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SPINE FINAL > Things I can't remember > Flashcards

Things I can't remember Flashcards

1
Q

ROM opening for TMJ

A

35-50 mm

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2
Q

Lateral Deviation for TMJ ROM

A

10-15 mm

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3
Q

Protrusion TMJ ROM

A

3-6 mm

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4
Q

Acute phase Treatment of TMJ

A 
Patient Education
Postural Retraining
Modalities 
Biofeedback
E-Stim
Massage
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5
Q

What are the 2 components of TMJ opening?

A

Rotation 25mm

Glide 15 mm

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6
Q

C-curve TMJ opening demonstrates

A

Hypomobility, internal derageent of the manidble which deviates toward involved side midrange of opening.

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7
Q

S-Curve is due to what

A

Muscle imbalance, lateral excursion with mouth open

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8
Q

Reciporical Clicking is a sign for

A

Anterior Disc Displacement with reduction

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9
Q

Type of pain:

Cramping, Dull, Aching

A

Muscle

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10
Q

Type of pain:

Dull, ache

A

Ligament or capsule

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11
Q

Sharp, shooting pain

A

nerve root

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12
Q

Burning, pressure like, stinging, aching

A

Sympathetic nerve

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13
Q

Deep, nagging, ache

A

BONE

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14
Q

Sharp, severe, intolerable

A

Fracture

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15
Q

Throbbing, diffuse

A

Vasculature

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16
Q

Action of SCM

A

Unilaterally; cervical rotation to opposite side, cervical lateral flexion to same side

Bilaterally; cervical flexion, raises the sternum and assists in forced inspiration.

-Spinal Accessory nerve

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17
Q

Decorticate Posturing disruption of what tract?

A

Lateral Corticospinal tract (supplies flexor muscles in the LEs)

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18
Q

Decerbrate is brain stem damage below what level

A

red nucleus, disruption of the Rubrospinal and Lateral Corticospinal.

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19
Q

Responds to shaking and loud voice

A

obtunded

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20
Q

Responds to painful stimulation, groans, reflex acitivty

A

Stupor

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21
Q

Sleeps when not stimulated, inattentive, responds to name

A

Lethargy

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22
Q

Memory impaired, disoriented

A

confusion

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23
Q

Contraindication for Cervical Thrust techniques

A
  • Cranial Nerve Sign
  • Loss of bowel or blader control (specific in lumbar)
  • Painful movements in all joint direction
  • Bilateral or multisegmental neurologic signs or symptoms
  • UMN signs
  • Emotional disorders
  • Anticoagants consumption or steriods for long time
  • Inexperienced clinician
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24
Q

Weight Bearing Axis in the spine

A

C1, 7, T10 and S2

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25
Q

Normal Spine ROMS

C0-C1

A

10-15 deg of flexion/extension

8 deg of SB

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26
Q

Limited SB in C-spine due to the

A

Uncovertebral Joints

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27
Q

C1-2 ROM

A

ROTATION GREATEST: 45 deg

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28
Q

C3-C7 ROM

A

64 deg Flex
24 deg Ext
40 deg lateral flex
40 deg rotation

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29
Q

Facet Joint Alignment for
Cervical
Thoracic
Lumbar

A

Cervical: 45 deg to vertical in sagittal plane at C2-7
Thoracic: 60 deg to the vertical in sagittal plane
Lumbar: vertically oriented (90) little rotation and flexion

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30
Q

The Dorsal Primary Ramus innervates?

A

Paraspinal Muscles and Facet joints( medial branch of DPR especially important in facet joint innervation)

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31
Q

In C-spine, each nerve root is named for the vertebra ______?

A

Below, for example C5 nerve root exists between C4 and C5

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32
Q

In the rest of the spine, each nerve root is named for the vertebra _____?

A

Above, for example L4 nerve root exists between L4 and L5

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33
Q

However, with P/L disc herniation in Lumbar spine, what nerve root would be affected if there was an L4/5 herniation?

A

L5. and L5/S1 –>S1 would be affected.

