T and L Spine Mech

Question 1

Rule of 3’s

Answer 1

Refers to the location of the spinous process in relation to the transverse process in the thoracic spine

Question 2

T1-3

Answer 2

Spinous process located at the level of the corresponding transverse process

Question 3

T4-6

Answer 3

Spinous process located 1/2 a segment below the corresponding transverse process

Question 4

T7-9

Answer 4

Spinous process located at the level of the transverse process of the vertebrae below

Question 5

T10

Answer 5

Same as T7-9 (SP located at level of TP of segment below)

Question 6

T11

Answer 6

Same as T4-6 ( SP located at 1/2 a segment below the TP)

Question 7

T12

Answer 7

Same as T1-3 (SP located at same level as TP)

Question 8

Superior Facet Orientation Mneumonics

Answer 8

Cervical: Backwards, upwards, medial (BUM)

Thoracic: Backwards, upwards, lateral (BUL)

Lumbar: Backwards, medial (BM)

Question 9

Coupled Motion

Answer 9

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

Question 10

Linkage

Answer 10

Relationship of joint mechanics with surrounding structures

Joint assessment requires joint isolation for accurate measurement and evaluation

Question 11

Vertebral Nomenclature

Answer 11

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

Question 12

Type 1

Answer 12

In the neutral range, side bending and rotation are coupled in opposite direction

Groups of vertebra TONGO

Question 13

Type 2

Answer 13

In sufficient flexion or extension, side bending and rotation are coupled in the same direction

Single vertebra

Question 14

Third Principle

Answer 14

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

Question 15

Rotation of vertebrae

Answer 15

Pushing anteriorly on a right TP rotates the vertebra to the left.

Pushing left rotates it to the right

Question 16

“Hard End Feel”

Answer 16

A hard end feel on the right TP—–> Right PTP——> Vertebra is rotated to the right—–>Restrictive barrier on the LEFT

And vice versa

Question 17

Scoliosis

Answer 17

Lateral curvature of the spine.

Name towards the convexity: Levo-left, dextro-right

Question 18

Scoliosis: PE

Answer 18

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

Question 19

Scoliosis: Management

Answer 19

OMT

<25 degrees: Monitor with frequent radiographs
25-45 degrees: non-operative bracing
>25 degrees: surgical fusion-prevents progression

Question 20

Radiculopathy

Answer 20

Pain with dermatomal distribution

Neurological function may be impaired: lower extremity weakness and diminished reflexes

Work up: MRI

Positive straight leg test

Question 21

Spinal Stenosis

Answer 21

Bilateral lower limb pain

Neurogenic claudication

Neurological function may be impaired: lower extremity weakness and diminished reflexes

Work up: MRI

Question 22

Spina Bifida

Answer 22

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

Question 23

Sacralization

Answer 23

One or both TP’s of L5 are long and articulate with the sacrum

Question 24

Lumbarization

Answer 24

Failure of S1 to fuse with the rest of the sacrum

Question 25

Spondylosis

Answer 25

Bony spurs

Question 26

Spondylolysis

Answer 26

Fracture with no anterior movement of the vertebral body

Question 27

Spondylolethesis

Answer 27

Fracture or slipping of the vertebra with anterior movement of the body