Chapter 25 Worksheet The Spine

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The Spine Chapter 25

Anatomy of the Spine b b b Bones of the vertebral column • Cervical

Beefcake of the Spine b b b Bones of the vertebral column • Cervical (7), thoracic (12), lumbar (5), sacral (v fused), coccyx (4+ fused) – Intervertebral Disks - shock absorbers • Ligamentous Structures (anterior and posterior longitudinal and supraspinous) Muscles of the Spine (superficial and deep) • Erector spinae muscle group: superficial portion • Interspinalis, multifidus, rotatores, and semispinalis : Deep portion Spinal String, Nerves and Peripheral Branches

b 1. Disc b 2. Body b 3. Dura mater b 4. Epidural

b 1. Disc b ii. Trunk b three. Dura mater b iv. Epidural space b 5. Spinal cord b 6. Subarchnoid space

Preventing Injuries to the Spine b b Cervical Spine • Strengthening – protect by

Preventing Injuries to the Spine b b Cervical Spine • Strengthening – protect by resisting excessive motion • Range of Motion – flexibility • Using correct techniques Lumbar Spine • Avoid Stresses – completing ADLs properly • Correct Biomechanical Abnormalities – strength and flexibility in the core • Correct techniques when lifting

Assessment of the Spine b b History

Cess of the Spine b b History "very important" – R/O string injury Ascertainment • posture and movement evaluation – Fatback: decrease lumbar curve with increase pelvic – Swayback: hip exten. at hip, flex of thoracic on lumbar spine; lumbar in lordosis, thoracic in kyphosis – Lordosis: increase in lumbar curve – Scoliosis: lateral curvature of spine – Kyphosis: increase in thoracic curve

b Palpation – proximal to distal; muscles and bony prominence b Special Tests •

b Palpation – proximal to distal; muscles and bony prominence b Special Tests • stress tests • Range of Motion b Neurological Exam • reflex

Injuries to the Spine Cervical Sprain (whiplash) –cervical sprain • Etiology: sudden snap of

Injuries to the Spine Cervical Sprain (whiplash) –cervical sprain • Etiology: sudden snap of the caput • Signs and Symptoms: similar to sprain but last longer • Direction: Referral to r/o fracture an neurological problems; collar, RICE, NSAIDs, etc

Spine Injuries b Acute Toticollis (Wryneck) • Etiology: cold draft of air or head

Spine Injuries b Acute Toticollis (Wryneck) • Etiology: cold draft of air or head in unusual position for extended period of time • Signs and Symptoms: point tender, muscle spasm • Management: r/o more serious injury; intermission pain spasm cycle b Cervical String and Nerve Root Injuries • Etiology – – Laceration : dislocation or fracture Hemorrhage: dislocation, fx, sprain and strains Contusion: trigger-happy force to neck that does not cause dislocation Spinal Shock: severe twist or snap; transient signs of spinal string injury • Signs and Symptoms: paralysis, motor and sensory systems afflicted • Direction

Injuries to the Spine b Brachial Plexus Neurapraxia (Burner) • Etiology: stretch or compression

Injuries to the Spine b Brachial Plexus Neurapraxia (Burner) • Etiology: stretch or compression of brachial plexus • Signs and Symptoms: burning sensation, numbness, tingling, weakness • Management: in one case symptoms resolve, athlete tin return b Cervical Spine Stenosis • Etiology: narrowing of spinal canal; congential or developed • Signs and Symptoms: transient quadriplegia; persistent burners; weakness • Direction: referral for diagnosis; advise to D/C participation

Injuries to the Spine b Mechanisms • Congenital: spondylolisthesis (forward subluxation of 5 th

Injuries to the Spine b Mechanisms • Built: spondylolisthesis (forward subluxation of v th vertebrae); abnormal bony construction )length, width of vertebrae), etc • Idiopathic (mechanical or traumatic) – Mechanical: faulty posture, bad mechanics – Back Trauma: injuries occuring in contest; WATCH OUT FOR MIS-MANAGEMENT – Recurrent or chronic depression dorsum pain: malalignment, nerve rot compressions, muscle weakness

Injuries to the Spine b Herniated Lumbar Disk: usually L 4 -L 5 or

Injuries to the Spine b Herniated Lumbar Disk: usually 50 4 -L 5 or Fifty five -Due south 1 • Etiology: forward bending and twisting • Signs and Symptoms: Radiating pain unilaterally • Management: pain control; if persists, surgery may exist indicated b Spondylolysis (degeneration of vertebrae) and Spondylolisthesis (slipping of the vertebral disk) • Etiology: hyperextension, direct blow, sudden twist • Signs and Symptoms: aching pain, change positions often, possibly some neurological symptoms • Management: bracing, residuum, rehab focuses on trunk strengthening

$Injuries to the Spine b Coccyx Injuries: sprain, subluxations, fractures • Etiology: direct impact$

Injuries to the Spine b Coccyx Injuries: sprain, subluxations, fractures • Etiology: direct impact • Signs and Symptoms: refer for x-ray, pain • Management: ring seat, analgesics b Sacroiliac Joint Dysfunction(sprain, inflammation, hypermobility, hypomobility) • Etiology: twisting, falling, landing heavy on one leg, etc • Signs and Symptoms: tenderness over site, guarding, pain, ASIS or PSIS asymmetrical • Management: manage pain, mobilizations, exercises to strengthen and re-align

Rehabilitation Principles for the Spine b Joint Mobilization (decrease pain, increase mobility, increase ROM)

Rehabilitation Principles for the Spine b Articulation Mobilization (decrease hurting, increase mobility, increment ROM) b Flexibility Exercises b Strengthening Exercises b Techniques for the Low Back • • • Pain Control (mobs, traction, modalities, etc) General Trunk Workout Joint Mobilization Traction Flexibility Exercises Strengthening Exercises