Lecture #3 - Spinal Motion Assessment

That everything is safe.

Screen and refer before any further assessment.

Fractures, ligaments, and vertebral/internal carotid arteries.

<p>Whether active and/or passive movement is being performed and if all or some movements are included.</p> Signup and view all the answers

<p>It varies according to spinal region and the individual.</p> Signup and view all the answers

<p>The more superior vertebral body moves on the more inferior vertebral body.</p> Signup and view all the answers

<p>Cervical and lumbar regions.</p> Signup and view all the answers

<p>Flexion, Extension, Lateral Flexion, Lateral Translation, Anterior/Posterior Translation, and Rotation.</p> Signup and view all the answers

<p>20-30%</p> Signup and view all the answers

<p>Ensure the mouth doesn't open.</p> Signup and view all the answers

<p>Standing.</p> Signup and view all the answers

<p>Patient positioning.</p> Signup and view all the answers

<p>Shooting pain down the spine.</p> Signup and view all the answers

<p>Smoothness and compensation.</p> Signup and view all the answers

<p>Normal range and normal end-feel.</p> Signup and view all the answers

<p>Not moving into extension, but just returning to neutral.</p> Signup and view all the answers

<p>Side lying position.</p> Signup and view all the answers

<p>That the person doesn’t have a GH instability.</p> Signup and view all the answers

<p>A facet dysfunction.</p> Signup and view all the answers

<p>Almost never.</p> Signup and view all the answers

<p>Good body mechanics with the table at an appropriate height.</p> Signup and view all the answers

<p>Let the head go back if there is no dizziness.</p> Signup and view all the answers

<p>To evaluate intervertebral motion and joint glide abnormalities.</p> Signup and view all the answers

<p>PPIVM focuses on assessing small portions of the spine segmentally, while PROM evaluates the entire range of motion of a joint.</p> Signup and view all the answers

<p>Tissue resistance is the limit of motion felt as the joint surfaces approach their end of the elastic phase.</p> Signup and view all the answers

<p>Hypermobility can occur due to guarding and compensatory mechanisms within adjacent segments.</p> Signup and view all the answers

<p>The joint should be positioned in the resting or loose packed position.</p> Signup and view all the answers

<p>Strength, length, and function.</p> Signup and view all the answers

<p>It typically indicates issues with the joint capsule or periarticular tissues.</p> Signup and view all the answers

<p>The comparison assumes the opposite side is not impaired, which may not always be true.</p> Signup and view all the answers

<p>They commonly attempt to create stability in adjacent segments to compensate.</p> Signup and view all the answers

<p>It allows for a detailed understanding of movement dysfunction at specific spinal levels.</p> Signup and view all the answers

<p>Anteriorly and posteriorly.</p> Signup and view all the answers

<p>The shape and orientation of the articulations, size and location of articulating processes, and the ligaments and muscles.</p> Signup and view all the answers

<p>Coupled motion indicates that movement around one axis is consistently associated with movement around another axis.</p> Signup and view all the answers

<p>Substantial rotation with small amounts of flexion and extension.</p> Signup and view all the answers

<p>Side bending and rotation are equally limited, with flexion less limited than extension.</p> Signup and view all the answers

<p>Compliance of fibrocartilage, age, disc-vertebral height ratio, disease, dimensions of end plates, and gender.</p> Signup and view all the answers

<p>Inclinometers, goniometers, and measuring tapes.</p> Signup and view all the answers

<p>The cervical spine.</p> Signup and view all the answers

<p>Hypomobile indicates limited movement, normal indicates expected movement, and hypermobile indicates excessive movement.</p> Signup and view all the answers

<p>Pain, palpation, observation, range of motion, and cueing or correction.</p> Signup and view all the answers

<p>The prominence of C2 may indicate upper cervical instability during flexion.</p> Signup and view all the answers

<p>Willingness to go through range of motion, resistance of muscles and ligaments, individual strength, and presence of pain.</p> Signup and view all the answers

<p>It is the movement between two articulating surfaces without reference to external forces.</p> Signup and view all the answers

