Spinal Flashcards

1
Q

Traversing Nerve Root VS Exiting Nerve Root

A

Traversing Nerve Root
- affect by paracentral disc prolapse
E.g. L4 nerve root travel at L3-4 and exit at L4-5 level

Exiting Nerve Root
- affected by foraminal disc prolapse
E.g. L3 nerve root exit at L3-4 level

Lx: posterolateral disc herniation–>affect traversing nerve root
e.g. L2-3–>affect L3 traversing nerve root

Cx: lateral disc herniation–>affect exiting nerve root
e.g. C3-4–>affect C4 exiting nerve root

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2
Q

Line of gravity (Surface Landmark)

A
  • Through the ear lobe
  • Through the shoulder joint
  • Midway of the trunk
  • Through the greater trochanter
  • SL. Ant to the knee joint
  • SL. Ant to the ankle joint
    (through the calcaneocuboid joint)
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3
Q

Line of Gravity (Bony Landmarks)

A

Neck & head:
- Sl. behind the coronal suture through the external auditory meatus
- Through the dens of the axis
- Through cervical vertebral bodies

Lx & hip:
- Through lumbar vertebral bodies
- Through sacral promontory
- Sl. behind the hip joint

LL:
- Sl. Ant to the knee joint
- Through calcaneocuboid joint

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4
Q

Center of gravity

A
  • Slightly anterior to S2
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5
Q

Disc Herniation Severity

A
  • Disc protrusion: disc bulges and places pressure on annulus fibrosis (distended but remains intact)
  • Disc prolapse: nucleus pulposus is contained only by the outermost fibers of the annulus fibrosis
  • Disc extrusion:
  • nucleus pulposus ruptures through the annulus fibrosus
  • part of the nucleus pulposus moves into the epidural space of the spinal canal

*Disc sequestration:
piece(s) of the nucleus pulposus break completely away
lie within the epidural space of the spinal canal

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6
Q

Traction Points to notes

A
  • lumbar vertebral separation will occur with traction forces less than 1/4 of body weight

-Lumbar = 30-60% WB
Cervical = 10-30% WB

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7
Q

Traction Contraindications

A

Acute problem:
- acute sprain/strain
- inflammation

Bone related problem
- unhealed fracture
- vertebral instability

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8
Q

Sacral Nutation and Counternutation

A

Nutation=posterior tilt of pelvis

Counternutation=anterior tilt of pelvis

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9
Q

Actions of Muscles of Mastication

A

Depression:
Lateral pterygoid

Elevation:
- Masseter
- Temporalis
- Medial pterygoid

Protrusion:
- Lateral pterygoid
- Medial pterygoid
- Masseter

Retraction:
- Temporalis
- Masseter

Lateral deviation (e.g. Rt):
Lateral pterygoid (Lt)
Medial pterygoid (Lt)
Temporalis (Rt)
Masseter (Rt)

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10
Q

Movement of TMJ

A

Rotation–>start to mid-range

Lateral pterygoid (superior head) attach onto the disc and draws it anteriorly

Gliding–>after initial rotation–>disc displace anteriorly

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11
Q

ULTT 1

A

Median nerve:
➢ Shoulder girdle depression
➢ Shoulder abduction to 110 degrees
➢ Shoulder external rotation
➢ Forearm supination
➢ Wrist extension
➢ Finger and thumb extension
➢ Elbow extension

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12
Q

ULTT 2

A

Median nerve:
➢ Shoulder girdle depression
➢ Shoulder external rotation
➢ Forearm supination
➢ Wrist extension
➢ Finger and thumb extension
➢ Elbow full extension
➢ Shoulder abduction

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13
Q

ULTT 3

A

Radial nerve:
➢ Shoulder girdle depression
➢ Shoulder abduction to 10 degrees
➢ Shoulder internal rotation
➢ Forearm pronation
➢ Wrist flexion and ulnar deviation
➢ Finger and thumb flexion
➢ Elbow extension

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14
Q

ULTT 4

A

Ulnar nerve:
➢ Shoulder girdle depression
➢ Shoulder abduction to 90 degrees
➢ Shoulder external rotation
➢ Forearm pronation
➢ Wrist extension and radial deviation
➢ Finger and thumb extension
➢ Elbow flexion

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15
Q

Scoliosis Curvature number

A

Normal: 5-7 or less

Treatable with exercises: 15 or less

Compress organs within ribs & compromise of vital capacity:
60 or more

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16
Q

Scoliosis: Convex side

A
  • Rib push posterior (rib hump)
  • Thoracic cage narrow
  • Vertebral body point towrad
  • Shoulder higher
  • Pelvic level lower
  • Leg may be shorter
17
Q

Scoliosis: Concave side

A
  • Rib push anterior and lateral
  • Spinous process point towards
  • Lamina thinner and vetebral canal narrower
  • Shoulder lower
  • Pelvic level higher
  • Leg may be longer
18
Q

Levator ani component

A
  • Puborectalis
  • Pubococcygeus
  • Iliococcygeus
19
Q

Erector Spinae & Transversospinales

A

Erector Spinae
- Iliocaostalis
- Longissimus
- Spinalis

Transversospinales
- Semispinalis
- Multifidus
- Rotatores