Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Cunningham Tech III
NYCC final Dr. Cunningham WI10
| Question | Answer |
|---|---|
| the __________ region of spine is predisposed to hyperkyphosis with aging | thoracic |
| ribs create __________from hyperkyphotic tendencies of thoracic spine | protection |
| rib subluxation in the thoracic spine is _________ | common! |
| mid to upper thoracics are considered __________posture | cervical |
| lower thoracics are considered __________posture | lumbar |
| the thoracic area has _________ issues!!! Somatovisceral (somatoautonomic) reflexes. | Autonomic |
| the thoracic has ___functional regions | 3 |
| name the 3 functional regions of the thoracic spine | cervicothoracic, midthoracic, thoracolumbar |
| where is the apex of the mid-thoracic region? | T6-T7 apex |
| the regional anatomy of thoracic: it is a ____-joint complex with costovertebral and costoransverse joints | 3-joint complex |
| 2 types of joints found in thoracic | costovertebral and costotransverse joints |
| thoracic body shape | wedged |
| there are up to _____joints in the thoracic 3-joint complex | 12 |
| thoracic regional anatomy - "up to 12 joints" means 2 ________, 4 _________, 2 ________, and 4 ___________ | 2,4,2,4 is: 2 IVD's, 4 facet joints, 2 costotransverse, 4 costovertebral |
| 2,4,2,4 thoracic | 2 IVD's, 4 facet joints, 2 costotransverse joints, 4 costovertebral joints |
| the long spinous processes of thoracics limit ________ | extension |
| facet angle of thoracic | 60 degrees to transverse plane, 20 degrees to coronal plane |
| the superior thoracic facet is _________ to the inferior thoracic facet. | anterior |
| where do facet angulations change in the thoracic spine? | at thoracolumbar junction |
| kinematically, the combined flexion/extension range of thoracics is _________ as we move down the spine. | GREATER the lower you go (more flexion/extension possible) |
| There is more __________ than lateral flexion as we move down the kinematic chart for thoracic, but this quality also decreases. | Rotation |
| Lateral flexion ________ as descend kinematic chart for thoracics. | increases |
| Rotation __________ as we descend the kinematic chart for thoracics. | decreases |
| 2 increases in ROM, 1 decrease in ROM for thoracic spine kinematic chart: | Flexion/extension and Lateral flexion increase as descend, Rotation decreases as descend |
| what decreases posterior joint flexion/extension in the thoracics | ribs |
| ________ orientation affects thoracolumbar junction Lateral flexion and Rotation. | Facet (almost vertical at thoracolumbar jcn.) |
| _________ is sagittal rotation with anterior translation. | Flexion |
| Flexion is sagittal ___________ with anterior __________ . | rotation, translation |
| In flexion, the thoracic disc is compressed _________ | anteriorly |
| In flexion, the thoracic annulus fibrosis is susceptible to ____________ tension forces. | posterior |
| Thoracic disc to vertebral body ratio | 1:5 |
| 1:5 is the | thoracic disc to vertebral body ratio |
| In thoracic rotation, the spinous processes cross to __________ side, one above farther than one below. | opposite |
| The superior spinous process of thoracic rotates ________ than the inferior spinous process. | more |
| small amounts of _____________ are always associated with rotation. | lateral flexion |
| lateral flexion with rotation is known as ________ motion. | coupled |
| In _______________ thoracic (motion), the TVP's approximate on concavity, separate on convexity. | lateral flexion of thoracics |
| Which has larger amounts of coupled motion in thoracic spine: lateral flexion or rotation? | lateral flexion |
| Lateral flexion has a _________ amount of coupled motion, compared to rotation of thoracics. | large |
| In thoracic coupled motion, rotation occurs to side of ___________ and the spinous processes deviate _____. | lateral bending, away |
| The ________________ deviate away and ___________ occurs to the side of lateral bending in thoracic spine. | spinous processes, rotation |
| Spinous processes ___________, while vertebral bodies ___________! | deviate, rotate |
| If the vertebral body is stuck in a right rotation malposition (left rotation restriction), which way is the spinous process deviated? | spinous is deviated left |
