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MSK II > Vetebral Column > Flashcards

Vetebral Column Flashcards

(50 cards)

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1
Q

Neurophysiological Effect of Joint Mob

A

Firing of articular mechanoreceptors proprioceptors
Firing of cutaneous/muscular receptors
Altered nociception

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2
Q

Mechanical effect of joint mob

A

Stretching of joint restrictions
Breaking of adhesions
Altered positional relationships
Diminish/eliminate barriers to normal motion

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3
Q

Psychological effect of joint mob

A

Confidence gained thru improvement
Positive effects from manual contact
Response to joint sounds

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4
Q

Total vertebra

Cervical

Thoracic

Lumbar

A

29

7

12

5

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5
Q

Sacral

coccygeal

A

5

4

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6
Q

Three separate joints in vertebral motion segment

A

2 facets, IVD and Vertebral bodies

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7
Q

How many pairs of facet joints?

What type of joints are facets?

A

24

Planar

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8
Q

Upper cervical facet orientation

Lower cervical

A

horizontal

45 degrees

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9
Q

Z-joints/uncovertebral made of what process?

A

Uncinate process

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10
Q

Thoracic facet joint orientations

Lumbar

A

Almost vertical (Facilitates rotation/resist anterior displacement)

Vertical with J-shaped structures (resists rotation and anterior shear)

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11
Q

Three sub-systems contribute to stability

A

Passive: Anatomical structures
Active: muscles, source of active stiffness
CNS: Feedforward and feedback

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12
Q

Absolute contraindications

A 
Joint hypermobility/instability
Joint inflammation/effusion
Hard end-feel
Medically instable
Acute pain that worsens with repeated attempts
Acute radiculopathy
Bone disease/fractures
Spinal Arthropathy
Deteriorating CNS pathology
Status post joint fusion
Blood clotting disorders
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13
Q

Variables affecting spinal motion

A 
Disc-vertebral height ratio
Compliance of fibrocartilage
Dimension/shape of adjacent endplates
Age
Disease
Gender
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14
Q

Coupling

A

Two or more motions coupled when one motion is always accompanied

Opposite of each other in UPPER cervical

Same side in LCS

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15
Q

Facet joints

A

Glide up and forward or down and back if occur in same directions, flexion/extension occurs

If movements occur in opposite direction, side-bending occurs

Rotation ALWAYS coupled with SB (LOWER CS)

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16
Q

Fryette’s first law

A

When you stand neutral and you side bend right, spine will rotate to the left

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17
Q

Fryette’s second law

A

When you flex or hyperextend your spine and you side bend to the right, your spine will rotate to the right (SAME SIDE)

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18
Q

Fryette’s third law

A

If motion in one plane is introduced to spine, any motion occurring in other direction is restricted

When you flex, you can’t move as much in other planes

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19
Q

“Can’t Close”

A

Restriction of Ext/SB/Rot to SAME side of pain

**Articular

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20
Q

“Can’t open”

A

Restriction of flex/SB/rot to OPPOSITE side of pain

**Capsular

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21
Q

Cervicoencephalic

Atlanto-occipital

Atlanto-axial

Cervicobrachial

Study These Flashcards
A

C0-C1

C1-C2 (rotation)

C3-C7

22
Q

Most rotation occurs here

Study These Flashcards
A

Occipital Atlanto region

Injury to area can cause
Cognitive dysfunction, CN dysfunction, Sympathetic system dysfunction

23
Q

Atlanto-occipital joints

Study These Flashcards
A

Yes and maybe joint

Ellipsoide

Flex/ext 15 to 20 degrees
side flexion of 10 degrees

24
Q

Atlanto-axial

Study These Flashcards
A

No joint

Flexion/ext 10 degrees
Side flexion 5 degrees
Rotation 50 degrees (primary motion)

