The Spine

Question 1

What are the three functions of the spine?

Answer 1

Protection, stability, mobility

Question 2

What does the spine protect?

Answer 2

Elements of CNS and PNS
Brain stem, SC, spinal plexus, cauda equine, nerve roots

Question 3

How does the spine provide stability?

Answer 3

Provides rigid column for head and extremity movement against multi-directional forces

Question 4

What forces does the spine provide stability against?

Answer 4

Tension, compression, bending, twisting

Question 5

How does the spine provide mobility?

Answer 5

Allows segmental, 3D motion directly within the rigid column when needed

Question 6

What are the spinal regions? How many vertebrae in each?

Answer 6

Sub-cranial
Cervical (7 vertebrae)
Thoracic (12 vertebrae)
Lumbar (5 vertebrae)
Sacral (5 fused)
Coccyx

Question 7

What does a spinal segment consist of?

Answer 7

Adjacent halves of two vertebrae
Disc
Contents of vertebral and intervertebral foramen
Facets
Associated ligaments
Associated muscle, fascia, and integumentary innervates by spinal nerve

Question 8

What are the different joints in spinal segment?

Answer 8

Disc (anteriorly)
Two synovial facet joints (posteriorly)

Question 9

What does the disc consist of?

Answer 9

Annulus fibrosis, nucleus pulposis, vertebral end plates

Question 10

What is annulus fibrosis?

Answer 10

Fibrosis collagenous circular layers laid down perpendicular to one another

Question 11

What is the nucleus pulposis? What force does it resist?

Answer 11

Centrally located proteoglycan rich gellatenous material; resists compression

Question 12

What are the facets created by?

Answer 12

Inferior articular process of superior vertebra
Superior articular process of inferior vertebrae

Question 13

What do spinal curve help with?

Answer 13

Load distribution

Question 14

What type of curves are developed at a young age?

Answer 14

Born w/ C curve
C spine lordosis develops w/ onset of head lift
L spine lordosis develops w/ onset of sitting

Question 15

How to assess physiologic joint motion

Answer 15

Through end range and end feel

Question 16

How to assess non physiologic joint motion

Answer 16

Component motions and joint play

Question 17

What 3 things to keep in mind whenever assessing motion

Answer 17

Quality, quantity, subjective response

Question 18

4 tools to measure spine ROM

Answer 18

Tape measure
Goni
Inclinometer
C-ROM device

Question 19

Dynamic motions when assessing strength

Answer 19

Eccentric and concentric

Question 20

Ways to assess static strength

Answer 20

Postural strength and endurance

Question 21

How do you assess neural elements?

Answer 21

-Subjective, med hx, risk factors and flags (cancer, instability, fracture)
-dermatomes, Myotomes, DTR, neuro tension

Question 22

What are the three big cervical spine concerns?

Answer 22

Instability/fracture, neurological s/s, vertebral artery sign

Question 23

What are some examples of neurological s/s that are concerning in regards to c/s?

Answer 23

Chord signs (upper C spine lesion), UMN lesion
Paresis
Ataxia
Abnormal reflex

Question 24

What are examples of vertebral artery sign?

Answer 24

Dizziness, drop attacks w/ head turning or cervical extension

Question 25

How can you find clinical spinal representations?

Answer 25

By systems review, lifespan, chief complaint, medical dx

Question 26

What are the 4 treatment objectives of Kaltenborn for spinal dysfunction?

Answer 26

-control pain and inflammation
-limited movement, restore normal motion
-hyper mobility, stabilize
-inform, instruct and train