<p>A blank entry signifies pain-free ROM.</p> Signup and view all the answers

<p>Adjusting neck positioning is crucial to accurately feel the movement of individual vertebral segments, especially since each segment has different end feels.</p> Signup and view all the answers

<p>During side bending assessments, the sensation can vary between the spinous processes and can experience gapping or closing based on the direction of movement.</p> Signup and view all the answers

<p>The reliability and specificity of mobilization and manipulation techniques are heavily challenged, despite their appealing appearance.</p> Signup and view all the answers

<p>The four types of PAIVMs are PACVP, side glides, TVP, and PAUVP.</p> Signup and view all the answers

<p>PACVPs and PAUVPs must be performed in the prone position for the thoracic and lumbar spine.</p> Signup and view all the answers

<p>In the C spine, clinicians typically use a thumb-on-thumb technique, while in the L spine, the angle may need adjustments due to the lordotic curve.</p> Signup and view all the answers

<p>Side glides in the cervical spine often involve applying pressure on the articular pillars.</p> Signup and view all the answers

<p>Performing PAIVMs in patients with spinal instability can aggravate their condition and result in complications.</p> Signup and view all the answers

<p>Palpating TSPs involves pushing laterally and away from the spinous processes, while SPs are pushed directly on or off to the side.</p> Signup and view all the answers

<p>The typical patient positioning required for TVP is supine or prone.</p> Signup and view all the answers

<p>Clinicians should consider adjusting their angle slightly to accommodate the lumbar spine's lordotic curve.</p> Signup and view all the answers

<p>Palpating the TSPs in the lumbar spine is challenging due to their depth of more than an inch and their position beneath various tissues.</p> Signup and view all the answers

<p>The PACVP technique is significant as it replicates end feel assessments, which can indicate segmental mobility and stability.</p> Signup and view all the answers

<p>Thumb-related techniques generally allow clinicians to feel more precise motions and end feels compared to ulnar border techniques.</p> Signup and view all the answers

<p>Risks include ligament instability, fractures, and involvement of arteries such as the vertebral or internal carotid arteries.</p> Signup and view all the answers

<p>This determination affects patient safety and influences the accuracy of the assessment outcomes.</p> Signup and view all the answers

<p>Correct patient positioning is crucial for minimizing discomfort and ensuring effective movement assessment.</p> Signup and view all the answers

<p>Movement is described by the orientation of the more superior vertebral body in relation to the more inferior vertebral body.</p> Signup and view all the answers

<p>Total range of motion is achieved through sequential movements across segments, where each segment contributes a small degree of movement.</p> Signup and view all the answers

<p>Practitioners must screen or refer patients before proceeding with further assessments in cases of fractures or instability.</p> Signup and view all the answers

<p>These ligaments are critical stabilizers of the cranio-vertebral region, impacting the safety and integrity of motion assessments.</p> Signup and view all the answers

<p>FLLARD encapsulates the six degrees of freedom in spinal movement: Flexion, Extension, Lateral flexion, Lateral translation, Anterior/ posterior translation, and Rotation.</p> Signup and view all the answers

<p>A PPIVM.</p> Signup and view all the answers

<p>Local and regional evaluation.</p> Signup and view all the answers

<p>The joint capsule.</p> Signup and view all the answers

<p>No.</p> Signup and view all the answers

<p>Strength, length, and function.</p> Signup and view all the answers

<p>Assessment segment-by-segment with side flexion.</p> Signup and view all the answers

<p>Due to guarding and the body's mechanism of stability.</p> Signup and view all the answers

<p>The resting (or loose packed) position.</p> Signup and view all the answers

<p>It indicates reaching the limit of available motion.</p> Signup and view all the answers

<p>Assumed normality of the opposite side.</p> Signup and view all the answers

<p>The positioning of the neck is crucial, as it allows for proper movement assessment at each vertebral segment, enabling clearer differentiation of movement quality.</p> Signup and view all the answers

<p>It is significant because the anatomical orientation and movement quality change between segments, which affects the assessment of mobility and restrictions.</p> Signup and view all the answers

<p>Right side bending will typically cause closing on the left side of the spinous processes and gapping on the right side, and vice versa for left side bending.</p> Signup and view all the answers

