S1B3 - Omm1: Spine & Thorax

Front 1

What are three functions of the spinal cord?

Back 1

Transfer weight and the bending movements of the head and trunk to the pelvis. Allows physiologic motion between the head, trunk and pelvis. Protects the spinal cord.

Front 2

What is a vertebral unit?

Back 2

2 vertebrae, the intervertebral disk between them and the connecting elements (arthrodial, ligamentous, muscular, vascular, neural and lymphatic).

Front 3

What are the orientation of the superior articular facets of typical cervical, thoracic and lumbar vertebrae?

Back 3

Cervical and lumbar: backwards, upward, medial (BUM). Thoracic: backwards, upward, lateral (BUL). BUM BUL BUM.

Front 4

What acts a limit of motion in flexion of the spine?

Back 4

Intervertebral disk.

Front 5

Describe intervertebral disk.

Back 5

Functions as a cushion to compressive loading of the spine. Consist of nucleus pulposis (shock absorbing center), annulous fibrosis (outer concentric laminated bands of fivrous tissue) and cartilaginous end plates.

Front 6

What type of movements is the spine capable of?

Back 6

Flexion, extension, rotation, sidebending.

Front 7

What is the spine's ROM limited by?

Back 7

Thickness, elasticity and compressibility of discs. Shape and oreintation of zygapophysial joints. Tension of articular capsules of facet joints. Resistance of back muscles and ligaments.

Front 8

Define anatomic barrier.

Back 8

The bone contour and/or soft tissues, especially ligaments, which serve as the final limit to motion in an articulation beyond which tissue damage occurs.

Front 9

Define physiologic barrier.

Back 9

The soft tissue tension accumulation which limits the voluntary motion of an articulation. Further motion toward the anatomical barrier can be induced passively.

Front 10

Define restrictive barrier.

Back 10

An impediment or obstacle to movement within the physiological limits of an articulation that reduces the active motion range.

Front 11

What is the reference point that vertebral motion is described from?

Back 11

Motion of a vertebral segment is in reference to the ANTERIOR & SUPERIOR part of the vertebral body.

Front 12

How is somatic dysfunction named for the spine?

Back 12

Named for the position the segment is in (or moves EASIEST), relative to the segment below. This is OPPOSITE that of the RESTRICTION of motion. Somatic dysfunction can also be named for the restricted motion but the word restricted needs to be included.

Front 13

List the symbols and their definitions describing spinal motion.

Back 13

Front 14

Describe sagittal motion of the spine.

Back 14

Occurs around a transverse axis through a sagittal plane. With flexion, spinous processes separate further and facets open. With extension, the opposite occurs.

Front 15

Describe rotational motion of the spine.

Back 15

Occurs around a vertical axis through a transverse plane. Transverse process moves posterior on the same side of the rotation. The spinous process moves toward the opposite side.

Front 16

Describe sidebending motion of the spine.

Back 16

Occurs around an anterior/posterior axis through a coronal plane. Transverse processes approximate toward the side of the sidebending (concave) and separate on the opposite side (convex).

Front 17

What are Fryette's Principles?

Back 17

Generalizations about how the thoracic and lumbar spinal segments move.

Front 18

What is the 1st principle of physiologic motion?

Back 18

When the thoracic and lumbar spine is in a neutral position (between flexion and extension), when the vertebra sidebends to one side, the vertebra involved with this motion rotate to the opposite direction. Sidebending is toward the concavity and rotation toward the convexity of the vertebral curve. NEUTRAL mechanics. Type I somatic dysfunction.

Front 19

Describe type 1 somatic dysfunction.

Back 19

No extreme of flexion or extension. Sidebending “X” followed by rotation “Y”. Commonly occur in groups. Commonly cause discomfort but not pain, often chronic. Muscles involved are typically the long restrictors.

Front 20

What is the 2nd principle of physiologic motion?

Back 20

When the thoracic and lumbar spine is in either the flexed or extended position (non-neutral), rotation and sidebending of the vertebral unit occurs to the same side. NON-NEUTRAL mechanics. Type II somatic dysfuncction.

Front 21

Describe type II somatic dysfunction.

Back 21

Occurs at extremes of flexion and extension. Rotation "X" and sidebending "X". Typically occurs at one segment. Commonly causes acute pain, muscles involved are typically the short restrictors.

Front 22

What is the 3rd principle of physiologic motion?

Back 22

Initiating motion of a vertebral segment in any plane of motion will reduce the movement of that segment in other planes of motion. This helps us with making a correct diagnosis and with performing treatment.

Front 23

What part of the spine does not follow the principles of phsiologic motion?

Back 23

Cervical spine.

Front 24

Describe the neutral mechanics for the cervical spine.

Back 24

In the typical cervical spine (C2-7), motion is coupled so that a vertebral segment sidebends and rotates to the same side (opposite of thoracic and lumbar).

