T and L Spine Mech Flashcards
Rule of 3’s
Refers to the location of the spinous process in relation to the transverse process in the thoracic spine
T1-3
Spinous process located at the level of the corresponding transverse process
T4-6
Spinous process located 1/2 a segment below the corresponding transverse process
T7-9
Spinous process located at the level of the transverse process of the vertebrae below
T10
Same as T7-9 (SP located at level of TP of segment below)
T11
Same as T4-6 ( SP located at 1/2 a segment below the TP)
T12
Same as T1-3 (SP located at same level as TP)
Superior Facet Orientation Mneumonics
Cervical: Backwards, upwards, medial (BUM)
Thoracic: Backwards, upwards, lateral (BUL)
Lumbar: Backwards, medial (BM)
Coupled Motion
Consistent association of a motion along or about one axis, with another motion about or along a 2nd axis
-Principle motion cant be produced without the associated motion occurring as well
Linkage
Relationship of joint mechanics with surrounding structures
Joint assessment requires joint isolation for accurate measurement and evaluation
Vertebral Nomenclature
Motion is always referenced to the movement of the anterior/superior surface of the vertebra
Excessive motion (or restriction) is in reference to the vertebra above, in a functional vertebral unit
(excess motion of L2 is the motion of L2 on L3
Type 1
In the neutral range, side bending and rotation are coupled in opposite direction
Groups of vertebra TONGO
Type 2
In sufficient flexion or extension, side bending and rotation are coupled in the same direction
Single vertebra
Third Principle
Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion
- If motion is restricted in one direction, motion will also be restricted in other directions
- If motion is improved in one direction, motion will improve in other directions
Rotation of vertebrae
Pushing anteriorly on a right TP rotates the vertebra to the left.
Pushing left rotates it to the right
“Hard End Feel”
A hard end feel on the right TP—–> Right PTP——> Vertebra is rotated to the right—–>Restrictive barrier on the LEFT
And vice versa
Scoliosis
Lateral curvature of the spine.
Name towards the convexity: Levo-left, dextro-right
Scoliosis: PE
Asymmetry of the waist and shoulders
Rib cage prominence.
Cobb angle: a measure of the lateral curvature of the spine
Forward bending test, or scoliometer
Scoliosis: Management
OMT
<25 degrees: Monitor with frequent radiographs
25-45 degrees: non-operative bracing
>25 degrees: surgical fusion-prevents progression
Radiculopathy
Pain with dermatomal distribution
Neurological function may be impaired: lower extremity weakness and diminished reflexes
Work up: MRI
Positive straight leg test
Spinal Stenosis
Bilateral lower limb pain
Neurogenic claudication
Neurological function may be impaired: lower extremity weakness and diminished reflexes
Work up: MRI
Spina Bifida
Spina Bifida Occulta: Failure of the neural tube to close without herniation
Meningocele: Failure of the neural tube to close with protrusions of the meninges thru the defect
Myelomenginocele: Failure of the neural tube to close with protrusion of the meninges and spinal cord thru the defect
Sacralization
One or both TP’s of L5 are long and articulate with the sacrum
Lumbarization
Failure of S1 to fuse with the rest of the sacrum
Spondylosis
Bony spurs
Spondylolysis
Fracture with no anterior movement of the vertebral body
Spondylolethesis
Fracture or slipping of the vertebra with anterior movement of the body