25
Cervicobrachical Region
C3-C7 ``` Symptoms in area: Neck or arm pain Headaches Restricted ROM Paresthesia Altered myotomes/dermatomes Radicular signs ```
26
Buffers axial compression by distributing compressive forces Withstands tension in disc
NP AF
27
Vertebral Artery
Passes thru transverse Supplies 20% of blood supply to brain Can be compressed (osteophyte formation or injury to facet joint) Stress by rotation, extension, and traction
28
VBA System
Three vessels two VA one Basilar
29
Four portions to VBA
Proximal, Transverse, Suboccipital, Intracranial
30
Proximal Portion
From origin of subclavian to entry to Cspine through Transverse of C6
31
Transverse portion
C6 to C2
32
Suboccipital Portion
Exit at C2 to penetration into cord Divided into 4 parts 1. within Transverse of C2 2. Between C2 and C1 3. In transverse of C1 4. Between posterior arch of atlas and entry into foramen magnum
33
VA most vulnerable to compression and stretching
C1-C2 with cervical rotation
34
Transverse forearm of C1 is more ____than that of C2 VA
Lateral
35
Intracranial portion
IC runs from foramen magnum to formation of basilar artery at lower border of Pons ICP is more prone to obstructions
36
Branches of VA
1. Meningeal branches: supply bone and dura mater 2. Anterior Spinal Artery 3. Posterior Spinal Artery 4. Muscular branches 5. Posterior inferior cerebellar artery
37
VA insufficiency
Occur because of close proximity of VA and bony structures of Spine or RA, sickle cell, etc.
38
Manifestations of VBI
``` Dizziness, Drop Attacks, Diplopia, Dysarthria, Dysphasia, Nausea, Numbness, Nystagmus, Tinnitus Headache Wallenberg/Horner syndromes Paresthesia/Hemi Scotoma/Vision obstruction Periodic LOC Lip/Perioral Anesthesia Hemifacial Paralysis Hyperreflexia Babinski, Clonus Gait Ataxia ```
39
Risk factors for Arterial Damage (Stroke)
``` BP >140/90 Hypercholesterolemia Hyperlipidemia Diabetes Family history of MI Smoking BMI >30 Repeated or recent injury Upper Cervical Instability ```
40
Subdural Hematoma
Worse Headache of life
41
Imaging
Conventional Angiography: Gold Standard MRA (Stenosis/Occlusions) Doppler Sonography (assesses blood flow velocity)
42
Five D's And the N's
Dizziness, Diplopia, Drop attacks (Drop foot, drooping of face/eyes), Dysarthria, Dysphagia, Dysphasia Ataxia Nystagmus, Numbness, Nausea
43
Absolute contraindications to Manual Therapy
Infection, Acute circulatory, Malignancy, Open wounds, Recent fracture, Hematoma, Hypersensitivity to skin, Poor end feel, Advance diabetes, Cellulitis, severe pain, Extensive radiation of pain
44
Examination of VA
Maintain Immediate pre-mobilization position for a minimum of 10 seconds to test system STOP when signs noted Observe for Nystagmus, Changes in pupil, assess quality of speech, have pt reports changes in symptoms
45
Common issues
``` Worse headaches (Thunder headache) Different headache than I have ever had ``` Dizziness and headaches/neck pain! (Two most common for stroke) Be conservative
46
To assess comorbidities look at
RBP Upper cervical spine instability testing BMI
47
Avoid prior to SMT on Cspine Only if you observe proper evaluation techniques ONLY IF YOU GAIN CONSENT
Excessive rotation, Non physiological movements in joints, aggressive forceful maneuvers Through history, quality observation skills
48
Relative precautions to joint mobilization
Malignancy, Joint replacement, bone disease, CT disorders, Pregnancy or immediately post partum, Recent trauma (radiculopathy, cauda equina), early healing phase of CT injury, People unable to community, Psychogenic patients, corticosteroids, skin rashes/open wounds, Elevated pain levels that make palpation unreasonable
49
Neutral zone
Defines a region of laxity around neutral resting position of segment Minimal loading occurring in passive structures and active Spinal motion produced with minimal internal resistance
50
Two roles of Meniscoid
# Fill space during joint displacement Actively assist in dispersal of synovial fluid

MSK II (3 decks)

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