Vertebral column Flashcards by T T

Cervical ROM

F: 60
E: 60
LF: 45
R: 80
TMJ: 35-50 mm opening

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Cervical flexion muscles

SCM, longus cervicis, longus capitis, rectus capitis anterior

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Cervical extension muscles

trapezius, splenius cervicis and capitius, longissimus capitis, levator scapulae, suboccipitals

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Cervical lateral flexion muscles

scalenes
levator scap
longissimus capitis
splenius capitus and cervicis
rectus capitis lateralis

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Cervical rotation muscles

SCM
longus capitis and coli
rotatores
splenius
suboccipitals

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Cervical abnormal end feel

early myospasm: muscle/lig tear
late myospasm: instability
empty: lig rupture
hard: bone approximation (osteophyte)

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Cervical normal end feel

tissue stretch

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Cervical joint types

gliding - zygopophyseal joints
pivot - atlantoaxial joint
fibrocartilaginous - intervertebral joints
hinge and gliding - TMJ

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Alar ligament

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Nuchal ligament

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Ligamentum flavum

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Interspinous ligament

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Anterior longitudinal ligament

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Posterior longitudinal ligament

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Transverse ligament of dens

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Thoracic ROM

F: 60
E: 25
LF: 35
R: 50

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Ortho tests for cervical sprain/strain

AROM/PROM
muscle tests
cervical distraction

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Ortho tests for cervical joints, discs, facets

cervical compression

Ortho tests for cervical instability

alar ligament stress test
transverse lig stress test
Rust’s sign

Ortho tests for cervical radiculopathy/nerve tension

cervical compression/distraction
Soto-Hall
valsalva
brachial plexus compression test

Ortho tests for TOS

adson’s
Roo’s/EAST
Wright’s

Ortho tests for thoracic nerve compression

SLR

Ortho tests for thoracic sprain/strain or contracture

AROM, PROM

chest expansion test

Thoracic joint types

gliding: zygopophyseal, costotransverse, costovertebral, sternocostal
fibrocartilaginous: intervertebral disc joints

Thoracic flexion muscles

rectus abdominis, abdominal obliques

Thoracic extension muscles

multifidi, erector spinae

Thoracic lateral flexion muscles

erector spinae, semispinalis, abdominal obliques, quadratus lumborum

Thoracic rotation muscles

rotatores, multifidi, semispinalis, erector spinae, internal/external oblique

Thoracic rib elevation muscles

erector spinae, intercostals, serratus posterior superior, levator costarum

Thoracic spine normal end feel

tissue stretch

Lumbar spine ROM

F: 70 E: 30 LF: 30 R: 30

Ortho tests for lumbar strain/sprain

ROM, palpation Kemp's Nachla's

Ortho tests for lumbar radiculopathy

SLR, well leg raise Braggard's Piriformis test

Ortho tests for SI joint lesion

Belt test Lasege's test Nachla's test motion palpation

Ortho tests for lumbar instability

lumbar flexion/extension test segmental instability test P-A glide test

Lumbar joint types

gliding: zygapophyseal joints fibrocartilaginous: intervertebral joints

Muscles for lumbar flexion

iliopsoas, rectus abdominis, internal/external oblique

Muscles for lumbar extension

multifidi, erector spinae

Muscles for lumbar lateral flexion

erector spinae, semispinalis, rectus abdominis, internal/external oblique, quadratus lumborum

Muscles for lumbar rotation

rotatores, multifidi, semispinalis, erector spinae, internal/external oblique

Normal lumbar ROM end feel

tissue stretch, rotation may have bony end-feel (facets)

Abnormal lumbar end feel

early myospasm - muscle/lig tear late myospasm - instability empty - lig rupture hard - bony approximation (osteophyte)

Red flags for cervical sprain/strain

no indication of improvement after 1 week progressively worse after 1 or 2 weeks symptoms or signs of symptom magnification non-compliance with recommendations seeks rest, not involved in usual daily responsibilities seeks more drugs, or drugs not having effect (addiction) cannot return or makes no attempt to return to work appearance of secondary gains related to illness behaviour (social, vocational, financial) Becomes progressively dysfunctional Shows signs and symptoms of depression

Pathologic headache warning signs

``` abrupt onset or very severe new headache in older patient headache due to trauma assoc. neuro signs cognitive changes seizures, vomiting without nausea persistent/progressive headache nuchal rigidity anticoagulent therapy diastolic pressure > 115 mmHg persistent or severe headache in child suspicion of alcohol or drug dependence known cancer signs of papilledema ```