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147 Cards in this Set
- Front
- Back
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Atlanto-occipital articulation |
Flexion and extension |
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Atlanto-axial articulation |
Rotation |
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Articulations between C2 and S1 |
All the same (?) |
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Anterior Longitudinal Ligament |
Tends to prevent excessive hyperextension - runs down the vertebral column on the anterior surface of the bodies - found in the thoracic and lumbar regions just deep to the aorta - Thin superiorly and thick inferiorly |
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Posterior Longitudinal Ligament |
Prevents excessive flexion - runs along the vertebral bodies posteriorly, inside the vertebral foramen - thick superiorly, thin inferiorly (which increases disk injury in lumbar region) |
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Supraspinal Ligament |
Extends from C7 distally to the sacrum posteriorly along the tips of the spinous processes |
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Interspinal Ligament |
Runs between successive spinous processes |
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Ligamentum Nuchae |
Very thick - takes the place of the Supraspinal and Interspinal ligaments in the cervical region |
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Ligamentum Flavum |
Connects adjacent laminae anteriorly |
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SCM Origin and Insertion |
O: Sternum and Clavicle I: Mastoid Process |
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SCM Action and Innervation
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A: Bilaterally - flexes neck, hyperextends head Unilaterally - Laterally bends the neck, rotates to the opposite side N: Accessory Nerve (Cranial Nerve XI); 2nd and 3rd cervical nerves |
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Scalene Muscles Origin and Insertion |
O: Transverse Processes of the cervical vertebrae I: First and Second ribs |
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Scalene Muscles Action and Innervation |
A: Bilaterally - assists in neck flexion Unilaterally - neck lateral bending N: Lower cervical nerves |
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Erector Spinae Muscles Origin and Insertion |
O: Spinous processes, transverse processes, and posterior ribs from the occiput to the sacrum and ilium I: Spinous processes, transverse processes, and posterior ribs from the occiput to the sacrum and ilium |
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Erector Spinae Muscles Action and Innervation |
A: Bilaterally - extend neck and trunk Unilaterally - laterally bend neck and trunk N: Spinal Nerves |
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Transversospinalis Muscles Origin and Insertion |
O: Transverse Processes I: Spinous processes of vertebra above |
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Transversospinalis Muscles Action and Innervation |
A: Bilaterally - extend neck and trunk Unilaterally - rotate neck and trunk to opposite side N: Spinal Nerves |
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Splenius Capitis Muscles Origin and Insertion |
O: Lower half of nuchal ligament, spinous processes of C7 through T3 I: Lateral occipital bone, mastoid process |
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Splenius Capitis Muscles Action and Innervation |
A: Bilaterally - extend head and neck Unilaterally - rotate and laterally bend the face to same side N: Middle and Lower Cervical Nerves |
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Splenius Cervicis Muscles Origin and Insertion |
O: Spinous processes of T3 through T6 I: Transverse processes of C1 through C3 |
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Splenius Cervicis Muscles Action and Innervation |
A: Bilaterally - extend neck Unilaterally - rotate and laterally bend the neck to the same side N: Middle and Lower Cervical Nerves |
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Rectus Abdominis Muscles Origin and Insertion |
O: Pubis I: Xiphoid process and costal cartilages of 5th, 6th, and 7th ribs |
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Rectus Abdominis Muscles Action and Innervation |
A: Trunk flexion, compression of abdomen N: 7th through 12th intercostal nerves |
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External Oblique Muscle Origin and Insertion |
O: Lower 8 ribs laterally I: Iliac crest and linea alba |
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External Oblique Muscle Action and Innervation |
A: Bilaterally - trunk flexion, compression of abdomen Unilaterally - lateral bending, rotation to opposite side N: 8th through 12th intercostal, iliohypogastric, and ilioinguinal nerves |
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Internal Oblique Muscle Origin and Insertion |
O: Inguinal ligament, iliac crest, thoracolumbar fascia I: 10th, 11th, and 12th ribs - abdominal aponeurosis |
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Internal Oblique Muscle Action and Innervation |
A: Bilaterally - trunk flexion, compression of abdomen Unilaterally - lateral bending, rotation to same side N: 8th through 12th intercostal, iliohypogastric, and ilioinguinal nerves |
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Transverse Abdominis Muscle Origin and Insertion |
O: Inguinal ligament, iliac crest, thoracolumbar fascia, and last 6 ribs I: abdominal aponeurosis and linea alba |
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Transverse Abdominis Muscle Action and Innervation |
A: Compression of abdomen N: 7th through 12th intercostal, iliohypogastric, and ilioinguinal nerves |
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Quadratus Lumborum Muscle Origin and Insertion |
O: Iliac Crest
I: 12th rib, transverse processes of all 5 lumbar vertebrae |
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Quadratus Lumborum Muscle Action and Innervation |
A: Trunk lateral bending N: 12th Thoracic and 1st lumbar nerves |
