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74 Cards in this Set
- Front
- Back
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shape of occipital condyles and condyles of C1 are shaped how?
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to allow motion in flextion and extension (O/A)
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what limits flexion range?
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anterior protion of C1-bowl shaped; anterior margins approximated to form wedge shape
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where does weight of head sit on atlas?
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on lateral masses
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what is significant about atlas?
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no spinous processes
no body |
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what weight is on dens?
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none
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what kind of motion is A/A?
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mostly rotation, 50% of spine rotation
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what ligament croses over the dens to support in place?
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transverse ligament-part of cruciate ligament
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what is important about A/A synovium?
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it exists and can lead to arthritis of this articulation
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what is motion of C2 on C3?
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typical like rest of C vert (C2-C7)
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what is importance of transverse ligament?
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essential to prevent damage to spinal cord
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when might you see rupture of transverse ligament?
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weakend state
*rheumatoid arthritis *down's syndrome *traumatic injuries such as fracture |
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name the 3 components of transverse ligament
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superior longitudinal band
transverse ligament of atlas inferior longitudinal band |
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where are Alar ligaments?
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strong bundles of fibrous tissues
attachemtn from dens-->medial aspect of occipital condyles |
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what is special about C1/C2?
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atypical bodies
atypical articulations |
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what are supportive lateral joints?
what do they do? |
joints of Lushka (uncinate process)
restrict sidebending reduce risk of herniated nucleus pulposus |
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what does anterior longitudinal ligament do?
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prevents hyperextension
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attachments of anterior longitudinal ligament
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on anterior aspect of vertebral bodies from atlas-->sacrum
attaches superiorly to anterior arch of atlas and anterior atlanto-occipital membrane |
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attachments of posterior longitudinal ligament
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tectorial membrane (occipital-axial ligament) at base of skull-->each vert-->sacrum
narrows as it moves lower |
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number of cervical nerves?
location? |
8
come out above vertebral body *no disc between C1 and C2 |
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where do C5-T1 rami pass?
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between anterior and middle scalene muscles
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importance of axillary artery?
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name cords of brachial plexus according to relative position
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final function of spinal nerves?
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dermatomes--sensation
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superficial posterior muscles of Cspine? (3)
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trapezius
erector spinae group levator scapulae |
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trapezius
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CN XI
stabilizes, elevates scapula most superficial |
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levator scapulae
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elevates medial scapula, rotates medially
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intermediate posterior muscles of C Spine? (2)
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splenius cervicis
splenius capitis |
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deep posterior muscles of Cspine? (8)
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iliocostalis cervicis, longissimus (cervicis/capitis), spinalis cervicis, semispinalis (cervicis, capitis), multifidus, rotatores
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anterior muscles and flexors of neck? (6)
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scalenes, SCM, platysma, hyoid, longus colli, longus capitis
attach the sternum to hyoid/hyoid to skull |
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action of scalenes
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lateral stabilizers, sidebend neck to same side
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action of SCM
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flexes and rotates the head to opposite side
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gross cervical ranges of motion
flexion/extension lateral flextion (SB) rotation |
F/E: 130 degrees
SB: 35 and 35 degrees Rot.: 80-90 degrees R and L |
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what do these have in common?
hx of trauma, fall, sports injury, tumor, radiculopathy |
reasons to use caution on exam
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path of vertebral artery
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through vertebral foramen, join to form basilar artery
*may become occulded by thrombosis |
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C0/C1 atypical mechanics
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rotate and sidebend opposite with rotation/extension
*note: non neutral but opposite |
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C1/C2 atypical mechanics
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pure rotation, no sidebending
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C2-C7 mechanics
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typical; sidebending and rotation in same direction but can be in opposite direction
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what does right lateral translation produce?
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left sidebending
force came from left-->right |
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what does left lateral translation produce?
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right sidebending
force from right-->left |
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lateral translation naming?
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named for freer motion
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OA
main motion sidebending and rotation |
flexion and extension
opposite sides |
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AA
main motion sidebending and rotation |
rotation
opposite sides |
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C2-C4
main motion sidebending and rotation |
rotation
same sides |
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C5-C7
main motion sidebending and rotation |
sidebending
same sides |
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occiput on atlas reveals restriction in R lateral translation in extended position. what is DX?
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FRLSR
R lateral trans. causes L sidebending (which is restricted); freer in R sidebeing; restricion in extension also means freer in flexion. OA will rotate/sidebend opposite directions... |
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+ttp of the left cervical transverse process at C4. translation to R is restricted in flexion
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C4ERSr
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qualities of indirect OMM
and action |
passive, relaxing, "laid back"
-rebalances tissue by calming down mechanoreceptors in fascia and muscle tendon receptors |
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The Barrier Concept
position of motion |
AWAY from restrictive barrier into position of free motion
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what is created?
