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46 Cards in this Set

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What are three functions of the spinal cord?
Transfer weight and the bending movements of the head and trunk to the pelvis. Allows physiologic motion between the head, trunk and pelvis. Protects the spinal cord.
What is a vertebral unit?
2 vertebrae, the intervertebral disk between them and the connecting elements (arthrodial, ligamentous, muscular, vascular, neural and lymphatic).
What are the orientation of the superior articular facets of typical cervical, thoracic and lumbar vertebrae?
Cervical and lumbar: backwards, upward, medial (BUM). Thoracic: backwards, upward, lateral (BUL). BUM BUL BUM.
What acts a limit of motion in flexion of the spine?
Intervertebral disk.
Describe intervertebral disk.
Functions as a cushion to compressive loading of the spine. Consist of nucleus pulposis (shock absorbing center), annulous fibrosis (outer concentric laminated bands of fivrous tissue) and cartilaginous end plates.
What type of movements is the spine capable of?
Flexion, extension, rotation, sidebending.
What is the spine's ROM limited by?
Thickness, elasticity and compressibility of discs. Shape and oreintation of zygapophysial joints. Tension of articular capsules of facet joints. Resistance of back muscles and ligaments.
Define anatomic barrier.
The bone contour and/or soft tissues, especially ligaments, which serve as the final limit to motion in an articulation beyond which tissue damage occurs.
Define physiologic barrier.
The soft tissue tension accumulation which limits the voluntary motion of an articulation. Further motion toward the anatomical barrier can be induced passively.
Define restrictive barrier.
An impediment or obstacle to movement within the physiological limits of an articulation that reduces the active motion range.
What is the reference point that vertebral motion is described from?
Motion of a vertebral segment is in reference to the ANTERIOR & SUPERIOR part of the vertebral body.
How is somatic dysfunction named for the spine?
Named for the position the segment is in (or moves EASIEST), relative to the segment below. This is OPPOSITE that of the RESTRICTION of motion. Somatic dysfunction can also be named for the restricted motion but the word restricted needs to be included.
List the symbols and their definitions describing spinal motion.
Describe sagittal motion of the spine.
Occurs around a transverse axis through a sagittal plane. With flexion, spinous processes separate further and facets open. With extension, the opposite occurs.
Describe rotational motion of the spine.
Occurs around a vertical axis through a transverse plane. Transverse process moves posterior on the same side of the rotation. The spinous process moves toward the opposite side.
Describe sidebending motion of the spine.
Occurs around an anterior/posterior axis through a coronal plane. Transverse processes approximate toward the side of the sidebending (concave) and separate on the opposite side (convex).
What are Fryette's Principles?
Generalizations about how the thoracic and lumbar spinal segments move.
What is the 1st principle of physiologic motion?
When the thoracic and lumbar spine is in a neutral position (between flexion and extension), when the vertebra sidebends to one side, the vertebra involved with this motion rotate to the opposite direction. Sidebending is toward the concavity and rotation toward the convexity of the vertebral curve. NEUTRAL mechanics. Type I somatic dysfunction.
Describe type 1 somatic dysfunction.
No extreme of flexion or extension. Sidebending “X” followed by rotation “Y”. Commonly occur in groups. Commonly cause discomfort but not pain, often chronic. Muscles involved are typically the long restrictors.
What is the 2nd principle of physiologic motion?
When the thoracic and lumbar spine is in either the flexed or extended position (non-neutral), rotation and sidebending of the vertebral unit occurs to the same side. NON-NEUTRAL mechanics. Type II somatic dysfuncction.
Describe type II somatic dysfunction.
Occurs at extremes of flexion and extension. Rotation "X" and sidebending "X". Typically occurs at one segment. Commonly causes acute pain, muscles involved are typically the short restrictors.
What is the 3rd principle of physiologic motion?
Initiating motion of a vertebral segment in any plane of motion will reduce the movement of that segment in other planes of motion. This helps us with making a correct diagnosis and with performing treatment.
What part of the spine does not follow the principles of phsiologic motion?
Cervical spine.
Describe the neutral mechanics for the cervical spine.
In the typical cervical spine (C2-7), motion is coupled so that a vertebral segment sidebends and rotates to the same side (opposite of thoracic and lumbar).