| Upper thoracics are like ___________, because lateral flexion and rotation are same direction (RLF + RR, LLF + LR). | cervicals |
| Both cervicals and upper thoracics behave similarly in what two planes of motion? | lateral flexion and rotation = similar in cervs and upper thoracics |
| __________ thoracics are like lumbars, in that lateral flexion and rotation are in opposite direction (LLF + RR, RLF + LR). | lower |
| Lower thoracics and lumbars share similar traits, in that their lateral flexion and rotation are in the _________ direction. | opposite |
| When a figure is moving in a plane from position 1 to position 2 it is subject to a combination of rotation and translation. However, a point may be determined around which the figure has virtually rotated. What is this called? | Instantaneous axis of rotation (kinematics) |
| 3 kinematic directions/axes for thoracics | flexion/extension, lateral bending, axial rotation |
| Most important kinetics concept for test | Everything is initiated by Concentric contraction (ConCon) and controlled by Eccentric contraction (ECon). |
| Kinetically, everything is initiated by ____________ contraction and controlled by ___________ contraction. | Concentric, Eccentric |
| does kinematics consider dynamic static and dynamic forces and levers acting on a joint? If not, then what does? | no, Kinetics (movement) considers forces and levers |
| In mechanics, ____________ is the study of the relationship between the forces that act on a body and the changes they produce in the motion of that body. | Kinetics |
| ConCon is an abbreviation for | Concentric contraction |
| ECon is the abbreviation for | Eccentric contraction |
| ConCon's are ____________; ECon's are ______________. | initiators, controllers |
| flexion of thoracic spine is initiated/ConCon by | Rectus Abdominis |
| flexion of thoracic spine is controlled/ECon by | Erector spinae muscles |
| Ligamentum flavum, Interspinous ligaments, Supraspinous ligaments, PLL, Capsule, IVD (post), and Muscles tissue limits are all examples of what _________ flexion in the thoracic spine. | limits |
| Extension of thoracic spine is initiated/ConCon by | Erector spinae |
| Extension of thoracic spine is controlled/ECon by | Rectus Abdominis |
| Spinous processes, facet joints, anterior IVD's, ALL, muscle tissue limits are all limiters of __________ in the thoracic spine. | extension |
| Lateral flexion of thoracic spine is initiated/ConCon by | ipsilateral erector spinae muscles and Quadratus Lumborum |
| The ____________ erector spinae and Q.L. initiate/ConCon lateral flexion in the thoracic spine. | ipsilateral |
| Lateral flexion is controlled/ECon in the thoracic spine by | contralateral erector spinae and QL |
| The ipsilateral __________joints of thoracic spine limit lateral flexion. | FACET |
| What limits lateral flexion in the thoracic spine? | ipsilateral facet joints |
| Which contralateral thoracic structure especially limits lateral flexion? | ribs! (the answer is always ribs) |
| What muscles initiate/ConCon rotation in the thoracic spine? | contralateral semispinalis, multifidus, and rotatores |
| Muscles that control/ECon rotation in the thoracic spine | It is controlled by ConCon and ECon of erector spinae and abdominal obliques. |
| Is rotation initiated/ConCon by ipsilateral or contralateral spinal rotator groups? | contralateral |
| Joint capsules, facet surfaces, interspinous ligaments, supraspinous ligaments, ligamentum flavum, and intrinsic/extrinsic musculature all limit__________ in the thoracic spine. This is especially true of the ______! | rotation, ribs! |
| prime mover of thoracic spine | Semispinalis thoracis |
| Well-developed ____________ and _____________ produce rotational restrictions and malpositions in the thoracic spine. | rotatores and multifidus |
| Semispinalis Thoracis is a prime mover of the thoracic spine. It's fibers go from what to what? | lower transverse processes to upper spinous processes |
| hypertonicity of semispinalis thoracis can cause abnormal _______________ in the thoracic spine (lateral flexion and rotation restrictions) | coupled motion |
| Semispinalis thoracis can produce sectional _________ | subluxations |
| Where is hyperkyphosis most predominant? | upper thoracic |
