Term
| where is the iliolumbar ligament |
|
Definition
| 1in superior and 1in lateral to PSIS |
|
|
Term
| where are the sacrotuberous and sacrospinous ligaments |
|
Definition
| the triangles coming off the sacrum/coccyx to the ischium |
|
|
Term
| where is the ligamentum flavum |
|
Definition
|
|
Term
| what causes central hypertrophy of thus central spinal stenosis |
|
Definition
|
|
Term
| name the reflexes for C5, C6, C7, L4, S1 |
|
Definition
C5: biceps
C6: brachioradialis
C7: triceps
L4: patella
S1: achilles |
|
|
Term
| motor function of L4, L5, L6 |
|
Definition
L4: extensior of quads
L5: dorsifle foot
S1: plantar flex foot and bit toe |
|
|
Term
| straight leg raise: when is it positive, what does this suggest |
|
Definition
positive if produces symptoms below knee at <70deg hip flexion
lumbar pain without radiation is negative
hamstring tightness is negative
opposite side positive is strongly suggestive of nerve root lesion
suggests herniated disc |
|
|
Term
| well leg raise: when is it positive, what does this suggest |
|
Definition
lift opposite leg to problem
if there is pain in the problem leg than it is positive
suggests meningeal irritation or herniated disc |
|
|
Term
| braggards: how is it done, what is positive, what does this suggest |
|
Definition
life leg on problem side until pain, lower 5deg, dorsi flex
if this recreates cheif complaint tan it is positive
suggests inflammation of spinal nerves (esp sciatic) |
|
|
Term
| hoovers sign: how is it done, what is positive, what does this suggest |
|
Definition
ask pt to lift affected leg with hand under unaffected side
positive is no pressure on hand
this suggests faking it |
|
|
Term
| how do you do a physical exam on thehip |
|
Definition
flexion
abduction
external rotation
extension |
|
|
Term
| what is a schmorl's hernia |
|
Definition
| protrusion of cardilage of the intervertebral disc into vertebral body usually due to degeneration and aging with a strong family history, can cause necrosis of the vertebrae |
|
|
Term
| thomas test; how is it done, what is positive |
|
Definition
patient supine on table, flex one knee up to chest, other extended
if opposite hip flexes or ASIS goes ip then its positive |
|
|
Term
| what is a vertebral body hemangioma |
|
Definition
most common tumor of spinal axis
usually a incidental finding |
|
|
Term
| how do steroids affect the spin |
|
Definition
cause advanced drug induced osteoperosis
AVOID OMT LOW VELOCITY |
|
|
Term
| how is the prostate related to problems in the spine, how is it diagnosed |
|
Definition
it metastasis to the lumbar causing osteoblastic proliferation
see dense lesions through out pelvis and lower spine |
|
|
Term
| what is the most common spondyloarthropathy |
|
Definition
|
|
Term
| ankylosing spondylitis: age, gender, raced |
|
Definition
15-35yo
M:F 4:1
caucasian:black 3:1 |
|
|
Term
| ankylosing spondylitis: 4 signs |
|
Definition
insidious onset of low back pain
stiffness
poor chest expansion
exaggergated drsal kyphosis
HLA-B positive in 90% |
|
|
Term
| what root is affected in relation to a lumbar disc bulge |
|
Definition
|
|
Term
| what is spondylosis, most common location |
|
Definition
defect of fracture of PARS INTERARTICULARIS (without slip)
usually L5 |
|
|
Term
| spondylosis: pt history, X-ray signs |
|
Definition
low back pain
worse with activity
decreased lumbar lordosis
scottie dog has a collar on lumbar oblique view |
|
|
Term
| what is spondylolisthesis, where is it most often located |
|
Definition
slippage of vertebra on adjacent vertebra
isthmic L5-S1 most common |
|
|
Term
| spondylolisthesis: patient signs, x-ray signs |
|
Definition
low back pain
worse with adtivities
may have radicular symptoms
may have sensory motor findings
decreased ROM
painful extension
graded 1-4 on lateral lumbar xray |
|
|
Term
| explain how a spondylolisthesis is graded |
|
Definition
1. 1 unit off disc below
2. 2 units off
3. 3 units off
4. completely (or almost) off |
|
|
Term
| psoas origin and insertion and location |
|
Definition
L1-4 or 5 to lesser trochanter
under medial arcuate ligament |
|
|
Term
| what does a spasm of psoas cause |
|
Definition
flexed and sidebent
lumbar, hip, and or right pain
snapping or popping in hip
flexed at waist
sidebent towards
externally rotated at hip |
|
|
Term
| what is it called when the pubis like isnt connected |
|
Definition
|
|
Term
| common cause of psoas spasm |
|
Definition
| acute injury (often lifting) or overuse in athletes |
|
|
Term
| how is psoas syndrome treated |
|
Definition
muscle energy and counterstain: avoid direct when associated with acute injury
