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TREATMENTS > CHAPTER 8- Lumbar & Thoracic > Flashcards

CHAPTER 8- Lumbar & Thoracic Flashcards

(63 cards)

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1
Q

Flexion

A

trunk brought toward anterior surface of thighs - sagital plane

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2
Q

Extension

A

Return from anatomical position flexion and any motion past anatomical position

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3
Q

Lateral Flexion

A

Side bending - frontal plane

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4
Q

Rotation

A

(Left and Right) - spine rotates as the trunk is twisted to either side - transverse plane

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5
Q

ROM should be performed in what order?

A

AROM, PROM, MRT

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6
Q

If there is NO PAIN with ACTIVE movement there will be no pain with

A

Passive movement

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7
Q

PAIN in AROM indicates a problem in what tissues

A

contractile or inert

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8
Q

Factors that can prematurely limit AROM

A

ligamentous or capsular damage, muscle tightness, pain from nerve compression or tension, disc pathology, fibrous cysts, previous surgeries or joint disorders such as arthritis

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9
Q

PROM pain predominantly implicates what tissue

A

INERT

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10
Q

Factors that can prematurely limit PROM

A

SAME as AROM: ligamentous or capsular damage, muscle tightness, pain from nerve compression or tension, disc pathology, fibrous cysts, previous surgeries or joint disorders such as arthritis

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11
Q

MRT produces pain with there is

A

mechanical disruption of tissue

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12
Q

5 Mechanical Forces

A 
Tension - forces pulling apart 
Compression - forces coming together 
Torsion - Force with a twist
Bending - Compression and tension 
Shearing - Forces moving against each other in the opposite direction
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13
Q

Radiculopathy is pain from

A

nerve compression or tension at the root coming off the spine

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14
Q

Peripheral Neuropathy is pain with

A

nerve compression or tension distal to the spine towards the extremities

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15
Q

Kyphosis [characteristics]

A

an abnormally increased curvature of the thoracic spine - hunch back

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16
Q

Primary function of the kyphotic curve

A

Shock absorption

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17
Q

An individual with increased kyphotic curve is likely to have an exagerated… [OBSERVATION]

A

cervical lordosis and forward head posture, protracted scapulae, arms interiorly rotated

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18
Q

Describe uppercross Syndrome - muscles affected and how. [palpation]

A

Hypertonic - cervical extensors (posterior neck muscles)
- Suboccipitals, upper traps, levator scap, SCM
Hypertonic - Pec Major, Pec Minor

Weak - Flexors; Longus captis & coli
Weak- Rhomboids; middle trap, lower trap, serratus anterior

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19
Q

Kyphosis HISTORY

A

Pain and fatigue in thoracic area esp. after a long day, referred pain from TrPts

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20
Q

Kyphosis [RANGE OF MOTION]

A

AROM; limited flex/ext, loss of spinal rotation

PROM: same as AROM, reduced glenohumeral rotation

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21
Q

Kyphosis [Tx]

A

Lengthen hypertonic anterior muscles, deep glides, superior to inferior to posterior overstretched muscles

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22
Q

Right refelx

A

bring eyes level with horizon

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23
Q

Hyperlordosis [Characteristics]

A

AKA - sway back - exaggerated curvature in the lumbar spine.

