What is a vertebral unit?
- 2 adjacent vertebra bodies and the associated arthrodial, ligamentous, muscular, vascular, neural, and lymphatic structures.
What comprises the anterior aspect of the vertebral column?
- Body (weight bearing structure)
- IV discs
Describe certain aspects of the zygapophysis joints.
- True synovial joint (articular cartilage with synovial fluid)
- articulate between the superior and inferior facets
- Will determine the overall movement of the vertebral bodies based on orientation of the facets.
How is motion described with respect to the vertebra?
Position or motion is described based on the most anterior and superior aspect of the vertebral body
Sidebending left will induce what with respect to the vertebra?
- allow for free translation to the right
- will not allow translation to the Left (closed facet)
- left will have closed facets
- right will have open facets.
Sidebending to the right will induce what type of movement with respect to the vertebra?
- allow for free translation to the left, and restricted motion to the right
- right facets will be closed
- left facets will be opened
Define the "neutral range"
- The range of movement where the vertebra has majority of weight located on the body of the vertebra and discs.
- The facets are considered "idle" and are not engaged.
- flexion/extension is still possible but not enough to engage the vertebra in one direction or another.
Which of Fryette's principles only apply to thoracic or lumbar vertebra?
principles 1 and 2
A somatic dysfunction described as arthrodial restriction can best be described as:
- Articular restriction of facet joint causing reflexive muscle guarding.
- Caused by thin layer of adhesion at the facet joint.
- The adhesion is further maintained by hypertonic muscles
What can commonly induce arthrodial restrictive SD?
- acute trauma sustained by hypertonic muscles.
- Microtrauma due to repetitive motion
- Fascial or ligamentous contracture
- Poor posture.
Muscular restriction can be used to describe specific types of SD. What are the common types and how are they best described?
- Type I: affects the long paraspinal musculature. Spanning 2+ vertebral segments. Longissimus, spinalis muscles.
- Type II: short paraspinal muscles. Spanning 1-2 segments. Multifidus, rotatores
Describe a Type I SD.
Chronic problem most likely due to postural compensation.
- affects group curve, and long paraspinal musculature.
Describe Type II SD.
- Acute process at 1 vertebral body.
- Involves short paraspinal muscles spanning 1-2 segments. Multifidus, rotatores.
Describe what a fascial/ligamentous restrictive SD is.
- Restriction due to scaring, fibrosis, inflammation or the fascia or ligaments of the spine.
- These then lead to restriction of motion, and new neutral position.
Edema is a type of SD, but how will this promote SD?
- Fluid accumulates causing fascia to stretch and become less mobile. Therefore ROM is reduced and pain is associated.
What muscles can contribute to type I muscular SD?
- Serratus posterior superior/inferior
What muscles can contribute to Type II muscular SD?