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Flashcards in Fryette's Mechanics - Steve Deck (51)
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1

What plane and axis are depicted here? Type of movement?

Transverse (Horizontal) Plane

Vertical Axis

Rotation

2

What plane and axis are depicted here? Type of movement?

Side-bending:

Coronal (Frontal) Plane; Anterior-Posterior Axis

3

What plane and axis are depicted here? Type of movement?

Flexion/Extension:

Sagittal Plane; Transverse Axis

4

Define Neutral positioning


•The point of balance of an articular surface from which all the motions physiologic to that articulation may take place2. 

 


•NOTE: Neutral is not a single point, but rather a RANGE in which the weight of the trunk is borne on the vertebral bodies and discs3.
 

5

When flexing or extending the spine what joints are being engaged?

facet (zygapophysial) joints

6

At what level does general spinal motion occur?

Define this thing!

The level of the vertebral unit.


•: Two adjacent vertebrae (vertebral segments) and their associated arthrodial, ligamentous, muscular, vascular, neural and lymphatic elements2.
 

7

What are the structural components of the anterior segment of the spinal column?  What is their function?

Structure:

•Vertebral Bodies
•Vertebral Discs
•Longitudinal Ligaments*

Function:

•Load Bearing

8

What are the structural components of the posterior segment of the spinal column?  What is their function?

Structure:

•Vertebral Arches
•Facet (Zygapophysial) Joints
•Transverse Processes
•Spinous Processes
•Ligaments*

Function:

•Guide and Limit Motion

9

How are vertebral units named?  How are spinal and vertebral movements described


•Vertebral Units are named for the superior member (vertebrae) of the unit.

•All spinal and vertebral movements are described in relation to the motions of their anterior and superior surfaces. 
 

10

What is fryette's first principle?


I.In the NEUTRAL range, side-bending and rotation are coupled in OPPOSITE directions = Type I Mechanics
 

11

What is Fryette's second principle?


I.In sufficient flexion or extension (NON-NEUTRAL), side-bending and rotation are coupled in the SAME direction = Type II Mechanics
 

12

What is fryette's third principle?


III. Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion.
 

13

All together now!  What are Fryette's Principles?  What note should we keep in mind?

I.In the NEUTRAL range, side-bending and rotation are coupled in OPPOSITE directions = Type I Mechanics
II.In sufficient flexion or extension (NON-NEUTRAL), side-bending and rotation are coupled in the SAME direction = Type II Mechanics
III.Initiating movement of a vertebral segment in any plane of motion will modify the movement of that segment in other planes of motion.
 

NOTE: Fryette’s Principles (I and II) apply only to thoracic and lumbar vertebrae. 

14

What's this memory tool for?

Fryette's First Principle

15

Describe Neutral - Type I mechanics


When the spine is in a neutral position and side-bending is introduced, the bodies of the vertebrae will rotate toward the convexity.
 

16

Principle #1 states that in neutral position...


Side-bending and rotation occur in opposite directions.
 

17

Principle II of Fryette's principles states that in non-neutral position (flexed or extended)


Rotation and side-bending are to the same side.
 

18

Describe Non-neutral (Type II) Mechanics

When the spine is either forward or backward bent and side-bending is introduced, the vertebrae will rotate toward the concavity

19

What is this memory tool for?

Fyrette's 2nd principle

20

In what plane and around what axis does flexion occur?


•Forward or anterior bending in the sagittal plane around a transverse axis (past the neutral range).
 

21


•In Neutral, if T6 side-bends right, which way will it rotate?
 


–It will rotate left.
 

22


•In a flexed (non-neutral) position, if T7 rotates left, which way will it side-bend?
 

It will side bend left

23

What is fryettes third principle again?  What regions does this principle apply to?


[*] When motion occurs in any one plane within a joint, the motion in all other planes of that joint will be influenced.
 

 

Note: Fryette’s third principle applies to cervical, thoracic and lumbar vertebrae.

