Spine Mechanics Flashcards
vertebral unit
two adjacent vertebrae
associated intervertebral disc
Rule of 3’s
refers to the location of the spinous process in relation to the transverse process in the thoracic spine
T1-T3
spinous process located at the level of the corresponding transverse process
*same level
T4-T6
spinous process located 1/2 a segment below the corresponding transverse process
T7-T10
spinous process located at the level of the TP of the vertebrae ONE below
T11
spinous process located 1/2 a segment below the corresponding transverse process
T12
Spinous process located at the level of the corresponding transverse process
*same level
Cervical Superior Facet Orientation
backward, upward, medial
BUM
Thoracic Superior Facet Orientation
backward, upward, lateral
BUL
Lumbar Superior Facet Orientation
backwards medial
Anterior Longitudinal Ligament
covers and connects the anteroalateral aspects of the vertebral bodies and IV discs
Posterior longitudinal ligament
weaker band that runs within the vertebral canal along the posterior aspect of vertebral bodies
- resists hyperflexion
- prevents posterior herniation of nucleus pulposus
Ligamentum Flava
connect the laminae of adjacent vertebrae
Rotatores
breves and longi
- bilateral: extend
- unilateral: rotates opposite
multifidus
found in lumbar region (skips 2-4 vertebrae)
- bilateral: extends the spine
- unilateral: flexes spine to the same side, rotates opposite
Semispinalis
- bilateral: extends thoracic and cervical spine
- unilateral: bends to same side, rotates opposite
Flexion
40-90 degrees
Extension
20-45 degrees
Sidebending
15-30 degrees
Rotation
3-18 degrees
Coupled Motion
CONSISTENT association of a motion along or about one axis with another motion along a 2nd axis
-principle motion can’t be produced without the associated motion occuring
Linkage
relationship of joint mechanics with surrounding structures
-increased ROM
Elastic barrier
range between the physiologic & anatomic barrier of motion in which passive ligamentous stretching occurs BEFORE tissue disruption
Excessive motion/restriction
references the vertebrae above in a functional vertebral unit
-ie. excess motion of L2 is the motion of L2 on L3
Type 1 Mechanics
- Neutral
- Sidebending and rotation are couple in OPPOSITE directions
- tends to be a group of vertebrae
Type 2 Mechanics
- Flexion or Extension
- Sidebending and Rotation are coupled in the SAME direction
- tends to be a single vertebrae
Naming Somatic Disfunction
- locate the vertebra
- Indicate position (N, F, E)
- Indicated sidebending
- Indicated rotation
Fryette’s 3rd Principle
initiating a movement of a vertebral segment in any place of motion will modify the movement OF THAT SEGMENT in other planes of motion
-restricted in 1 direction (motion will be restricted in other directions
Fryette’s Principles
THORACIC AND LUMBAR SPINE ONLY
- neutral: sidebending and rotation are couple in oposite directions
- F/E: sidebending and rotation are coupled in the same direction
Push TP right
vertebra rotates left
Right PTP
restriction of left rotation
-hard end feel
(restricted in rotation to the left)
Spine of the Scapula
T3 spinous process
T3 transverse process
Inferior angle of the Scapula
spinous process of T7
TP of T8
Iliac Crest
level of L4 vertebra
Scoliosis
lateral curvature of the spine named toward convexity (Levo-left and dextro-right) -more common in females Cobb angle do forward bending test
Cobb angle and managment in Scoliosis
less than 25 degrees -conservative: monitor 25-45 degrees -non-operative: braces more than 45 -surgical fusion to prevent progression
failure of proper management can cause respiratory compromise (50+) and cardiac compromise (75+)
Mechanical Low Back Pain
radiation below the knee
radiculopathy
spinal stenosis
cauda equina syndrome
Straight Leg Raise Test
raise the leg with knee extended (nonspecific test)
- positive test: pain (15-30 degrees)
- -lumbar disc etiology
–tests for radiculopathy, Spinal stenosis
Radiculopathy
pain with dermatomal distribution
neurological function may be impaired (lower extremity weakness and diminished reflexes)
-MRI
Spinal Stenosis
BILATERAL lower limb pain
neurogenic claudication
neuro function may be impaired (LE weakness, diminshed reflexes)
typically chronic
positive straight leg test
Cauda Equina Syndrome
impaired neuro function
- sadle anesthesia
- LE weakness
- diminished reflexes
- urinary retention
EMERGENCY
usually traumatic
MRI
Spina Bifida Occulta
failure of the neural tube to close without hernation
Spina Bifida Meningocele
failures of the neural tube to close with the protrusions of the meninges through the defect
S. B. Myelomenginocele
failure of the neural tube to close with protrusion of the meninges and spinal cord through the defect
Sacralization
one or both TPs of L5 are long and articulate with the sacrum
Spina Bifida
defect in the closure of the lamina
lumbarization
failure of S1 to fuse with the rest of the sacrum
*uncommon AF
Spondylosis
bony spurs
Spondylolysis
scotty dog fx
Spondylolesthesis
slipping of one vertebra on another
