front 1 what percentage of PT cases involve back pain | back 1 40% |
front 2 What is the pelvis considered? | back 2 an accessory vertebrae |
front 3 strong and rarely tears | back 3 anterior longitudinal ligament |
front 4 annulus fibrosis is | back 4 very strong |
front 5 imbibe | back 5 brings in nutrients |
front 6 what are some ways to load and unload the spine? | back 6 weightbearing, changing seated position, traction/separation |
front 7 what is the nerve of the trapezius? | back 7 CN XI (spinal accessory nerve) |
front 8 what is contained within suboccipital musculature? | back 8 vertebral artery and suboccipital nerve |
front 9 what do you never recommend for low back pain? | back 9 bed rest |
front 10 why are there breathing issues associated with Sheueremann's disease? | back 10 thoracic vertebrae is out of place and affects rib cage, this in turn affects lungs as they cannot expand as much (due to bony structure) |
front 11 c curve scoliosis | back 11 one curve |
front 12 s curve scoliosis | back 12 two curves |
front 13 what does rupture of the transverse ligament lead to? | back 13 slipping of C1 and C2 vertebrae |
front 14 laminectomy | back 14 surgical excision of one or more SP and the adjacent supporting vertebral laminae |
front 15 anterior longitudinal ligament | back 15 flows along anterior aspect of vertebral bodies from occiput to sacrum, woven into anterior surface of IV disc, offers resistance to vertebral distraction, TAUT DURING EXTENSION, SLACKENED DURING FLEXION. |
front 16 posterior longitudinal ligament | back 16 located within the spinal canal along the posterior surfaces of the vertebral bodies and IV discs from axis to coxxyx, interwoven with posterior aspect of IV disc, thickest in thoracic region, lateral expansions over IV disc are thinner than in central portion |
front 17 ligamentum flavum | back 17 yellow elastic collagen fibers, form posterior wall of vertebral column, arise from posterior, upper 1/3 of lamina and course superiorly to insert on lower 1/3 of lamina above |
front 18 ligamentum nuchae (nuchal ligament) | back 18 ligament arising from nuchal line of the occiput and extending to SP of C7, attachment point for many posterior back muscles |
front 19 what do intervertebral discs create? | back 19 symphysis joints, also make up 25% of the spine |
front 20 3 principal functions of intervertebral discs | back 20 bind vertebral bodies together, permit movement within a vertebral segment, transmits load across the segment |
front 21 2 major components of intervertebral discs | back 21 annulus fibrosis and nucleus pulposus |
front 22 annulus fibrosis definition | back 22 outer ring composed of concentric lamellae of fibrocartilage |
front 23 nucleus pulposus | back 23 inner mass of collagen fibers and mucoprotein gel |
front 24 functions of annulus fibrosis | back 24 containment of nucleus pulposus, stabalizes vertebral segment, permission of movement, imbibe fluids and nutrition, transmission of force, equalization of stress |
front 25 what can too much disc pressure cause? | back 25 bulging of discs or herniation, no direct blood flow so its important to load and unload the spine. |
front 26 spinal column pressure increases with | back 26 sitting, coughing, sneezing, lifting, trunk rotation |
front 27 spinal column pressure decreases with | back 27 standing, lying down |
front 28 Trapezius SA | back 28 medial 1/3 of superior nuchal line, external occipital protuberance, ligamentum nuchae, SP of C7-T12 |
front 29 Trapezius IA | back 29 lateral 1/3 of clavicle, acromion, spine of scapula |
front 30 Trapezius N | back 30 spinal accessory nerve (CNXI) |
front 31 Trapezius A | back 31 upper fibers: elevate scapula middle fibers: retract scapula lower fibers: depress scapula |
front 32 motions of the scapula | back 32 elevation, depression, protraction, retraction, upward rotation, downward rotation |
front 33 Latissimus dorsi PA | back 33 SP of inferior 6 thoracic vertebrae, thoracolumbar fascia, iliac crest, inferior 3-4 ribs |
front 34 Latissimus dorsi DA | back 34 floor of intertubecular groove of humerus |
front 35 Latissimus dorsi N | back 35 thoracoabdominal nerve (C6-C8) |
front 36 Latissimus dorsi A | back 36 extends, adducts, medially rotates the humerus |