24

When complex physiologic Type I or Type II mechanics of a vertebral unit are restricted in any plane of motion, we have?

somatic dysfunction

25

Describe...
•1. Arthrodial (Joint) Restriction

 

What is this maintained by?
 


–Thin Layer Adherence at Facet Joints
•Maintained by muscle hypertonicity
 

26

Describe muscular restriction


–Longer paraspinal muscles maintain Type I dysfunctions
•Often postural compensation/chronic process
–Short paraspinal muscles maintain Type II dysfunctions
•Often acute process
 

27


Describe Fascial and Ligamentous Restriction
 


–Fibrosis/scarring/inflammation can shorten fascia and ligaments associated with paraspinal muscles
 

28

What is edema


–Interstitial fluid distends, stretches, and restricts tissues, causing motion restriction
 

29

Type I somatic dysfunction is...

group of vertebrae stuck in Type I mechanics

 


–Example:  L1-4 sidebent right and rotated left and not improving with flexion or extension.
 

30

Type I somatic dysfunction is often...

And is maintained by...


–Often a postural compensation/chronic process maintained by long paraspinal muscles
 

31

Type II Somatic dysfunction is a...

single vertebrae stuck in type II mechanics

32

Type II somatic dysfunction is often an...

Acute process maintained by short paraspinal muscles

33

Describe the following for type I mechanics

Segment(s)

Muscle Involvement

Rotation/sidebending

Cause

Group curve

Long paraspinals

Opposite sides

Chronic Process/postural compensation

34

Describe the following for type II mechanics

Segment(s)

Muscle Involvement

Rotation/sidebending

Cause

Single vertebral segment

short paraspinals

same side

acute process/trauma/viscero-somatic reflexes

35

Dysfunctions are diagnosed by inspection, palpation, and motion testing, what are we looking for in these three broad categories?


•Inspection
–Paraspinal fullness
–Group curves

 

•Palpation
–“Speed Bumps”
–Posterior transverse process is a clue to rotation

 

•Motion testing
–Motion must be localized to the segmental level
–Test all cardinal motions
•Rotation
•Side-bending
•Flexion/Extension/Neutral
 

36

What is the rule of 3's important for?  What does it describe?


Important for diagnosis and treatment.
 The rule describes the location of the SPINOUS PROCESS
 

37

What is the vertebral level associated with the superior scapular border?

T2

38

What is the vertebral level associated with the scapulaar spine?

T3

39

What is the vertebral level associated with the scapular angle?

T7

40

What vertebral level is associated with the iliac crests?

L4

41

When we say "L4 is rotated right", what are we describing the rotation in relation to?

relative to L5

42

How are somatic dysfunctions named?


Somatic dysfunctions are named for the direction of ease (freer motion), NOT for the direction of restriction.
 

43

With these findings, what diagnosis would you come to?

 


 T7-T10
On palpation, transverse processes were found to be posterior on the right
 On motion testing, rotation was found to be more free to the right
 These findings did not improve in flexion or extension
 

44


T7-10NSLRR (Type I SD) 
 

45

Diagnose the following findings...


T7
 On palpation, the transverse process was found to be posterior on the right

 On motion testing, rotation was found to be more free to the right
Findings improved in flexion

 


 T7FRSR(Type II SD) 
 

46

If a vertebra is restricted in right rotation...

It is rotated left

47

If findings improve in flexion...

 

If findings improve in extension...

The vertebra is flexed

 

The vertebra is extended

48

Findings improve means...

Symmetry and/or motion is restored

49

If flexing or extending a segment or group does not bring a return to symmetry or improved motion, we know that...


•it must exhibit neutral mechanics, and is a Type I (neutral) somatic dysfunction.
 

50

A 44 y/o female presents with upper back pain.  The patient is examined in the seated position and palpation reveals a posterior right transverse process that is even with the scapular spine.  Motion at this segment is restricted in left sidebending.  Findings improve in flexion.  What is the segmental diagnosis?

T3 FRRSR

51