Test 2 Flashcards
how does the occipital condyle move in the superior facet?
the occipitial condyles move anterior and medially in the superior facet
sidebending in the cervical spine is limited by?
c
rib 3 is attached via the?
head to the vertebral body of t2 and t3
which is true regarding the swing phase of gait?
The ipsilateral sacral base moves anteriorly about an oblique axis
what levels are sympathetics and describe their neurons
T1-L2 Preganglionic fibers- short myelinated
Postganglionic fibers- long unmyelinated
what level sypmathetic neurons go into paraspynal gangliuon?
T1-T4
What level sypmathetic neurons synapse in the celiac ganglion?
T5-T9
what level of sympatheitc neurons go to the superior mesenteric ganglion?
T10-T11
what level go to the inferior mesenteric ganglion?
T12-L2
Where do preganglionic sympathetics originate form in the spinal cord?
Intermediolateral neuronal column
where is the sympathetic chain located?
costotransverse angle
what four cranial nerves carry parasympathetic fibers
3, 7, 9,10
what sacral levels carry parasympathetics?
S2-S4
describe parasympathetic neurons?
Pre-ganglionic fibers: long
Post-ganglionic fibers: short
what are the parasympathetic effects?
DUMBBELS Diarrhea/defecation Urination Miosis- pupil constrict Bradycardia Bronchospasm Emesis Lacrimation Salivation Example: OPIATES
what two bones form the jugular foramen?
the temporal bone and the occiput forms the jugular foramen
What structure can be used to effect vegas?
juglular foramen
what is facilitation?
Facilitation indicates an area of impairment or restriction develops a lower threshold for irritation and dysfunction when other structures are stimulated.”
-Facilitated segments are hyper-irritable and hyper-responsive.
Muscles are maintained in a hypertonic state.
What type of mechanics is more associated with viscero-somatic reflexes and facilitations?
type 2
muscles of the hip motions:
Psoas (F), Gluteus Maximus (E), Gluteus Medius (AB), Adductor Longus (AD), Piriformis (ER), Gluteus Med and Minimus (IR)
what is an ober test?
The Ober’s test evaluates a tight, contracted or inflamed tensor fasciae latae (TFL) and iliotibial band (ITB)
what type of joint is the knee joint?
modified synovial hinge
what is the best test for ACL?
lachmans
what joint is the true ankle joint?
Tibiotalar Provides plantar flexion and dorsiflexion.
what motions are at the talocalcaneal joint? (subtalar)
Provides inversion and eversion.
actions of: Gastrocnemius and Soleus , Popliteus , Peroneus L&B, Tibialis Anterior , Extensor Hallucis Longus
Muscles: Gastrocnemius and Soleus (PF), Popliteus (IR/ER femur on leg), Peroneus L&B (Everter), Tibialis Anterior (Inverter), Extensor Hallucis Longus (Extensor GT)
what bones make up the medial longitudinal arch?
calcaneus tallus navicular 3 cuneiform 1st three metatarsals
what bones make up the lateral longitudinal arch?
calcaneus cuboid lateral 4th and 5th metarsal
what bones make up the transverse arch?
base of metatarsals cuboid and 3 cuneiforms
what does the talar tilt test?
ATF and calcaneal fibular ligament
what is supination of the foot?
inversion adduction plantar fexion
what is pronation of the foot?
eversion dorsifelxion abduction
what is hopkins test?
squeeze the tibia and fibia between your hands positive if pain checking for syndesmotic injury (high ankle sprain)
describe the j tug method hvla anterior talus
Exert a posterior force on the talus through the 5th digits.
4. Engage the barrier. The final corrective force is a “J” motion, quickly pulling the foot
inferiorly (90% of the effort) while slightly increasing dorsiflexion (10% of effort).
ME for anterior lateral malleolus?
Place your thumbs over the anterior aspect of the lateral malleolus, wrapping your fingers around the patient’s ankle bilaterally.
Engage the feather edge of the restrictive barrier by applying a gentle posterior pressure to the lateral malleolus with your thumbs and dorsiflexing the ankle with your abdomen or thigh.
Instruct the patient to plantar flex their foot while you provide an isometric counterforce.
Maintain this contraction and counterforce for 3-5 seconds.
Instruct the patient to relax.
Wait until the tissues relax (usually about 2 seconds) then reengage the feather edge of the restrictive barrier.
Repeat steps 3-6 two to four times or until no further change is noted.
Return the patient to neutral.
Reassess.
posterior talus hvla?
The cephalad hand is on the anterior aspect of the patient’s right distal tibia.