front 37 Levator scapula PA | back 37 posterior tubercles of TP of C1-C4 |
front 38 Levator scapula DA | back 38 superior aspect of medial border of the scapula |
front 39 Levator scapula N | back 39 dorsal scapular nerve (C5) and cervical (C3,C4) nerves |
front 40 Levator scapula A | back 40 elevates scapula and tilts the glenoid cavity inferiorly by rotating the scapula in a downward direction |
front 41 Rhomboid Minor PA | back 41 nuchal alignment & SP of C7+T1 |
front 42 Rhomboid Minor DA | back 42 medial border of scapula from the spine to the inferior angle |
front 43 Rhomboid Minor N | back 43 dorsal scapular nerve (C4-5) |
front 44 Rhomboid Minor A | back 44 retract scapula and rotate the scapula in downward direction to depress the glenoid cavity, fix scapula to thorax; can assist with elevation of scapula with L.S |
front 45 Rhomboid Major PA | back 45 SP of T2-T5 |
front 46 Serratus Posterior Superior SA | back 46 ligamentum nuchae, SP of C7-T3 |
front 47 Serratus Posterior Superior IA | back 47 superior borders of ribs 2-4 |
front 48 Serratus Posterior Superior N | back 48 2nd-5th intercostal nerves |
front 49 Serratus Posterior Superior A | back 49 elevate ribs, assist with inhalation |
front 50 Where is there no scapular attachment or action? | back 50 Serratus posterior superior |
front 51 Serratus Posterior Inferior SA | back 51 SP of T11-L2 |
front 52 Serratus Posterior Inferior IA | back 52 inferior borders of ribs 8-12 near angles |
front 53 Serratus Posterior Inferior N | back 53 ventral rami of 9th-12th thoracis spinal nerves |
front 54 Serratus Posterior Inferior A | back 54 depress ribs, assist with exhalation |
front 55 Splenius Capitis O | back 55 ligamentum nuchae & SP of C7-T6 |
front 56 Splenius Capitis I | back 56 mastoid process and superior nuchal line of occipital bone |
front 57 Splenius Capitis N | back 57 dorsal rami of spinal nerves |
front 58 Splenius Capitis A | back 58 acting alone: ipsilateral lateral flexion and rotation acting together: extend the head and neck |
front 59 Splenius Cervicis I | back 59 tubercles of TP C1-C3 or C4 |
front 60 Spinalis O | back 60 broad tendon from posterior aspect of illiac crest, posterior surface of sacrum, inferior lumbar SP, supraspinous ligament |
front 61 Spinalis I | back 61 SP of thoracic and cervical vertebrae, skull |
front 62 Spinalis N | back 62 dorsal rami of spinal nerves |
front 63 Spinalis A | back 63 unilateral: lateral bending of vertebral column bilateral: extend the head and neck |
front 64 Longissimus O | back 64 broad tendon from posterior surface of sacrum, inferior lumbar SP, supraspinous ligament |
front 65 Longissimus I | back 65 to ribs superiorily between tubercle and angle, mastoid process |
front 66 Longissimus N | back 66 dorsal rami of spinal nerves |
front 67 Longissimus A | back 67 unilateral: lateral bending of vertebral column bilateral: extend the head and the neck |
front 68 Iliocostalis O | back 68 broad tendon from superior aspect of illiac crest, posterior surface of sacrum, inferior lumbar SP, supraspinous ligament |
front 69 Iliocostalis I | back 69 angle of lower ribs and cervical TP |
front 70 Iliocostalis N | back 70 dorsal rami of spinal nerves |
front 71 Iliocostalis A | back 71 unilateral: lateral bending of vertebral column bilateral: extend the head and neck |
front 72 Iliocostalis N | back 72 dorsal rami of spinal nerves |
front 73 Iliocostalis A | back 73 unilateral: lateral bending of vertebral column bilateral: extend the head and neck |
front 74 Semispinalis capitis O | back 74 TP C4-T12 |
front 75 Semispinalis capitis I | back 75 occipital bone, SP in thoracic and cervical regions spanning 4-6 segments |
front 76 Semispinalis capitis N | back 76 dorsal rami of spinal nerves |
front 77 Semispinalis capitis A | back 77 extend head, cervical, and thoracic regions. contralateral rotation |
front 78 Semispinalis O | back 78 TP of C4-T12 |
front 79 Semispinalis I | back 79 occipital bone, SP in thoracic and cervical regions spanning 4-6 segments |
front 80 Semispinalis N | back 80 dorsal rami of spinal nerves |
front 81 Semispinalis A | back 81 extend head, cervical and thoracic regions. Contralateral rotation. |