What is considered non-neutral mechanics for the cervical spine?
Flexion or extension coupled with the other two planes of motion (rotation precedes sidebending).
Where does almost half of neck flexion and extension occur?
At the occipitoatlantal (OA) joint. This joint also sidebends to one side while rotating to the opposite side.
Where does half of neck rotation occur?
Atlantoaxial (AA) joint.
What is C2FRrSr?
The second cervical vertebrae in relation to the third cervical vertebra has non neutral mechanics, is flexed, rotated and sidebent to the right.
What is T4NSlRr?
T4 is the center segment of a group that has neutral mechanics, sidebent left and rotated right.
What is L5ERlSl?
L5 has non neutral mechanics, extended, rotated left and sidebent left.
Describe the relation of spinous processes to transverse processes in the thoracic spine.
Rule of 3's: SP of T1,2,3 (12) project directly posteriorly so that the tip of each SP is in the same plane as the TP of the associated vertebrae; SP of T 4,5,6 (11) project slightly inferiorly, so that the tip of each SP is about ½ way between the TP of its associated vertebrae and the one below; SP of T7,8,9 (10) project more inferiorly so that the top of each SP is in the same plane as the TP of the vertebrae below.
What is NSR dysfunction?
Neutral, sidebent, rotated (type I). A group of transverse processes on one side of the vertebral column are more posterior and resistant to anterior movement in the neutral position and do not change during flexion or extension.
What is ERS dysfunction?
Extended, rotated, sidebent (type II). The transverse process on one side becomes more posterior and resistant to anterior movement during flexion and becomes more symmetrical during extension. Zygapophysial joint is relatively more closed.
In extended a dysfunction, what is the postion of the facets?
Facet where dysfunction is occuring is closed on the same side as the rotation and sidebending.
How do you treat ERS dysfunction?
Part of treatment goal is to "open" the "closed" facet. Direct treatment is to encourage movement toward the FRySy position (dysfunction in ERxSx). Flexion, rotation y, and side bending y (y-to-x translation) would “open” the “closed” x facet.
What is FRS dysfunction?
Flexed, rotated, sidebent (type II). The transverse process on one side becomes more posterior and resistant to anterior movement during extension and becomes more symmetrical during flexion. Zygapophysial joint is relatively more open.
In flexed a dysfunction, what is the postion of the facets?
Facet where dysfunction is occuring is opening on the oppostie side as the rotation and sidebending.
How do you treat FRS dysfunction?
Part of treatment goal is to "close" the "open" facet. Direct treatment is to encourage movement toward the ERySy position (dysfunction in FRxSx). Extension, rotation y, and side bending y (y-to-x translation) would “close” the “open” y facet.
Somatic dysfunciton in the thorax can impede circulation to …?
Somatic dysfunction will impede both segmental flow as well as regional and multiregional.
Why is lymphatic drainage in the thorax important?
Impedence of flow through the thoracic ducts will cause edema.
List the autonomic inervation in the thorax.
T1-4: head and neck, with T1-T6 to the heart and lungs. T5-T9: all upper abdominal viscera. T10-T11:small intestine distal to the duodenum, kidney, ureters, gonads and right colon. T12-L2: left colon and pelvic organs. Parasympathetics: Cranial Nerve X and Vagus.
What can visceral disturbances cause?
Increased musculoskeletal tension in the somatic structures that are innervated from the corresponding spinal levels through viscerosomatic reflexes.
What is dextroscoliosis?
Scoliosis where the spine rotates to the right and is accompanied with side bending to the left when the patient bends forward. Hump is on right side, convexity of spinal is curve is on the right side.
What is levoscoliosos?
Scoliosis where the spine rotates to the left and is accompanied with side bending to the right when the patient bends forward. Hump is on left side, convexity of spinal is curve is on the left side.
What are acute TART changes found for viscerosomatic reflexes?
Increased skin temperature, increased moisture, and/or skin drag, skin thickening, increased subcutaneous fluid, prolonged red reflex.
What are chronic TART changes found for viscerosomatic reflexes?
Thickened skin and subcutaneous tissues, rapid fading red reflex, localized muscle contraction, muscles are hard, tense and hypersensitive to palpation, stiff joints with articular motion restrictions that are firm, deep muscle contraction involving two or more segments.