Vertebral Column Overview Flashcards
Neurophysiological Effects
- Firing of articular mechanoreceptors/proprioceptors
- Firing of cutaneous and muscular receptors
- Altered nociception
Mechanical Effects
- Stretching of joint restrictions
- Breaking adhesions
- Altered positional relationships
- Diminish/eliminate barriers to normal motion
Psychological Effects
- Confidence gained through improvement
- Positive effects from manual contact
- Response to joint sounds
Indications for Joint Mobilizations
- Improve loss of movement
- Reduce closing or opening dysfunction
- Restore normal articular relationships
- Provide symptom relief and pain control
- Enhance motor function
- Improve nutrition to disk
- Reduce muscle guarding
- Develop patient confidence
Joint Mobilization ABSOULTE CONTRAINDICATIONS
- Hypermobility
- Joint inflammation/effusion
- Hard end feel
- Medically unstable
- Acute pain
- Acute radiculopathy
- Bone disease or fracture
- Spinal arthropathy
- Deteriorating central nervous system
- Status-post joint fusion
- Blood clotting disorders
Joint Mobilization RELATIVE PRECAUTIONS
- Malignancy
- Total joint replacement
- Bone disease not detectable on radiograph
- Systemic connective tissue disorder
- Pregnancy or immediately postpartum
- Recent trauma, radiculopathy
- In early healing phase
- In individuals unable to communicate
- Psychogenic patients
- Corticosteroid use
- Skin rashes or open wounds
- Elevated pain levels
Number of Total Vertebra
29 (33)
Number of Cervical Vertebra
7
Number of Thoracic Vertebra
12
Number of Lumbar Vertebra
5
Number of Sacral Vertebra
5
Number of Coccygeal Vertebra
4
Vertebral Motion Segment?
Facet joints connecting together
Three Separate Joints
2 facet joints and 1 vertebral body
Pairs of Facet Joints
24
Type of Facet Joint
Planar
Upper Cervical Spine Facets Orient
Horizontal
Lower Cervical Spine Facets Orient
45 degrees
Z Joints/Uncovertebral Joints Are Made of What Process?
Uncinate Process
This Process Limits Side-Bending and Posterior Translation?
Uncinate Process
Articular Surfaces are Covered In?
Hyaline Cartilage
Thoracic Facet Orient
Vertical
Lumbar Facet Orient
Vertical with a J-shape surface
Intervertebral Disk
Thicker in the front (anterior) for cervical and lumbar to create lordosis
Major Stressor to the Disk
- Axonal Compression
- Shearing
- Bending
- Twisting
Static Spinal Stability
State of equilibrium
Zero velocity
Dynamic Spinal Stability
Implies a change over time with constant velocity
Passive System
Anatomical structures contributing to stability
Active System
Muscles, source of active stiffness
Central Nervous System
Feedforward and feedback control
Neutral Zone
Defines a region of laxity around the neutral resting position of a spinal segment
- Minimal loading is occurring in the passive and active structures
Position Best for Training Patients
Neutral spinal positions
Amount of Motion Variables
- Disk-Vertebral height ratio
- Compliance of fibrocartilage
- Dimension/Shape of adjacent vertebral end plates
- Age
- Disease
- Gender
Upper Cervical Coupling Motion
To the opposite side (Rotation left, side-bending right)
Lower Cervical Coupling Motion
To the same side (Rotation left, side-bending left)
Facet Joint Movement in Lower Cervical
Glides up and forward or down and back
Fryette’s First Law
Standing in a neutral position and side bend to the RIGHT, rotation will be LEFT
Fryette’s Second Law
When flexed and side bend RIGHT, rotation will be RIGHT
Fryette’s Third Law
When flexed other motions will be decreased
Can’t Close
Restriction of extension, side-bending, and rotation to the same side of pain
- Closing restriction
Can’t Open
Restriction of flexion, side-bending, and rotation to the opposite side of pain
- Opening restriction
Diseases Affecting Upper Cervical
Down Syndrome and Arnold Chari Syndrome
Region in Cervical Where Majority of Rotation Occurs?
C1-C2
Atlanto-Occipital Joint
C0-C1
**Flexion and Side-bending occurs
“Yes and Maybe” movement
Atlanto-Axial Joint
C1-C2
**Rotation occurs
“No” movement
Ligament Preventing Dens From Going Posterior Into Spinal Cord?
Transverse Ligament
Cervicobrachial Region
C3-C7
Symptoms of Injury in C3-C7
- Neck and/or arm pain
- Headaches
- Restricted ROM
- Paresthesia
- Altered myotomes and dermatomes
- Radicular sign
Joint of Luschka
Limits Flexion
Uncus gives saddle form to aspect of cervical vertebra
Percentage of Height in Cervical Spine Made From Discs?
25%
Nucleus Pulposus
Buffers axial compression by distributing compressive forces
Annulus Fibrosus
Withstands tension in disc
T or F
Cervical Nerve Roots Come Out Above Vertebra?
TRUE
C4 Nerve Root Comes out between C3 and C4
