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Flashcards in Thoracic And Lumbar ME Deck (25)
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1

Vertebral unit

Defined as 2 adjacent vertebrae with associated Disc, ligaments, musculature, vasculature and neural/lymphatic drainage.

Motion is Referred by the superior segment in relation to the lower one

(i.e T3 vertebral unit = T3 in relation T4)

2

Position of initial injury in type 1 somatic dysfunctions

Generally, patient was in neutral and side-bent towards one direction while rotated to the other at time of injury.

- often manifests as a response to a type 2 dysfunction

3

Position of initial injury of type 2 somatic dysfunction

Patient was flexed or extended and being side-bent or rotated to one side (usually the same)

- usually manifests at the end of a group if in a group

- extension specifically often is a product of segmental muscle contraction from a viscerosomatic reflex

4

Scoliosis

Lateral deviation of vertebral column usually greater than 10 degrees one way

More common in female vs male with peak incidence in 12-14 years

Often associated with type 1 issues

1/20 people have some degree of scoliosis

Only 1/200 have clinical symptoms

Named for direction of convexity

Most common type of Scoliosis is single C shaped in the thoracic region. (If it worsens through chronic use, then will eventually become S shaped)

5

Dextroscoliosis vs levoscoliosis

Dextroscoliosis:
Right side apex
- rotation is right, concave left, convex right, side bent left

Ribs are rotated posteriorly and the space between the right ribs are increased
- more common in thoracic spine


Levoscoliosis
Left sided apex
- rotation is left, concave right, convex left, sidebent right

More common in in lumbar spine

6

Classifications of scoliosis

Reversibility: functional or structural

Severity: determined on Cobb angles (larger = worse)

Location: thoracic or lumbar, double or single curve

Etiology

7

Adams test

Pt takes shirt off and stands with feet together with physician behind pt .

Patient bends forward at the waist and physician evaluates for asymmetry

8

Is neutral the same position for each vertebrae or when seated/lying prone?

No

Due to natural curves of the spine along the AP axis

9

Why is sidebending more prominent in the lumbar region than the thoracic?

Ribs are present in the thoracic region

10

Single segment type 1 somatic dysfunction

Very rare and topically only occur at L5.

Very painful and is pretty much the only exception to the principles of Fryette

11

Are type 1 and type 2 motions normal or abnormal?

Normal motions of the spine. It’s how the vertebrae compensate, the motion itself is not abnormal

12

Type 1 somatic dysfunction

Occurs in groups w/ spine in neutral range

Side-bending and rotation are opposite
- exist because vertebrae was sidebent and rotated opposite and remained when spine was neutral

Only works for thoracic and lumber vertebral motion only

13

Type 2 somatic dysfunction

Usually a single vertebrae

Occurs only when spine is in overflexion/extension

Side-bending and rotation are coupled in the SAME direction

* extension type 2 is typically a product of segmental muscle contraction from viscerosomatic reflex*

14

Ways to screen for thoracic examination

Postural screening

Scoliosis screening

Neurological exam

TART w/ AROM/PROM

Visual inspection

Segmental exams

15

Principle 3

Initiating motion of a vertebral segment in any plane of motion will modify the movement in other planes of motion (typically reducing it)

NO SOMATIC DYSFUNCTION ASSOCIATED

16

Most common type of scoliosis

Single C shaped curve

17

Rotation movement of the vertebrae definition

Movement in a transverse plane about the vertical axis

18

Sidebending movement of the vertebrae definition

Movement in a coronal plane about an anterior-posterior axis

19

Flexion movement of the vertebrae definition

Anterior movement in a sagittal plane about a transverse axis

20

Extension movement of the vertebrae definition

Posterior movement in a sagittal plane about a transverse axis

21

Is neutral range of motion a single point?

No

It is a range in which the weight of the trunk is borne on the vertebrae bodies, discs and facets while “idle”

22

When should Lateral recumbent position for lumbar/thoracic ME be considered?

Between T10-L5

23

Ways to screen for lumbar examination

Postural screening

Scoliosis screening

Neurological exam

TART w/ AROM/PROM

Visual inspection

Segmental exams

Straight leg raise

Nachlas test

Schober tests

24

Seating with respect to thoracic and lumbar ME

Upper thoracic = sit at the side being rotated towards

Mid-lower thoracic = sit at the side being rotated towards

25

Why do we tuck the patients neck in during upper thoracic region ME?

To isolate the upper thoracic and keep the cervical vertebrae together