Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

anatomy > exsc 460 FINAL > Flashcards

exsc 460 FINAL Flashcards

1
Q

Trunk Posture Posterior View: plumb line dropped from ________ should bisect ________

A

occipital protuberance

vertebral spinous processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

angle formed by the direction the spinous process and the frontal plane- should be 90d

A

angle of protuberance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

most prominent spinous process

A

C7 or T1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

should be symmetrical

A

ribs
arm to body distance
muscular development (no evidence of spasm or atrophy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Trunk Posture Anterior View: should be symmetrical

A

muscular development
ribs
body countour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lateral View: curves

A

cervical-anterior
thoracic-posterior’
lumbar- anterior
sacral- posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

development

A

cephalocaudal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

primary curves are:

A

thoracic and sacrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

secondary curves are:

A

cervical and lumbar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

at birth:

A

whole spine is concave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

at 3 months:

A

child begins raising head and cervical curve develops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

at 6-8 months:

A

child begins to sit up and lumbar curve begins to develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

abdominal tonus

A

lack of protrusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

functions of abdominal wall

A 
protection
support of viscera
elimination
forced expiration
trunk flexion and rotation
pelvic tilit
stabilization of trunk and pelvis (most important stabilization muscles)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

relationship of abdominal muscles to curves of spine

A

pelvic tilit

lordosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

abdominal ptosis

A

a pathological weakness or absence of the abdominal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

beevors sign

A

determines integrity of segmental innervation of rectus abdominus and corresponding paraspinal muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how beevors sign test is performed

A

patient does 1/4 sit up with arms folded on chest, umbilicus drawn to the stronger or uninvolved side, away from the weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Deepest layer of the spine

A

multifidus- rotation toward opposite side and extension
rotatores- same as above
interspinalis- extend vertebrae
intertransversarii- lateral flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

intermediate layer

A

erector spinae:
spinalis
longissimus
iliocostalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

superficial layer

A

latissimus dorsi

gluteus maximus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

vertebrae of lumbar spine

A

large and massive w/ short thick and strong pedicles

facet joints absorb shear and rotational forces in the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

thicker and narrower in the thoracic than in the cervical and lumbar regions
limits hyperextension of spine and forward displacement of one vertebra on another

A

anterior longitudinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

thicker in thoracic than in cervical and lumbar regions

posterior lateral corners of intervertebral discs are poorly covered

A

posterior longitudinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

connects laminae of adjacent vertebrae from axis to sacrum

A

ligamentum flavum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

connects tips of spinous processes of adjacent vertebrae from 7th cervical to sacrum

A

supraspinous ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

connects the adjoining spinous processes from their tips to their roots

A

interspinous ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

connects transverse processes of adjacent vertebrae

A

intertransverse ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what covers the superior and inferior surfaces of vertebral bodies?

A

hyaline cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

intervertebral fibrocartilages (discs) are made up of how much water?

A

85-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

how much nerve supply does the disc have?

A

minmal, peripheral posterior aspect of the annulus fibrosus may be innervated by a few nerve fibers from the sinuvertebral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what 3 distinct tissues make up the intervertebral disc?

A

annulus fibrosus
nucleus pulposos
vertebral endplate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the annulus fibrosus?

A

outer circumfrence of disc made of 10-20 concentric rings of type 1 collagen fibers that criss cross at an angle of 30-60degrees to the spinal axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

is the annulus fibrosus vascular?

A

only the periphery of the disc is vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the nucleus pulposus?

A

central portion of the disc

loose collagen fibril network contained within an extensive gelatinous matrix (type II collagen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

at birth the nucleus pulposus:

A

contains a high portion of mucopolysaccharides which cause the disc to resist deformation.
these mucopolysaccharides decrease with age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the function of the nucleus pulposus?

A

transmit vertical loading (compression) to radially directed tensile forces in the annulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

is the nucleus pulposus vascular?

A

no, avascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How does the nucleus pulposus receive nutrition?

A

passive diffusion from the periphery of the annulus fibrosus and the vertebral bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is the vertebral endplate?

