The Spine Flashcards
What are the three functions of the spine?
Protection, stability, mobility
What does the spine protect?
Elements of CNS and PNS
Brain stem, SC, spinal plexus, cauda equine, nerve roots
How does the spine provide stability?
Provides rigid column for head and extremity movement against multi-directional forces
What forces does the spine provide stability against?
Tension, compression, bending, twisting
How does the spine provide mobility?
Allows segmental, 3D motion directly within the rigid column when needed
What are the spinal regions? How many vertebrae in each?
Sub-cranial
Cervical (7 vertebrae)
Thoracic (12 vertebrae)
Lumbar (5 vertebrae)
Sacral (5 fused)
Coccyx
What does a spinal segment consist of?
Adjacent halves of two vertebrae
Disc
Contents of vertebral and intervertebral foramen
Facets
Associated ligaments
Associated muscle, fascia, and integumentary innervates by spinal nerve
What are the different joints in spinal segment?
Disc (anteriorly)
Two synovial facet joints (posteriorly)
What does the disc consist of?
Annulus fibrosis, nucleus pulposis, vertebral end plates
What is annulus fibrosis?
Fibrosis collagenous circular layers laid down perpendicular to one another
What is the nucleus pulposis? What force does it resist?
Centrally located proteoglycan rich gellatenous material; resists compression
What are the facets created by?
Inferior articular process of superior vertebra
Superior articular process of inferior vertebrae
What do spinal curve help with?
Load distribution
What type of curves are developed at a young age?
Born w/ C curve
C spine lordosis develops w/ onset of head lift
L spine lordosis develops w/ onset of sitting
How to assess physiologic joint motion
Through end range and end feel
How to assess non physiologic joint motion
Component motions and joint play
What 3 things to keep in mind whenever assessing motion
Quality, quantity, subjective response
4 tools to measure spine ROM
Tape measure
Goni
Inclinometer
C-ROM device
Dynamic motions when assessing strength
Eccentric and concentric
Ways to assess static strength
Postural strength and endurance
How do you assess neural elements?
-Subjective, med hx, risk factors and flags (cancer, instability, fracture)
-dermatomes, Myotomes, DTR, neuro tension
What are the three big cervical spine concerns?
Instability/fracture, neurological s/s, vertebral artery sign
What are some examples of neurological s/s that are concerning in regards to c/s?
Chord signs (upper C spine lesion), UMN lesion
Paresis
Ataxia
Abnormal reflex
What are examples of vertebral artery sign?
Dizziness, drop attacks w/ head turning or cervical extension
How can you find clinical spinal representations?
By systems review, lifespan, chief complaint, medical dx
What are the 4 treatment objectives of Kaltenborn for spinal dysfunction?
-control pain and inflammation
-limited movement, restore normal motion
-hyper mobility, stabilize
-inform, instruct and train
