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MSK II > Vertebral Column > Flashcards

Vertebral Column Flashcards

1
Q

PT Evaluation 3 R’s

A
  1. Reproducible Sign
  2. Region of origin
  3. Reactivity level
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2
Q

Hypomobility syndrome want to promote…

A

Mobilization

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3
Q

Instability syndrome want to promote…

A

Stabilization

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4
Q

Symptoms get worse what do you do for application of joint mobilization?

A
  1. Hold/monitor

2. Decrease 1 variable, repeat 1-5 reps and reexamine

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5
Q

Symptoms get slightly better, what do you do for application of joint mobilization?

A

Repeat 1-5 Reps, reexamine

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6
Q

Symptoms dramatically better, what do you do for application of joint mobilization?

A

Hold, monitor

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7
Q

No change in symptoms, what do you do for application of joint mobilization?

A

Increase 1 variable, repeat 1-5 reps and reexamine

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8
Q

What are neurophysiological effects of joint mobilizations?

A
  1. Firing of articular mechanoreceptors, proprioceptors
  2. Firing of cutaneous and muscular receptors
  3. Altered nocioception
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9
Q

What are the mechanical effects of joint mobilizations

A
  1. Stretching of joint restrictions
  2. Breaking adhesions
  3. Altered positional relationships
  4. Diminished/eliminate barriers to normal motion
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10
Q

What are the psychological effects of joint mobilizations?

A
  1. Confidence gained through improvement
  2. Positive effects from manual contact
  3. Response to joint sounds
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11
Q

Evidence regarding manipulation effectiveness

A

acute low back pain.

- Spinal manipulation is safe, effective, and recommended intervention in management of LBP

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12
Q

Indication for joint mobilizations

A
  1. Improve loss of accessory or physiological movement
  2. Reduce closing/opening dysfunction of the spine
  3. Restore normal articular relationships
  4. provide symptom relief and pain control
  5. Enhance motor function through reduction of pain and restoring articular relationships
  6. Improve nutrition to intra-articular structures by promoting mobility
  7. Reduce muscle guarding
  8. Curtail a progressive loss of mobility associated with disease or injury
  9. Increase/maintain mobility when an individual is unable to do so independently
  10. Safely encourage early mobility following injury
  11. Develop patient confidence in respect of favorable outcome
  12. Provide preparation or support for other manual/nonmanual interventions
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13
Q

Contraindications for Grades I-IV joint mobilizations

A
  1. Hypermobility/instability
  2. Inflammation/effusion
  3. Hard end feel
  4. Medically unstable
  5. Presence of acute pain that increases with repeated attempts
  6. Acute radiculopathy
  7. Bone disease or fracture detectable on radiograph
  8. Spinal arthorpathy (DISH)
  9. Deteriorating CNS pathology
  10. Status post joint fusion
  11. Blood clotting disorder
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14
Q

Relative precautions for grades I-IV joint mobilizations

A
  1. Malignancy (> 50 y.o., failure to respond, unexplained weight loss)
  2. Total joint replacement
  3. Bone disease not detectable on radiograph (Osteoporosis, osteopenia, osteomalacia, chronic renal failure)
  4. systemic connective tissue disorder (rheumatoidarthritis, Down’s syndrome, Ehrlos-Danlos syndrome,Marfan’s syndrome, lupus erythematosus)
  5. Pregnancy or immediately postpartum, oral contraceptives, anticoagulant therapy
  6. Recent trauma, radiculopathy (distal to knee/elbow), cauda equina
  7. early healing phase with new developing CT
  8. Individuals unable to communicate
  9. Psychogenic patients
  10. Long term corticosteroid use
  11. Skin rash/open wounds in region being treated
  12. elevated pain levels that make palpation and stabilization unreasonable
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15
Q

How many total vertebrae

A

29

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16
Q

How many cervical vertebra

A

7

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17
Q

How many thoracic vertebra

A

12

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18
Q

How many lumbar vertebra

A

5

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19
Q

How many sacral verteba

A

5

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20
Q

How many coccygeal vertebra

A

4

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21
Q

What is a vertebral motion segment

A

two facets above and below

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22
Q

What are the three separate joints in vertebral motion segment

A

2 facets and the IV and the vertebral bodies

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23
Q

How many pairs of facet joints are in the spine

A

24

24
Q

What type of joint are facet joints classified as

A

Planar

25
Q

In UCS facets are oriented in what alignment

A

horizontal

26
Q

In LCS facets change to what position

A

45 degrees

27
Q

Z joints/uncovertebral joints are made up by what anatomical process?