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Motions available in the TMJ |
Mandibular depression, elevation, lateral deviation, protrusion, and retrusion |
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Temporalis Muscle Action |
Bilaterally - elevation, retrusion (posterior fibers) Unilaterally - ipsilateral lateral deviation |
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Masseter Muscle Action |
Bilaterally - elevation Unilaterally - ipsilateral lateral deviation |
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Medial Pterygoid Muscle Action |
Bilaterally - elevation and protrusion Unilaterally - contralateral lateral deviation |
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Lateral Pterygoid Muscle Action |
Bilaterally - depression and protrusion Unilaterally - contralateral lateral deviation |
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Levator Palpebrae Action |
Elevate the eyelid (open the eyes) |
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Orbicularis Oculi Action |
Circular muscle around the eye - closes the eye |
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Corrugator Supercilii Action |
Draws the eyebrows down and medially (frowning) |
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Occipitofrontalis Action |
Scalp down the front of the forehead - raises the eyebrows to wrinkle the forehead |
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Procerus Action |
Wrinkles the nose (expressing distaste) |
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Orbicularis Oris Action |
Encircles the mouth - purses the lips (kissing) |
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Buccinator Action |
Positioning food in the mouth and blowing air out (like blowing up a balloon) |
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Zygomaticus major Action |
Smile! Draws angles of the mouth upward and laterally |
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Mentalis Action |
Protrudes the lower lip (pouting) |
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Depressor Labii Inferior Action |
Draws the lower lip down and laterally (frowning) |
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Biceps Reflex |
Tells you something about the integrity of the nervous system - nerve that innervates the bicep (C5) - one piece of the puzzle |
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Brachioradialis Reflex |
Tells us something about C6 |
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Triceps Reflex |
Tells us something about C7 |
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Tinel Sign |
Designed to illicit pain/tenderness along the nerve (tap along the path of the nerve - symptoms better, worse, or the same - hurts worse is a + Tinel sign... same is - Tinel sign) |
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Neurological Level tests C5 |
Motor: deltoid Reflex: biceps Sensation: lateral upper arm |
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Neurological Level tests C6 |
Motor: Biceps/Wrist Extensors Reflex: Brachioradialis Sensation: Lateral lwer arm, thumb, index finger |
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Compression of Cervical Spine |
Will reduce pain if nerve is compressed - if head tilted, called spurlings test |
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Valsalva Test |
Will increase pain if pt has a disc problem |
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Adson Test |
used to asses subclavian artery as in thoracic outlet syndrome - take pt's radial pulse and as you continue to feel the pulse, abduct, extend, and laterally rotate the arm - then instruct the person to take a deep breath and turn their head toward the arm being examined - if there is compression of the subclavian artery, there will be a significant decrease in the strength of the pulse |
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Neurological control test for upper extremities |
pt stands with arms flexed to 90 degrees with eyes closed - pt is asked to hold this position for 30 seconds - examiner notes drifts outward or downward which may indicate a brain lesion |
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Romberg Test |
pt asked to stand with feet together, arms at side with eyes open - assess balance, then ask pt to close eyes for at least 20 seconds (some suggest 60) - note any balance problems. + = pat sways excessively or falls to one side - a true + Romberg is when the pt falls or loses their balance - suggest a possible lesion involving peripheral nerves or conditions affecting the dorsal columns of the spinal cord |
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Finger-to-nose test |
pt stands or sits with eyes open and is asked to bring the index finger to the nose - test is repeated with eyes closed - repeat several times and at increasing speed |
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Finger-to-thumb test |
oppose each finger to thumb on each hand |
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Hand flip test |
alternately touch back of stationary hand with front and back of test hand fingers |
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Heel-to-knee test |
Heel to opposite knee and down to floor |
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Proprioceptive Movement test |
if pt has the ability to know where their limb is or whether it's moving |
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Proprioceptive position in space test |
if pt has the ability to know where their limb is or whether it's moving |
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Thomas test |
Pt supine near the end of table, flex knees, flatten back and then extend hip so that leg lies flat - tight hip flexors if cannot let legs, lie flat down against table |
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Ober Test |
test for tight TFL - side lying and let test leg adduct down to other leg |
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Drawer's Sign |
Supine with knees flexed and resting on table - test for cruciates (ligamentous laxity) |
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Lachman's Test |
