Spinal Flashcards
Traversing Nerve Root VS Exiting Nerve Root
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
Line of gravity (Surface Landmark)
- 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)
Line of Gravity (Bony Landmarks)
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
Center of gravity
- Slightly anterior to S2
Disc Herniation Severity
- 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
Traction Points to notes
- lumbar vertebral separation will occur with traction forces less than 1/4 of body weight
-Lumbar = 30-60% WB
Cervical = 10-30% WB
Traction Contraindications
Acute problem:
- acute sprain/strain
- inflammation
Bone related problem
- unhealed fracture
- vertebral instability
Sacral Nutation and Counternutation
Nutation=posterior tilt of pelvis
Counternutation=anterior tilt of pelvis
Actions of Muscles of Mastication
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)
Movement of TMJ
Rotation–>start to mid-range
Lateral pterygoid (superior head) attach onto the disc and draws it anteriorly
Gliding–>after initial rotation–>disc displace anteriorly
ULTT 1
Median nerve:
➢ Shoulder girdle depression
➢ Shoulder abduction to 110 degrees
➢ Shoulder external rotation
➢ Forearm supination
➢ Wrist extension
➢ Finger and thumb extension
➢ Elbow extension
ULTT 2
Median nerve:
➢ Shoulder girdle depression
➢ Shoulder external rotation
➢ Forearm supination
➢ Wrist extension
➢ Finger and thumb extension
➢ Elbow full extension
➢ Shoulder abduction
ULTT 3
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
ULTT 4
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
Scoliosis Curvature number
Normal: 5-7 or less
Treatable with exercises: 15 or less
Compress organs within ribs & compromise of vital capacity:
60 or more
