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Athletic Therapy > the spine > Flashcards

the spine Flashcards

1
Q

cervical spine

A

portion of the spinal column consisting of the first seven vertebrae that lie in the neck

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2
Q

movements from c0-1

A

protraction and retraction

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3
Q

movements that happen at c2

A

rotation

~50%

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4
Q

atlas and axis

A

1 and 2 cervical vertebrae
support the head
permit cervical rotation
arches in atlas form bony ridge to accommodate odontoid process and medulla of the spinal cord

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5
Q

mobility of the cervical spine

A

attributed to flat, oblique faceing of the spines articular facets to the horizontal positioning of the SP

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6
Q

thoracic spine

A

12 vertebrae
long transverse processes and prominent and thin spinous processes
1 through 10 have articular facets on each transverse process with which the ribs articular
the head of the rib articulates between two vertebrae and thus share half of a facet

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7
Q

SR mechanics

A

c0-2

side bending and rotation are coupled movements and occur in opposite direction

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8
Q

RS mechanics

A

c3-7

side bending and rotation occur in the same direction

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9
Q

Ribs rule of thirds

A

T1-3, 12: SP are lame level as TP of same vertebrae
T4-6, 11: SP are 1/2 level inferior from TP of same vertebrae
T7-9, 10: SP are 1 full level inferior from TP of the same vertebrae

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10
Q

lumbar spine

A

5 vertebrae
support low back and are large and thick
large spinous and transverse process
superior articular processes face medially while the inferior face laterally
all movement occurs here but less flexion and extension

cauda equina L2-S1

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11
Q

sacrum

A

keystone bone
makes the pelvis
weight transferral bone with pelvis
ligaments make this joint very stable

termination of dural sac

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12
Q

coccyx

A

four vertebraefused together to form the tailbone

*end filum terminale of dura mater

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13
Q

nucleus pulposus

A

soft, fibrocartilaginous central portion of intervertebral disk

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14
Q

annulus fibrosus

A

composed of fibrocartilage, it is the outer portion of the intervertebral disc

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15
Q

intervertebral discs

A

fibrocartilage pads that separate the cushion the vertebrae
annulus fibrosis and nucleus pulposus
used for shock absorption

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16
Q

anterior longitudinal ligament

A

connect anterior surface of adjacent vertebral bodies
wide and strong
restricts extension

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17
Q

posterior longitudinal ligament

A

in vertebral canal

extends full length of the posterior aspect of the bodies of the vertebrae and acts to limit flexion

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18
Q

supraspinous ligament

A

attaches to each spinous process and is referred to as the ligamentum nuchae in the cervical region

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19
Q

iliolumbar ligament

A

STRONG

passing from TP of the 5th lumbar vertebrae to the posterior part of the inner lip of the iliac crest

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20
Q

sacroiliac ligament

A

The posterior SI ligament runs along the back of the sacroiliac joint and provides considerable stability
The ligament connects the back of the hip bones (posterior-superior iliac spine and iliac crest) to the sacrum.

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21
Q

sacrotuberous ligament

A

sacrum to ischial tuberosity

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22
Q

why sacrotuberous and sacrospinous so important

A

The sacrotuberous and sacrospinous ligaments create the greater sciatic foramen and the lesser sciatic foramen. The largest nerve in the body, the sciatic nerve, passes through the greater sciatic foramen formed by these ligaments. Trauma to these ligaments, and the consequent inflammation, can lead to sciatic nerve pain, which runs down through the leg along the course of the nerve.

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23
Q

sacrospinous ligament

A

sacrum to ischial spine

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24
Q

interspinous ligament

A

between the SP limits rotation and flexion of the spine

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25
Q

ligamentum flavum

A

connect laminae of the adjacent vertebrae
limits flexion
*spinal stenosis could be secondary to flavum hypertrophy/thickening- as it is in the spinal canal and if thickened can cause neurological symptoms

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26
Q

iliocostaalis L,T,C

A

O: crest of the sacrum, SP of lumbar and lower thoracic vertebrae, iliac crest and angles of the ribs
I: angles of the ribs, tp of cervical vertebrae
A: extension and SB to one side

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27
Q

longissimus T,Ce,Ca

A

O: tp of lumbar, thoracic and cervical vertebrae
I: tp of the vertebrae aove the vertebrae of origin and the mastoid process of the temporal bone (Capitus)
A: extension of back and head, head rotation and sb

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28
Q

spinalis thoracic and cervicis

A

O: spinous process of upper lumbar, lower thoracic and 7th cervical
I: spinous process of upper thoracic and cervical
A: extend