Supine with one knee slightly flexed and resting in examiner's hands - test for cruciates |
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Patellar Tendon Reflex |
Patellar deep tendon reflex (L4) |
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McMurray's Test |
Test for meniscal problem in the knee - supine, flex hip and knee, palpate medially, rotate tibia externally on the femur and extend while applying a valgus stress - reverse for lateral meniscus |
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Apprehension Test for Patellar Dislocation |
supine, attempt to move the patella laterally |
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Patella Femoral grinding test |
supine, push patella distally and then have pt contract quads while providing resistance to the patella |
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Ankle Reflex |
ankle jerk (S1) |
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Neurological level tests L4 |
Motor: Tibialis Anterior (DF and INV) Reflex: Knee Jerk Sensation: Medial aspect of leg |
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Babinski Sign |
Stimulate from heel laterally and across MT medially - positive = flare toes up negative = curl toes down - positive suggests an UMN lesion |
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Straight Leg Raise test |
sciatic or nerve impingement in lower back - supine, relaxed, illicit pain on left side by raising left leg (passive - performed by examiner) - symptoms better, worse or the same - may cause "shooting pain" down the leg - don't confuse with tight hamstrings |
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Test for Hamstring Tightness |
pt supine with hips flexed to 90 degrees and knees flexed fully as well with feet not touching the table - pt is asked to fully extend one knee as much as possible - if that same side knee is flexed more than 20 degrees, the hamstrings are considered tight |
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Hoover Test |
Supine, cup under heels, have pt raise one leg - pt will always push down on other if really trying |
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Patrick or Fabere's Test |
supine, test leg ER with foot resting on opposite knee - compress opposite pelvis and test medial aspect of knee - positive = problems with SI joint |
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Distraction of Cervical Spine |
Trying to illicit any relief from a compressed nerve - slight retraction: better, worse or the same |
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Neurological Level tests C7 |
motor: triceps reflex: triceps sensation: middle finger |
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Neurological Level tests C8 |
motor: thumb extensors no reflex sensation: medial aspect of lower arm |
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Neurological Level tests T1 |
motor: finger ABduction no reflex sensation: medial aspect of the elbow and upper arm |
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Homan's Sign or Test |
To test for DVT - fully dorsiflex the pt's ankle with the knee extended - pain in the calf from this maneuver is a + Homan's sign - tenderness upon deep palpation of the calf muscle is further evidence of a DVT |
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Sharp/Dull Sensation |
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Light touch Sensation |
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True Leg Length Discrepancy |
measure the distance from the left ASIS to the left medial malleolus and compare to the right side of same |
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Valgus and Varus Stress at the Knee |
Valgus: Stress toward other knee (remember "Gum" - knees stick together) Varus: Stress away from opposite knee |
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Phalen's Test |
to test for possible carpal tunnel syndrome - have pt flex both wrists and hold together for at least one minute to see if symptoms are reproduced |
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Neurological control test for lower extremities |
pt sits with legs extended out in front without touching the ground - holds for 20-30 seconds - if drift is noted, suspect a brain lesion |
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Neurological level tests L5 |
Motor: Extensor hallucis longus No reflex Sensation: Dorsum of foot |
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Neurological level tests S1 |
Motor: Peroneals (Eversion) Reflex: ankle jerk Sensation: lateral aspect of foot and lower leg |
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Importance of spine being curved instead of straight |
Provide the vertebral column with more strength and resilience - approx. 10X more than if it were straight |
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Atlas/Axis Landmarks and Characteristics |
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C7 Landmarks and Characteristics |
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Transverse Foramen (Cervical Vertebrae) |
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Costal Facet (Thoracic Vertebrae) |
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Ligaments of the spine:
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Posture - Lateral View |
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Posture - Anterior View |
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Posture - Posterior View |
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Spine
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Scoliosis |
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Longitudinal Arch of Foot |
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Rib hump or spinal Rotation (Scoliosis) |
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Genu Varus vs Genu Valgum |
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Postural sway (anteroposterior displacement of entire body) |
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Muscles that control Lateral Pelvic Tilt |