The restrictive barrier is engaged by applying a posterior force through the distal tibia with the cephalad hand.
The final corrective force is a quick, posteriorly directed thrust to the tibia through the cephalad hand.
Return the patient to neutral.
hvla posterior talus with tractional emphasis?
One hand is wrapped around the dorsum of the foot with 5th digit over the talus.
The other hand grasps the calcaneus. (The extremity may be lifted off the table).
Engage the barrier by simultaneously plantar flexing the foot, applying an anterior force on the calcaneus, and applying traction caudally by leaning body weight back. The final corrective force is a tractional/distractive thrust (90% of effort), while guiding the foot into further plantar flexion and talus into further anterior glide (10% of effort).
Inferior/plantar tarsal/metatarsal hvla hiss whip
The final corrective force is a quick, anteriorly and superiorly directed thrust from the thumbs to the dysfunctional tarsal/metatarsal bone using a whipping motion, like “cracking a whip”. This can be repeated up to three times.
Inferior/plantar tarsal/metatarsal hvla cross hand
The hypothenar eminence of the thrusting (non-stabilizing) hand is placed over the dysfunctional tarsal/metatarsal. The opposite hand crosses over the top of the thrusting hand with the hypothenar eminence of that stabilizing hand being placed at the same level of the mid-foot away from the dysfunction to stabilize the neighboring tarsals/metatarsals. (Note: If the dysfunction is on the medial aspect of the right mid-foot, then the right hand is the thrusting hand; if the dysfunction is on the lateral aspect of the right mid-foot, then the left hand is the thrusting hand. The opposite is the case for the left foot. Please, note that the video shows an alternative hand placement to this).
The final corrective force is a quick, anterior force directed into the table with the thrusting hand (non-stabilizing hand).
Medial calcaneus tp location
Tender Point Location: 1 inch distal and slightly posterior to the medial malleolus (medial aspect of the calcaneus)
tp lateral calcaneous
1 inch distal and slightly posterior to the lateral malleolus
what is tensegrity?
tensegrity systems are stabilized by continuous tension, with discontinuous compression.
microtubules are what part of the microtensegrity unit?
Microtubules are the compression bearing elements
microfilaments are what part of the microtensegrity unit?
Microfilaments and intermediate fibers are the tension bearing elements
what are three key areas of proprioception for posture?
foot, SI joint, Cervical spine
what are extrinsic gravitational strain factors?
Surgeries
Traumas
Increased Gravitational stress (like a G6)
what are intrinsic gravitational strain factors?
Age (muscle weakness, fascial elasticity, bone mass)
Altered integrity of soft tissue (hypermobility, CT disorder)
Incompetent bony structures (spondylolysis, spondylolisthesis)
Poor Tissue Health (disease, poor nutrition, smoking)
how do dynamic/phasic muscles respond to muscle imbalance?
Inhibition
Hypotonicity
Weakness (Psuedoparesis)
how do postural/tonic muscles respond to muscle imbalance?
Facilitation
Hypertonicity
Shortening
what is the janda recipee?
Sensorimotor balance training
Stretch before strengthen
Re-educate movement pattern
what are the dirty half dozen?
Muscle imbalance was the most prevalent in 90%
-Non-neutral (type II) Lumbar dysfunction
Pubic symphysis dysfunction
Sacral base posterior
Innominate Shears
Leg Length discrepancy with un-level sacral base
Muscle imbalance
what are the steps for treating muscle imbalance?
STEP 1 PROPRIOCEPTIVE BALANCE
Step 2 Stretch Tonic/Facilitated Muscles
Step 3 Muscle re-education/ strengthening
what does it mean if a patients asis drops inferiorly when doing a pelvic clock test?
Indicates weakness of abdominal muscles or hypertonicity of adductors
what does a failed pelvic clock with heel slide mean?
A failed test indicates weak abdominal muscles or facilitated and hypertonic hip flexors
what is the normal firing pattern for proper hip abduction?
- Gluteus medius, 2. Tensor fascia lata, 3. Quadratus Lumborum, 4. Lumbar erector spinae.
what is the normal firing pattern for hip extension?
- Hamstrings, 2. Gluteus Maximus, 3. Contralateral Lumbar Erector Spinae, 4. Ipsilateral Lumbar Erector Spinae.
Facilitation is the result of multiple changes
Increased dynorphin production = increased excitability
Destruction of inhibitory interneurons with the proliferation of excitatory interneurons.
Activation of Glial Cells amplifies inflammation
Neuropeptide and amino acid neurotransmitters
Spinal memory—pain patterns can be reactivated by milder stimuli later