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new neutral point or center of range of motion
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clinical application of barrier concept
(3) |
-rebalance of mechanoreceptors/adaptations
-diagnoses a maladapted patters; moves fasciea reducing strain patterns; reduces mechanoreceptor protective reflexes by positioning to a position of balance or ease -very effective in acute and painnful somatic dysfunction as well as inflammatory pathological conditions (puts in position of comfort) |
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definition of fascia
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dense regular CT in layers
-all CT of the body that has supportive FUNCTION (ligaments, tendons, dural membranes, linings of body cavities) |
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3 main types of fascia
+ specialized |
superficial
deep subserous DURA--specialized **has mechano and propriocepteors... |
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Structure of fascia
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elastic
collagen ground substance specialized mechanoreceptors-proprioceptors and nociceptors |
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functions of fascia (6)
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support of nerves/vessels
compartmentalization continuity immune system sensory motor |
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Relationship of fascia to somatic dysfunction
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irritant-->macrophages activated-->increased vascularity-->increased fibroblastic activity-->increase production of CT-->increased myofibrotic activity (tissue shrinks)-->shrinkage of CT-->abn. movement
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Myofascial Release definition
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engagement of continual palpatory feedback to achieve release of myofascial tissues
(A.T.Still and students; later R. Ward) |
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Indirect Myofascial Release
-actions/characte ristics |
gentle; no activation of nociceptive pathways
-dampens down mechanoreceptors in system by reflex inhibition and mechanical relaxation or strain patterns in proprioceptive system |
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indirect myofascial release good for...
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spasm, pain, inflammation as it relaxes and decongests tissue and promotes healing
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how indirect myofascial release works
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relaxes strain patterns in peripheral snesory system--> reduces proprioceptor and nociceptor signal; assists in the removal of the chemical mediators present and muscle guarding reflexes
--resultant improvement in local vascular and interstitial circulation to help above action and in healing |
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muscular components of indirect techniques (5)
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maintenance of postures
movement agonist-antagonist principle neuromuscular reflexes intimately associated with fascia |
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POE(T) technique
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-point of entry into musculoskeletal system
-traction & twist into or away from barrier -hold and wait (~20 S) -release slowly |
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CREEP (and other engineery terms)
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basis of how myofascial release works!
(engineering terms as lots of these terms were by Dr. R. Ward) -chronic warping b/c of bad positioning *piezoelectric phenomenon: mechanical stress transformed into electrical potentials -can be direct or indirect force applied into fascia |
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strain-counterstrain definition
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if there is a dysfunctional area there is a tender point associated with it. put pt in most relaxed position to turn this point off.
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disadvantages of myofascial release
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takes skill, concentration, knowledge of fucntional anatomy
-takes time; about 50S often for chronic somatic dysfunction areas treated -may not work on subluxation sites; chronic sites with fibrosis or where direct mechanical forces needed more than neuromusculoskeletal receptors |
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Strain Counterstrain OMT
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-one of most significant OMT useable
-safe, therapeutic, can be diagnostic--good in ED or hospital - |
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basic strain counterstrain treatment
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make an acute somatic dysfucntion and adaptive positions exaggerated in patterning
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position of counterstrain
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away from barrier to point of comfort (often position of injury)
-make crooked--crookeder; if they are bent over have them bend over further |
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Lawrence H. Jones
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-accidentally discovered strain-counterstrain in Ontario, Or 1955
-collaborated with Dr. J. Travell M.D. for work on myofascial pain syndromes |
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current models of strain counterstrain explanation
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Drs. Frank Willard, Edward Goering, Richard Van Buskirk et al using Nociceptive and Proprioceptive models
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Korr's contribution to strain/counterstrain
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separately explained how strain counterstrain worked using muscle spindle
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Agonist-Antagonist Muscles
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A: originally strained muscle
B: reflexly shortened muscle registering false and continuing message of strain (a visceral somatic reflex source) |
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STRAIN
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-injury to a joint; unable to return to normal position b/c inhibited by muscular tension
-this muscular tension prevents further movement toward the barrier; does not preclude movement in direction of free motion -both agonists and antagonists are affected |
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characteristic of tenderpoints
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SENSORY
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direction of counterstrain thinking
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directed to the neuromuscular reflexes rather than the tissue stresses
-requires monitoring tender points |
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definition of strain counterstrain in terms of muscle therapy (antagonist/agonist)
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indirect form of OMT that strains antagonist muscle and relaxes agonist muscle in case of injury
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