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Where do majority of spine problems occur?
where secondary curves meet primary curves
How do intervertebral disks get injured?
generally by pressure squeezing the nucleus out of the disk, can cause pressure on spinal cord if bad enough
How can intervertebral disk injuries have an affect?
pain doesnt occur until other structures are impinged upon, compression of spinal nerve causes sensory and motor deficits for the affected dermatome and myotome, causes sharp shooting painand muscle spasm, pain with flexion
management for intervertabral injuries?
ice/heat, muscle stim/relaxant, extension exercises, spinal stabilization, traction
lateral stenosis?
narrowing of the intervertebral foraman
central stenosis?
narrowing of the spinal canal/foramen
What is scoliosis?
abnormal curve in the frontal plane of lumbar and thoracic spine
what are the two types of scoliosis?
idiopathic adolescent scoliosis, found during onset of puberty and adult scoliosis, can be from untreated adolencent scoliosis or aging/dgeneration of spine
What are some indications of scoliosis?
when bending over spoinous processes are not lined up and rib flare
treatment for scoliosis?
is curve is less than 25 degrees rehab, braces for curves 25-40 degrees, and surgery for anthing greater than 60 degrees
spondylolysis?
unilateral stress fracture of pars interarticularis, also known as the scottie dog fracture, vertebrae are still in line, is an extension injury to one side (common for high jumpers and lineman)
Spondylolisthesis?
bilateral stress fracture os pars interarticularis, vertebrae instability, body of vertebrae can slide forward
transverse or spinous process practure of lumbar spine?
caused bye a direct blow to back or extreme forced motion
vertebral body compression fracture of lumbar spine?
found at thoracic-lumbar region, very dangerous die to possibility of impingement of spinal canal
wedge fracture
fracture of the body in a wedge shape in the thoracic spine, caused by a axial compression
How do rib fractures occur?
compression of rib cage or direct blow
Scheuermanns Disease
degeneration of epipyseal end of vertebral bodiesin three or more adjacent segements, increased thoracic kyphosis (forward bending), typical onset is about 8-12 years old
Atlantoaxial instability?
occurs in 10-30% of children with down syndrome
hangmans fracture?
bilateral fracture of pars interarticularis of C2, leaves dens very unstable, occurs with axial loading or extreme cervical flexion
Where are the most common cervical fracture sites?
C4, C5, C6
signs of a cervical fracture?
painful palpitation of spinous process, radiation of pain, weakness, or numbness into dermatome/myotome, paralysis or loss of bowel/bladder control
Which nerves innervate the diaphragm?
C3, C4, C5 keep the diaphragm alive
How do most skull fractures occur?
blunt force trauma
signs and symptoms of a skull fracture?
defect with palpation, CSF coming from nose or ear, eccymosis around eyes (raccoon eyes) or behind ear, unequal and unreactive pupils, blood in ear canal
management for skull fracture?
immediate activation of EAP and hospitalization, stabilize head and neck, treat for shock and keep patient calm
What is a concussion?
wide spread injury to the brain, range from mild to severe, mild traumatic brain injury, can cause lasting neurological deficits, alot more serious than mant people think
What are some signs and symptoms?
dizzyness, headache, fog, blurred vision, nausea, wil be different for everyone
What is post concussion syndrome?
concussion symptoms that last for days or months after the incident, do not return to play until all symptoms are resolved
What is second impact syndrome?
when a second concussion episode occurs before the first has resolved fully, cuses rapid swelling of brain increasing intercranial pressure, likely to occur in people less than 20
epidural hematoma?
a tear in a meningeal artery from a blow to the head or skull fracture, blood accumulation occurs within minutes to a few hours
subdural hematoma?
the most common cause of death for head trauma injuries for athletes, tear in blood vessels that bridge the dura mater and brain, symptoms occurs hours,days, or months after trauma
signs and symptoms of a hematoma?
breifly unconscious, possible the athlete will have preiod of lucidness, the bigger the hematoma the more these symptoms will be prevelent, headache, drowsiness, disoriented, cognitively impaired, decreased motor and behavioral ability, cranial nerve disfunction, unilateral dilated pupil
What accounts for the bulk of all low back injuries?
muscle strains/joint sprains
acute muscle strain/joint sprain injuries
result from coupled motions ivolving rotation and either flexion of extension
chronic muscle strain/joint sprain injuries
posture is the biggest contributing factor, also tightness in hamstrings/hip flexor is also a contributor
treatment for msucle strains and joint sprains?
ice, passive stretching, bracin options, medications, therapeutic exercises