| cervicothoracic and mid/upper thoracics are prone to a series of ______________ restrictions called Hyperkyphosis. | extension restrictions |
| when there is hypokyphosis in the mid-thoracics, there is a(n)___________ in curvature. | DEcrease |
| What are 2 trade terms for hypOkyphosis? | "dishing" or "Anterior thoracics" |
| If hyperkyphosis are cervicothoracics in flexion malpositions/extension restrictions, what are hypOkhyphotic mid-thoracics? | extension malposition/flexion restrictions |
| When adjusting thoracics, consider the angle of the disc space in __________ | extension |
| When adjusting thoracics, consider the angle of the disc space in ___________ and stay in the plane line of disc. | extension (like bearing down too hard on one side of the horizontal upper bar in a "T", you will lose effectiveness by straying off the perpendicular angle of vertical and horizontal - change with the curve of thoracic) |
| Because of coupled motion in the thoracic spine, a single adjustment goes | a long way |
| What else besides coupled motion produces far-ranging effects from thoracic adjustment? | sympathetic chain and cell bodies |
| Do not adjust the thoracic spine if the pain is not _________________________. Watch for referred pain because there may be a hidden pathology (ie, hernia, appendicitis, cancer) | reproducible with NMS exam |
| You should not adjust the thoracic spine if there has been ____________ trauma until you rule out fractures or any other significant tissue damage (sprain/strain). | post-traumatic |
| Should you adjust the thoracic spine if there is a sudden onset of pain from light activity? What and where could be the danger? | No, compression fracture especially in thoracolumbar junction |
| Beware of the bone density disease _______________ when adjusting thoracics. It is a relative contraindication. | osteoporosis |
| Complications to thoracic adjustments include mild to moderate painful reactions, due to __________ stretching, tearing ___________, or adjusting a stiff, dry joint. | tissue, adhesions |
| Besides moderate pain, thoracic adjustments can cause a | sympathetic storm of flushing, sweating, etc. Uncommon. |
| The final complication of thoracic adjustments, besides pain and sympathetic storm, is the accidental __________________ due to improper hand placement or TOO MUCH FORCE. | Rib fracture |
| Dorsal ligament connecting tubercle of rib to transverse process | lateral costotransverse ligament |
| Ventral ligament connecting head of rib to demi-facets of vertebral bodies. | Articular ligament |
| Costocorporeal articulation | rib to vertebrae at demi-facets |
| Costotransverse articulation | rib to transverse process articulating surface |
| 3 basic types of rib motions | bucket handle, pump handle, caliper |
| movement which is greater in the lower thoracic spine and increases the transverse diameter of the rib cage. | bucket handle movement |
| movement of ribs that occurs more in the upper thoracics. Elevates anterior rib cage with upward and forward movement of sternum or A-P diameter of rib cage. | Pump handle |
| Movement associated with ribs 11 and 12. | Caliper motion |
| Why is the movement of ribs 11 and 12 considered to be caliper-like along the horizontal plane? | because there are no costotransverse joints to limit motion |
| What motion tends to increase lateral dimension of rib cage with slight A-P increase? | Caliper |
| lower thoracic, transverse diameter | bucket handle |
| upper thoracic, A-P | pump handle |
| lateral dimension, ribs 11 and 12 | caliper motion |
| Is the SacroIliac (SI) joint a synovial joint? | YES |
| What causes pain in the SI area, the tissue or the joint? | tissue |
| The most misunderstood joint | SI |
| The SI has mobile, _______________ joints. | diarthrodal |
| Controversial syndrome that is growing in recognition | SI syndrome |
| Lumbar posture is connected to ___________posture. | pelvic |
| Gravitational forces increase _____________to the lumbopelvic posture over time. | distortion |
| Common origin of scoliosis | SI |
| ____________could be due to SI misalignment, anatomically short leg, or an anomaly. The Logan Technique is often used. | Scoliosis |
| The SI is part of a ___-joint complex of the pelvis. | 3 |
| What makes up the 3-joint complex of SI in pelvis? | 2 SI's, 1 symphysis pubis |
