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Spine and Thorax Pathologies

Terms in this set (25)

- the bony vertebral column
- connective tissue sheet
- fat around spinal cord (cushions)
- fluid (cushions)
What protects the spinal cord?
football, diving, gymnastics, cheerleading, equestrian, race car driving
What are some sports where spinal cord injuries are common?
C4, C5, C6
Most common fractures (spine)
- C1 fracture
- axial load
- mainly from football (spear tackle)
- feels like head is not connected to the head
- may result in death or severe neural issues
- signs & symptoms: local pain, neck muscle spasm, neck stiffness/ rigidity, diminished C2 dermatome
Explain Burst Fracture/ Jefferson Fracture
- axial load with forced flexion and forced rotation OR forced hyperextension
- signs & symptoms: localized pain, cervical muscle spasm, numbness in trunk and/or limbs, paralysis in trunk or limb, loss of bowel or urine functions, positive Babinski test, deep tendon reflexes absent
Explain Mid-Cervical Spine Fractures
- stabilize head and neck
- ABCs
- facemask removal
- palpate for fracture
- neuro screen
- place on spine board
- activate EMS (because it's considered a medical emergency)
Steps for Cervical Fracture Management
- muscle imbalance based on forward head/ rounded shoulder posture
- elevated and winged scapula
- protracted shoulders
- overstressed C1-C2
- C4-C5 and T4 overstressed due to altered shoulder mechanics
- tight or weakened muscles in certain areas
Explain Janda's Upper Crossed Syndrome
- in the neck
- common strains are upper trapezius and levator scapula
- signs & symptoms: localized pain, point tenderness, pain with passive stretch (someone stretching for you), trigger points
- acute treatment: ice, compression, rest, electrical stimulation
- chronic treatment: heat, massage, transverse process release, posture exercises
Explain Cervical Strains
- whiplash
- in the neck
- acceleration/deceleration (moving forwards and backwards quickly)
- football tackles and hockey
- signs & symptoms: neck pain, muscle guarding (stabilizing), point tenderness, restricted motion, headache
- refer to a physician
- grades 1-3:
- 1: no collar
- 2: collar for 72 hours
- 3: collar for 72+ hours
Explain a Cervical Sprain
- cervical nerve root compression
- known as a lower motor neuron lesion
- MOI: inflammation/swelling, cervical disc herniation, osteophytes from OA
- signs & symptoms: DTR: (hyporeflexic diminished, dermatomes diminished or lost, myotomes weak)
- management: cervical traction (decompress nerve)
Explain Cervical Radiculopathy
- lower back
- a disc herniation
- irritation of one or more nerve roots due to compression
- most common: L5 or S1
- most frequent causes: poor posture, obesity, smoking, occupation, improper lifting, repetitive stresses, vibrations
- other causes: tumor, local inflammation, facet arthritis
- pain with sitting, pain pattern worsens with coughing, possible lateral shifts, low back pain and pain down a leg
- dermatomes diminished or gone, myotomes weak, DTR hyporeflexive
Explain Lumbar Radiculopathy
- in the neck
- MOI: congenital, central disc herniation, chronic inflammation, disease (RA or syringomyelia), trauma, or fracture
- DTR: increased hyper-reflexive
- upper neuron motor lesion
- neck may or may not be painful, clumsy hands, UE/LE weakness, paresthesia, numbness, and burning
- management: refer to physician, surgery, rehab (posture correction and traction)
Explain Cervical Stenosis
-in the back
- central vs. lateral vs. combined
- congenital
- acquired
- osteophytes, hypertrophied tissues, centrally herniated disc, tumor
- relief in flexion, pain with extension
- LE sensory loss and weakness, possible bowel/bladder involvement, saddle area numbness
- sitting or flexion to relieve pain, poor mobility, stenotic gait (tilted forward to front, head rigid, no arm movement, shuffle with short steps), poor standing tolerance, possible balance impairment
- low back pain (into legs, hyper-reflexive)
Explain Lumbar Stenosis
- pars fracture (@ spinous process of the vertebrae)
Spondylolysis
- pars fracture (@ spinous process of the vertebrae) with anterior movement on vertebrae below
Spondylolisthesis
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