<p>The key challenge lies in accurately targeting and assessing a single segment amidst the complexity of the surrounding structures and movements of adjacent segments.</p> Signup and view all the answers

<p>The four types are PACVP, Side Glides, TVP, and PAUVP, and they primarily replicate instability tests of the spine.</p> Signup and view all the answers

<p>PACVP is significant because it applies central pressure to the spinous processes, facilitating an understanding of central vertebral mobility.</p> Signup and view all the answers

<p>It's necessary to adjust the angle of pressure to account for the lordotic curve, especially on L4-L5 where inclination is more pronounced.</p> Signup and view all the answers

<p>The clinician should position themselves either supine or prone with their thumbs interlaced to maintain stability while applying pressure.</p> Signup and view all the answers

<p>Differentiation is made by careful palpation, ensuring to assess movement on the articular pillars while avoiding rib involvement to accurately gauge vertebral mobility.</p> Signup and view all the answers

<p>Care must be taken because the tests can provoke instability if a significant issue is present, potentially worsening the patient's condition.</p> Signup and view all the answers

<p>Tissue resistance refers to the palpated resistance that clinicians feel when assessing the quality of movement and integrity of the spinal tissues.</p> Signup and view all the answers

<p>Hand positioning should utilize the ulnar border for patient comfort and the medial border of the fifth metacarpal to ensure effective pressure application.</p> Signup and view all the answers

<p>Lateral side glides are crucial as they assess lateral mobility and segmental involvement, revealing potential dysfunctions in the cervical spine.</p> Signup and view all the answers

<p>Segmental movement feeling varies due to individual anatomical differences, muscle tension, and the presence of any pain or pathology during assessment.</p> Signup and view all the answers

<p>Rotation occurs ipsilaterally with side bending.</p> Signup and view all the answers

<p>Coupling motion varies by region and segment within the spine.</p> Signup and view all the answers

<p>The main types of motion are osteokinematic and arthrokinematic movements.</p> Signup and view all the answers

<p>The shape, orientation of articulations, and the ligaments and muscles at each segment contribute to their movement potential.</p> Signup and view all the answers

<p>These subcategories help facilitate targeted assessment and treatment strategies for the upper and lower cervical spine.</p> Signup and view all the answers

<p>Compliance of the fibrocartilage influences flexibility and motion range of the spine.</p> Signup and view all the answers

<p>The atlantoaxial joint primarily facilitates rotation in the cervical spine.</p> Signup and view all the answers

<p>Aging typically results in decreased spinal mobility due to changes in disc height and overall vertebral health.</p> Signup and view all the answers

<p>The dimensions and shape dictate the possible articulatory movements between adjacent vertebrae.</p> Signup and view all the answers

<p>In the cervical spine, side bending and rotation are equally restricted, while flexion is less restricted than extension.</p> Signup and view all the answers

<p>It indicates optimal joint mobility and overall spinal health.</p> Signup and view all the answers

<p>Pain, structural abnormalities, and muscular resistance may limit range of motion during assessments.</p> Signup and view all the answers

<p>Common tools include inclinometers, goniometers, and measuring tapes.</p> Signup and view all the answers

<p>Hypomobility refers to a notable restriction in joint movement compared to normal range.</p> Signup and view all the answers

<p>The mouth should not open during the measurement.</p> Signup and view all the answers

<p>The patient should stand with arms resting on shoulders and elbows flexed to 90 degrees.</p> Signup and view all the answers

<p>Smoothness indicates an absence of compensatory movements or instability.</p> Signup and view all the answers

<p>Lumbar spine motion needs to be limited or locked down.</p> Signup and view all the answers

<p>Increased space may relieve spinal nerve root compression symptoms.</p> Signup and view all the answers

<p>It is indicated when repeat movements provoke notable differences in symptoms.</p> Signup and view all the answers

<p>Motion palpation is critical to assess normal joint mobility.</p> Signup and view all the answers

<p>Normal range and normal end-feel are required for a joint's normal classification.</p> Signup and view all the answers

<p>Positioning the head off the edge of the bed may limit range of motion less.</p> Signup and view all the answers

