptoms, palpate c-spine and perform extremity CMS assessment

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4
Q

What indicators warrant activation of CSI management protocol?

A

Unconsciousness, bilateral neurological complaints obvious deformity and significant c-spine pain

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5
Q

C1

A

None

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6
Q

C2

A

Neck flexion

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7
Q

C3

A

neck lateral flexion and extension

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8
Q

C4

A

Shoulder shrug

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9
Q

C5

A

Shoulder abduction

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10
Q

C6

A

Elbow flexion/wrist extension

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11
Q

C7

A

Elbow extension/wrist flexion

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12
Q

C8

A

Ulnar deviation/thumb extension

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13
Q

T1

A

Finger intrinsics (abd, add, opposition)

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14
Q

L1

A

None

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15
Q

L2

A

Hip flexion

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16
Q

L3

A

Knee extension

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17
Q

L4

A

Ankle dorsiflexion

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18
Q

L5

A

Hallux extension

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19
Q

S1

A

Plantar flexion, eversion, knee flexion, hip extension (gastrocs and hammy’s)

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20
Q

S2

A

Plantar flexion, knee flexion, hip extension

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21
Q

What root level is for the diaphragm and how do you sensory test it?

A

C4 and you test the shoulder tops

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22
Q

What is the most common neurological cervical injury?

A

Unilateral neurapraxia of the cervical nerve roots and brachial plexus “burner” or “stinger”

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23
Q

List 2 techniques to get an athlete on a spine board

A

Prone log roll or 6 person lift

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24
Q

How many vertebrae?

A

33

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25
Q

How many vertebrae are movable (true)?

A

24

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26
Q

Which vertebrae are movable?

A

Cervical, thoracic lumbar

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27
Q

How many vertebrae are immovable and what are they?

A

9 are false and they are the sacrum and coccyx

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28
Q

Cervical spine has how many vertebrae?

A

7

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29
Q

C1 has no _____ or ______

A

Body or spinous processes

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30
Q

C2 allows for

A

Rotation (no duh)

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31
Q

Movements of C1

A

Flexion, extension, lateral

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32
Q

How many vertebrae in the thoracic spine?

A

12 and they articulate with ribs

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33
Q

Largest and thickest vertebrae

A

Lumbar spine

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34
Q

How many vertebrae in lumbar spine?

A

5

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35
Q

Fusion of 5 vertebrae in adults

A

Sacrum

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36
Q

Also known as tailbone

A

Coccyx

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37
Q

While sitting weight is transmitted through these joints

A

Sacrum/SI joint

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38
Q

Between each of the cervical, thoracic, and lumbar is an

A

Intervertebral disk

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39
Q

Each intervertebral disk is composed of _______ and the _________

A

Annulus fibrosis and nucleus pulposus

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40
Q

Forms the periphery of the disk Composed of strong, firbrous tissue

A

Annulus fibrosus

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41
Q

In the center of the annulus fibrosus, shock absorption

A

Nucleus pulposus

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42
Q

Wide strong band extends the full length of the anterior surface of vertebrae

A

Anterior longitudinal ligament

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43
Q

Inside the canal and extends the full length of the posterior aspect

A

Posterior longitudinal ligament

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44
Q

Connects spinous processes

A

Supraspinous

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45
Q

Extends the spine

Superficial

A

Erector spinae

46
Q

Deep muscles of the spine

A

Go from vertebrae to vertebrae
Extend and rotate the spine
Multifidus, quadratus
lumborum

47
Q

How many pairs of spinal nerves are there?

A

31

48
Q

Specific area of sensory in a spinal nerve is called

A

Dermatomes

49
Q

Nerves form a

A

Plexus

50
Q

Movements of the vertebral column

A

Flexion
Extension
Right and left lateral flexion
Rotation to the left and right

51
Q 
Can be life threatening
Strengthening is critical
Bull the neck
Isometric, isotonic, isokinetic contractions can be used
Watch for spearing
A

Preventing c-spine injuries

52
Q

What back pain is the most common?