| The SI joint allows movement throughout the pelvis during gait and changes in posture. It most importantly absorbs | compressive forces |
| With the lumbopelvic region, the SI joints form a ___-joint complex. | 5 |
| What makes the 5 joint complex of lumbopelvic and SI's? | 2 SI's, 2 posterior facets, 1 IVD |
| The 5-joint complex of lumbopelvic and SI's creates a __________link to the lower extremity and spine. | kinematic |
| Forces from above, __________affected first. Forces from below, __________affected first. | Sacrum (above), Ilium (below) |
| Forces from _________affect the sacrum first. Forces from _________affect the ilium first. | Above (sacrum), Below (ilium) |
| pain referred out from SI/femoroacetabular joint | sclerotoginous |
| Sacrum is a "______" in an arch | keystone |
| Sacrum provides additional support during weight-bearing due to __________ phenomenon. | locked-in (keystone) |
| SI's are true ____________joints. | synovial |
| The sacral facet is mostly ___________cartilage. | hyaline |
| Sacral joint surface covers S1-S3. There is an ________ and _________ joint of sacrum. | upper and lower |
| the Ilium facet is mostly _____________cartilage. | fibro |
| The SI joint is ________ (texture) at birth then _________ (texture) at 60+ yrs. and may fuse with adhesions. | smooth, roughens |
| Degree of orientation medial to lateral, A-P of SI joint (pubic symphysis is also at this angle of degree) | 30 degrees |
| The surfaces of the upper and lower joints of SI move reciprocally. The upper moves in response to loads from _________, the lower joint is influenced by loads from ___________. | above, below |
| Anatomically, the lumbosacral joint complex is a ____ joint spinal motion segment. | 3 |
| 3 joints of 3 joint spinal motion segment of lumbosacral plexus | disc and 2 facet joints |
| Cervical spine is divided into _________and _________cervical spine. | upper and lower |
| the smallest, most mobile spinal region with a 12 pound bowling ball on top | cervical |
| cervical posture is akin to _________posture | thoracic |
| gravitational forces increase __________over time in the cervical spine | distortions |
| where do upper body distortions commonly begin? | cervical spine |
| the cervical spine has significant _________ and vascular issues | neurological |
| 2 distinct regions of cervical spine | uppers, lowers |
| upper cervicals are segments __________ | Co-C1-C2 (OA and AA motion segments) |
| lower cervicals are segments __________ | C2-C3 to C7-T1 |
| Lordosis sometimes extends to T?-T? | T2-T3 |
| Do upper thoracics impact cervical function? | yes |
| The upper cervicals are the __________ from skull to the rest of the spine. | transition |
| What part of the spine is anatomically unique? | upper cervicals |
| Why are upper cervicals anatomically unique? (3) | 1-no discs, 2-OA has two lateral joints, 3-AA has two lateral joints and one central joint |
| type of central joint of AA (atlantoaxial)? | trochoid |
| Occipito-Atlantal Motion Segment: what is the occipital joint surface feature - convex or concave? | convex |
| Superior joint surface of Atlas functions like hypermobile bony "__________" | meniscus |
| The Atlas superior joint allows mostly movement of | Flexion/extension |
| Occiput motion is almost all | flexion/extension |
| there is very little lateral flexion or rotation (5 degrees) in the | occiput |
| When we laterally flex our head, what happens to the occiput and atlas? | Occiput slides towards convexity and atlas slips towards concavity. |
| The inferior joint surface of the ________ vertebrae is roiund and convex, as is the superior surface. | Atlas |
| The motion of the atlas is mostly | rotation |
| The position of Occiput attachment sites create | suboccipital muscle tension HA! |
| Upper cervical deep muscular anatomy at suboccipital often displays MUSCULAR restrictions at what 2 joints? | OA,AA |
| Pay attention to slide on Occipito-Atlanto-Axial F/E - do the OA and AA function together or separately? | together |
| MYODURAL bridge | possible cause of CERVICOGENIC HEADACHES (also called vertebrogenic headache) |
| In OA-AA movement, the occiput glides posterior (___) and the atlas rotates (____) and glides posterior (____) | (-Z), (+thetaX), (-Z) |
