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183 Cards in this Set
- Front
- Back
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The ligament that extends from the sides of the dens to lateral margins of foramen magnum |
Alar
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Attaches the atlas to the lateral masses of C1 to hold the dens in place
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Transverse
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Name tow diseases that weaken the AA ligaments and cause subluxation
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RA
Down's syndrome |
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The articulation of the superior uncinate process and the superadjacent vertebrae is
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Joints of Lushka
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_________ are superior lateral projections originating from the posterior lateral rim of the vertebral bodies of C3-C7
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Uncinate Processes
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These joints play an important role in cervical sidebending
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Joints of Lushka
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Degeneration or hypertrophy changes in the Joints of Luschka can lead to
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foraminal stenosis and nerve root compression
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The most common cause of cervical nerve root pressure is degeneration of _______ plus _______
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Joints of Luschka plus hypertrophic arthritis
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Motion of occipital condyles on atlas C1
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OA
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C1 motion on C2
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AA
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50% of cervical rotation of cervical spine
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AA
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If AA is rotated right that means that ____ is rotated on _____
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C1 is rotated right on C2
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~ 50% of cervical Flexion/Extension occur
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in OA
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C2-C7 motion
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Rotation and Sidebending to the same side
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For OA motion testing, a right deep sulcus indicates
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left sidebending, which indicates right rotation
B/C sidebending and rotation are opposite in OA |
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In OA translation motion testing, right translation will =
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Force is from left to right= Left sidebending ie Karate chop
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AA rotation motion testing, a right rotated atlas exhibits
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Restriction in left rotation
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C2-C7 translation motion testing is similar to occiput except that you place your fingers on
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Lateral border of articular pillar
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C2-C7 rotational motion testing, you place your fingers over _________. Then rotate the head left and right checking for
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Posterior surface of the articular pillars
Freedom of Resistance |
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An acute injury to the cervical spine is best treated with
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Indirect Fascial Treatment or
Counter Strain |
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Where is the location of pain in cervical foraminal stenosis?
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Pain radiates into the upper extremity
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What is the quality of pain for Foraminal stenosis?
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Dull ache, shooting pain or paresthsias
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What are the signs and symptoms of Cervical Stenosis?
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Positive Spurling's Test=Increased neck pain with Extension
Paraspinal muscle spasm Tenderpoints |
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What is the radiologically finding for cervical foraminal stenosis? AP view?
Oblique? |
Osteophytes formation on AP and Lateral views
Oblique view shows narrowing of intervertebral foramina |
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What OMT treatment should be used for Cervical Foraminal Stenosis?
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ME
FPR, Myofascial release, counterstrain |
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The spinous process is located at the level of the corresponding transverse process
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T1-T3 and T12
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The spinous process is 1/2 a segment below the corresponding
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T4-T6 and T11
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The spinous process is located at one level below
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T7-T9 and T10
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Rules of three: T10 follows same as
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T7-T9
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Rules of three: T11 follows
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T4-T6
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Rules of three T12 follows
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T1-T3
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Spine of scapula
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T3
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Inferior angle of scapula
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spinous process of T7
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The sternal notch
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T2
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The sternal angle attaches _____ rib and is at level _____
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Rib 2 and Level T4
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The main motion of the thorax is
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Rotation
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The motions of the thoracic spine in order
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Rotation> Sidebending> Flexion and Extension
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If the spine is in the neutral position and sidebending is introduced rotation would occur to the
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Opposite side, T5-T10 NRrSL
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Primary muscle of respiration
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Diaphragm
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Contraction of the diaphragm has what affects on blood and lymph?
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causes pressure gradients to help return lymph and blood back to the thorax
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Diaphragm innervation
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C3,4,5
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Intercostal muscles of respiration
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External, Internal, innermost, and subcostal
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What are the secondary muscles of respiration?
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Scalenes
Pec minor Serratus anterior and posterior Quadratus lumborum Latissimus dorsi |
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NAme the landmarks of a typical rib
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Tubercle
HEad Neck Angle Shaft |
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What are the typical ribs
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3-10
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Atypical ribs
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1,2,11,12 sometimes 10
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Why is Rib 1 atypical?
