Ch. 20 Spine Content

Free Response Name the three major spinal segments. How many vertebrae are in each segment? What is the natural curve at each segment?

• Cervical: 7 vertebra. Lordotic curve.

• Thoracic: 12 vertebra. Kyphotic curve.

• Lumbar: 5 vertebra. Lordotic curve

Free Response: Name the first two vertebrae of the cervical spine, and the specific movement that these two vertebrae allow at the cervical spine.

1. Atlas (C1): allows for nodding motion (flexion/extension)

2. Axis (C2): allows for rotation

   overall just head rotation

anterior longitudial ligament

prevents hyperextension of the spine

posterior longitudinal ligament

prevents hyperflexion. Run in the back of the vetebral bodies

supraspinous ligament

connects spinous processes and helps limit hyperflexion

Muscles responsible for movement at spine

erector spinae (iliocostalis, longissimus, and spinalis), trapezius, multifidus, and deep cervical flexors, all of which contribute to extension, flexion, rotation, and lateral flexion of the spine. 

1. Know muscles responsible Lumbar and thoracic flexion.

rectus abdominis, internal and external obliques, and the psoas major

Know the groups of muscles on either side of the spine that run vertical. (long ropy bands)

Erector Spinae Group (Primary Vertical Muscles)

1. Iliocostalis – Located laterally, helps with extension and lateral flexion of the spine.

2. Longissimus – The middle column, responsible for spinal extension and maintaining posture.

3. Spinalis – Located medially, assists with spinal extension and stabilization.

Phrenic Nerve

1. Nerve that comes out of the cervical plexus, responsible for controlling the diaphragm.

   1. Damage above C3 could potentially cut off electrical impulse that reaches the phrenic nerve.

   2. Can cut the diaphragm, can’t breathe, diaphragm is a muscle

Free Response (5 pt.): Describe the function of an intervertebral disc and explain the two structures that make up the disc.

1. Include picture to supplement the explanation.

Function:

• Acts as a shock absorber between vertebrae.

• Allows for spinal flexibility and movement.

• Maintains proper spacing between vertebrae to prevent nerve compression.

Structure:

1. Nucleus Pulposus

   • Gel-like inner core of the disc.

   • Provides cushioning and absorbs impact.

   • Helps with spinal movement and flexibility.

2. Annulus Fibrosus

   • Tough, outer fibrous layer of the disc.

   • Composed of concentric rings of collagen fibers.

   • Maintains structural integrity and prevents herniation of the nucleus pulposus.

These discs are located between each vertebra in the spine and degenerate over time due to wear and tear, leading to conditions like herniated discs or disc degeneration.

Multiple Choice:

1. What is the mechanism of injury for a cervical fracture?

• Generally an axial load w/ some degree of cervical
  flexion
  • Addition of rotation may result in dislocation

Free Response (5 pt.): What initial care steps should be taken with a suspected cervical dislocation?

1. Call 911.

2. Put on a cervical collar.

3. Check CSM.

4. Check ABCs.

5. Instruct athletes not to move.

6. Be prepared to perform CPR or rescue breathing.

   (treat the patient like a unconcious patient)

Whiplash (Cervical Spine Sprain

Caused by sudden hyperflexion/hyperextension, like in car accidents.

Lumbar Sprain

Twisting or sudden movement leading to ligament damage.

Acute Torticollis

Neck stiffness from muscle spasm, often from sleeping in an awkward position.

Result of synovial capsule impingement w/in a facet

Sciatica

Sharp radiating pain down the leg, often from a herniated disk compressing the sciatic nerve.

Inflammatory condition of the sciatic nerve
• Nerve is vulnerable to torsion or direct blows that
place abnormal amounts of stretching or pressure on
nerve

Identify the mechanism of injury for a herniated lumbar disk.

Caused by
abnormal
stresses and
degeneration
due to use
(forward
bending and
twisting). move too much forward

Know the disk that is most often injured.

L4-L5 and L5-S1 discs in the lower lumbar spine

The radiating pain associated with a herniated disk comes from an irritation of what structure?

irritate unilaterally (one side of body) or in a dermatoral pattern (skin area). compressed spinal nerve

Free Response (6 pt.): Describe the mechanism of injury for a brachial plexus stinger or pinched nerve. Name the structures involved in the injury, the signs and symptoms, and guidelines for when the athlete can return to activity.

Cause of Injury

• Result of stretching or compression of the brachial

plexus

• Referred to as stinger or burner.

Signs of Injury

• Burning sensation, numbness and tingling as well as

pain extending from the shoulder into the hand

• Some loss of function of the arm and hand for

several minutes

• Symptoms rarely persist for several days

• Repeated injury can result in neuritis, muscular

atrophy, and permanent damage

Return to activity once S&S have returned to normal

• Strengthening and stretching program

• Padding to limit neck ROM during impact

• Full strength and sensation must return.

• No pain, numbness, or tingling.

• Must be cleared by a medical professional.nger or burner

Free Response (8 pt.): Explain the difference between a spondylolysis and a spondylolisthesis.

Spondylolysis refers to degeneration of the vertebrae

due to congenital weakness (stress fracture results). Slipping of one vertebrae above or below another is

referred to as spondylolisthesis and is often

associated with a spondylolysis