A

Uncinate process. This process limits side-bending and posterior translation and glides

28
Q

What are the two roles of meniscoidal of facet joints?

A
  1. fill space during joint displacement

2. actively assist in the dispersal of synovial fluid

29
Q

Thoracic spine facet joint orientation

A

vertical direction. Facilitates rotation

30
Q

What motion is resisted by facets in thoracic spine

A

resists anterior displacement

31
Q

Lumbar spine facet joint orientation

A

Vertical with J shaped surface.

32
Q

Motion restricted by facet joint in lumbar spine

A

restricts rotation and anterior shear

33
Q

What contributes to lordosis in lumbar and cervical spine

A

IVD.

34
Q

Three sub-systems that contribute to stability

A
  1. Passive system - anatomical structures contributing to stability
  2. Active system - muscles
  3. CNS - feedforward (anticipatory) feedback (reflex) control
35
Q

Spinal stability - Neutral Zone (Panjabi)

A

region of laxity around neutral resting position of spinal segment

36
Q

What happens in neutral zone

A
  1. Minimal loading is occurring in passive structures and active structures
  2. Spinal motion is produced w/ min internal resistance
37
Q

Movement of vertebral column occurs in what manner

A

diagonal pattern as combinations of flex/ext with a coupled motion of SB/rotation

38
Q

What produces movement in spine

A

agonist and synergistic muscles which initiate and supply power of movement

39
Q

What muscles control and modify movements of the spine

A

antagonistic spinal muscles

40
Q

Amount of motion available at each region of spine is affected by what variables?

A
  1. Disc-vertebral height ratio
  2. compliance of fibrocartilage
  3. Dimension/shape of adjacent vertebral end plates
  4. Age
  5. Disease
  6. Gender
41
Q

Coupling of spinal motion in UCS

A

SB and rotation occur in opposite directions

42
Q

Coupling of spinal motion in LCS

A

SB and rotation occur in same direction

43
Q

Fryette’s First Law

A

When any part of lumbar/thoracic spine is in neutral position, SB of vertebra will be opposite to the side of rotation of that vertebra.
1. standing neutral SB right, you will ROTATE left

44
Q

Fryette’s Second Law

A

When any part of spine is in position of flexion/hyperextension, SB of vertebra will be to same side as rotation
1. flex/hyperextend your spine and SB right.. you will rotate right

45
Q

Fryette’s third law

A

If motion in one plate is introduced to spin any motion occurring in another direction is thereby restricted.
1. when perform forward flexion, won’t be as much motion in other planes

46
Q

Restriction Ext/SB/Rot to same side as pain

A

Closing restriction - articular

47
Q

Restriction Flex/SB/Rot to side opposite of pain

A

opening restriction - capsular

48
Q

Level of spine: cervicobrachial

A

C3-C7

49
Q

Level of spine: atlanto-axial

A

C1-C2

50
Q

Level of spine: atlanto-occipital

A

C0-C1

51
Q

Injury to cervicoencephalic region

A
  1. Cognitive dysfunction
  2. CN dysfunction
  3. Sympathetic system dysfunction (sweating abnormalities, pupillary dilation)
52
Q

Principal motion of atlanto-occipital joint?

A

Flexion extension (15-20) degrees.

Also have Side flexion (10 deg)
Rotation negligible.
YES AND MAYBE JOINT

53
Q

What is the most mobile articulation of the spine?

A

Atlanto-axial joint

54
Q

Motion at atlanto-axial joint

A

Flex-ext = 10 deg
side flex = 5 deg
Rotation = 50 deg - primary movement
NO JOINT

55
Q

Symptoms in Cervicobrachial region

A
  1. Neck and/or arm pain
  2. HA
  3. Restricted ROM
  4. Paresthesia
  5. Altered myotomes and dermatomes
  6. Radicular signs
56
Q

What makes up about 25% of cervical spine height?

A

IVD

MSK II (4 decks)

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