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Articulates only with T1 and no angle
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Why is Rib 2 atypical?
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A large tuberosity on the shaft for serratus anterior
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Why are Rib 11 and 12 atypical?
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Articulate only with vertebrae and lack tubercles
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What are the true ribs?
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Ribs 1-7, attach to the sternum
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What are false ribs?
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Ribs 8-12, do not attach directly to sternum
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What are the floating ribs?
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Ribs 11 and 12
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What are the three classifiactions of rib motion?
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Pump-handle
Bucket-motion Caliper motion |
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Upper ribs motion is
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pump-handle motion
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The middle ribs motion
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bucket handle
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The lower ribs motion
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caliper motion
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An inhalation dysfunction is defined as
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the dysfunctional rib will move cephalad during inhalation but not caudad during exhalation
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The rib will appear "held up"
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Inhalation dys
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Anterior narrowing of intercostal space above dysfunctional rib
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Inhalation
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Superior edge of posterior rib is prominent
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Inhalation dys
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The key rib to treat in inhalation dys
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the lowest rib
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The key rib to treat in exhalation dys
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The highest rib
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Erector spinae group acronym
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I Like Spagetti
Ilocostalis Longisssimus Spinalis |
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The lower ribs motion
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caliper motion
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An inhalation dysfunction is defined as
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the dysfunctional rib will move cephalad during inhalation but not caudad during exhalation
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The rib will appear "held up"
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Inhalation dys
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Anterior narrowing of intercostal space above dysfunctional rib
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Inhalation
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Superior edge of posterior rib is prominent
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Inhalation dys
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The key rib to treat in inhalation dys
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the lowest rib
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The key rib to treat in exhalation dys
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The highest rib
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Erector spinae group acronym
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I Like Spagetti
Ilocostalis Longisssimus Spinalis |
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The intervertebral disc level at the level of iliac crest
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L4-L5
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T10 dermatome at umbilicus which is anterior to ________disc
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L3 and L4
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A bony deformity where one or both of the transverse processes of L5 articulate with sacrum
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Sacralization
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Failure of fusion of S1 with other sacral
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Lumbarization
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A developmental anomaly with a defect in the closure of lamina of vertebral segment
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Spina Bifida
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No herniation thru the defect with course of patch hair over the site
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Spina Bifida occulta
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Herniation of the meninges thru the defect
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Spina bifida meningocele
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Herniation of the meninges and the nerve thru the defect. Assoc. w/ neurological deficits.
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Spina bifida meningomyelocele
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The major motion of lumbar spine
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Flexion/extension
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What is the alignment of the facets the major motion of the lumbar spine is F/E
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Backward and medial for the superior
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The lower ribs motion
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caliper motion
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An inhalation dysfunction is defined as
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the dysfunctional rib will move cephalad during inhalation but not caudad during exhalation
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The rib will appear "held up"
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Inhalation dys
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Anterior narrowing of intercostal space above dysfunctional rib
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Inhalation
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Superior edge of posterior rib is prominent
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Inhalation dys
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The key rib to treat in inhalation dys
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the lowest rib
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The key rib to treat in exhalation dys
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The highest rib
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Erector spinae group acronym
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I Like Spagetti
Ilocostalis Longisssimus Spinalis |
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The intervertebral disc level at the level of iliac crest
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L4-L5
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T10 dermatome at umbilicus which is anterior to ________disc
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L3 and L4
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A bony deformity where one or both of the transverse processes of L5 articulate with sacrum
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Sacralization
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Failure of fusion of S1 with other sacral
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Lumbarization
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A developmental anomaly with a defect in the closure of lamina of vertebral segment
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Spina Bifida
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No herniation thru the defect with course of patch hair over the site
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Spina Bifida occulta
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Herniation of the meninges thru the defect
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Spina bifida meningocele
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Herniation of the meninges and the nerve thru the defect. Assoc. w/ neurological deficits.
