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The two parts of the intervertebral disc
Nucleus pulposus & Annulus fibrosus
Define Spondylolysis
a defect in the pars interarticularis of the lumbar spine
What is the rehab for HNP?
body mechanics, physical conditioning, stability/core stabilization, lifting techniques
Define Kyphosis
increased posterior convexity of the thoracic spine
What is the most catastrophic cervical spine injury
fracture/dislocation resulting in quadriplegia
The 5 L's of lifting
Load, Lever, Lordosis, Legs, & Lungs
Define Spondylolisthesis
Vertebrae slips anteriorly on the vertebrae below caused by unstable bilateral pars interarticularis fracture.
State a test and the corresponding nerve that can assess for neural tension
Straight Leg Raise- Sciatic
Femoral Neural Tension- Femoral
Describe the issues involved with kyphosis
rounded back with protracted scapula
posterior muscles & ligaments are stretched and weak
anterior muscles typically tight/shortened
Cervical spine muscle strains involve which muscles?
upper trapezius, levator scapulae, scalenes, SCM, spinal erectors, rhomboids
The most common cause of spinal stenosis
Degenerative arthritic changes
Define cervical spondylosis
chronic degenerative disc condition.
OA of the facet joints
State the typical causes of lumbar spine muscle strains
sudden violent contraction
rapid stretching
combined lumbar extension & rotational torque
eccentric loading
repetitive overuse
Define scoliosis and how is it named
ANY abnormal lateral curvature of the spine affecting cervical, thoracic, and lumbar segments. Named by the side of convexity
Two causes of thoracic outlet syndrome
cervical rib
shortened anterior scalene or pectoralis minor
malunion of clavicle fractures
subluxed 1st thoracic rib/elevated 1st rib
adaptive shortening of fascia
Describe the 3 stages/categories of HNP
Disc protrusion, extruded disc, sequestrated disc
Discuss the grades for spondylolisthesis and which are usually treated with surgery?
Grade 1: 0-25% displacement
Grade 2: 25-50% displacement
Grade 3: 50-75% displacement
Grade 4: 75-100% displacement
Grades 3 and 4 are treated with surgery
1. pain/edema control
2. mobilization
3. prevention of re-injury
4. return to activity
Differentiate between structural and functional scoliosis
Structural- fixed curve/irreversible or congenital
Functional- caused by poor posture, pain, leg length discrepancy, muscle spasms. Curve resolves once cause is treated
Three causes of TMJ dysfunction
missing teeth
overbite
underbite
malocclusion/ faulty bite
trauma
bell's palsy
In reference to peripheralization & centralization, discuss the effects of position changes on the nucleus pulposus
Extension: nucleus moves anteriorly
Flexion: nucleus moves posteriorly
Describe the types of spondylolisthesis
Type 2: Mechanical
Type 3: Degenerative
Type 4: Traumatic
Type 5: Pathologic/tumors
What is included in the standard treatment for lumbar spine muscle strains?
INDIVIDUALIZED!
assess pain/inflammation
stability/strengthening
flexibility
cardiorespiratory conditioning
Describe the therapy interventions to treat scoliosis
improve motion, increase strength, reduce back pain, stretch concave side, strengthen convex side, axial stretch/elongation, general core strengthening, general conditioning
Describe the typical treatment for dysfunction of the TMJ
stress reduction, avoid symptomatic movements, posture training, address pain, electrotherapy, joint mobs, stretching and massage, resisted isometrics, night splint