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34
Q 
Grades and Joint Status
0
1
2
3
4
5
6
A 
0-Ankylosed
1-Very Hypomobile
2-Slight Hypomobile
3-Normal
4-Slight Hypermobile
5-Very Hypermobile
6-Unstable
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35
Q

Alar ligament resists

A

Flexion, C/L SB and Rotation of the neck

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36
Q

Co-C1 Arthrokinematics

A

Convex-Concave

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37
Q

C1-C2 arthrokinematic

A

Convex-on Convex (AA)

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38
Q

Below C2

A

Concave on Convex

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39
Q

Capuslar pattern for TMJ

A

Limited opening

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40
Q

Capsular pattern for Upper Cervical

A

Forward Flexion more limited than extension

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41
Q

C1-C2 capsular pattern

A

restricted rotation

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42
Q

Lower Cervical/Upper T-spine/Lumbar capsular pattern

A

SB and R equally limited

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43
Q

Hangman’s Fracture

A

Bilateral fracture of the pedicles of C2

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44
Q

Jefferson’s Fracture

A

Bilateral fracture of the arches of the Atlas

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45
Q

Restriction define

A

cannot go into a certain position

46
Q

Movement Restriction in C-Spine

Flexion and R SB

A

Left hypombolility
Extensor muscle tightness
Posterior capuslar adhesion
Left Joint Dysfunction (into extension)

47
Q

Movement Restriciton in C-spine

Extension and Right SB

A

Right extension Hypomobility
Left flexor muscle tightness
Anterior Capsular adhesion
Right joint dysfunction (into flexion)

48
Q

Alar Ligament Stress test how is it performed?

A

Attempt to SB the patient’s head while stabilizing C2, can also rotate in seated at C2.

49
Q

IF ligamentous tissue damage of intra-articular lesion the safest intial step

A

is to unload the joint and control movement with a soft collar.

50
Q

In the lower C-spine the most flexion and extension, SB and R occurs at what level?

A

C5-6

51
Q

Increasing ROM into extension where is the stabilizing hand and where is the mobilizing hand (cranial glide)

A

Stablizing hand is on the superior segment

Manipulating hand is on the inferior segment

52
Q

Manipulation C0-2 neck is in

A

extension

53
Q

Manipulation for C3-4 neck is in

A

neutral

54
Q

Manipulation for C5-7 neck is in

A

slight flexion

55
Q 
MYOTOME
C1-2
C3
C4
C5
C6
C7
C8
T1
L2
L3
L4
L5
S1
A 
Neck flexion/Extension
SB
Shoulder Elevation
Shoulder ABD
Elbow FLexion and wrist extension
Elbow Extension and wrist flexion
Finger extension (THUMB)
Finger Abduction
Hip Flexion
Knee Extension
DF
Big toe extension
PF
56
Q

Patient presents with ptosis, smaller pupil, constriction of pupil, decrease sweating, conjuctiva

A

Horner’s Syndrome (can relate to pancoast tumor) due to a sympathetic nervous system problems. Ipsilateral to site of lesion

57
Q

Disc Displacement with out reduction (key features)

A

-persistent limited opening
-Deviation of mandible to afffect side with opening and protrusion
-Limited condylar translation, condyle never assumes a normal position with the disc.
no clicking

58
Q

In chronic closed lock episodes what happens?

A

the condyle may steadily push the disc forward to achieve almost normal ROM of mouth opening despite the presence of a non-reducing disc.

59
Q

TMJ disc attaches anteriorly to ______and posteriorly to _______

A

Lateral pterygoid, condyle

60
Q

Superiorly lateral pterygoid pulls disc_____and inferior lateral pterygoid pulls disc ______

A

anteriorly and inferiorly

61
Q

When the disc stays in anterior position with jaw closed, the disc is displaced posteriorly to condyle when opened with 1-2 clicks. Then is displaced anteriorly again with 1-2 clicks as jaw closes this is defined as

A

open lock, disc displacement with reduction

62
Q

Biomechanics of TMJ
Rotation
GLide

A

25 mm rotation, lower compartment

15 mm glide, upper compartment

63
Q

Opening and protrusion of TMJ involves what action?

