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OS Fall Exam 2 > Thoracic and Lumbar Spinal Mechanics > Flashcards

Thoracic and Lumbar Spinal Mechanics Flashcards

1
Q

Vertebral Unit

A

two adjacent vertebrae

associated intervertebral disc

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2
Q

How many Junctions are there and what are they?

A
  1. craniocervical
  2. cervicothoracic
  3. Thoracolumbar
  4. Lumbosacral
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3
Q

Gravitational Line

A 
External Auditory Canal
Head of the Humerus
L3
Anterior 1/3 of Sacrum
Lateral Malleolus
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4
Q

Spinal Curves

A

Cervical Lordosis
Thoracic Kyphosis
Lumbar Lordosis
Sacral Kyphosis

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5
Q

Thoracic Vertebrae

A
  • Medium, heart shaped, costal facets present

- Spinous Process long and posterio-inferiorly sloped

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6
Q

Lumbar Vertebrae

A
  • Large body, kidney shaped

- Short, broad spinous process

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7
Q

Rule of 3’s

A

Refers to location of spinous process in relation to the transverse process in the thoracic spine

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8
Q

Rule of 3’s: T1-T3

A

Spinous process located at level of corresponding transverse process

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9
Q

Rule of 3’s: T4 -T6

A

Spinous process located 1/2 a segment below the corresponding transverse process

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10
Q

Rule of 3’s: T7 - T9

A

Spinous process located at the level of the transverse process of the vertebrae one below

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11
Q

Rule of 3’s: T10

A

Same as T7-T9, spinous process at level of transverse process of below vertebrae

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12
Q

Rule of 3’s: T11

A

Same as T4-T6, spinous process is 1/2 segment below corresponding transverse process

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13
Q

Rule of 3’s: T12

A

Same as T1-T3, spinous process at same level of corresponding transverse process

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14
Q

Superior Facet Orientation: Cervical

A

backward, upward, medial (BUM)

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15
Q

Superior Facet Orientation: Thoracic

A

backward, upward, lateral (BUL)

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16
Q

Superior Facet Orientation: Lumbar

A

Backward, Medial (BM)

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17
Q

Ligaments of the spine

A
  • Anterior longitudinal l.
  • Posterior longitudinal l.
  • Ligamentum Flavum l.
  • Interspinous l.
  • Intertransverse l.
  • Supraspinous l.
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18
Q

Anterior Longitudinal L.

A

Covers and connects anterolateral aspects of the vertebral bodies and IV discs
- limits extension

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19
Q

Posterior Longitudinal L.

A

Narrower, runs within vertebral canal along the posterior aspect of vertebral bodies

  • Resists hyperflexion
  • Prevents posterior herniation of nucleus pulposus
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20
Q

Ligamentum Flava

A
  • Connect the laminae of adjacent vertebra
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21
Q

Interspinous l.

A

connects adjoining spinous processes

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22
Q

intertransverse l.

A

connects adjoining transverse processes

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23
Q

Iliolumbar ligaments

A
  • goes up to L4

- Decrease motion at lumbosacral region and stabilize pelvis

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24
Q

Rotatores Breves

A

Origin: T1-T12 (between transverse and spinous processes of adjacent vertebra
Action: Bilateral - extends thoracic spine
Unilateral - Rotates thoracic spine to opposite side

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25
Q

Rotatores Longi

A

-T1-T12 between transverse spinous process, skipping one vertebra
-Action:
Bilateral-extends thoracic spine
Unilateral-Rotates thoracic spine to opposite side

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26
Q

Multifidus

A

-Origin: Sacrum, illium, mamillary processes of L1-L5, transverse and articular
Insertion: Superomedially to spinous processes, sipping two to four vertebrae
-Innervation: Spinal n.
-Action:
Bilateral-Extends spine
Unilateral-Flexes spine to same side, rotates it to opposite side

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27
Q

Semispinalis

A

Semispinal: capitis, cervicis, thoracis
Skips more than four vertebrae
-Action:
Bilateral-Extends thoracic and cervical spines and head (stabilizes craniovertebral joints)
Unilateral-Bends head, cervical and thoracic spines to same side, rotates to opposite side

28
Q

ROM: Flexion

A

40-90

29
Q

ROM: Extension

A

20-45

30
Q

ROM: Sidebending

A

15-30

31
Q

ROM: Rotation

A

3-18

32
Q

Coupled Motion

A

Consistent association of a motion along or about one axis with another motion about or along a 2nd axis

33
Q

Linkage

A
  • Relationship of joint mechanics with surrounding structures
  • Requires joint isolation for accurate measurement and evaluation
  • Compare normal vs. result of compensation
34
Q

Vertebral nomenclature: Motion

A

referenced to movement of anterior/superior surface of vertebrae

35
Q

Vertebral nomenclature: Retriction

A

reference to vertebrae above in a functional vertebral unit

36
Q

Physiologic barrier

A

Limit of active motion

37
Q

Anatomic barrier

A

limit of motion imposed by anatomic structure

-limit of passive motion

38
Q

Elastic barrier

A

Range between physiologic and anatomic barrier of motion in which passive ligamentous stretching occurs before tissue disruption

39
Q

Restrictive barrier

A

Functional limit within anatomic range of motion

-Abnormally diminishes the normal physiologic range

40
Q

Why does spinal somatic dysfunction matter?