A

Lower back pain with

53
Q

How do you prevent a lumbar injury

A

Avoid unnecessary strain
Be aware of posture anomalies of the athlete
Abdominal strength is essential

54
Q

Cervical neck MOI

A 
Axial Load
Flexion
Hyperextension 
Rotation and Flexion 
Rotation and Hyperflexion 
Lateral Flexion
55
Q

Gymnasts, hockey, diving, football, rugby
Relatively uncommon in athletics but must be prepared.
MOI: Axial loading and flexion, rotation, hyperextension
S/S:
common in C4-C6
Point tenderness
Muscle spasms = decrease ROM
Numbness & pain in extremities, loss of bladder/bowel cont

A

Cervical fracture

56
Q

MOI: Violent flexion, extension or rotation, affects anterior and posterior ligaments
S/S: Persistent, tender over transverse and spinous processes, pain occurs a day later

A

Cervical sprain (whiplash)

57
Q

MOI: Pain on one side of the neck upon waking up, synovial lining or capsule is pinched
S/S: Palpable pt. tenderness and muscle spasm, limited side flexion, and rotation

A

Acute torticolis (wry neck)

58
Q

Athlete lies supine. Examiner grasps the patient’s head under the occiput and chin and gradually applies traction.

A

Cervical distraction

59
Q

Cervical distraction positive test

A

reduction or elimination of symptoms caused by cervical radiculopathy

60
Q

Athlete seated with neck bent to affected side. Carefully compress straight through the head. Repeat on opposite side.

A

Spurling compression test

61
Q

Spurling compression positive test

A

pain in the upper extremity on the side the head is flexed = pressure on the nerve root

62
Q

Kyphosis resulting from wedged fx of 3 or more vertebrae, causes nucleous pulposis to enter into vertebrae
S/S: Kyphosis and lumbar lordosis but no pain, point tender over spinous processes and back ache at end of day

A

Scheuremens disease

63
Q

athlete is seated or standing. The examiner pushes the hands together to compress the ribcage and then releases the pressure.

A

Rib compression

64
Q

Rib compression positive test

A

Pain with compression or release of pressure indicates the possibility of a rib fracture, rib contusion, or costochondral separation.

65
Q

MOI: Sudden extension and rotation, faulty posture, excessive lumbar lordosis
S/S: Pain with active extension and passive flexion

A

Lumbar strain

66
Q

Inflammatory condition of the sciatic nerve
MOI: Nerve compression, irregularities in
vertebrae, tight piriformis muscle
S/S: Acute or chronic, sharp shooting pain that follows the nerve pathway

A

Sciatica

67
Q

Athlete is supine. Examiner slowly raises the legs until tightness or pain is noted

A

Straight leg raise

68
Q

Straight leg raise positive test

A

Pn @ 30 degrees = hip problem or inflamed nerve
Pn. @ 30-60 = sciatic nerve
Pn. @ 70-90 = SI joint

69
Q

MOI: Congenital degeneration of the vertebrae, appears as a stress fx, most common in boys
S/S: Asymptomatic until hyperextension or disk
herniation

A

Spondylolysis

70
Q

MOI: One vertebrae slipping on one below it, a complication of spondy higher in girls
S/S: hyperlordosis

A

Spondylolisthesis

71
Q

Procedure:

subject stands on one foot and extend their back, repeat on opposite side.

A

Stork test

72
Q

Stork positive test

A

Lumbar pain= possible fracture of pars of vertebrae

73
Q

Subject is sitting
ask subject to take a deep breath and blow against closed fist (bowel movement)
This increases intrathecal pressure

A

Valsalva maneuver

74
Q

Valsalva maneuver positive test

A

Pain or neurologic symptoms in buttox and thigh = Herniated disc

75
Q

Athlete is lying prone. Athlete uses hands to push up upper body and extend spine

A

Press ups

76
Q

Press ups positive test

A

pain radiating into the buttocks/thigh = herniated disc

77
Q

MOI: Twisting with both feet on the ground, falling backward, landing heavily on one leg
S/S: Point tender on SI joint, ASIS and PSIS may be asymmetrical, side bending toward the injury side increases pain

A

Sacroiliac pain

78
Q

Athlete is supine or side lying. Examiner has both hands over the lateral aspect of the pelvis.
Examiner applies downward pressure through the anterior portion of the ilium, spreading the SI joints

A

SI compression

79
Q

SI compression positive test

A

SI pain

80
Q

Athlete is supine

Examiner applies pressure to spread the ASIS

A

SI distraction

81
Q

SI distraction positive test

A

SI joint pain

82
Q

Athlete is supine with the foot of the
involved side crossed over the opposite thigh (figure–4 position) & the leg resting in the full external rotation
Examiner has one hand on the opposite ASIS & the other hand on the medial apsect of the flexed knee
Examiner applies overpressure at the knee & ASIS

A

Fabers (Patrick’s) test

83
Q

Faber’s positive test

A

SI joint pain

84
Q

History questions to ask

A

Did you land on top of, or hit someone with your head?
Did you lose consciousness?
Do you have pain in your neck?
Any tingling, numbness, or burning in your shoulders, arms or hands?
Equal muscle strength in both hands?
Able to move your ankles and toes?