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24
Q

Hyperlordosis causes

A

chronic tightness, fatigue and poor posture, osteoporosis

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25
Hyperlordosis [HISTORY]
Low back pain, flank pain, TrPts
26
Hyperlordosis [OBSERVATION]
best assessed w/ latera; view
27
Hyperlordosis [PALPATION]
Short/ Tight: erectors, QL, illiopsoas, TFL Overstretched/ weak: rectus abdominus, glutes med, max
28
Describe Lower crossed syndrome
Hypertonic - spinal extensors (low back muscles) and hip flexors. Weak - Abs and glutes
29
Hyperlordosis [ROM]
Further extension of the lumbar spine causes pain and discomfort
30
Hyperlordosis [Special TEST]
Modified Thomas test (knee to chest, supine) - for tight iliopsoas
31
Hyperlordosis [Tx]
Work muscles tightest to weakest, stretch client
32
Decreased lumbar lordosis causes
poor sitting or working postures, hypertonicity in abdominal or hamstring muscles
33
Decreased lumbar lordosis [HISTORY]
possible pain - if present, close to spine
34
Decreased lumbar lordosis [Observation]
visually evident - tucked butt
35
Decreased lumbar lordosis [PALPATION]
tight lumbar muscles, active Trpts, possible palpable spinous processes in lumbar region
36
Decreased lumbar lordosis [ROM]
AROM - limitations in froward trunk flexion PROM - same MRT - no pain, functional muscle weakness
37
Decreased lumbar lordosis [Tx]
focus on hamstrings, retrain posture
38
lumbar Facet syndrome
low back pain that originates from articular dysfunction of the facet joint
39
Two types of scoliosis
Functional - excessive muscle tension- not bony deformity | Structural - fixed bony deformity - inherited or acquired
40
Scoliosis - define
lateral rotary curvature in the spine, common in children - often outgrown.
41
Scoliosis - C Curve
one curve
42
Scoliosis - S Curve
two curves
43
Scoliotic curve named for
the CONVEX side
44
Spondylosis
Vertebral stress fractures from excessive loads (Slumped posture being the greatest excessive load on spine)
45
Spondylolisthesis
Forward slippage of the vertebrae typically the L5- S1 junction Bilateral lumbar stress fracture involving a forward slippage of a portion of vertebra
46
Herniated nucleus pulposis [HNP/ IVD herniation]
Herniated disc due to pressure on the disc causing the inner gel to bulge or herniate
47
Degrees of disc herniation
Protrusion bulge no tear Prolapse or extrusion partial but not complete rupture Sequestration complete rupture
48
HNP [Characteristics]
Compression of nerve root from narrowing of intervertebral foramen or the buldge pushing on the nerve root
49
Direction of protrusion [IVD, HNP]
poterior-lateral
50
HNP [History]
Paraesthesia, deep aching back pain w/ sharp shooting, | electrical pain along nerve root pathway, pain worse @ end of day, decreases w/ rest
51
HNP [O]
possible hyperlordosis when standing, slouched w/ lumbar spine in flexion when sitting, ct may compensate by leaning away fro area
52
HNP [P]
Hypertonicity, tenderness, TrPts, possible distal atrophy
53
HNP [R]
AROM/ PROM - limited & painful in all planes | MRT - possible weakness in affected mms
54
HNP [S]
Slump test (seated push head down, lift leg), Straight leg raise (SLR) - symptoms present at 70 degrees
55
HNP [Tx]
Reduce compressive loads - open area, use caution w/ deep pressure.
56
Lumbar/Spinal Ligament Sprain
occurs when excess tensile (pulling) stress causes ligaments to overstretch or tear.
57
Lumbar/Spinal Ligament Sprain [H]
pian close to spine, acute injury right before pain, aggravated by specific movements
58
Lumbar/Spinal Ligament Sprain [O]
Gait changes, watch how they walk - possible guarding
59
Lumbar/Spinal Ligament Sprain [P]
may be too deep to palpate, possible surrounding mm tightness.
60
Lumbar/Spinal Ligament Sprain [ROM]
AROM/ PROM - pain when affected fibers stretch | MRT - possible pain from tendinous/ fascial connections to ligament, possible weakness in area
61
Lumbar/Spinal Ligament Sprain [Tx]
deep XFF in subacute/ chronic stage
62
Thoracic Outlet Syndrome [TOS] is most frequently felt where
along ulnar pathway - common to have paraesthesia down the arm
63
TOS Impingement sites [4]
``` True neurologic TOS 1. Cervical rib [structural] Non- specific TOS 2. Anterior/ mid scalenes [functional] 3. Pectoralis minor [functional] 4. clavicle and ribs (costoclavicular) [functional ```

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