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30 terms

PCOM: Tui Na Structural, week 1 disorders of the spine

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Cervical Sprain-Strain protocol (12 steps)
Sitting: Mild Rolling (neck, shoulders), finger springing (neck, shoulders), grasping (neck, shoulders, arms), rolling w/ passive movement (neck, shoulders), press-rub (Points GB 20, 21, UB 10, Du 16); Lying down: press-release (side of neck), push (neck), finger springing (side of neck), passive movement; Sitting: grasping (neck, shoulders, arms), rolling w/ passive movement, chafe w/ lineament
Upper spine vulnerabilities
wind-cold-damp, physical trauma
TCM organs to which pain in upper spine may be related
lungs, LI, UB, GB, liver
TCM organs to which pain in T5-T12 may be related
heart, pericardium, lungs, liver, GB, spleen, stomach
vertebrae of the upper spine
C1-T4
vertebrae of the middle spine
T5-T12
vertebrae of the lower spine
L1-L5 and sacrum
middle spine vulnerabilities
more stable due to attachment of ribs
lower spine vulnerabilities
wind-cold-damp, physical trauma due to sudden overloading
TCM organs to which lower spine may be related
kidneys and kidney qi
symptoms of sprain-stain of cervical spine
pain, stiffness, immobility, muscle spasms
causes of sprain-strain of cervical spine
impact trauma or overloading of soft tissue
sudden deceleration syndrome
whiplash - extensive micro-trauma of the cervical soft tissue
causes of sudden deceleration syndrome
sudden deceleration, overextending muscle fibers, connective tissue, joint capsules, and nerve fibers
symptoms/pathologies of sudden deceleration syndrome
immediate pain which recedes after 30-60 minutes; severe pain and swelling, inability to lift head, headache, blurred vision 2-3 hours after trauma; weakness and difficulty holding head and neck erect
why are SDS symptoms staged
delay in micro-traumatic bleeding - blood and fluid seep slowly into soft tissues
cervical spondylosis
degeneration of soft tissue if the inter-vertebral facet joints
causes of cervical spondylosis
recurring sprain-strain, wind-cold-damp invasion, possibly inter-vertebral disc change from previous protrusion or herniation
symptoms/pathologies of cervical spondylosis
fusion and immobilization of the vertebra, narrowing of the foramina compressing nerve roots, pain and swelling
cervical disc protrusion
herniated, "slipped or ruptured disk"
causes of cervical disc protrusion
degeneration of annular fibers of the nucleus pulposa leads to protrusion of border of disc
symptoms/pathologies of cervical disc protrusion
protrusion of the disc causes pressure and displacement of soft tissues and root nerve compression resulting in pain, numbness, inflammation of the nerve sheath, tingling and weakness
three levels of disc protrusion
partial - fibers intact; partial herniation - fibers separated, but pulposa in place; complete herniation - pulposa extruded
cervical spondylolysis
"cracking vertebrae" - vertebra develop small cracks, gradually degenerating and narrowing the vertebral disc space
cervical spondylolisthesis
"slipping vertebrae"
causes of cervical spondylolisthesis
degeneration of soft tissue allows vertebrae to slip forward
symptoms/pathologies of cervical spondylolisthesis
ledge can be palpated between vertebrae; increased friction between inter-vertebral joints causes narrowing of inter-vertebral spaces and nerve compression
causes vertebral artery syndrome
compression of vertebral artery due to muscular tension at occipital area
symptoms/pathologies of vertebral artery syndrome
in specific positions: dizziness, loss of consciousness, visual distortion, pain and tenderness
cervical vertebral fracture
broken neck - vertebral body, TP, SP may be fractured due to physical trauma. Immobilize patient and transport to ER