<p>The presence of shooting pain down the spine is a significant indicator.</p> Signup and view all the answers

<p>It ensures good body mechanics and proximity to the patient for effective palpation.</p> Signup and view all the answers

<p>The patient should be instructed to allow the head to flex and extend appropriately.</p> Signup and view all the answers

<p>Presence of hinging points during motion palpation can reveal curvature issues.</p> Signup and view all the answers

<p>Their inter-rater reliability can vary significantly, leading to inconsistent outcomes.</p> Signup and view all the answers

<p>Elbows should be pulled back to promote thoracic extension while stabilizing posture.</p> Signup and view all the answers

<p>Bone health, ligament status, blood flow, and vulnerability of the spinal cord.</p> Signup and view all the answers

<p>It is described by the superior vertebral body moving on the inferior vertebral body.</p> Signup and view all the answers

<p>Whether to perform active and/or passive movement, and whether to assess all or some movements.</p> Signup and view all the answers

<p>It affects convenience, patient comfort, and the impact of gravity on the assessment.</p> Signup and view all the answers

<p>Because it can pose significant risks during spinal movement evaluations.</p> Signup and view all the answers

<p>Movement starts at the upper vertebra and continues sequentially down the spine.</p> Signup and view all the answers

<p>Flexion, extension, lateral flexion, lateral translation, anterior/posterior translation, and rotation.</p> Signup and view all the answers

<p>A thorough screening and potential referral must occur prior to assessment.</p> Signup and view all the answers

<p>PAIVM (Passive Accessory Intervertebral Movements)</p> Signup and view all the answers

<p>The joint should be positioned in the resting or loose packed position.</p> Signup and view all the answers

<p>It often indicates involvement of the joint capsule or periarticular tissues.</p> Signup and view all the answers

<p>Strength, length, and function.</p> Signup and view all the answers

<p>PPIVM assesses smaller portions of the spine segmentally, whereas PROM examines overall range of motion.</p> Signup and view all the answers

<p>It pertains to the transition between the end of the elastic phase and the beginning of the plastic phase.</p> Signup and view all the answers

<p>Using a technique that incorporates a bit of side flexion.</p> Signup and view all the answers

<p>It suggests the body's mechanism to compensate for instability.</p> Signup and view all the answers

<p>Ensure the mount doesn’t open.</p> Signup and view all the answers

<p>Instruct the patient to stick their chest forward.</p> Signup and view all the answers

<p>By observing the influence of the restrictions on subsequent movements.</p> Signup and view all the answers

<p>Patient should be relaxed and well-supported in a neutral spinal position.</p> Signup and view all the answers

<p>Smoothness and compensation.</p> Signup and view all the answers

<p>It indicates possible facet dysfunction.</p> Signup and view all the answers

<p>It may suggest that the movements are more active-assisted than truly passive.</p> Signup and view all the answers

<p>Check that the person doesn't have glenohumeral instability.</p> Signup and view all the answers

<p>Move the shoulders rather than the thorax itself.</p> Signup and view all the answers

<p>Upper motor neuron pathology.</p> Signup and view all the answers

<p>PPIVM assessment.</p> Signup and view all the answers

<p>It affects the consistency and accuracy of the findings.</p> Signup and view all the answers

<p>The therapist should maintain good body mechanics and be as close to the patient as possible.</p> Signup and view all the answers

<p>Start away from the restricted and painful segments.</p> Signup and view all the answers

<p>The overall position of the neck must be adjusted to feel movement at the specific segment being examined.</p> Signup and view all the answers

<p>Feeling the end feel helps to differentiate the mobility and stability of each segment, which may vary from C3 to C6.</p> Signup and view all the answers

<p>Feeling multiple segments allows for a more comprehensive understanding of spinal motion and alignment across the region.</p> Signup and view all the answers

<p>Isolating one segment is challenging because the movement often affects adjacent segments, complicating the assessment.</p> Signup and view all the answers

<p>PACVP should be performed with the patient in a prone position for both the thoracic and lumbar spine.</p> Signup and view all the answers

<p>Side glides are used to evaluate lateral mobility and to assist in assessing segmental motion in the cervical spine.</p> Signup and view all the answers