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Spina bifida meningomyelocele
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The major motion of lumbar spine
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Flexion/extension
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What is the alignment of the facets the major motion of the lumbar spine is F/E
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Backward and medial for the superior
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The lumbosacral angle is formed by the intersection of
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Horizontal line
Line of inclination of the sacrum |
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Acute back pain may be caused due to
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Fracture, recent strain or disc herniation, an infection, or referred pain
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Due to narrowing of the ________ postriolateral herniation of intervertebral disc a common problem
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longitudinal ligament
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Location of pain for herniated disc
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lower back and lower leg
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Numbness and tingling may be sharp burning, shooting down the leg
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Herniated nusleus pulposus
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What are the signs and symptoms of herniated disk
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Weakness and Decreased
Sensory deficit over corresponding dermatome + Straight leg raise test |
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Psoas syndrome organic causes
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1. Appendicitis
2. Sigmoid colon dysfunction 3. Ureteral calculi 4. Ureter dysfunction 5. Metastatic carcinoma of the prostate 6. Salpingitis |
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Increased pain when standing or walking, + Thomas test, tenderpoint medial to ASIS, nonneutral L1 or L2, + pelvic shift test to the contralateral
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Psoas Syndrome
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A flexion contracture of iliopsoas is often associated with a
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Nonneutral dysfunction L1 or L2
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Anterior displacement of one vertebrae in relation to the one below
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Spondylolisthesis
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Most often site for Spondylolisthesis
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L4 and L5
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What is the cause of Spondylolisthesis?
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Fatigue fractures in pars interarticularis
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What is the radiologically finding of Spondylolisthesis?
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Forward displacement of one vertebrae on another grades 1-4
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Grading of Spondylolisthesis
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Grade 1= 0-25%
Grade 2= 25-50 Grade 3= 50-75 Grade 4 = >75 |
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A defect of pars interarticularis w/o anterior displacement of the vertebral body.
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Spondylolysis
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Oblique X-ray shows Scotty dog
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Spondylolysis
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What X-ray view reveals spondylolysis
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Oblique view shows scotty dog with a collar
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A radiographical term used for degenerative changes within the intervertebral disc and ankylosing adjacent vertebrae
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Spondylosis
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What is the Tx for Spondylolisthesis?
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Reduce lumbar lordosis
No HVLA |
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Curve that is sidebent left = ____scoliosis
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Right scoliosis=dextroscoliosis
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Curve sidebent right = ______ scoliosis
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Left scoliosis= levoscoliosis
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Measure scoliotic curves use
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Cobb Angle
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Cobb angle
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X-ray films:
1. draw horizontal lines from the vertebrae involved 2. Draw perpendicular lines from these horizontal line and measure the acute angle |
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Mild scoliosis =
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5-15
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Moderate Scoliosis
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20-45
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Severe Scoliosis
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>50
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Respiratory function is compromised if scoliosis curve is greater than
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50
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CV function is compromised if thoracic curve is greater
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75
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Most common cause of scoliosis
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Idiopathic
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Konstancin exercises
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Tx for Mild Scoliosis
A series of exercise that improve scoliotic curve |
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Tx for Moderate Scoliosis
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OMT, Konstancin, and PT + spinal orthotic
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Tx for Severe Scoliosis
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Surgery
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A short keg syndrome results in
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Sacral base unleveling
Vertebral sidebending and rotation Innominate rotation |
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The most common cause of short leg syndrome
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Hip replacement
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What is the Tx for short leg syndrome?
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OMT directed toward the spine and lower extremity, if leg length still exist get a standing X-ray and consider a heel lift if femoral head diff is >5mm
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Pneumonic for rotator cuff muscles
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SITS:
Supraspinatus Infraspinatus Teres Minor Subscapularis |
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Shoulder muscle: Abduction of Arm
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Supraspinatus
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External Rotation of Arm
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Infraspinatus
Teres Minor |
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Internal Rotation of Arm
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Subscapularis
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Primary flexor of shoulder/arm
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Deltoid( Anterior Portion)
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Primary abductor of shoulder
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Deltoid middle portion
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Primary extensors of shoulder
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Latissimus dorsi, Teres Major, Deltoid
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Primary adductors of shoulder
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Pectoralis major, latissimus Dorsi
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Primary External rotators of shoulder
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Infraspinatus, Teres Minor
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What is the Tx for short leg syndrome?