A

Ant/inferior/lateral glide

64
Q

It is important to normalize what before referring patients to get any permanent dental procedure or appliance?

A

Normalize c-spine posture

65
Q

Capsular pattern for SIJ

A

pain when joints are stressed

66
Q

Closed Pack and open pack for SIJ

A

nutation and counternutation

67
Q

Whiplash injury typically involves what ligament

A

Anterior long. Ligament (Hyperextension)

68
Q

MOI: Penetration wounds, Stab, GSW
Loss of pain, temperature, light tough on OPPOSITE SIDE

Loss of motor function and vibration, position sense, deep touch on SAME SIDE

A

Brown-Sequard

69
Q

MOI: Flexion Injury to cervical spine, damage to anterior spinal cord.

Loss of motor function and Pain an temp

with preservation of position, vibration, and touch sense

A

Anterior cord SYndrome

70
Q

MOI: Hyperextension cervical spine or degenertive narrowing of spinal canal (spinal Stenosis)

A

CENTRAL CORD SYDROME

UE> LE
MOTOR>Sensory

71
Q

MOI: late stage syphilis, wide steppage gait is what SCI?

A

Posterior cord syndrome, loss of position sense, vibration and touch sense.Preservation of motor, pain and temperature.

72
Q

Bakody’s sign

A

test is used to test for radicular symptoms, especially inolving C4/5. decrease in symptoms is a positive test.

73
Q

Grade 1 nerve injury, nerve sheath and axons intact

A

Neuropraxia

74
Q

Grade 2 nerve injury, nerve sheath intact some axons torn

A

Axonotomesis

75
Q

Grade 3 nerve injury, nerve sheath and axons cut (may be partial or complete)

A

Neurotmesis

76
Q

Brachial Plexus Injury, ERB’s PALSY MOI: Forceps delivery of a newborn, or falling on neck at angle. What is involved and what does it result in?

A

Upper trunk C5-C6
cause from excessive lateral neck flexion, away from shoulder
Loss of Lateral Rotators (Rcuffs of shoulder), arm flexors and hand extensors)
-at birth-infants show recovery usually within 2-3 mothns.

77
Q

Brachial Plexus injury, Klumpe’s. Cause from upward pulling on ABD arm grabbing something when you fall. Results in?

A

claw hand. Lower trunk injury C8 and T1. Weakness shown in tricpes. Sensory loss on ulnar side.Paralysis of hand instrisnic muscles and flexors of the wrist and fingers.

78
Q

Palsy vs. Polio?

A

Polio-viral infection disease affecting the grey matter of the spinal cord, muslce weakness mostly affecting the LEs.

79
Q 
Name the corresponding vertebral level
Hyoid Bone
Thyroid Cart.
First cricoid ring
Carotid tub
A

C3
C4
C6, lateral to to first criocoid ring.

80
Q

Pronated Feet resutls in–>

A

Medial rotation at the tib (tib abduction)
Genu Valgum at the knee (knocked knee)
Coxa Vara -hip muscle weakness
can all affect lumbar spine and SIJ.

81
Q

What view would you need to see the Unicovert. joints in the C-spine?

A

Oblique

82
Q

Left lateral trunk flexion is limited primarily by

A

due to the rib cage?

83
Q

During opening of the mouth a palpable and audible click is discovered in the Left Temporomandibular joint. The physician informs the therapist that the patient has an anteriorly dislocated sick. This click most likely signifies that

A

The condyle is sliding anterior to obtain a normal relationship with the disc

84
Q

the lumbar spine because of horizontal plane facet limit

A

rotation

85
Q

With spinal column injuries, the spine is considered stable

A

the spine is considered stable when at least 2 columns of the spine are intact. (total of 3).