front 82 Multifidus O | back 82 sacrum, illium, TP T1-T3, articular processes C4-C7 |
front 83 Multifidus I | back 83 pass superomedially to SP of vertebrae above, spanning 2-4 segments |
front 84 Multifidus N | back 84 dorsal rami of spinal nerves |
front 85 Multifidus A | back 85 stabilize the vertebrae during movement of the vertebral column |
front 86 Rotatores O | back 86 TP of vertebrae, best developed in thoracic area |
front 87 Rotatores I | back 87 pass superomedially to attach at the junction of lamina and TP or SP of vertebrae above their origin, spanning 1-2 segments |
front 88 Rotatores N | back 88 dorsal rami of spinal nerves |
front 89 Rotatores A | back 89 stabilize the vertebrae, assist with extension and rotary movements ??? propioception |
front 90 Quadratus lumborum SA | back 90 medial 1/2 of inferior border of 12th rib and tips of lumbar TP |
front 91 Quadratus lumborum IA | back 91 iliolumbar ligament and internal lip of illiac crest |
front 92 Quadratus lumborum N | back 92 ventral branches of T12 and L1-L4 nerves |
front 93 Quadratus lumborum A | back 93 extends and laterally flexes the vertebral column, fixes 12th rib during inspiration |
front 94 Interspinalis O | back 94 superior surfaces of SP of cervical and lumbar vertabrae |
front 95 Interspinalis I | back 95 inferior surfaces of SP of vertebrae superior to vertebrae of origin |
front 96 Interspinalis N | back 96 dorsal rami of spinal nerves |
front 97 Interspinalis A | back 97 aid in extension and rotation of vertebral column |
front 98 Intertransversarii O | back 98 TP of cervical and lumbar vertebrae |
front 99 Intertransversarii I | back 99 TP of adjacent vertebrae |
front 100 Intertransversarii N | back 100 dorsal and ventral rami of spinal nerves |
front 101 Intertransversarii A | back 101 unilateral: aid in lateral bending of vertebral column bilateral: stabilize the vertebral column |
front 102 Levatores Costarum O | back 102 Tips of TP of C7 and T1-T11 |
front 103 Levatores Costarum I | back 103 inferiorily to rib between tubercle and angle |
front 104 Levatores Costarum N | back 104 dorsal rami of spinal nerves C8-T11 |
front 105 Levatores Costarum A | back 105 elevate the ribs, assist in inspiration, lateral bending of vertebral column |
front 106 Where is the suboccipital triangle? | back 106 lies deep to the trapezius and semispinalis capitis |
front 107 4 muscles within the suboccipital triangle | back 107 rectus capitis posterior major (superomedial border), rectus capitis posterior minor, inferior oblique of the head (inferolateral border), superior oblique head (superolateral border) |
front 108 Where is the vertebral artery and suboccipital nerve contained? | back 108 suboccipital triangle |
front 109 sprain | back 109 involves ligamentous tissue, usually as a result of excessive force (contraction or motion) |
front 110 strain | back 110 involves overly strong muscle contraction resulting in stretch or microtear of muscle fibers |
front 111 spasm | back 111 muscle reaction to injury or inflammation of structures within the back (disc, ligaments, etc.) , involuntary contraction of a muscle or group of muscles creating pain |
front 112 treatment for low back pain | back 112 never recommend bed rest! |
front 113 symptoms of disc herniation | back 113 pain, numbness, weakness, gait change, "stuck", worse in AM |
front 114 treatment of disc herniation | back 114 unloading of the spine, alignment, posture, NSAID's, surgery last resort |
front 115 indications for laminectomy | back 115 stenosis, bone spurs, herniated discs |
front 116 spinal fusion surgery (posterior approach) | back 116 used for laminectomies, fractures of TP or SP |
front 117 spinal fusion surgery (anterior approach) | back 117 greater visualization of discs |
front 118 Scheurmann's disease | back 118 juvenile kyphosis, male adolescents primarily, etiology uncertain, backache and local changes in vertebral bodies |
front 119 diagnostic criteria for Scheurmann's disease | back 119 anterior wedging of 3 or more thoracic bodies (5 degrees), irregular end plates, separated epiphysis, Schmorl's nodes, loss of disc height |
front 120 treatment for Scheurmann's disease | back 120 reduce WB, exercise for better use of postural muscles, bracing and serial casting, NSAID's |
