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Flashcards in Traction Deck (58):
1

What is the history of traction in Egypt 3000 BC

Axial traction for the reduction of spinal fractures

2

What is the history of traction by hippocrates 776 BC

Treatment of back pain

3

Who used hippocrates traction for low back pain treatment (3)

1. Galen
2. Avicenna
3. Pare

4

What did W. Gayle Crutchfield do for traction in 1933

Cranial tongs for treatment of cervical spine injuries

5

What did James Cyriax use traction for in the 1950s

Small nuclear protrusions

6

What is the definition of joint distraction

Separation of two joint surfaces perpendicular to the plane of the articulation

7

True or False:
For joint distraction to occur the force applied must be great enough to cause soft tissue elongation around the joint to allow for joint surfaces to distract

True

8

What percent of the body weight is needed to increase the length of the L-spine

25%

9

What percent of the body weight is needed to distract zygapophyseal joints in the L-spine

50%

10

What percent of the body weight is needed to increase the length of the C-spine

7%

11

How much separation occurs in the C-spine due to 25 lbs of traction

2-20 mm

12

Is the separation long lasting or short lived

Short lived

13

What did Krause et al determine about the effects of 60-120 lbs of lumbar traction

It can reduce disc prolapse and cause retraction of herniated disc material

14

What did Onel et al determine about the percent of herniated nucleus pulposus that retracted during traction for median, posterolateral, and lateral protrusions

Median: 78.5%
Posterolateral: 66.6%
Lateral: 57.1%

15

What does AB equal in the disc herniation index

Maximum AP disc length

16

What does CD equal in the disc herniation index

Width of the herniated disc at mid AB distance

17

What does EF equal in the disc herniation index

Maximum canal length

18

What does GH equal in the disc herniation index

Width of the spinal canal at mid AB distance

19

What is the equation for herniation index

(ABxCD)/(EFxGH)x1000

20

What did Worden et al determine about the process of stretching soft tissue with traction

It is the same as stretching and soft tissue

21

What did Mathews determine about traction causing muscle relaxation

Muscles relaxed due to reduction in the pressure on pain sensitive structures

22

What type of traction is the depression of monosynaptic response due to prolonged stretch

Static traction

23

What type of traction is the stimulation of GTOs to inhibit alpha motor neurons

Intermittent traction

24

What did Saunders determine about the percent of the body weight required to move joints in the spine

50%

25

True or False:
Lower forces of traction may reduce pain by stimulation of mechanoreceptor (spinal gate)

True

26

How does the patient get relief from traction (9)

1. Increasing space between vertebrae
2. Separating apophyseal joints
3. Widening of intervertebral foramina
4. Stretching muscles and ligaments
5. Reducing muscle spasm
6. Changing intervertebral disc pressure
7. Tensing PLL to exert force on disc
8. Creating suction force on disc
9. Flattening abnormal lumbar lordosis

27

How does traction effect bone

Increase the movement between vertebrae

28

How does traction effect ligaments

Tensile loads ligaments

29

How does traction effect articular facet joints (3)

1. Increases separation
2. Decreases compression loading
3. Allows synovial fluid exchange

30

How does traction effect muscles (2)

1. Lengthens tight muscles
2. Activates proprioceptors

31

How does traction effect nerves

Decompression

32

What are the indications for traction (12)

1. Reduce disc herniation
2. Nerve root impingement
3. Joint hypomobility
4. Subacute inflammation
5. Paraspinal muscle spasm
6. Adhesions
7. Muscle spasm
8. Foraminal stenosis
9. Contracted CT
10. Apophyseal joint impingement
11. Radiating pain that doesn't respon to repeated movements
12. Reduce low back pain

33

The DRX9000 spinal decompression machine claims to have a success rate of what for patients with LBP

86%

34

What are possible causes of nerve root impingement (6)

1. Disc
2. Ligament encroachment
3. Narrowing of intervertebral forament
4. Osteophyte encroachment
5. Nerve root swelling
6. Spondylolisthesis

35

What does traction of a hypomobile joint allow for

The ability to glide and distract spinal joints

36

What are the contraindications of traction (17)

1. Places that motion is contraindicated
2. With acute injury or inflammation
3. Joint hypermobility or instability
4. Peripheralization of symptoms with traction
5. Uncontrolled hypertension
6. Malignancy
7. Infectious spinal diseases
8. RA
9. Spinal cord compression
10. Osteoporosis
11. Cardiovascular disease
12. Aortic aneurysm
13. Severe respiratory disease
14. Pregnancy
15. Hiatal hernia
16. Abdominal hernia
17. Active peptic ulcers

37

What are the precautions of traction (10)

1. Structural diseases
2. When pressure from belts may be hazardous
3. Displacement of annular fragment
4. Medial disc protrusion
5. Severe pain fully relieved by traction
6. Claustrophobia
7. Patient can't tolerate prone or supine position
8. Disorientation
9. TMJ problems
10. Dentures

38

What is inversion traction

Using the body weight to provide distraction force

39

When was inversion traction popular

10-20 years ago

40

Why did inversion traction lose popularity

Potential increase in systolic and diastolic BP and ophthalamic artery pressure

41

What are the 2 types of mechanical traction

1. Static
2. Intermittent

42

What is static mechanical traction used for (3)

1. Irritable conditions
2. Inflammation
3. Disc protrusions

43

What is intermittent mechanical traction used for (2)

1. Joint dysfunctions
2. Mobilization effect

44

What are the application techniques of traction (10)

1. Inversion traction
2. Auto traction
3. Mechanical traction
4. Electric traction
5. Weighted traction
6. Hydraulic traction
7. Self traction
8. Unilateral lumbar traction
9. Positional traction
10. Manual traction

45

When is supine hook lying position of the patient during mechanical spinal traction the most optimal position (2)

1. General joint hypomobility
2. Spinal stenosis

46

When is prone position of the patient during mechanical spinal traction the most optimal position (1)

1. Disc conditions

47

When is unilateral lumbar traction done

For unilateral symptoms

48

What is the definition of positional traction

Placing a patient in a position for a prolonged period of time so as to decompress target tissue

49

What is the definition of manual traction

The application of force by the therapist so as to distract the target tissue

50

How much flexion should the C-spine be placed in during mechanical traction while supine

20-30

51

How much flexion should the C-spine be placed in during mechanical traction while supine if you are treating the AO or AA joint

0 degrees of flexion

52

What are the 2 types of manual traction

1. Towel traction
2. Conventional manual traction

53

What is the definition of self traction

The use of gravity or the weight of the body to exert a distraction force on the spine

54

What were the clinical prediction rule variables that Raney et al determined for cervical traction for mechanical neck pain (5)

1. 55 years old and up
2. Positive shoulder abduction test
3. Positive ULNT A (Elvy's test)
4. Symptoms peripheralize with PACVP of C4-C7
5. Positive neck distraction test

55

What is considered a quality score for Raney et al's clinical prediction rule

67%

56

How many of the clinical prediction rules are required for cervical traction to be indicated

3 or more

57

What does the clinical prediction rule yield for a LR

+ 4.8

58

What does a + 4.8 LR yield

A small to moderate shift in probability