A

Restrictions of motion in the spine:

  • reduce efficiency
  • impair flow of fluids
  • alter nerve function
  • create structural imbalance
41
Q

Harrison Fryette, DO

A

Developed first 2 fryette’s principles in 1918

  • applicable to thoracic and lumbar spine
  • C.R. Nelson, DO developed the third principle in 1948
42
Q

Fryette: Type one spinal mechanics

A
  • in neutral range (not flexed/extended), sidebending and rotation are coupled in opposite directions
  • Rotation toward convexity
  • GROUP of vertebrae

TONGO: Type One Neutral Group Opposite

43
Q

Fryette: Type two spinal mechanics

A
  • in sufficient flexion or extension (non-neutral), sidebending and rotation coupled in SAME direction
  • rotation is towards concavity
  • tends to be a SINGLE vertebra

TTOSS: Type two 0(non-neutral) Single seg Same direction

44
Q

Somatic Dysfunction: nomenclature

Type 1 mechanics

A
  1. locate vertebrae or group
  2. indicate position
  3. indicate sidebending
  4. indicate rotation
45
Q

Somatic dysfunction nomenclature: Type 2 mechanics

A
  1. Locate vertebra or group
  2. indicate position
  3. indicate sidebending
  4. indicate rotation
46
Q

Fryette: third principle

A

Initiation movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion

  • If motion restricted in one direction, motion will also be restricted in other directions
  • if motion imporoved in one direction, then improved in other directions
47
Q

if push on right transverse process, vertebra rotates…

A

left

48
Q

if push on left transverse process, vertebra rotates…

A

right

49
Q

spine of scapula

A

T3 spinous process

T3 transverse process

50
Q

Inferior angle of scapula

A

T7 spinous process

T8 Transverse process

51
Q

Iliac Crest

A

L4 vertebra

52
Q

Dextroscoliosis

A

-convexity right (frames heart)

53
Q

Levoscoliosis

A

Convexity left (obscures the heart)

54
Q

Cobb Angle

A

look at top and bottom of vertebrae in scoliosis and measure angle
-<25: conservative, monitor with radiographs
-25-45: non-operative, bracing
->50: surgical fusion, prevents progression (respiratory compromise)
<75 (cardiac compromise)

55
Q

Straight Leg Raise Test

A

-Raise the leg with knee extended, nonspecific test
(+) Test = Pain (reproducing symptoms)
indicates: pain from 15-30 degrees is lumbar disc etiology

56
Q

Herniated Lumbar nucleus pulposus

A

L4-L5: pain in sacroiliac joint, hip, lateral thigh, leg
- numbness in lateral leg, first 3 toes
- Weakness in dorsiflexion and difficulty walking on heel
L5-S1: pain in sacroiliac joint, hip posterolateral thigh, leg to heel
- numbness in back of calf, lateral heel, foot to toe
- weakness in plantar flexion and difficulty walking on toes

57
Q

Spinal Stenosis

A

Lower extremity weakness and diminished reflexes

  • Neurogenic claudication: pain in back and radiating to their leg and stops when seated
  • MRI (+) straight leg test
58
Q

Cauda Equine Syndrome

A 
EMERGENCY
-MRI
-can be permanent if not taken care of immediately 
-saddle anesthesia
-lower extremity weakness 
diminished reflexes
-urinary retention
59
Q

Spina Bifida

A

-Group of congenital anomalies where neural tube fails to completely close

60
Q

Spina Bifida Oculta

A

failure of neural tube to close without herniation

-tuft of hair

61
Q

Meningocele

A

failure of neural tube to close with protrusions of meninges through defect

62
Q

Myelomeningocele

A

failure of neural tube to close with protrusion of meninges and spinal cord through the defect

63
Q

Sacralization

A

One or both TP’s of L5 are long and articulate with the sacrum (fuse)

64
Q

Lumbarization

A

Failure of S1 to fuse with rest of sacrum (not common)

65
Q

Spondylosis

A

bony spurs

66
Q

Spondylolysis

A

fracture of articularis and have scotty dog sign

67
Q

Spondylolesthesis

A

slipping of one vertebra on another

OS Fall Exam 2 (2 decks)

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