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29
Q

multifidis

A 
O: posterior sacrum, Ilium, transverse
processes of lumbar, thoracic,
and C4-C7
I: Spinous Processes of a more
superior vertebra
A: Together: Extend vertebral
column
Singly: Laterally flex vertebral
column and rotate head to
opposite side
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30
Q

rotatores

A

O: TP of each vertebrae
I: SP of the adjacent superior vertebae
A: trunk extension and rotation

31
Q

interspinales

A

O: SP below
I: SP above
A: trunk and neck extension

32
Q

semi spinalis T, Ce, Ca

A

O: TP of tspine and 7 cervical
I: SP of the 2-4 cervical through the 4 thoracic and occipital bone
A: extension and head rotation

33
Q

splenius cap, cerv

A

O: SP of upper tspne and 7cspine and ligamentum nuchae
I: occipital bone, mastoid process of temporal bone and TP of upper 3 c/s
A: extend head and neck, rotation and SB together

34
Q

more hypermobile/compensatory region in the spine

A

cervical spine
will increase ROM from another segment in spine
in order to complete entire motion

35
Q

spine rotation happens at

A

C2
T9-12
L5-S1

36
Q

kyphosis

A

excessive outward curvature of the spine, causing hunching of the back

37
Q

lordosis

A

abnormal anterior curvature of the lumbar spine

sway back condition

38
Q

scoliosis

A

abnormal lateral curvature of the spine

can be functional and/or structural

39
Q

vertebral artery test

A

Patient supine with head supported on table (follow the progression)
1.- Extend head and neck for 30 sec. if no change in symptoms, progress to next step
2.- Extend head and neck with rotation left, then right for 30 seconds, if no change in symptoms progress to next step
3.- With head being cradled off table, extend head and neck for 30 seconds. If no change in symptoms, progress to next step
4.- With head being cradled off table, extend head and neck with rotation left for 30 seconds, and then right
(+) TEST: dizziness, visual disturbances, disorientation, blurred speech, nausea/vomiting

40
Q

spurling test

A

TESTING: dysfuction of cervical nerve root
POSITION: sitting, head side bent to uninvovled side, apply pressure through head straight down, repeat with head bent toward involved
(+) TEST: pain and/or paresthesia in dermatomal pattern

41
Q

brachial plexus test

A

Application of pressure to head, neck and shoulders to re-create MOI
Lateral flexion of the neck w/ same side pain indicates a compression injury
Lateral flexion of the neck w/ opposite side pain indicates stretch or traction injury

42
Q

standing forward bend

A

IS dysfunction
follow with sacral positionals
ilium moving on the sacrum

43
Q

seated forward bend

A

SI dysfunction
follow with sacral positionals
sacrum moving on the stabilized ilium

44
Q

straight leg raise

A

may indicate problems at the sciatic nerve, SIJ, lumbar spine
pain at 30: hip or inflammed nerve
pain from 30-60: sciatic nerve
if df increases pain: nerve room or sciatic nerve irritation (laseague sign)
pain between 70-90: SIJ

45
Q

kernig test

A

pt supine with knee and hip flexed to 90
passively extending knee to elicit pain in the hamstrings
back pain may be a sign of nerve root irritation

46
Q

brudzinski sign

A

supine
flexing the neck causes a flex flexion of one or both knees and increase in pain
may indicate lumbar disc or nerve root irritation

47
Q

well straight leg raise

A

supine
unaffected leg passively extended into hip flexion
produce low back pain
can radiate along sciatic nerve
nerve root inflammation or disk herniation

48
Q

milgrim test

A

INSTRUCT: pt supine, raises both of pt’s legs 2-3 inches off the table and instructs pt to hold legs off the table for 30 seconds

POSITIVE: inability to perform test and/or low back pain

INDICATES: weak abdominal muscles or SOL

The test increases subarachnoid pressure and is positive when the patient is unable to hold the position for 30 seconds without pain, indicating pathology within or outside the spinal cord sheath, such as a herniated disc

49
Q

hoover test

A 
supine 
cup both calcanei 
active straight leg raise of one side 
if cheating/lying, there wont be any downward pressure on the side that isnt being raised
malingering
50
Q

bowstring test

A

sciatic nerve irritation
affected side is lifted until pain is felt
the knee is flexed until pain is relieved at which pressure is applied to popliteal fossa
positive indicates a radioculopathy
if lowered leg and ad dorsi and neck flexion: nerve root

51
Q

FABERS

A

flexion, abduction, external rotation
supine and figure 4 position
may produce pain in the inguinal region indicating a hip pathology
overpressure to knee produces pain SIJ

52
Q

FADIR

A

flexion, adduction, internal rotation
supine laying
test positive if pt indicates increase in low back pain - lumbar pathology