A

thin layers of hyaline cartilage that cover the superior and inferior surfaces of the vertebral bodies.
endplates are 1 mm thick and allow nutrient transport in and out of discs via passive diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

condition characterized by an abnormal anterior convexity of the lumbar spine

A

lumbar lordosis

most common postural deviation seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Etiology of lumbar lordosis

A 
mal posture
muscle imbalance
overweight or pregnant
compensation due to kyphosis
fashion-high heels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

X-ray evalutaion of lumbar lordosis shows:

A

pelvic angle and sacral angle increase from 30d to 40d
lumbosacral angle decreases from 140
anterior distance between vertebral bodies is greater than normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

clinical evaluation of lumbar lordosis

A

increased pelvic inclination/anterior tilt

lack of pain, edema, or discoloration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

pathological changes

A

posture changes: accompanying kyphosis

internal rotation of hips

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What muscle and Ligament changes accompany lumbar lordosis

A

abdominals stretched/weakened
low back extensors shortened
hip flexors tight
hip extensors weakened/stretched

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

sporting activities that aggravate lordosis

A

football lineman
gymnastics
equestrian events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Basic 5 exercises for Lumbar Lordosis

A 
pelvic roll
strengthen abdominals
strengthen hip extensors
stretch low back extensors
stretch hip flexors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

how to establish good postural practice:

A

encourage regular physical fitness program
provide knowledge base
provide motivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Low Back Pain: Nociceptors detect pain through what 3 changes?

A

mechanical changes
chemical changes
temperature changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are mechanical changes?

A

over stimulation of mechanoreceptors

severe deformation of a tissue=perception of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are Chemical changes?

A

presence of various chemicals such as hydrogen ions, potassium ions, or polypeptides from break down of proteins and acetylcholine. deficiency of blood or oxygen.
longer lasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are temperature changes?

A

thermoreceptors produce the perception of pain when extremes in temperature occur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How much of all people will experience back pain during their life?

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

the annual incidence of back pain ranges from:

A

15-45%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

vast majority of low back pain takes how long to resolve?

A

2-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

_____ of patients experience improvement in _____

A

90%

6-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

recurrence rate:

A

58-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what ages are most commonly affected

A

35-55

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

difficulty in treatment lies with:

A

ability to achieve a definitive diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

3 predisposing factors to etiology of low back pain

A

poor sitting posture
loss of extension
frequency of flexion

62
Q

low back pain shows a fluctuation of symptoms depending on:

A

patients activities and postural positions

63
Q

certain positions _____ the pain while others ____ the pain

A

aggravate

relieve

64
Q

what must be done to determine the movements that are therapeutic to each patient?

A

mechanical evaluation

patient performs series of end-range spinal movements

65
Q

What is postural syndrome?

A

soft tissues surrounding the vertebrae are subjected to prolonged periods of mechanical stress. (bending finger back)

66
Q

characteristics of postural syndrome:

A

pain always intermittent in nature
pain is strictly positional
time factor, pain not immediate
pain removed immediately by postural correction

67
Q

What is dysfunction syndrome?

A

occurs when adaptively shortened structures surrounding the vertebrae are subjected to mechanical stress on attempting normal end range movement

68
Q

characteristics of dysfunction syndrome:

A

pain always intermittent in nature
no time factor
pain immediate
pain abolished immediately when stress is removed
pain occurs only at end range of motion, never while moving throughout range of movement
not rapidly reversible
managed by gradual stretching of tight structures
pain should be relieved immediately after stretch
is complete

69
Q

What is derangement syndrome?

A

anatomical disruption and displacement of part of the intervertebral disc complex at the affected spinal level

70
Q

characteristics of derangement syndrome?

A

pain usually constant in acute stage
pain produced or exacerbated immediately or eventually by certain movements and positions
pain appears during movement range

71
Q

prevention of low back pain

A 
learn and participate in daily exercise program
"Back school"
reduce stress
quit smoking
watch weight
always warm up and cool down
72
Q

majority of acute low back pain will spontaneously resolve within:

A

2-6 weeks

73
Q

an aggressive rehabilitation program is focused around an individualized, structured exercise program geared to create improved:

A

stamina, balanced strength, flexibility, and endurance

74
Q

goal of acute treatment

A

relieve pain and muscle spasm

75
Q

name several acute treatments:

A 
bed rest 1-2 days
cryotherapy
thermotherapy
massage
manipulation
electrical stimulation
76
Q

goals for post-acute treatment

A

restore ROM, strength, endurance, and flexibility to enable patient to return to work, sport, etc.

77
Q

McKenzie has popularized the use of _____.