| In right lateral flexion, for example, the occiput glides _______. The atlas slides up and glides _______. What does the Axix do? | left, right, RLF and RR (spinous left) |
| Most of OA's rotation is at the end of global | ROM |
| AA has huge __________! (motion) | rotation |
| the ____ is very active during the first 25 degrees of global cervical rotation, then spreads throughout. | AA |
| In Occipito-Atlanto-Axial Rotation, the __________side moves posteriorly, the __________ side moves anteriorly. | ipsilateral, contralateral |
| There are multiple attachments from occiput to (segments) _______. | C1 and C2 |
| C1 and C2 segments function with each other especially during | F/E |
| Postural distortions or muscle contractions affect C1, C2 or both? | both |
| Deep ligaments of upper cervical segments __________ motions. | stabilize |
| Ligament which limits lateral flexion in cervicals | Alar |
| Ligaments which limit flexion and translation | Transverse |
| Atlantodental interspace relates to ___________space. | spinal cord |
| Upper cervical kinematics - occiput centers of rotation are called _______________-axex of rotation. | instantaneous |
| Each lower cervical vertebrae MOTION SEGMENT typically has ___ joints | 5 |
| Each lower cervical vertebra has ____ joints. | 10 |
| Joints of Luschka are also called | uncovertebral joints |
| the uncovertebral joints are from uncinate processes and are __________joints! | synovial (have synovial lining and membrane) |
| is there a capsule in uncovertebral joints? | no, but they ARE synovial joints |
| Uncovertebral joints (UN) guides __________ | motion |
| motion of uncovertebral joints | Lateral flexion with rotation |
| do uncovertebral joints degenerate? | yes |
| Degeneration of Uncovertebral joints can cause (due to "blunting") | root impingement! |
| The nerve lying on top of the uncovertebral joint lies in the | lateral recess |
| Blunting of UN joints "blunt" due to uncinate processes doing what? causing what? | hypertrophying and moving into the lateral recess, causing nerve impingement |
| Regional anatomy of cervical joint complex: there is a __________nucleus. | central |
| there is a _________disc to body ratio in cervical joints | large |
| why do we need a large disc to body ratio in cervical joint complexes? | increases mobility |
| facet angles of cervicals | 45 degrees (know this for test) |
| Lower cervicals have broad thick _____________ for weight bearing | articular pillars |
| Do cervical vertebrae have large or small IVF's? | large |
| What cervical vertebrae is most like thoracics? | C7 |
| the large spinous process of C7 is called the | vertebra prominens |
| C& has a small anterior __________ | tubercle |
| Does C7 have an uncinate process? | no |
| the vertebral artery is or is not in the foramen of C7 | is not |
| there is an occasional _______ present at C7 that may cause ischemic attacks or other pathology | cervical rib (or elongated TP) with a true, costotransverse joint |
| 4 structures important to the upper cervical complex: | Ligamentum nuchae, ligamentum flava, Posterior Atlanto-Occipital membrane, Vertebral ARtery |
| there is no vertebral artery at ___ | C7 |
| The concept of cervical curve is controversial. The idea is that a ____________curve dampens compressive forces and balances the weight of the skull over the disc and facets. | Secondary curve |
| Changes in the cervical curve are common - possible changes? | degeneration, congenital (disc and facet shape), postural, traumatic |
| A reversed cervcial curve with hyperlordosis is not good and usually causes significant __________ | dyskinesia |
| A hypOlordotic curve in cervical spine causes | increased disc load, increased muscular effort as head translates forward |
| Lower cervical spine kinematics involve segments | C2-3 to C7-T1) |
| There is a decrease in lateral bending as you go ________ the cervical spine. | down |
| degrees of Flexion/Extension per lower cervical spine motion segment | 15 degrees |
| Greatest amount of flexion/extension cervical segments | C4-5 and C6-7 |
| Ipsilateral flexion causes ipsilateral ________ in cervicals with spinous deviation away from side of flexion. | rotation |
| there is not a lot of lateral flexion at | lower cervicals |
Created by:
hecutler
Popular Chiropractic sets