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MSK II - Exam 1 > Spine- Thoracolumbar I- Intro thru Stabilization > Flashcards

Spine- Thoracolumbar I- Intro thru Stabilization Flashcards

1
Q

What is the first part of a biomechanical exam?

A

scan or screen

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2
Q

What describes normal ROM?

A

Smooth, coordinated and full

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3
Q

Can impairments be present without symptoms?

A

YES

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4
Q

What is the primary purpose of a biomechanical exam?

A

Assess for further detail in involved area

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5
Q

What does limited ROM NOT indicate?

A

Lack of accessory motion

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6
Q

What does pain with passive elbow extension and resisted elbow flexion indicate? (most likely)

A

musculotendinosis

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7
Q

What can stiff areas do if NOT addressed?

A

Cause painful hypermobile compensations elsewhere

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8
Q

Are stiff areas always painful?

A

No

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9
Q

Where are hypermobile compensations often found?

A
  • the past of LEAST resistance
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10
Q

What can a stiff lower thoracic region and thoracolumbar junction lead to? (potentially?)

A

Hypermobile mid to lower lumbar spine

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11
Q

What can a stiff SI joint and hip lead to? (potentially?)

A

Hypermobile lower lumbar spine

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12
Q

What are our general Rx and purposes for hypomobility and hypermobility?

A

Mobility in hypomobile areas, stability in hypermobile areas

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13
Q

Why are hypermobile areas usually painful?

A

Axis of motion is less controlled

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14
Q

What can cause the axis of motion to be less controlled?

A

Trauma, injury, etc.
- damages tissue, creates a lax joint, and loss of stability to the ligaments and capsule, etc.

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15
Q

What should we do with hypermobile areas?

A

Stabilize

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16
Q

Should we treat adjacent joints/areas when addressing an injury/pain?

A

YES

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17
Q

What does the orientation of facets determine?

A

Direction and amount of motion

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18
Q

What plane are the thoracic spine facet joints in?

A

Mostly frontal plane but ribs limit greater SB

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19
Q

What motion is greatest in the thoracic spine? How much?

A

Rotation: 25-30˚

20
Q

What motions are the most in the thoracic spine? Least?

A

Rotation, then SB, flexion, with the least amount in extension

21
Q

Where is there the MOST rotation in the thoracic spine?

A

T5 and T10

22
Q

Where is there the LEAST rotation in the thoracic spine?

A

T11 and T12

23
Q

Why is there less rotation in the lower most thoracic spine?

A

Facets transition to the shape of lumbar facets, start to look and act like lumbar vertebra

24
Q

What is the shape of the lumbar spine facet joints? What plane?

A

Slightly curved
- anterior more coronal, particularly at L5,S1
- Posterior more sagittal

25
Q

What motion is the MOST in the lumbar spine?

A

Flexion and extension

26
Q

What motion is the LEAST in the lumbar spine? how much in degrees?

A

Rotation, 5-7˚ total

27
Q

What is controlled mobility MORE than?

A

Just strength of superficial and big muscles

28
Q

What are the 4 variables for stabilization?

A
  1. Joint Integrity (i.e cartilage)
  2. Passive Stiffness (i.e. ligaments)
  3. Neural Input
  4. Muscle Function
29
Q

What are characteristics of local muscles?

A
  • closer to axis of motion
  • often deeper
  • stabilization > rotary forces
  • postural
  • aerobic > anaerobic
  • MORE often type I fibers
30
Q

What are characteristics of global muscles?

A
  • further away from axis of rotation
  • often superficial
  • rotary > stabilization forces
  • spurt muscles
  • anaerobic > aerobic
  • MORE often type II fibers
31
Q

What are some muscles we need for stabilization in the thoracolumbar region? (be able to find and label these)

A
  • Quadratus Lumbourm
  • Psoas Major
  • Multifidus
  • Transverse Abdominus
  • Rotatores longus
32
Q

What other body part is critical for low back stabilization?

A

PELVIC FLOOR

33
Q

What does the Psoas muscle do for stabilization?

A

Frontal plane stabilizer

34
Q

What does the quadratus lumborum do for stabilization?

A

Frontal plane stabilizer

35
Q

What do the pelvic floor and transversus abdominus do for stabilization?

A

Increase contraction of multifidus

36
Q

What does the multifidi/rotatores do for stabilization?

A

If smaller = higher injury rates and LBP

37
Q

What muscles do pain, swelling, disuse, and joint laxity effect?

A

Decreased and delayed motor performance and control of local muscles such as transversus abdominus, multifidi, etc.

38
Q

What type of muscle is inhibition preferential to?

A

Type I muscles

39
Q

What declines with pain, swelling, disuse, and joint laxity?

A

strength declines with local muscle atrophy, specifically multifidus, along with every other muscle function

40
Q

What non-contractile tissues will have increased stress with lack of stabilization?

A

Cartilage, ligament and capsule become gradually more symptomatic

41
Q

What can pain, swelling, disuse, and joint laxity cause regarding global muscles?

A

Increased and inefficient motor activity of global muscles such as external abdominal obliques/erector spinae, etc.

42
Q

What does atrophy lead to?

A

FATTY INFILTRATION

43
Q

What percentage of muscle cross sectional area is fat in those over 60?

A

50%

44
Q

What happens to fiber type with pain, swelling, disuse and joint laxity?

A

Type I to type II, lose endurance stabilizing function

45
Q

Does muscle function normalize automatically once symptoms are improved?

A

NO

46
Q

What percentage of muscle activation is sufficient to keep stability and is suitable to improve muscular endurance?

A

30% - doesn’t take a lot for improvement

MSK II - Exam 1 (7 decks)

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