Hip abductors (mainly the gluteus maximus and minimus), and the trunk lateral benders (erector spinae and quadratus lumborum) |
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Antigravity muscles |
Neck flexors, neck and trunk extensors, trunk flexors, hip extensors, knee extensors |
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Function of the respiratory system |
Main function is to supply oxygen to and eliminate carbon dioxide from the lungs |
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Thoracic Cage
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Diaphragm |
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Costovertebral Articulations and Costal Facets |
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Movement of the thoracic cage and inspiration/expiration |
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Cervical Flexion (Goniometer) |
Axis: Ear Lobe Stationary Arm: Perpendicular to ceiling Moveable Arm: Parallel with base of nose Action: Chin to Chest |
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Lateral Trunk Flexion (Goniometer) |
Axis: S2 Stationary Arm: Perpendicular to floor Moveable Arm: Along spinous processes, pointing toward C7 Action: Slide hand along thigh towards knee |
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Trunk Flexion (Goniometer) |
Tape Measurer: C7 and S2 Action: Take initial measurement with pt standing. Have pt roll forward segmentally without bending at hips - take secondary measurement and subtract first. |
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Cervical Rotation (Goniometer) |
Axis: Top of head Stationary Arm: Parallel with acromion processes Moveable Arm: parallel with nose Action: Pt turns head toward shoulder without rotating shoulders |
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Trunk Extension (Goniometer) |
Tape Measurer: C7 and S2 Action: Take initial measurement with pt standing. Instruct pt to bend backwards without moving hips - take secondary measurement and subtract first. |
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Trunk Rotation (Goniometer) |
Axis: Top of head Stationary Arm: Parallel with PSIS's Moveable Arm: Parallel with Acromion process Action: Pt crosses arms over chest and rotates body without lifting hips off table. |
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Lateral Cervical Flexion (Goniometer) |
Axis: C7 Stationary Arm: Parallel to spinous processes, pointing toward S2 Moveable Arm: midline of skull Action: Pt moves ear toward shoulder on same side |
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Cervical Extension (Goniometer) |
Axis: Ear Lobe Stationary Arm: Perpendicular to ceiling Moveable Arm: Parallel with base of nose Action: Look at ceiling |
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Trunk Flexion (MMT) |
Position: Supine Action: Do a sit up - looking for inferior angle of scapula to leave table 5: Fingertips on ears, knees straight 4: Arms crossed over chest, knees straight 3: Arms down toward side, knees straight 2: Arms down toward side, knees bent 1: Cough |
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Cervical Flexion (MMT) |
Position: Supine Action: Chin to chest, hold |
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Trunk Rotation (MMT) |
Position: Supine Action: Bring arm toward opposite hip 5: Fingertips on ears, knees straight 4: Arms crossed over chest, knees straight 3: Arms down toward side, knees straight 2: Arms down toward side, knees bent 1: Palpation of obliques |
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Cervical Extension (MMT) |
Position: Prone, head off table Action: Lift head up (make sure to provide support in case they are not a 5), hold |
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Cervical Rotation (MMT) |
Position: Supine Action: Move head to both sides - have pt hold ear against bottom palm while you try to turn their head the opposite direction |
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Trunk Extension (MMT) |
Position: Prone Action: Lift chest off table - looking for xiphoid process to come off table 5: Fingertips on ears 4: Hands on lumbar region of back 3: Hands on sacrum region of back 2: Hands down toward side 1: Palpate muscles |
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Sore foot or Antalgic Gait |
Quick release - "Get off it" |
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Weak Dorsiflexors |
Fairly flat foot - toe strike first - equins gait or slow drop foot |
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Weak Plantarflexors |
No toe off phase, flat foot |
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Weak Knee Extensors |
quads - lean forward, knee buckling swing phase - "slap" into extension |
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Weak Hip Flexors |
Use whole body to swing through getting leg in front |
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Weak Knee Flexors |
Hamstrings - knee hyperextends - can't slow down swing phase |
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Weak Hip Extensors |
Glute Max gait - Trunk post rocking horse |
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Weak Hip Abductors |
Glute med - trunk over affected side - trendelenburg |
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Fused Ankle |
Zero movement in affected side - light weight on foot - short steps |
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Fused Knee Joint |
Zero knee flexion/extension - vaulted on opposite side |
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Plantarflexion Contracture |
Tip toe walking - knee could be bent |
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Knee Flexion Contracture |
Knee stuck in flexion with more dorsiflexion or plantar flexion depending on how bad |
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Leg length discrepancy |
Tip toe walking - non side bent compensating |
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Hip Flexion Contracture |
Forward bent, walk on toe, knee bent |
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Spastic Gait - LE are adducted and platarflexed (scissor gait) |
hip adductors are tight, bring foot across midline |