<p>Clinicians should interlace their fingers with the thumb on thumb technique to maintain stability and control.</p> Signup and view all the answers

<p>The lordotic curve may necessitate changing the angle of approach to accurately assess vertebral motion.</p> Signup and view all the answers

<p>A common mistake is failing to account for the patient’s lordotic curve during the assessment.</p> Signup and view all the answers

<p>The sensation during side bending can vary, often felt between the spinous processes and laterally.</p> Signup and view all the answers

<p>PAIVMs may aggravate any existing instability, necessitating caution during assessment.</p> Signup and view all the answers

<p>Transverse vertebral pressure (TVP) is used to assess rotation accurately without anterior gliding.</p> Signup and view all the answers

<p>The TSPs in the lumbar region may be deeply located, roughly one inch from the posterior aspect of the back.</p> Signup and view all the answers

<p>Clinicians must tailor their techniques to account for the unique anatomical features and mobility limits of each spinal region.</p> Signup and view all the answers

<p>Coupled motion is significant as it describes the association of movement around one axis with movement around another. For example, when side bending to the left, some right rotation occurs simultaneously.</p> Signup and view all the answers

<p>The shape and orientation of articulations dictate the types of movements allowed, such as flexion, extension, and rotation, by defining the available space and angles for movement. These anatomical characteristics determine the overall functional motion capabilities of the spine.</p> Signup and view all the answers

<p>As individuals age, the compliance of fibrocartilage decreases, disc height may reduce, and degenerative diseases can develop, collectively limiting spinal motion. This change is part of the natural aging process affecting overall spinal health.</p> Signup and view all the answers

<p>Distinguishing between osteokinematic and arthrokinematic movements is crucial because they represent different aspects of spinal motion: osteokinematic involves gross movements of bones, while arthrokinematic deals with the movement at joint surfaces. This differentiation aids in identifying specific limitations and guiding treatment.</p> Signup and view all the answers

<p>Ligaments provide stability and limit excessive movements in the spine, thus governing the range and type of motion that can occur in various segments. They ensure that spinal movements fall within a safe and functional range.</p> Signup and view all the answers

<p>In flexed postures, the coupled motion pattern differs compared to neutral due to altered biomechanical relationships in the spine. Specific segmental interactions may change, resulting in different degrees of movement and possibly pain responses.</p> Signup and view all the answers

<p>The dimensions and shape of adjacent vertebral end plates influence the distribution of forces and ranges of motion at the joints, thereby affecting stability and mobility in the spine. Variations can lead to different mechanical behaviors and potential for injury.</p> Signup and view all the answers

<p>External factors like pain can limit range of motion by causing protective muscle guarding, while individual strength impacts the capacity to achieve full motion. Together, these factors can hinder functional movements and impact rehabilitation.</p> Signup and view all the answers

<p>The capsular pattern of the cervical spine shows that side bending and rotation are equally limited, while flexion is less limited than extension. This pattern can indicate specific joint issues during assessment.</p> Signup and view all the answers

<p>The upper cervical spine's ellipsoidal and horizontal plane joint design facilitates substantial flexion and extension while allowing limited side bending and rotation. This specialized structure is critical for head mobility.</p> Signup and view all the answers

<p>The resistance of muscles and ligaments is influenced by muscle strength, elasticity, and tension levels. External factors like fatigue and injury can also impact this resistance at the time of assessment.</p> Signup and view all the answers

<p>The lumbar spine's restricted rotation is significant because it prevents excessive strain on the intervertebral discs and surrounding structures, preserving spinal integrity. This limitation is crucial for maintaining stability during various activities.</p> Signup and view all the answers

<p>Willingness to engage in ROM significantly impacts assessments by influencing the patient's ability to perform movements and report discomfort, thereby affecting the accuracy of the evaluation outcomes. This psychological aspect must be considered when interpreting results.</p> Signup and view all the answers

<p>The presence of pain can significantly alter assessment outcomes by limiting the patient's willingness or capability to perform certain movements, leading to misleading results regarding overall spinal mobility. Assessing pain reactions is thus vital for an accurate evaluation.</p> Signup and view all the answers