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OMT directed toward the spine and lower extremity, if leg length still exist get a standing X-ray and consider a heel lift if femoral head diff is >5mm
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Pneumonic for rotator cuff muscles
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SITS:
Supraspinatus Infraspinatus Teres Minor Subscapularis |
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Shoulder muscle: Abduction of Arm
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Supraspinatus
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External Rotation of Arm
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Infraspinatus
Teres Minor |
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Internal Rotation of Arm
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Subscapularis
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Primary flexor of shoulder/arm
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Deltoid( Anterior Portion)
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Primary abductor of shoulder
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Deltoid middle portion
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Primary extensors of shoulder
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Latissimus dorsi, Teres Major, Deltoid
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Primary adductors of shoulder
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Pectoralis major, latissimus Dorsi
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Primary External rotators of shoulder
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Infraspinatus, Teres Minor
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Primary Internal Rotator of shoulder
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SIT:
Subscapularis Infraspinatus Teres minor |
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Most common dys of SC joint
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Clavicle, anterior and superior on sternum
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What three ligs. stabilize the AC joint?
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AC ligament
Coracoacromial lig Coracoclavicular lig |
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The most common somatic dys at the AC joint
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Clavicle, superior and lateral on the acromion
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Compression can occur at what three places in TOS?
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1. Tween anterior and middle scalenes
2. Tween clavicle and first rib 3. Tween pectoralis minor and upper ribs |
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______ ligament divides the greater and lesser sciatic foramen
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Sacrospinous ligament
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Physiologic axes of the sacrum and innominates Pneumonic
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DRIP:
D=Dyanmic R=Respiratory I= Inherent/Innominate P = Postural |
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LOL/ROR is aka _______ sacral torsion and is N or NN
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Forward/ anterior and Neutral Mechanics
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LOR/ROL is aka _______ sacral tosion and is N or NN
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Backward/Posterior and NN
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Posterior pole of sacrum is always the side of ______
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Rotation: e.g IP is posterior on the left then LOL
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When to use indirect techniques?
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Acute painful sit
Hospitalized pts Metastatic CA Arthritits Osteoporosis Autoimmune |
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Umbilicus landmark is
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L3-L4
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Spine of scapula is
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T3/4
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Superior angle of scapula is
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T2
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A tenderpoint is
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Tender points are small tense edematous areas of tenderness 2-3mm
DO NOT RADIATE |
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What is a trigger point?
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Small tense hypersensitive areas
They RADIATE PAIN |
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What is Chapman Reflex?
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Small, Smooth, Firm, Discreet
~2-3 mm in diameter Predictable anterior and posterior fascial TART assumed to be visceral disease |
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What are the common weakened muscles in TOS?
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Serratus Anterior
Middle Trapezius/Rhomboids Lower Trap |
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Decreased ROM that consistently gets worse over one year.
Extension is preserved |
Frozen shoulder
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Internal rotation and adduction limited with
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Tight Anterior CApsule: Apply's Scratch Test
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What test is used for chronic anterior displaced GH?
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Apprehension
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Tender point Superior Medial of Coracoid?
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Extend abduct and internally rotate
Medial Coracoid |
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Supraspinatus TP Tx
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F ABD ER
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Infraspinatus TP Tx
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F IR adb
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Tendetpoint lies along the superior angle of the scapula
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Levator scapula
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Group of muscles associated with type II mechanincs
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Rotatores
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Direct HVLA for Abduction Lesion
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Apply traction and carry wrist into ABDUCTION
Apply HVLA in ADDUCTION |
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Anterior Cervical Fasica:Engage the scalenes with
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Medial and Inferior Pressure
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Teres Minor technique Tx
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Contact the Teres Minor and carry it superiorly, medially, and slightly anteriorly
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Coracobrachialis Tx Anterior technique
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Engage anterior shoulder and direct posterior and slightly medial
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