Front 25

What is considered non-neutral mechanics for the cervical spine?

Back 25

Flexion or extension coupled with the other two planes of motion (rotation precedes sidebending).

Front 26

Where does almost half of neck flexion and extension occur?

Back 26

At the occipitoatlantal (OA) joint. This joint also sidebends to one side while rotating to the opposite side.

Front 27

Where does half of neck rotation occur?

Back 27

Atlantoaxial (AA) joint.

Front 28

What is C2FRrSr?

Back 28

The second cervical vertebrae in relation to the third cervical vertebra has non neutral mechanics, is flexed, rotated and sidebent to the right.

Front 29

What is T4NSlRr?

Back 29

T4 is the center segment of a group that has neutral mechanics, sidebent left and rotated right.

Front 30

What is L5ERlSl?

Back 30

L5 has non neutral mechanics, extended, rotated left and sidebent left.

Front 31

Describe the relation of spinous processes to transverse processes in the thoracic spine.

Back 31

Rule of 3's: SP of T1,2,3 (12) project directly posteriorly so that the tip of each SP is in the same plane as the TP of the associated vertebrae; SP of T 4,5,6 (11) project slightly inferiorly, so that the tip of each SP is about ½ way between the TP of its associated vertebrae and the one below; SP of T7,8,9 (10) project more inferiorly so that the top of each SP is in the same plane as the TP of the vertebrae below.

Front 32

What is NSR dysfunction?

Back 32

Neutral, sidebent, rotated (type I). A group of transverse processes on one side of the vertebral column are more posterior and resistant to anterior movement in the neutral position and do not change during flexion or extension.

Front 33

What is ERS dysfunction?

Back 33

Extended, rotated, sidebent (type II). The transverse process on one side becomes more posterior and resistant to anterior movement during flexion and becomes more symmetrical during extension. Zygapophysial joint is relatively more closed.

Front 34

In extended a dysfunction, what is the postion of the facets?

Back 34

Facet where dysfunction is occuring is closed on the same side as the rotation and sidebending.

Front 35

How do you treat ERS dysfunction?

Back 35

Part of treatment goal is to "open" the "closed" facet. Direct treatment is to encourage movement toward the FRySy position (dysfunction in ERxSx). Flexion, rotation y, and side bending y (y-to-x translation) would “open” the “closed” x facet.

Front 36

What is FRS dysfunction?

Back 36

Flexed, rotated, sidebent (type II). The transverse process on one side becomes more posterior and resistant to anterior movement during extension and becomes more symmetrical during flexion. Zygapophysial joint is relatively more open.

Front 37

In flexed a dysfunction, what is the postion of the facets?

Back 37

Facet where dysfunction is occuring is opening on the oppostie side as the rotation and sidebending.

Front 38

How do you treat FRS dysfunction?

Back 38

Part of treatment goal is to "close" the "open" facet. Direct treatment is to encourage movement toward the ERySy position (dysfunction in FRxSx). Extension, rotation y, and side bending y (y-to-x translation) would “close” the “open” y facet.

Front 39

Somatic dysfunciton in the thorax can impede circulation to …?

Back 39

Somatic dysfunction will impede both segmental flow as well as regional and multiregional.

Front 40

Why is lymphatic drainage in the thorax important?

Back 40

Impedence of flow through the thoracic ducts will cause edema.

Front 41

List the autonomic inervation in the thorax.

Back 41

T1-4: head and neck, with T1-T6 to the heart and lungs. T5-T9: all upper abdominal viscera. T10-T11:small intestine distal to the duodenum, kidney, ureters, gonads and right colon. T12-L2: left colon and pelvic organs. Parasympathetics: Cranial Nerve X and Vagus.

Front 42

What can visceral disturbances cause?

Back 42

Increased musculoskeletal tension in the somatic structures that are innervated from the corresponding spinal levels through viscerosomatic reflexes.

Front 43

What is dextroscoliosis?

Back 43

Scoliosis where the spine rotates to the right and is accompanied with side bending to the left when the patient bends forward. Hump is on right side, convexity of spinal is curve is on the right side.

Front 44

What is levoscoliosos?

Back 44

Scoliosis where the spine rotates to the left and is accompanied with side bending to the right when the patient bends forward. Hump is on left side, convexity of spinal is curve is on the left side.

Front 45

What are acute TART changes found for viscerosomatic reflexes?

Back 45

Increased skin temperature, increased moisture, and/or skin drag, skin thickening, increased subcutaneous fluid, prolonged red reflex.

Front 46

What are chronic TART changes found for viscerosomatic reflexes?

Back 46

Thickened skin and subcutaneous tissues, rapid fading red reflex, localized muscle contraction, muscles are hard, tense and hypersensitive to palpation, stiff joints with articular motion restrictions that are firm, deep muscle contraction involving two or more segments.