86
Q

Superior Facet orientation for Cervical, Thoracic and Lumbar

A

BUM, BUL, BUM

87
Q 
Referred Pain (name the visceral organ)
Shoulder Blade-gallbladder
Shoulder from undersurface of diaphragm
Abdomen
Epigastrium
Left chest
Umbilicus
Testis
A
  1. gallbladder (t3-5)
  2. diagphragm
  3. abdomen
  4. heart
  5. spleen
  6. umbilicus
  7. ureter
88
Q

Pectus carniatum (pigeon chest)

A

ribs under the sternum and pushing and pushing sternum out, Impairs the effectivess of breathing by restricting ventilation volumen.

89
Q

Pectus excavatum (funnel chest)

A

Sternum being pushed posteriorly, decrease A-P dimension, heart may also be displaced, reduces RESPIRATION. seen in teenagers.

90
Q 
LandMarks
Spine of Scap
Xihopid process
Inferior Lateral Angle
Iliac crest
A

T3
T10
T7
L4-5

91
Q

FACET JOINT OPENING RESTRICTION

A

Stuck closed, opening problem
Deviation to same side during forward flexion
Difficulty side bending to oppposite side
Prominence of affected TP during extension

92
Q

Rule of thumb for scolosis
0-20 degrees
20-40
Over 40

A

observe
brace
surgery

93
Q

Which of the following ligaments are not important in the lumbar spine?

  • Ligamentum Flavum
  • PLL
  • ALL
  • Transforaminal
A

Transformainal (not important)

94
Q

Which muscles are primarily used for stability and if weak can shift load on disc?

A

Transversospinal group

95
Q

The outer half of the IVD is innervated by

A

sinuvertbral nerve and grey rami commincans

96
Q

External oblique action

A

rotation to the opposite side

97
Q

Extension Bias: Extension Approach

A

Patient usually presents with flexed posture, a lateral shift may also be present
Extension test decrease or centralize symptoms.
Dx: Disc lesion, impaired flex posture, fluid statsis.

-So can present with a flexed posture but they feel better when they go into extension

98
Q

Extension Bias-Extension Syndrome

A

The patient’s symptoms decrease in extension (lordosis)
Flexed postures or repetitive flexion load posterior or P/L intervertebral disc lesions or injury to PLL.
When extension motions relieve symptoms it is called extension bias.

99
Q

Management for Extension Bias

A

Patients would benefit from early interventions that emphasize extension of the involved segments.

AVOID isometrics and dynamic exercises during acute phases to preven an increase in disc pressure.

100
Q

Contraindications after Spinal Sx

A
  • Joint manipulations at the level of fusion

- Extension excercises including prone press up for laminectomy

101
Q

Spondylosis
Spondylolysis
Spondylolisthesis

A
  1. Degeneration of Intervertbral Disc
  2. A defect of the Pars interarticulars or arch of the vert.
  3. A forward displacement of one vertebra on another
102
Q

Compression of L5 nerve as it passes under the _____ligament can become irritated

A

iliolumbar ligament

103
Q

Isthmic Type 2 Spondilo?
age?
due to?

A

5-50
most common
due to predisposition to weakness leading to fracture of pars L5 on S1.

104
Q

Degenerative Type 3 Spondilo?
age
due to?

A

Older adults 50+
Facet arthrosis leading to subluxation of L4 on L5

High grade is more than 50% of slippage.

105
Q

If you are performing Hoover’s test and you hold patients legs and tell patient to lift leg. What is a positive test?

A

If the patient lifts one leg without downward pressure on the other leg, it is considered positive.

106
Q

What two ligaments in the spine are prone to ossifying?

A

Iliolumbar ligament leading to sacralization of L5

and Ligametum Flavum.

107
Q

What is the closed packed position of the SIJ?

A

Nutation

108
Q

Sacrotuberous and Sacrospinous ligaments both limit what motions?

A

Nutation and posterior innominate rotation

109
Q

Which muscle can develop trigger points that can underdetected and is a key lateral stablizer?

A

Quadratus lumborum

110
Q

Lumbopelvic Rhythm
-During flexion of the lumbar spine the lumbar spine will first flex ________then ________to allow more movement followed by hip flexion.

A

60-70 degree, then pelvis will rotate anteriorly

SPINE FINAL (1 decks)

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