53
Q

SI compression and distraction

A

compression or gapping
anterior sacroiliac ligaments
pt reports posterior gluteal or leg pain test is positive
SIJ or sprain

54
Q

knees to chest test

A

pulling knees to chest bilaterally will increase symptoms in the lumbar spine
single knee to check causes pain in the posterolateral thigh= sacrotuberous
pain in PSIS when pulling single leg to opposite shoulder= sacroiliac ligament

55
Q

baby cobra

A 
press ups
extend the spine
see if pain radiates into buttocks/thigh
which indicates herniated disk
if pain localizes or more generalizes be more conservative and perhaps surgical
56
Q

reverse straight leg raise

A

prone
lifts affect leg
pain in low back= L4 nerve root

57
Q

spring test

A

Prone position, downward pressure is applied to the spinous process to assess anterior/posterior motion
determine hyper/hopemobility of a specific segment

58
Q

prone knee flexion test

A

athlete prone with knees extended, also prone with knees flexed to 90°; compare lengths by inspecting the heels
a. (+) test: short side=posteriorly rotated SI

59
Q

whiplash

A

symptoms caused by sudden, uncontrolled extension and flexion of the neck, often in a automobile accident or big fall on tailbone

60
Q

wryneck

A

spasmodic torticollis

61
Q

torticollis

A

Torticollis is a problem involving the muscles of the neck that causes the head to tilt down. The term comes from two Latin words: tortus, which means twisted, and collum, which means neck. Sometimes it’s called “wryneck.” If your baby has the condition at birth, it’s called congenital muscular torticollis

62
Q

scheuermanns kyphosis

A

increase growth in the posterior t/spine as compared to the anterior t/s leading to a wedged vertebrae

63
Q

sciatica

A

pain that follows the pathway of the sciatic nerve, caused by compression or trauma of the nerve or its root

*paul telling us about the wallet in the back pocket

64
Q

herniated lumbar disc

A

Description: Prolapse of the annulus fibrosis of lumbar disc into spinal canal.

S/S: Lower back pain, radicular leg pain such as numbness, pins/needles, and tingling more commonly in one leg than the other. dissipating pain. Most note that sitting is their most uncomfortable position. Standing and lying supine is most comfortable.

Physical exam: No back tenderness, straight-leg raise increases radicular pain.
Other: L4/5 is most common. Rarely causes cauda equina syndrome

Imaging: X-Rays, MRI (w/o contrast)

Tx: NSAID, PT, Medrol Dosepak (PO steriods), Epidural steriod injections, surgical (only for neuro involement or cauda equina syndrome)

65
Q

spondylolisthesis/lysis

A

spondylolisthesis/lysis
spondylolisthesis is considered a complication of spondylysis
may be some slipping of one vertebrae onto the one below
results in hypermobility of a vertebral segment
L5-S1 most common (step deformity)

66
Q

spondylosis

A

degeneration of the vertebrae and a defect in the pars interarticularis (the region between the superior and inferior articulating facet
congenital weakness and occurs as stress fracture
no symptoms unless disc herniation or sudden traumatic hyperextension
begins unilaterally and can extend bilaterally

67
Q

traction

A

treatment choice for small protrusion of the nucleus pulposus
subatmospheric pressure is created which puts nucleus into its original position
as well tightening of the longitudinal ligament which also tend to push protrusion back towards its original position

68
Q

pivms

A 
passive intervertebral movements
done in side lying
flexion, extension, SB, Rotation
important to go slow
will indicate hyper/hypo mobility of a vertebral joint
and symmetry
69
Q

alar ligament

A

extends from sides of the dens to lateral margins of foramen magnum
resists rotation at c0-2

70
Q

accessory movements of c/spine

A

rotate to the L
R: anterior and inferior
L: posterior and inferior
to increase stability

71
Q

biconvex joint

A

atlas and axis on occiput

72
Q

apical ligament

A

The apical ligament is a small ligament that joins the apex (tip) of the dens of C2 to the anterior margin (basion) of the foramen magnum. It is the weak, fibrous remnant of the notochord and does not contribute significantly to stability.

73
Q

anterior atlantoacxial

A

strong membrane, fixed, above, to the lower border of the anterior arch of the atlas; below, to the front of the body of the axis.
limits extension

74
Q

posterior atlantoaxial

A

The posterior atlantoaxial ligament is a broad, thin membrane attached, above, to the lower border of the posterior arch of the atlas; below, to the upper edges of the lamina of the axis. It is a continuation of the Ligamentum flavum, and is in relation, behind, with the obliqus capitis inferior muscle
limits flexion

Athletic Therapy (23 decks)

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