85
Q

After you’ve ruled out a spinal injury what history questions should you ask?

A

Were you standing, twisting, sitting, bending?
Did the pain begin immediately?
How long has it been going on?
What motions/movements hurt your back?
Tingling or pain in your buttocks or down the back of your leg?

86
Q

General observation

A 
Head is tilted to one side
Shoulder is lower on one side, or carried forward 
Scapular imbalance
One hip is prominent
Hips are tilted
One arm hangs lower
One patella is lower than the other
87
Q

Increased thoracic curve

A

Kyphosis

88
Q

Compensatory change in the position of the head and neck

A

Forward head posture

89
Q

Decreased lumbar curve

A

Flatback posture

90
Q

Anterior shifting of entire pelvis

A

Swayback posture

91
Q

Increased curve in lumbar spine

A

Lordosis

92
Q

Lateral curvature of the spine

A

Scoliosis

93
Q

Cervical observations

A 
Look at the position of the head and neck
Symmetrical shoulders
Is the patient willing to move head
and neck
Check active ROM
94
Q

Lumbar observations

A

Pelvis and shoulders should be level
Soft tissues symmetrical
Unusual curve in lower back noticed

95
Q

Thoracic observations

A

Check active ROM

Flex forward and laterally/extend and rotate the trunk

96
Q

What if there is pain when you flex forward and laterally/extend and rotate the thoracic trunk

A

nerve root irritation to the lower thoracic region

97
Q

What if there is pain when you check ROM of thoracic

A

cervical disk or trigger

point

98
Q

What does most common thoracic pain have to do with?

A

Facet joints

99
Q

Spine palpation

A 
Athlete lying prone
Head and neck should be slightly
flexed
Pillow under the hips
Musculature on both sides of spine
Spinous processes
Sacroiliac joint
100
Q

General rule of thumb for spine rehab

A

Any movement that causes the back pain to radiate or spread over a larger area should not be included during this early phase of treatment

101
Q

Flexibility exercises for rehab

A

Flexion
Extension
Lateral bending
Rotation

102
Q

When should you do lumbar extension exercises

A

When back pain is diminished with lying down and
increased with sitting

Forward bending is limited and increase the pain

103
Q

Rehab cervical strengthening exercise for rotation

A

Put one palm on side of forehead and the other at back of head. Push with each hand, attempting to rotate head

104
Q

Rehab cervical strengthening exercise for lateral flexion

A

Place palm on side of head and press head into palm

105
Q

Rehab cervical strengthening exercise for extension

A

Lace fingers behind head, press head against hands

106
Q

Rehab cervical strengthening exercise for flexion

A

Press forehead against the palm of hand

107
Q

Why use extension exercises?

A

Reduction in the neural tension
Reduction of the lead on the disk which decreases disk pressure
Increases in the strength of extensor muscles

108
Q

Examples of lumbar extension exercises

A

Prone extension on elbows
Prone extension on hands
Alternate arm and leg extension (dead bug)
Supine hip extension-butt lift or bridge
-Double leg support
-Single leg support

109
Q

Indications for lumbar flexion exercises

A
  1. Back pain is diminished with sitting and increased with lying down or standing
  2. Forward bending eases the pain
  3. Abdominal tone and strength are poor
110
Q

Why use flexion exercises?

A

Reduction in the articular stresses

Opening of the intervertebral foramen

111
Q

Examples of lumbar flexion exercises

A 
Single knee to chest
Double knee to chest
Posterior pelvic tilt
Partial sit up
Rotation partial sit up
Pelvic tilt down (dog)
Pelvic tilt, tail tuck (cat)
Kneeling – dog tail wags
Kneeling Alternate arm and leg (bird dog)
112
Q

Core stabilization exercises

A

Quadriped
Triped
Biped (alternating)
Thera ball

Sports Med 2 (16 decks)

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