front 121 disc degeneration | back 121 results in less mobility and less shock absorption |
front 122 characteristics of structural scoliosis | back 122 disc spaces narrower on concave side, vertebral wedging, thinning of pedicles and laminae, narrowing of vertebral canal |
front 123 idiopathic scoliosis | back 123 80% of cases, prevalent in females, 1 in 4 children need treatment, genetic predisposition increases 20% if someone in family has it |
front 124 osteopathic scoliosis | back 124 spine disease or bony abnormality |
front 125 myopathic scoliosis | back 125 muscle weakness |
front 126 neuropathic scoliosis | back 126 CNS disorder |
front 127 detection of scoliosis | back 127 routine physical exam, shoulder assymetry |
front 128 treatment for scoliosis | back 128 bracing, exercise, prenatal, surgery |
front 129 osteopathic scoliosis (congenital) | back 129 closed vertebrae: wedge vertebrae open vertebrae: myelomeningocele |
front 130 variations of neuromuscular scoliosis | back 130 cerebral palsy, muscular dystrophy, polio |
front 131 surgery for scoliosis | back 131 only needed if curvature > 45 degrees, severe pain, neurological symptoms, insertion of rods posterior fusion of spine and in worse cases anterior. |
front 132 spondylosis | back 132 degenerative lesions/changes in vertebral bodies |
front 133 spondylolysis | back 133 loosening of the spine (pars interarticularis is fractured) |
front 134 spondylolisthesis | back 134 slipping of the spine (usually at L5 - vertebral bodies start to slip forward on the sacrum) |
front 135 stenosis | back 135 narrowing of vertebral foramen |
front 136 ankylosing spondylitis | back 136 chronic, progressive inflammation of joints in spine (rheumatoid), onset 20-40 years of age, 75% in males, decreased mobility in forward bending, bamboo spine, ossification of annulus and longitudinal ligaments |
front 137 ankylosing spondylitis treatment | back 137 exercise, proper positioning, NSAIDS, radiotherapy, fusion of spine |
front 138 spondylolysis and spondylolisthesis treatment | back 138 positioning, meds, avoid increased loadbearing and hyperextension |
front 139 vertebrae development step 1 | back 139 PRIMARY OSSIFICATION CENTERS, vetebrae begin to develop around early notochord during embryonic period, ossify week 8, each vertebrae has 3 bony structures (centrum and 2 halves of arch), bones united via hyaline cartilage |
front 140 vertebrae development step 2 | back 140 SECONDARY OSSIFICATION CENTERS develop during puberty and account for continued growth of spine, tips of SP and TP, anular epiphyses on superior and inferior surfaces of body |
front 141 what are the 3 types of spina bifida | back 141 spina bifida occulta, spina bifida meningocele, spina bifida myelomeningocele |
front 142 spina bifida occulta | back 142 involves only a bony structure, incomplete fusion of posterior vertebral arch |
front 143 meningocele | back 143 only involves the meninges, spinal cord still in tact |
front 144 myelomeningocele | back 144 spinal cord and membranes protrude, spinal cord doesnt develop properly and spinal nerves damaged. |
front 145 myelomeningocele characteristics | back 145 muscle paralysis below level of lesion, lack of sensation below level of lesion, bladder/bowel issues, hydrocephalus, etc. |
front 146 myelomeningocele treatment | back 146 surgery, ADL training, bowel/bladder training, maintain ROM, family involvement in developmental program |
front 147 fracture/dislocation of C1 | back 147 vertical force (diving or fall), compress masses, more likely with rupture of transverse ligament |
front 148 fracture/dislocation of C2 | back 148 40% of cervical fractures, usually in pars interarticularis, hyperextension of head on neck, fracture of the dens, blow to the head, can result in avascular necrosis |
front 149 other fractures/dislocation of vertebrae | back 149 sudden forceful forward flexion (car accident), fall in upright seated position (toilet), stretch or tear of longitudinal ligament |
front 150 treatment of fracture/dislocated vertebrae | back 150 mechanical/surgical stabilization, prevention of complications, restoration of function |