treat associated lumbar and pelvic dysfunction
PT/HEP: home exercise critical
avoidance of repetitive hip flexion |
|
|
Term
| what is the common lumbar and inominate dysfunction associated with psoas syndrome |
|
Definition
upper lumbar flexed, sidebent, and rotated to same side
posterior inominate and externally rotated hip |
|
|
Term
| DDX or red flags of neck and UE pain |
|
Definition
MI (esp in women and DM pt)- ask about N/V, diaphoresis, SOB
masses in neck causing compression
swallowing problems
lymphadenopathy
UE edema |
|
|
Term
| explain cervical motion of OA, AA, and cervical spin |
|
Definition
OA: F/E is primary, sideslipping (sidebend and rotate in opposite directions)
AA: rotation is primary, sidebending and rotation are in opposite dorections
C2-C7: sidebending and rotation are coupled |
|
|
Term
| explain how do to cervical HVLA |
|
Definition
flexed dysfunction tx in extension
extended dysfunction tx in flexion
sidebend towards fulcrum and rotate away
apply HVLA towards the sidebend
recheck |
|
|
Term
| contraindications to cervical HVLA |
|
Definition
severe RA
down syndrome -transverse lig laxity
severe osteoperosis
hypermobility -ehlers danlos
vascular insufficiency of C spine
oseomyelitis |
|
|
Term
| C5: motor and sensory areas |
|
Definition
deltoid, bicep
lateral arm, axillary nerve |
|
|
Term
| C6: motor and sensory areas |
|
Definition
wrist extension, bicep
lateral forearm, musculocutaneous nerve |
|
|
Term
| C4: motor and sensory areas |
|
Definition
wrist flxors
finger extensors
tricep
sensory to middle finger |
|
|
Term
|
Definition
finger flexion
hand intrinsics
sensory: medial forearm, medial anterior brachial cutaneous nerve |
|
|
Term
|
Definition
hand intrinsics
medial arm, medial brachial cutaneous nerve |
|
|
Term
| explain how to do spurling manuver, what is positive, what does this suggest |
|
Definition
sidebend, rotate, and compress
positive if pain radiates suggesting cervical root impingement |
|
|
Term
| what is addisons manuver used for, what is positive |
|
Definition
| pull arm back and if the subclavian is impinged by thoracic outlet syndrome then the hand will loose pulse |
|
|
Term
| where are the trigger point radiation areas for the sternal head of SCM |
|
Definition
upper sternum
occiput
around eye |
|
|
Term
| where are the trigger points to the sternal head of the SCM |
|
Definition
|
|
Term
| where are the trigger points for the scalenes |
|
Definition
| down the muscle less on middle scalene |
|
|
Term
| where are the trigger point radiation areas for the scalenes |
|
Definition
lateral upper arm
pec area
medial scapular |
|
|
Term
| where are the trigger points for the trapezius |
|
Definition
tip of shoulder
medial shoulder
on scapula
medial scapula |
|
|
Term
| where are the trigger point radiation areas for the trapezius |
|
Definition
occiput
tip of shoulder
medial scapula |
|
|
Term
| where are the trigger points for the levator scapular |
|
Definition
|
|
Term
| where are the trigger point radiation areas for the levator scapulae |
|
Definition
|
|
Term
| where are the trigger point radiation areas for the |
|
Definition
anterior lateral shoulder
center pec
medial lower arm |
|
|
Term
| where are the trigger point radiation areas for the serratus posterior superior |
|
Definition
scapulae
posterior shoulder
elbow
little finger |
|
|
Term
| where are the trigger points for the serratus posterior superior |
|
Definition
|
|
Term
| where are the trigger point radiation areas for the pec minor |
|
Definition
anerior lateral shoulder
down medial arm |
|
|
Term
| what is the composition of thoracic inlet |
|
Definition
|
|
Term
| what are the contents of the thoracic inlet |
|
Definition
viscera
vascular
nerves
CT - stibsons fascia |
|
|
Term
| what are the functions of the thoracic inlet |
|
Definition
support head and neck
create platform for C spine
anchor UE (sternoclavicular joint is only bony attackment in UE to adial skeleton) |
|
|
Term
| what are the three causes of thoracic outlet syndrome and a sign of each |
|
Definition
neurogenic: compression of brachial plexus, wasting numbness and tingling of hand muscles
vascular: compression of subclavian, pallor edema diminished pulse addisons positive
non-specific |
|
|
Term
| how does being pregnant changes the posture |
|
Definition
shifts center of gravity anterior
pelvis rotates forward
body compensates with lumbar extension and shoulders going back |
|
|
Term
| how much does lordosis and kyphosis change in pregnancy |
|
Definition
lumbar lordosos 7.2%
thoracic kyphosis 6.6% |
|
|
Term