A

extension exercises to strengthen erector spinae and maintain the neutral curvature of the spine

78
Q

goals of spinal stabilization:

A

increase capacity of muscular stabilizing system to maintain neutral zone of spine within physiological limits
increase the low back’s tolerance to insult through the conditioning of the key musculature
restore muscle, strength, and endurance
reestablish a coordinated muscle activity as required for prevention of recurrence and restoration of function
reduce pain associated with spinal instability

79
Q

stage 1 of spinal stabilization

A

focuses on activating the local stabilizing muscles

80
Q

stage 2 of spinal stabilization

A

involves exercises that require a co-contraction of the TrA and MULT during assumption of additional positions

81
Q

stage 3 of spinal stabiliztion

A

designed to maintain the abdominal draw and nature lordosis contraction during performance of exercises designed to recruit global stabilizers.

82
Q

Etiology of Herniated Intervertebral Discs

A

Natural degeneration
Sudden or sustained increases in intradiscal pressure
lifting, fall on buttocks, direct trauma to back
anything that increases intradiscal pressure causes posterior fibers of annulus to give way

83
Q

disc becomes softer and more susceptible to injury during:

A

pregnancy and labor and prolonged periods of bed rest

84
Q

____ of herniated disc patients had a positive family history

A

32%

85
Q

patients who have a positive family history are _____ greater risk

A

4-5 times

86
Q

herniated disc pain is accentuated by:

A

forward bending, coughing, sneezing, lifting, etc.

relieved by recumbency

87
Q

sciatic pain first appears:

A

as an ache in the buttocks followed by pain in posterior thigh, popliteal area, calf, ankle, and foot

88
Q

lumbar spine deviates away from:

A

affected side

89
Q

herniation is usually posterolateral, listing toward affected side increases:

A

pressure on the nerve and therefore increases symptoms

90
Q

______ is usually restricted as it exacerbates the pain.

A

flexion

91
Q

if tenderness is felt it is found where?

A

over the vertebral interspace just lateral to the midline in a large protruded disc

92
Q

motor signs are present in ______ of cases

A

96%

93
Q

sensory signs are found in ______ of pateints

A

80%

94
Q

straight leg test

A

patient is supine, hip slightly internally rotated, knee extended, examiner slowly flexes hip until patient complains of pain or tightness.
pain after 70d is probably joint pain
then examiner dorsi flexes the patients foot, if radiating sciatic pain returns, the test is positive

95
Q

well-leg raising test

A

patient supine, examiner raises unaffected leg, test is positive if sciatic pain produced on affected leg. these ruptures medial to nerve root.

96
Q

Bowstring Test

A

straight leg test with knee slightly flexed. thumb or finger pressure applied in popliteal space. if radiating sciatic pain, test is positive.

97
Q

most common site of problems in vertebral column

A

L5,S1 because it bears the most weight
transition between fixed sacrum and flexible lumbar vertebrae
greatest angle

98
Q

studies by Armstrong and Shah found that the nucleus migrates:

A

forward in lumbar extension and backward in lumbar flexion

99
Q

Protruded Disc

A

blugling of an intact annulus fibrosus

100
Q

prolapsed disc

A

only the outer fibers of the annulus contain the bulging nucleus

101
Q

extruded disc

A

disc material that extend beyond the annulus but still in continuity with disc material within disc space

102
Q

sequestrated disc

A

disc material lies outside the annulus and is no longer in continuity with the disc material

103
Q

schmorl’s nodes

A

herniation of nucleus pulposus into the vertebral body

104
Q

before surgery is undertaken, ____ and ____ of herniation must be established

A

existence and exact location

105
Q

x rays

A

narrowing of disc space is indicative of old rupture

106
Q

CT scan

A

reveal other pathology that may simulate a disc protrusion such as facet syndrome, spinal stenosis, tumor.

107
Q

myelography

A

rule out possibility of nerve root tumor

108
Q

should allow _______ of therapy before surgery

A

6 weeks

109
Q

conservative management

A 
1-2 weeks bedrest
ice or heat to relax low back muscles
muscle relaxants
exercise
proper posture practiced
110
Q

criteria for surgery

A

impaired function of bowel or bladder
progressive motor weakness
severe sciatic pain

111
Q

chemonucleolysis

A

injection of enzyme chymopapain into herniated nucleus pulposus
cause dissolution of mucopolysaccharides of the disk and reduce intradiscal pressure
3-6 months recover

112
Q

percutaneous automated discectomy

A

posterolateral approach, nucleotome is positioned in nucleus pulposus, activated by a foot pedal and moved gently back and forth within disc while suction aspiration takes place
permits immediate mobilization

113
Q

microdiscectomy

A

1-2 inch incision, use of operating microscope and microdiscecting technique to remove the disc under general anesthesia.
knee-chest position which decreases intraabdominal pressure and minimizes epidural bleeding.

