Flashcards in The Lumbar and Thoracic Spine: General Info Deck (32):
Spondylosis = the degeneration of ____?
Spondylolysis = The degeneration of what structure in the spine?
How does Spondylolysis occur? What direction does the spine have to move in order to result in this injury?
Spondylolisthesis = a injury to the spine occurs where _?_ happens?
Forward displacement of one vertebrae over another.
If the IVD is starting to degenerate this is called?
If a fracture occurs in the in the spine at the pars interaticularis what is this injury called?
Spondylolysis aka scotty dog fracture
When one is becomes forwardly displaced over another disc what is this called?
The role of the __?__ is to stabilize the spine, allow limited movement, and protect the intervertebral discs from shear forces caused by excessive forward bending, back bending, and rotation.
What are the 4 different levels of possible injury to the discs of the spine?
What does it mean if a disc is in protrusion?
The nucleus pulposus has gone from a round shape to oval but it hasn't ruptured through the annulus fibrosus.
What does it mean if a disc has prolapsed?
The nucleus pulposus has broken through most of the fibers of the annulus fibrosus. Only the very outer fibers contain it.
What does it mean if a disc is extruding?
The nucleus pulposus has ruptured through the annulus fibrosis fibers and is bulging into the spinal canal.
What does it mean if the disc is in sequestration?
The nucleus pulposus has ruptured through the annulus fibrosis and fragments are freely floating in the spinal canal
What is it called when the nucleus pulposus goes from round to oval?
What is it called when the nucleus pulposus breaks through part of the annulus fibrosis and only the outer fibers of containing it?
What is it called when the nucleus pulposus rupture completely through the annulus fibrosis and bulges into the spinal canal?
What is it called when the nucleus pulposus ruptures through the annulus fibrosis and fragments are freely floating into the spinal canal?
What are some activities that increase pressure in the low back?
lifting weight with back straight/ bent
What puts more pressure on your back lifting a weight with your back bent or straight?
Bent back = more pressure
eg lift with your knees not your back
what is the closed packed position of the low back?
what is the open packed position of the low back?
mid way between flex/ ext
What other joints should you rule out first before testing the lumbar/ Thoracic spine?
Hip : AF flexion/ medial rotation w over pressure
Pelvis: rocking, gapping, approximation
Cervical spine : AF flex, ext, side bend, rot with overpressure ( except for ext)
Because the torso is so heavy how will the ROM testing be modified?
Only AF movement with with overpressure to determine end feel.
When should you forgo any ROM in the spine?
When your cl is suffering from any neurological symptoms that suggest any degree of disc herniation.
Should you do Active resisted ROM testing if your client has a possible herniated disc? What about AF ROM?
Should be OK as long as they aren't in an acute flare up because then everything will hurt. (false positives)
Walk through Active free testing for T/L spine.
Cl stands and tucks in chin to chest
forward bends as far as possible
When a cl bends forward the movement is initiated by which muscle group and controlled by which other muscle group?
When the cl bend forward the action is started by to psoas/ abdominal muscles. The action is controlled by eccentric contraction of the sacrospinalis muscles and multifidus muscles.
When a client bends forward the lumbar spine should transition from a healthy lordotic curve to what shape?
is should flatten out not go kyphotic.
Walk through active free extension.
Client is standing he/she extends backward with the therapist stabilizing the pelvis.
Walk through active free side bending
Cl standing s/he sidebends trying to reach down the side of their leg attempting to touch their knee.
Walk through active trunk rotation.
Cl seated (to reduce movement of the pelvis) on table ( feet off the ground) cross arms over chest ( so they don't used them to compensate). End range is noted when cl contralateral knee moves forward. Apply over pressure only if there is not pain. ( this can clarify any vague sensations that the client might have been feeling.)