| how does the change in posture in pregnancy cause somatic dysfunction |
|
Definition
increased vertebral facet loading
increased shear across intervertebral discs
shortened segmental muscles
overstretched abdominals and psoas |
|
|
Term
| what are the signs of low back pain / problems in pregnancy |
|
Definition
adaptive gair (waddling)
unleval sacral base
anterior pelvic tilt
bony and ligamentous strain (sacrotuberous)
SI and LS dysfunction
symphosilysis |
|
|
Term
| what innervates the sympathetic for the pelvic viscera |
|
Definition
|
|
Term
| what innervates the parasympathetic for pelvic viscera |
|
Definition
|
|
Term
| what areas are innervated by the same parasympathetic and sympathetic as the pelvic viscera |
|
Definition
colon
appendex
kidney
ureter
adrenal medulla
bladder |
|
|
Term
| what are contraindications to treatment in pregnancy |
|
Definition
undiagnosed vaginal bleeding
threatened abortion
ectopic pregnancy
placenta pevia or abruption
PROM or preterm labor
prolapsed cord
eclampsia or severe preeclampsia |
|
|
Term
| what are the best treatments to use in pregnancy |
|
Definition
indirect fascial is DOC
if you do HVLA localize well
avoid supine techniques for supine compression syndrome
empower with self help techniques and exercises |
|
|
Term
| what OMT techniques are benificial in pregnancy |
|
Definition
SI articulation or BLT
pelvic diaphragm release
side lying thoracolumbar soft tissue for paraspinals and rib release
frog leg
diaphragm doming |
|
|
Term
| explain how do do ischial tuberosity spread |
|
Definition
| put thumbs on ischial tuberosities and spread |
|
|
Term
| explain how to treat the pelvic diaphram |
|
Definition
| pt on side, leg off table, push fingers into muscles just beside ischial tuberosity |
|
|
Term
| explain how to do the frogleg sacral articulation |
|
Definition
pt supine with knees flexed and spread
hand on sacrum and put in BLT
pull sacrum down as pt straightens legs |
|
|
Term
| what is in and out of pattern for ribs |
|
Definition
|
|
Term
if a rib resists exhalation it is...
if a rib resists inhalation it is... |
|
Definition
inhaled dysfunction
exhaled dysfunction |
|
|
Term
| what does a rib articulate with |
|
Definition
| transverse process of the same vertebrae and the one above |
|
|
Term
| inspiratory action of: pectoralis, serratus anterior, scalenes, latassimus dorsi, diaphragm |
|
Definition
scalenes: pull ribs 1-2 up
pec: pull ribs 2-5 up
serratus anterior: pull 5-9 up
lat: pull 11-12 down
diaphragm: uses central tendon as fulcrum, attached to quadratus lumborum to anchor 11-12 to contract against in inhalation |
|
|
Term
| what muscles indirectly effect rub function |
|
Definition
errector spinae
trapezius
serratus posterior, superior, inferior
psoas
quadratus lumborum |
|
|
Term
| what does HUGS stand for when remembering viscerosomatic reflexes |
|
Definition
H Heart T1-4
U Up GI T5-9
G Gonads T10-11
S seminal (prostate) T12 |
|
|
Term
| what are the viscerals for the UE and LE |
|
Definition
|
|
Term
| what are the viscerals for head, heart, lungs |
|
Definition
head 1-4
heart 1-4
lungs 2-7 |
|
|
Term
| what are the viscerals for upper middle and lower GI |
|
Definition
upper 5-9
middle 10-11
lower L1-2 |
|
|
Term
| what are the viscerals for the upper and lower GU |
|
Definition
|
|
Term
| what are the viscerals for the gonads, uterus/cervix, prostate, electile tissue |
|
Definition
gonad 10-11
uterus 10-12
prostate 12
erectile 11-L2 |
|
|
Term
| what collects lymph from abdomen pelvis and LE, where is it |
|
Definition
cisterna chyli
just below diaphragm |
|
|
Term
| how is lymph cleared from the lower body |
|
Definition
| cysterna chyli > diaphragm and abdominal visceral motion helps draw lymph superior to thoracic duct > thoracic inlet |
|
|
Term
| what tissues do lymphatics not perfuse |
|
Definition
CNS
epidermis
endymysium of muscle and cartilage
marrow
some peripherial nerves |
|
|
Term
| what do lymphatics usually follow course of |
|
Definition
|
|
Term
| explain the flow of lymph into thoracic duct |
|
Definition
| interstitium > blind ended permeable lymph capillaries > capillary plexuses > trunks > thoracic duct |
|
|
Term
| what drains into right lymphatic duct |
|
Definition
rith head and neck
right arm
right chest and some heart and lungs |
|
|
Term
| explain the ways that fluids return from the tissues |
|
Definition
90% capillaries
10% lymphatics |
|
|
Term
| what is the function of lymphatics |
|
Definition
return proteins that cannot permeate blood capillaries
remove particulate matter, bacteria, and exudate from ECF |
|
|
