Vertebral Column Flashcards
(29 cards)
3 R’s of Examination
Reproducible Sign
Region of Origin
Reactivity Level
Neurophysiological Effects of Joint Mobs
- Firing of articular mechanoreceptors and proprioceptors
- Firing of cutaneous and muscular receptors
- Altered nociception
Mechanical Effects of Joints Mobs
- Stretching of joint restrictions
- Breaking of adhesions
- Altered positional relationships
- Diminish/eliminate barriers to normal motion
Psychological Effects of Joint Mobs
- Confidence gained through improvement
- Positive effects from manual contact
- Response to joint sounds
T/F: Spinal manipulation is a safe, effective, and recommended intervention in the management of LBP
True
Indications for Joint Mobs
- Improve a loss of movement
- Reduce a closing or opening dysfunction of the spine
- Restore normal articular relationships
- Provide symptom relief and pain control
- Enhance motor function through reduction of pain
- Improve nutrition to structures by promoting movement
- reduce muscle guarding
- Early mobility following injury
- develop patient confidence
- prepare for other interventions
Absolute Contraindications to Joint Mobs
- Hypermobile or instable
- Joint inflammation/effusion
- hard end-feel
- medically unstable
- acute pain that worsens with repeated attempts
- acute radiculopathy
- bone disease or fracture (radiograph)
- spinal arthropathy (spondy, DISH, etc.)
- deteriorating CNS pathology
- Post-joint fusion
- Blood clotting disorder
Relative Precautions to Joint Mobs
- Malignancy
- Total joint replacement
- Bone disease not detectable on radiograph (steroid use, OA, etc.)
- Systemic connective tissue disorders
- Pregnancy/immediately postpartum
- recent trauma, radiculopathy
- Cauda Equina syndrome
- early healing phase of connective tissue
- Unable to reliably communicate
- Psychogenic patients w/ dependent behaviors
- Long-term corticosteroid use
- Skin rashes/open wounds in region being treated
- elevated pain levels
What are the 3 separate joints in a vertebral motion segment?
2 facets and IVD
How many pairs of facet joints are in the spine?
24 pairs of facet joints
What type of joint are they classified as?
Planar Joints
In the upper cervical spine the facet joints are oriented in what alignment?
Horizontal Alignment
In the lower cervical spine, the facets change to what position?
45 degrees
Z joint/Uncovertebral joints: are made up by what anatomical process?
Unicinate process
Role of the meniscoid in facet joint?
fill space during joint displacement AND actively assist in the dispersal of synovial fluid
3 sub-systems that contribute to stability
- Passive System: anatomical structures contributing to stability
- Active System: muscles, source of active stiffness
- CNS: feedforward and feedback control
Neutral Zone of Spinal Stability
region of laxity around the neutral resting position of a spinal segment
Minimal loading
Spinal Motion: Agonist/Synergistic Muscle
initiate and supply the power for the movement
Spinal Motion: Antagonist Muscle
control and modify the movements
What changes spinal motion?
- Disc-vertebral height ratio
- Compliance of the fibrocartilage
- Diminish/Shape of end plates
- Age
- Disease
- Gender
Coupling Motion: Upper Cervical
When you rotate to R, Side bending is to L
Coupling Motion: Lower Cervical
When you rotate to R. side bending is to R
T/F: Rotation is always coupled with Side bending in the lower cervical spine
True
Fryette’s First Law
Thoracic/Lumbar
When you’re standing in a neutral position and you side bend to the R, your spine will rotate to the L
Neutral spine = opposite motion