114
Q

laminectomy

A

most common
portion of lamina and some of ligamentum flavum is excised.
7-10 days for office workers
8-12 weeks for laborers

115
Q

exaggeration of the normal posterior thoracic curve

A

kyphosis

116
Q

includes kyphosis, forward head, and forward (rounded) shoulders

A

kyphosis syndrome

117
Q

etiology of kyphosis

A 
congenital
failure of curves to develop
acquired imitated posture
occupation
ectomorph more prone
118
Q

postural kyphosis

A

functional, non-fixed curves
result of minor muscle imbalances
curvature can be corrected easily by patient

119
Q

scheuermann’s disease

A 
adolescent roundback
more common form of kyphosis seen in young teenagers between ages 13-16
juvenile epiphysitis
fixed, structural
males more than females
120
Q

Adam’s Test

A

patient assumes adam’s position
in postural or functional kyphosis spine assumes normal smooth arc
in scheuermann’s or structural kyphosis the spine forms sharp angle or hump at the apex of the kyphosis

121
Q

muscles and ligaments involved

A

stretched/weak: thoracic erector spinae
scapular adductors
shortened: pectoral muscles
serratus anterior

122
Q

pathological changeds

A

can result in impaired vital capacity

increased lordosis common

123
Q

exercise alone will not prevent the _____

A

progression of a progressive spinal deformity

124
Q

major component in conservative management of scheuermann’s disease is ___

A

the use of a brace

125
Q

most common brace

A

milwaukee brace

126
Q

braces not found effective in patients with:

A

vertebral wedging of >10d
initial kyphosis of >65d
initiation of treatment after iliac epiphyses has closed

127
Q

exercises for kyphosis

A 
strengthen scapular adductors
strengthen thoracic erector spinae
stretch pectoralis major
stretch serratus anterior
stretch anterior thoracic ligaments
128
Q

lateral curvature of vertebral column >10d

A

scoliosis

129
Q

scoliosis is characterized not only by lateral curvature but by ________

A

vertebral rotation

130
Q

in structural scoliosis, the curve fails to

A

straighten out on side bending, this is indicative of vertebral and paravertebral bone and soft tissue deformities.

131
Q

infantile scoliosis

A 
onset between birth and 3 yrs
usually noticed in first year
males dominate
left thoracic curve most common
majority resolve spontaneously
life span limited to 30 yrs
132
Q

juvenile scoliosis

A

occurs between 3 and 10 yrs
13-21% of all idiopathic scoliosis
right thoracic most common
the older the child the more likely to be girl

133
Q

adolescent

A

from 10 till skeletal maturity
right thoracic most common
80% of idiopathic scoliosis

134
Q

chest flatness on side of

A

convexity

135
Q

rotation of vertebral bodies toward _______ and spinous processes toward _______

A

convexity, concavity

136
Q

intervertebral discs are compressed on the ______ side

A

concave

137
Q

distortion of vital structures

A

heart displaced downward

138
Q

right thoracic

A

most common

highly structural, cosmetic deformity

139
Q

thoracolumbar

A

t8-l3

not as cosmetically deforming

140
Q

double major

A

right thoracic and left lumbar

141
Q

double thoracic major

A

upper curve to the left and lower to the right, both in thoracic region
less deforming than simple curves because of symmetry

142
Q

lumbar

A

t11-l4
most to the left
lead to arthritic pain

143
Q

screening

A

takes 1 min per child, every 6-9 months

144
Q

when rotation occurs, the pedicle on the convexity ______ and the pedicle on the concavity _______

A

rotates toward the midline

away from the midline

145
Q

progression of scoliosis

A

girls more likely to progress
female to male ratio 8-10:1
younger the child at onset, the more likely curve is to progress

146
Q

most likely to least likely to progress

A

double major
thoracolumbar
thoracic
lumbar

147
Q

risser sign

A

measurement of excursion of iliac apophyses from anterolateral to posteromedial. when apophysis reaches SI junction and fuses to ilium, maturation nearly complete.

148
Q

scoliosis curves progress most rapidly during time of ____

A

peak height growth velocity

girl: 11-13
boy: 13-15

149
Q

3 major approaches to treatment

A

bracing and observation
exercise
surgery

150
Q

expectations of orthosis

A

prevent further curve progression
reduce initial curvature as much as possible
maintain curve reduction
encourage patient compliance through providing a comfortable fit

anatomy (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions