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312 Cards in this Set
- Front
- Back
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the point at which a patient can actively move any given joint
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physiologic barrier
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a point at which a physician can passively move any given joint
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anatomical barrier
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a restrictive barrier lies before or after the physiological barrier???
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before
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TART
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tissue/texture change
asymmetry restriction tenderness |
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Fryette's Law I
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If the spine is in a neutral position and sidebending is introduced, rotation will occur to the opposite side.
This applies to a group of vertebrae. |
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Fryette's Law II
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If spine is in a nonneutral position - flexed or extended, sidebending and rotation occur on the same side.
This applies to one vertebral segment. |
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For a neutral spine, which precedes: sidebending or rotation?
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Sidebending (N SL RR)
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For a nonneutral spine, which precedes: sidebending or rotation?
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Rotation (F RR SL)
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Fryette's laws apply to which vertebral segments?
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thoracic and lumbar
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Fryette's Law III
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If you move a segment at one plane, it changes the movement at other planes.
If excessive motion occurs in one vertebrae, you say that it occurs on the vertebrae below it. ("motion of L2 on L3") |
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If a segment gets better in flexion, then it is...
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Flexed
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If a segment gets worse in flexion, then it is likely it is...
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Extended
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Cervical superior facet orientation
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backward, upward, medial (BUM)
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Thoracic superior facet orientation
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backward, upward, lateral (BUL)
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Lumbar superior facet orientation
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backward, medial (BM)
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Motion of flexion/extension occurs in the _?_ axis and on the _?_ plane?
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transverse axis and sagittal plane
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Motion of rotation occurs in the _?_ axis and on the _?_ plane?
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vertical axis and transverse plane
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Motion of sidebending occurs in the _?_ axis and on the _?_ plane?
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anterior-posterior axis and coronal plane
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muscle contraction that results in the approximation of the muscle's origin and insertion without a change in its tension
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isotonic contraction
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muscle contraction that results in the increase in tension without an approximation of origin and insertion
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isometric contraction
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muscle contraction against resistance while forcing the muscle to lengthen
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isolytic contraction
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muscle contraction that results in the approximation of the muscle's origin and insertion
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concentric contraction
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lengthening of the muscle during contraction due to an external force
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eccentric contraction
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Direct or indirect? and Active or passive?
1. Muscle energy 2. Counterstrain |
1. ME = direct and active
2. CS = indirect and passive |
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Dose and frequency for pediatrics vs geriatric...
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Pediatric patients can be treated more frequently and geriatric patients should be given a longer time to respond to treatment before giving another treatment.
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Articular pillars are located...
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Articular pillars are located posterior to the cervical transverse processes
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Attachment of the anterior, middle and posterior scalenes...
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Anterior and middle scalene insert on rib 1.
Posterior scalene inserts on rib 2. They help elevate the ribs upon inhalation. |
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Sternocleidomastoid motion
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Unilateral contraction results in ipsalateral sidebending and contralateral rotation. (sidebend toward and rotate away).
Bilateral contraction results in flexion. |
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Shortening or restrictions within the sternocleidomastoid often result in _?_.
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torticollis
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Rheumatoid arthritis and Down's syndrome can weaken these ligaments leading to atlanto-axial subluxation, which could eventually cause a rupture and thus catastrophic neurological damage.
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alar ligaments and transverse ligament
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the Joint of Luschka is the articulation between...
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the uncinate process and the superadjacent vertebrae
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the most common cause of cervical nerve root pressure is the degeneration of what?
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the joints of Luschka
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Primary motion of the OA is....
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flexion and extension
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Primary motion of the AA is...
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rotation
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right translation of a cervical vertebrae is indicative of right or left sidebending?
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left
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If the OA is sidebent left, it is rotated...
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right
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If the AA is sidebent right, it is rotated...
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left
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main motion C2-C4
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rotation
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main motion C5-C7
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sidebending
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if a cervical vertebrae from C2 down is rotated left, then it is sidebent...
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right
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what do you stabilize to detect occipital rotation?
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arch of the atlas
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what do you use to determine sidebending at the OA?
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depth of the occipital sulci
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Flexing the neck to a 45 degree angle will enable motion testing of _?_.
How? |
Rotation of the AA by locking out rotation of C2-C7
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where do you place your fingertips for testing translation of C2-C7?
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articular pillars
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when you push directly anterior against the lateral mass of a C2-C7 vertebrae while supporting the head, what are you testing?
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rotation
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The spinous processes of what thoracic vertebrae are located at the level of the corresponding transverse vertebrae?
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T1-T3, T12
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The spinous processes of what thoracic vertebrae are located one-half a segment below the corresponding transverse vertebrae?
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T4-T6, T11
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The spinous processes of what thoracic vertebrae are located at the level of one transverse vertebrae below?
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T7-T9, T10
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The spine of the scapula corresponds with what vertebrae?
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T3
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The inferior angle of the scapula corresponds with what vertebrae?
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T7
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The sternal notch is at the level of what vertebrae?
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T2
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The sternal angle (the angle of Louis) attached to the what rib and is at level with which vertebrae?
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2nd rib, T4
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The nipple is at what dermatome?
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T4
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The umbilicus is at what dermatome?
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T10
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The main motion of the thorax is?
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rotation
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2 actions of the diaphragm?
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1. contracts with inspiration
2. causes pressure gradients to help return lymph and venous blood back to the thorax |
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attachments of the diaphragm?
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xyphoid process, ribs 6-12 on either side, and the bodies & intervertebral discs of L1-L3
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Innervation of the diaphragm?
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Phrenic nerve (C3-C5)
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2 actions of the intercostals?
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1. elevate the ribs during inspiration
2. prevent retractions during inspirations |
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Secondary muscles of respiration
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scalenes, pectoralis minor, serratus anterior & posterior, quadratus lumborum and latissimus dorsi
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5 landmarks of a typical rib
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head, neck, angle, shaft, tubercle
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typical ribs
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ribs 3-10
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atypical ribs
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1, 2, 11, and 12
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true ribs
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ribs 1-7
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false ribs
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ribs 8-12
(ribs 11 and 12 are floating) |
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Pump-handle motion applies to which ribs?
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ribs 1-5
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Bucket-handle motion applies to which ribs?
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ribs 6-10
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Caliper motion applies to which ribs?
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ribs 11 and 12
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Which rib is the "key" rib in an exhalation dysfunction?
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uppermost rib
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Which rib is the "key" rib in an inhalation dysfunction?
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lowermost rib
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An exhalation dysfunction, means the rib does not..?
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move cephalad during inhalation (inhalation restriction)
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what causes the weakness in the lumbar spine that makes the lumbar spine more susceptible to disc herniations?
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the narrowing of the posterior longitudinal ligament
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where does the nerve root exit in the thoracic and lumbar region?
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the intervertebral foramen below its corresponding vertebrae
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muscles that make up the erector spinae group
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iliocostalis, longissimus, spinalis
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origin and insertion of the iliopsoas
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O: T12-L5 vertebral bodies
I: lesser trochanter of the femur |
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action of the iliopsoas
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primary flexor of the hip
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somatic dysfunction of the iliopsoas is usually precipitated from..?
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prolonged shortening of the muscle
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signs/tests of iliopsoas somatic dysfunction...?
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pelvic side shift, a positive Thomas test, and somatic dysfunction of an upper lumbar segment
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The iliac crest is at the level of which vertebrae?
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L4-L5
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The T10 dermatome at the umbilicus is directly anterior to which vertebrae's intervertebral disc?
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L3 and L4
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an asymmetry of the facet joint angles, where facets that are usually in the sagittal plane (backwards and medial) are more aligned in the coronal plane
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facet trophism
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the most common anomaly of the lumbar spine that may predispose to early degenerative changes
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facet trophism
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a bony deformity in which one or both of the transverse processes of L5 are long and articulate with the sacrum; may lead to early disc degeneration
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sacralization
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most often occurs from the failure of fusion of S1 with the other sacral segments
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lumbarization
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the only physical sign of this anomaly is a course patch of hair over the site; no herniation; rarely associated with neurological defects
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spina bifida occulta
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a herniation of the meninges through the defect
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spina bifida meningocele
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a herniation of the meninges and the nerve root through the defect; associated with neurological deficits
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spina bifida meningomyelocele
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major motion of the lumbar spine
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flexion and extension
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2 ways in which the motion of the L5 will influence the motion of the sacrum...?
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1. sidebending of L5 will cause the sacral oblique axis to be engaged on the same side
2. rotation of L5 will cause the sacrum to rotate to the opposite side |
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ferguson's angle?
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intersection of a horizontal line with the line of inclination of the sacrum; usually between 25-35 degrees
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which is more common: acute or chronic causes of low back pain?
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chronic
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location of low back pain
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low back, buttock, posterior lateral thigh
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quality of back pain
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ache, muscle spasm
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signs and symptoms of low back pain
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increased pain with activity or prolonged sitting/standing, increased muscle tension
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the vast majority of disc herniations occur between which vertebrae
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L4 and L5 or L5 and S1
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a herniated disc in the lumbar region will exert pressure on which nerve root?
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the one below
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herniated disc pain location
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low back and lower leg
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quality of herniated disc pain
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numbness and/or tingling which may be accompanied by sharp burning and/or shooting pain, which worsens with flexion of the lumbar spine
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weakness and decreased reflexes associated with the affected nerve root; sensory deficit over the affected nerve root and positive straight leg raising test
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herniated disc signs and symptoms
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gold standard radiology for herniated disc?
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MRI
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HVLA for herniated disc?
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NO
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this often is precipitated from prolonged positions that shorten the psoas
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psoas syndrome or flexion contracture of the psoas
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organic causes of psoas syndrome...
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appendicitis, sigmoid colon dysfunction, ureteral calculi, ureter dysfunction, metastatic carcinoma of the prostate, salpingitis
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low back pain that can radiate to the groin
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psoas syndrome
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increased pain when walking or standing, positive Thomas test, tenderpoint medial to the ASIS, nonneutral dysfunction of L1 or L2, positive pelvic shift test to the contralateral side, sacral dysfunction on an oblique axis and contralateral piriformis spasm
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psoas syndrome
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heat or ice to treat psoas syndrome
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ICE to decrease pain and edema
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narrowing of the spinal canal or intervertebral foramina usually due to degenerative changes, causing pressure on nerve roots (or rarely the cord)
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spinal stenosis
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1. hypertrophy of the facet joints
2. calcium deposits within the ligamentun flavum and the posterior longitudinal ligament 3. loss of intervertebral disc height |
pathogenesis of spinal stenosis
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location of pain in spinal stenosis
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low back to lower leg or legs
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worsened by extension as when standing, walking or lying supine
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spinal stenosis
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radiology for spinal stenosis
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foraminal narrowing seen on oblique views
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anterior displacement of one vertebrae in relation to the one below
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spondylolisthesis
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spondylolisthesis usually occurs at which vertebrae?
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L4 or L5
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spondylolisthesis is usually due to...?
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fatigue fractures in the pars interarticularis of the vertebrae
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increased pain with extension-based activities, tight hamstrings bilaterally, stiff-legged, short-stride, waddling type gait, positive vertebral step-off sign, neuro deficits
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spondylolisthesis
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radiology for spondylolisthesis
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forward displacement of one vertebrae on another seen on lateral films
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HVLA with spondylolisthesis
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NO
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a defect usually of the pars interarticularis without anterior displacement of the vertebral body
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spondylolysis
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radiology of spondylolysis
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oblique views will identify the fracture of the pars interarticularis; often seen as a "collar" on the neck of a spotty dog
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pressure on the nerve roots of the cauda equina usually due to a massive central disc herniation
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cauda equina syndrome
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sharp pain, saddle anesthesia, decreased DTRs, decreased rectal sphincter tone, loss of bowel and bladder control
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cauda equina
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treatment for cauda equina
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emergent surgical decompression; if this is prolonged, irreversible paralysis may occur
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T or F, according to Fryette's laws any sidebending will automatically induce rotation
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true
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scoliosis occurs more in females or males?
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females; 4:1
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curve that is sidebent to the left, means its a _?_ scoliosis...
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scoliosis to the right = dextroscoliosis
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a spinal curve that is relatively fixed and inflexible. it will not correct with sidebending in the opposite direction. it is associated with vertebral wedging and shortened ligaments and muscles on the concave side of the curve.
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structural curve
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a spinal curve that is flexible and can be partially or completely corrected with sidebending to the opposite side.
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functional curve
*can progress to a structural curve |
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spinal curves measured on x-rays using this method to show the degree of scoliosis
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Cobb Angle
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Cobb angles for mild, moderate and severe scoliosis
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mild - 5-15 degrees
moderate - 20-45 severe - >50 respiratory function compromised if the angle is over 50 degrees, and CV function compromised if angle is over 75 degrees |
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the innominate is composed of which three bones
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ilium, ischium and pubis bones
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true pelvic ligaments
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anterior, posterior, and interosseous sacroiliac ligaments
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accessory pelvic ligament; originates at the inferior lateral angle and attaches to the ischial tuberosity
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sacrotuberous ligament
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accessory pelvic ligament; originates at the sacrum and attaches to the ischial spines; this ligament divides the greater and lesser sciatic foramen
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sacrospinous ligament
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originates from the transverse processes of L4 and L5 and attaches to the medial side of the iliac crest; it is often the ligament to become painful in lumbosacral decompensation
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iliolumbar ligament
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muscles that make up the pelvic diaphragm
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levator ani and coccygeus muscles
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secondary pelvic muscles; partially attach to the true pelvis
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iliopsoas, obturator internus, piriformis
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the sciatic nerve is likely to run through which muscle?
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piriformis
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the innominate rotates around the sacrum during the walking cycle about which axis?
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inferior
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respiratory motion of the sacrum; occurs about which axis? and moves in which direction during breathing?
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occurs about the superior transverse axis, ~S2
during inhalation, the sacral base moves posterior during exhalation, the sacral base moves anterior |
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inherent or craniosacral motion of the sacrum; occurs about which axis? and moves in which direction in response to craniosacral flexion or extension?
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motion occurs about the superior transverse axis
during craniosacral flexion, the sacral base rotates posteriorly or counternutates during craniosacral extension, the sacral base rotates anteriorly or nutates |
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define counternutation
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the posterior rotation of the sacral base that occurs during craniosacral flexion
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define nutation
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the anterior rotation of the sacral base that occurs during craniosacral extension
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four types of sacral motion?
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respiratory, craniosacral, postural, and dynamic
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postural motion occurs about which axis? and moves in which direction?
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occurs about the middle transverse axis of the sacrum; as the person begins to bend forward, the sacral base moves anteriorly; at terminal flexion, the sacrotuberous ligaments become taut and the sacral base will move posteriorly
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when and how does dynamic motion occur?
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motion that occurs during ambulation; as weight bearing shifts from one side to the other while walking, the sacrum engages two sacral oblique axes; weight bearing on one leg causes the sacral axis on the same side to become engaged
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in sacral torsions, L5 will rotate in which direction in relation to the sacrum?
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opposite
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which somatic dysfunction of the sacrum is common in post-partum patients?
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bilateral sacral flexion
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somatic dysfunction of the innominates and sacrum:
one innominate will rotate anteriorly compared to the other; rotation occurs about the inferior transverse axis of the sacrum |
anterior innominate rotation
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to determine the positive side of an innominate dysfunction...
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the side of the positive standing flexion test is the side of the dysfunction
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somatic dysfunction of the innominates and sacrum:
one innonimate will rotate posteriorly compared to the other; rotation occurs about the inferior transverse axis of the sacrum |
posterior innominate rotation
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somatic dysfunction of the innominates and sacrum:
one innominate slips superiorly compared to the other |
superior innominate shear
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somatic dysfunction of the innominates and sacrum:
one innominate slips inferiorly compared to the other |
inferior innominate shear
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somatic dysfunction of the innominates and sacrum:
condition in which the pubic bone is displaced either superiorly or inferiorly compared to the other |
superior/inferior pubic shear
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somatic dysfunction of the innominates and sacrum:
a condition where the innominate will rotate medially |
innominate inflare
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somatic dysfunction of the innominates and sacrum:
a condition where the innominate will rotate laterally |
innominate outflare
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3 rules of sacral torsion
1. L5 sidebent... 2. L5 rotated... 3. seated flexion test findings... |
1. when L5 is sidebent, a sacral oblique axis is engaged on the same side as sidebending
2. when L5 is rotated, the sacrum rotates the opposite way on the oblique axis 3. the seated flexion test is found on the opposite side of the oblique axis |
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In sacral torsion, L5 is sidebent to the same/opposite? side as the engaged oblique axis of the sacrum?
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same
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In _?_ sacral torsion, the rotation is on the same side of the axis...
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forward
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In _?_ sacral torsion, the rotation is on the opposite side of the axis..
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backward
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A positive backward bending test and a positive spring test indicate...
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backward sacral torsion
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somatic dysfunction of the innominates and sacrum:
if L5 is rotated to the same side as the sacrum... |
sacral rotation on an oblique axis
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somatic dysfunction of the innominates and sacrum:
the entire sacral base moves anterior about a middle transverse axis |
bilateral sacral flexion
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somatic dysfunction of the innominates and sacrum:
the entire sacral base moves posterior about a middle transverse axis |
bilateral sacral extension
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somatic dysfunction of the innominates and sacrum:
the sacrum shifts either anteriorly or posteriorly around a transverse axis |
right or left unilateral sacral flexion or extension
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rotator cuff muscles and their actions
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Supraspinatus - abduction of the arm
Infraspinatus - external rotation of the arm Teres minor - external rotation of the arm Subscapularis - internal rotation of the arm |
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deltoid action of the shoulder
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anterior portion - flexor
middle portion - abductor posterior portion - extensor |
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latissimus dorsi action of the shoulder
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extensor and adductor
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teres major action of the shoulder
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extensor
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teres minor action of the shoulder
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external rotator
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infraspinatus action of the shoulder
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external rotator
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subscapularis action of the shoulder
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internal rotator
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contracture of the anterior and middle scalenes may compromise what vessels?
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subclavian artery - it runs between the anterior and middle scalenes
but NOT the subclavian vein, it runs anteriorly to anterior scalene |
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the subclavian artery becomes...
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the axillary artery at the lateral border of the 1st rib
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the axillary artery becomes....
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the brachial artery at the inferior border of the teres minor muscle
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first major branch of the brachial artery that accompanies the radial nerve in its posterior course of the radial groove
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profunda brachial artery
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the brachial artery divides into which arteries?
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radial and ulnar arteries
(this occurs under the bicipital aponeurosis) |
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the radial artery supplies...
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lateral aspect of the forearm and dorsal aspect of the hand
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the ulnar artery supplies...
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medial aspect of the forearm and dorsal aspect of the hand
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radial artery becomes the...
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deep palmer arterial arch
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ulnar artery becomes the...
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superficial palmer arterial arch
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relationship between glenohumeral motion and scapulothoracic motion in abduction of the arm
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the arm can abduct 180 degrees, 120 due to glenohumeral motion and 60 due to scapulothoracic motion (2:1 ratio)
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acromioclavicular joint is stabilized by which ligaments?
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acromioclavicular, coracoacromial, and coracoclavicular ligaments
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thoracic outlet syndrome results in compression of...
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the subclavian artery and vein, and the brachial plexus as it exits the thoracic outlet
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the scalenes, cervical rib or clavicle may be tender, pulses in the upper extremity may be normal or diminished, positive Adson's test, military posture test or hyperextension testq
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thoracic outlet syndrome
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continuous impingement of the greater tuberosity against the acromion as the arm is flexed and internally rotated; "painful arc" - when pain is exacerbated upon abduction
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supraspinatus tendinitis
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inflammation of the tendon and its sheath of the long head of the biceps; usually due to overuse; can cause adhesions that bind the tendon to the bicipital groove; tenderness over bicipital groove
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bicipital tenosynovitis
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weakness in active abduction, along with a positive drop arm test; atrophy can occur; transient sharp pain, followed by an ache that lasts months; tenderness just below the tip of the acromion
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rotator cuff tear
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a common condition characterized by pain and restriction of the shoulder motion that increasingly gets worse over the year; typically caused by prolonged immobilization of the shoulder; tenderness at the anterior shoulder
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adhesive capsulitis/frozen shoulder syndrome
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winging of the scapula is a weakness of what muscle, caused by injury to which nerve?
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anterior serratus, long thoracic nerve
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most common form of brachial plexus injury; upper arm paralysis caused by injury to C5 and C6 nerve roots usually during childbirth; can result in paralysis of the deltoid, external rotators, biceps, brachioradialis and supinator muscles
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Erb-Duchenne's Palsy
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due to injury to C8 and T1; paralysis of intrinsic muscles of the hand
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Klumpke's palsy
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wrist drop and sometimes triceps weakness due to direct trauma of the what nerve?
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Radial nerve injury
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Could be caused by "crutch palsy", humeral fractures or "Saturday night palsy"
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radial nerve injury
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Some lovers try positions that they can't handle.
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scaphoid, lunate, triquetral, pisiform, trapezium, trapezoid, capate, hamate
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innervation of the flexors of the wrist and hand
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median nerve
*except for the flexor carpi ulnaris is innervated by the ulnar nerve |
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innervation of the extensors of the wrist and hand
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innervated by the radial nerve
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innervation of the biceps
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musculocutaneous nerve
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innervation of the supinator
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radial nerve
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innervation of the pronators - pronator teres and pronator quadratus
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median nerve
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What does in the median nerve innervate?
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flexors of wrist and hand
pronators of the forearm muscles in the thenar eminence 1st and 2nd lumbricals |
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What does the ulnar nerve innervate?
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Flexor carpi ulnaris
adductor pollicis brevis 3rd and 4th lumbricals |
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cubitus valgus
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carrying angle > 15 degree; abduction of the ulna (causes adduction of the wrist)
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cubitus varus
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carrying angle < 3 degrees; adduction of the ulna (causes abduction of the wrist)
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Radial head glide in relation to the forearm
When the forearm is pronated vs supinated... |
Pronated forearm, radial head glides posteriorly
Supinated forearm, radial head glides anteriorly |
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entrapment of the median nerve at the wrist; parasthesias of the thumb and first 2 and 1/2 digits
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Carpal Tunnel
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Tests for carpal tunnel
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Tinel's, Phalen, and prayer tests
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a strain of the extensor muscles of the forearm near the lateral epicondyle
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Lateral epicondylitis, aka tennis elbow
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a strain of the flexor muscles of the forearm near the medial epicondyle
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medial epicondylitis, aka golfer's elbow
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most common humeral dislocation
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anterior and inferior
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Primary extensor of the hip
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gluteus maximus
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primary flexor of the hip
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iliopsoas
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primary extensor of the knee
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quadriceps - rectus femoris, vastus lateralis, medialis and intermedius
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primary flexors of the knee
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hamstrings - semimembranosus and semitendinosus
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prevents anterior translation of the tibia on the femur
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anterior cruciate ligament
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prevents posterior translation of the tibia on the femur
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posterior cruciate ligament
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Movement fibular head in relation to pronation or supination of the foot
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Fibular head glides anteriorly with pronation of the foot
Fibular head glides posteriorly with supination of the foot |
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Pronation of the foot is what three movements?
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dorsiflexion, eversion and abduction
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Supination of the foot is what three movements?
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plantarflexion, inversion and adduction
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Femoral nerve innervates (motor and sensory)...
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Motor - quadriceps, iliacus, sartorius, and pectineus
Sensory - anterior thigh and medial leg |
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Sciatic nerve motor and sensory
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Motor - tibial: hamstings (except short head of the biceps femoris, most plantar flexors and toe flexors; peroneal: short head of the biceps femoris, evertors and dorsiflexors of the foot and extensors of the toes
Sensory - tibial: lower leg and plantar aspect of the foot; peroneal: lower leg and dorsum of the foot |
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coxa vara
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angle of the neck and shaft of the femur is less than 120 degrees
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coxa valga
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angle of the neck and shaft of the femur is more than 135 degrees
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genu valgum
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Q angle increased; "knee knocked"
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genu varum
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Q angle decreased; "bowlegged"
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posterior fibular head of a fracture of the tibia can disturb the function of what nerve?
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common peroneal nerve (aka, common fibular nerve)
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O'Donahue's triad to the knee includes...
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injury to ACL, MCL and medial meniscus
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Which ligament of the foot is the most commonly injured?
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anterior talofibular ligament
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the primary respiratory mechanism consists of...
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CNS + CSF + dural membranes + cranial bones + sacrum
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Normal rate of the C.R.I...?
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10-14 cycles per minute
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factors that decrease C.R.I.
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stress, depression, chronic fatigue, chronic infections
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factors that increase C.R.I.
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vigorous exercise, systemic fever, following OMT to the craniosacral mechanism
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attachments of the dura mater
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foramen magnum, C2, C3 and S2
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the influence of the meninges causing the cranial bones to move in response to the motility of the brain and SC as well as fluctuations in CSF is called...
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Reciprocal Tension Membrane
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the articulation of the sphenoid with the occiput
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sphenobasilar synchondrosis (SBS)
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craniosacral flexion causes...
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1. flexion of the midline bones
2. external rotation of the paired bones 3. sacral base posterior - counternutation 4. decreased AP diameter of the cranium |
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craniosacral extension causes...
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1. extension of the midline bones
2. internal rotation of the paired bones 3. sacral base anterior (nutation) 4. increased AP diameter of the cranium "fat head" |
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a type of SBS strain wherein the sphenoid and other related structures of the anterior cranium rotate in one direction about an anterioposterior axis, while the occiput and the posterior cranium rotate in the opposite direction; how is it named?
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Torsion; named for the greater wing of the sphenoid that is superior
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sphenoid and occiput rotate in the same direction, creating two parallel vertical axes and causing the SBS to deviate to the right or left
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Sidebending/Rotation
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SBS deviates cephalad or caudad
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cephalad - flexion
caudad - extension |
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strain of the SBS in which the sphenoid deviates cephalad or caudad
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cephalad - superior vertical strain
caudad - inferior vertical strain |
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strain of the SBS in which the sphenoid deviated laterally in relation to the occiput
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Left or right lateral strain
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SBS strain in which the sphenoid and the occiput are pushed closer together; CRI can be obliterated
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Compression
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Cranial nerve that exits the cribiform plate
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CN I
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Cranial nerve that exit the optic canal
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CN II
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Cranial nerves that exit the superior orbital fissure
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CN III
CN IV CN V - V1 CN VI |
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CN V, three exits
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V1 - superior orbital fissure
V2 - foramen rotundum V3 - foramen ovale |
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CN VII exits the cranium
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enters the internal acoustic meatus and exits the stylomastoid foramen
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CN VIII exits the cranium
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internal acoustic meatus
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Cranial nerves that exit the jugular foramen
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CN IX & CN X
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CN XI exits the cranium
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enters the foramen magnum and exits the jugular foramen
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CN XII exits the cranium
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hypoglossal canal
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the maintenance of a pool of neurons in a state of partial or sub-threshold excitation, wherein less afferent stimulation is required to trigger the discharge of impulses
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Facilitation
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Maintenance of a pool of neurons at a partial or sub-threshold state occurring at an individual spinal level
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segmental facilitation
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Abnormal or steady sensory stimulus to an interneuron at a spinal cord level can become sensitized to this stimulus and will have an increased or exaggerated output to the initiating site as well as surrounding areas. This is an example of _?_.
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Facilitation
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localized visceral stimuli produce patterns of reflex response in segmentally related somatic structures (visceral referral to somatic structures)
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Viscero-Somatic reflex
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somatic stimuli may produce pattern of reflex response in segmentally related visceral structures.
ex: triggerpoint at the right pectoralis major muscle causing supraventricular tachyarrhythmias |
Somato-visceral reflex
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Parasympathetic vs Sympathetic function
Eye - pupil |
Parasympathetic - constricts, miosis
Sympathetic - dilates, mydriasis |
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Parasympathetic vs Sympathetic function
Eye - lens |
Parasympathetic - contracts for near vision
Sympathetic - slight relaxation for far vision |
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Parasympathetic vs Sympathetic function
Glands - nasal, lacrimal, parotid, submandibular, gastric and pancreatic |
Parasympathetic - stimulates copious secretions
Sympathetic - vasoconstriction for slight secretion |
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Parasympathetic vs Sympathetic function
Sweat glands |
Parasympathetic - sweating on palms of hands
Sympathetic - copious sweating - cholinergic |
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Parasympathetic vs Sympathetic function
Heart |
Parasympathetic - decreases contractility and conduction velocity Sympathetic - increases contractility and conduction velocity
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Parasympathetic vs Sympathetic function
Lungs - bronchiolar smooth muscle |
Parasympathetic - contracts Sympathetic - relaxes
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Parasympathetic vs Sympathetic function
Lungs - respiratory epithelium |
Parasympathetic - decreases number of goblet cells to enhance thin secretions
Sympathetic function - increases number of goblet cells to produce thick secretions |
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Parasympathetic vs Sympathetic function
GI Tract - SM lumen, SM sphincters |
Parasympathetic
SM Lumen: contracts SM Sphincter: relaxes Sympathetic SM Lumen: relaxes SM Sphincter: contracts |
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Parasympathetic vs Sympathetic function
GI Tract - secretion and motility |
Parasympathetic - increases Sympathetic - decreases
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Parasympathetic vs Sympathetic function
Skin and visceral vessels |
Parasympathetic - none
Sympathetic - contracts |
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Parasympathetic vs Sympathetic function
Skeletal muscle |
Parasympathetic - none
Sympathetic - relaxes |
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Parasympathetic vs Sympathetic function
Bladder wall (detrusor) |
Parasympathetic - contracts Sympathetic - relaxes
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Parasympathetic vs Sympathetic function
Bladder sphincter (trigone) |
Parasympathetic - relaxes
Sympathetic - contracts |
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Parasympathetic vs Sympathetic function
Penis |
Parasympathetic - erection Sympathetic - ejaculation
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Parasympathetic vs Sympathetic function
Kidneys |
Parasympathetic - unknown Sympathetic - vasoconstriction of the afferent arteriole - decreased GFR - decreased urine volume
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Parasympathetic vs Sympathetic function
Ureters |
Parasympathetic - maintains normal peristalsis
Sympathetic - ureterospasm |
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Parasympathetic vs Sympathetic function
Liver |
Parasympathetic - slight glycogen synthesis
Sympathetic - glycogenolysis - release of glucose into the bloodstream |
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Parasympathetic vs Sympathetic function
Uterus - fundus and cervix |
Parasympathetic
Fundus: relaxation Cervix: constricts Sympathetic Fundus: constrics Cervix: relaxes |
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Innervation of the pupils
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CN III to the ciliary ganglion
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Innervation of the lacrimal and nasal glands
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CN VII to the sphenopalatine ganglion
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Innervation of the submandibular and sublingual glands
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CN VII to the submandibular ganglion
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Innervation of the parotid gland
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CN IX to the otic ganglion
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What does the pelvic splanchnic innervate?
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-lower ureter and bladder
-uterus, prostate and genitalia -descending colon, sigmoid and rectum |
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Spinal cord level: head and neck
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T1-T4
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Spinal cord level: heart
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T1-T5
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Spinal cord level: respiratory system
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T2-T7
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Spinal cord level: esophagus
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T2-T8
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Spinal cord level: upper GI - stomach, liver, spleen, gallbladder, portions of pancreas and duodenum
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T5-T9
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greater splanchnic nerve travels to which ganglion to innervate...?
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Celiac ganglion - upper GI tract
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Spinal cord level: middle GI tract - portions of the pancreas and duodenum, jejunum, ilium, ascending colon and proximal 2/3 of transverse colon
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T10-T11
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Lesser splanchnic nerve travels to which ganglion to innervate...?
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Superior mesenteric ganglion - middle GI tract, kidneys, upper ureters
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Spinal cord level: lower GI tract - distal 1/3 of transverse colon, descending colon and sigmoid colon, rectum
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T12-L2
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least splanchnic nerve travels to which ganglion to innervate...?
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Inferior mesenteric ganglion - lower GI tract, lower ureters
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Spinal cord level: appendix
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T12
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Spinal cord level: kidneys
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T10-T11
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Spinal cord level: adrenal medulla
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T10
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Spinal cord level: upper ureters
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T10-T11
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Spinal cord level: lower ureters
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T12-L1
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Spinal cord level: bladder
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T11-L2
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Spinal cord level: gonads
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T10-T11
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Spinal cord level: uterus and cervix
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T10-L2
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Spinal cord level: erectile tissue of penis and clitoris
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T11-L2
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Spinal cord level: prostate
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T12-L2
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Spinal cord level: arms
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T2-T8
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Spinal cord level: legs
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T11-L2
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smooth, firm, discretely palpable nodules, approximately 2-3 mm in diameter, located within the deep fascia or on the periosteum of a bone
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Chapman's Point
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the somatic manifestation of a visceral dysfunction
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Chapman's point
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Chapman's point on the tip of the anterior right 12th rib
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Appendix
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Chapman's point posteriorly at the transverse process of T11 vertebrae
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Appendix
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Chapman's point anteriorly 2" superior and 1" lateral to the umbilicus and posteriorly between the spinous and transverse processes of T12 and L1
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adrenals
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Chapman's point anteriorly 1" superior and 1" lateral to the umbilicus and posteriorly between the spinous and transverse processes of T12 and L1
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kidneys
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chapman's point on the periumbilical region
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bladder
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chapman's point on the lateral thigh within the iliotibial band from the greater trochanter to just above the knee
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colon
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a hypersensitive focus, usually within a taut band of skeletal muscle or in the muscle fascia; painful upon compression and can give characteristic referred pain, tenderness and autonomic phenomena
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trigger point
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this can represent the somatic manifestation of a viscero-somatic, somato-visceral or somato-somatic reflex
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trigger point
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what is the difference between a trigger point and a tenderpoint?
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trigger points may refer pain when pressed; whereas, tenderpoints do not
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