Spine Stuff - Midterm 2 - Extras Flashcards
spinal stability consists of what 3 subsystems?
- The passive subsystem: VB, facets, ligaments, caps & ms/tendon (passive tension)
- It provides stabilization of the elastic zone
- It limits the size of the neutral zone
- It provides the neural control subsystem with info about vertebral position & motion - The active subsystem: Spinal ms/tendons
- It generates the forces needed to stabilize the spine
- It controls the motion that occurs within the neutral zone &
- It contributes to maintaining the size of the neutral zone
- It provides the neural control subsystem with info about the forces generated by ms - The neural subsystem: It receives info from the passive & active subsystems
- From the info, it determines the requirements for spinal stability & acts on the spinal muscles to produce the required forces
define the neutral zone
Zone in which movt occurs at beginning of ROM before any effective resistance is offered from
- The muscular system or
- The osteo-ligamentous structures
components of the Lx spine scan/observation
slides 9 - 17
what ms is attached to each z-joint?
multifidus (helps w stabilization)
what are the spinal ligaments?
what links does the thoracolumbar fascia have with the body?
slides 8-11
name the inner unit muscles, their function and where they reside
- slides 13-20
name the outer unit muscles, their function and where they reside
slides 13, 21-26
what level does the spinal cord end?
L1/L2
where is the cauda equina?
descrube the nerve roots and rami
slide 33-36
what are the 5 nerve plexuses?
Brachial plexus: radial, median, ulnar n
Lx plexus = Femoral n (L2-L4)
Sacral plexus = Sciatic n (L4-S2 or 3)
describe the glides of the z-joint, close packed position for lx spine, capsular pattern
slide 41-48
where is the IV disc larger/where does it allow for more movement?
Larger in Cx & Lx spine & thin in Tx spine
more movement in Lx spine
describe the annulus fibrosis
- supports the axial load of the body
- innervations (from pain sensors) are more in the posterior or post-lateral aspect of the disc
- a disc tear is more common in the post/post-lat part of the disc
describe the vertebral end plate and it’s function
slides 11-12
describe the nucleus/nucleus hydration/main function
slides 13-15
describe nucleus axial loading
slide 16-18
describe the nucleus intradisc pressure - ie when it is highest and lowest
describe disk changes throughout the day/diurnal changes
describe disc changes relative to age
slide 23-27
describe degenerative disc disease (DDD)
slides 28-31
describe the pathophysiology of IDD/bulge and disc herniation
slides 32-35
describe the potential sources of pain for a disc lesion
slides 36-40
what is the diff btw neurodynamic tests and neuro exam?
describe extra vs intraneural
slides 7-10
what are precautions/contraindications for a neurodynamic assessment?
Contraindications (send back to DR!!)
- Neuro signs that are new or worsened
- Cauda equina signs
- Spinal cords signs
Precautions
- NS irritation, neuro signs that are stable
- Circulatory problems
- Systemic disease (diabetes, Hypothyroidism) - bc they have poorer quality of connective tissue
what entails a (+)’ve neurodynamic test and what does that mean?
(+) test when:
- Reproduce all or some of pt’s symptoms (but not always)
- ↓ ROM
- ↑ Resistance
- Modified normal reaction when compared to opposite side
- Modified symptoms with a distal manoeuver
(+) signs may indicate:
- Irritation of neural system or structures around neural system
- Adherence of neural system or structures around neural system