Disc Flashcards
type of collagen in your nucleus pulposus of your discs?
type 2
type of collagen in your annulus fibrosis of your discs?
type 1
what else is found in discs?
water and proteoglycans
how do discs get nutrition?
passively: imbibition
actively: spinal motion
optimal stim for annulus regeneration?
rotation
optimal stim for nucleus?
intermittent compression/decompression
what is most disruptive force to disc?
shear forces
most frequent site of DDD?
LS jxn
pt. profile: DDD
males 40-50,
occupation involves lifting, sitting or contact sports
constant intermittent low grade ache, LE pain= rare, morning stiffness
DDD agg. factors
ext. bending, sitting, sit to stand, lifting, sustained posture, sudden motion, end of range motion
rotation impaired
tx DDD
disc rehydration (bird dogs), limit rot.
types of disc herniation
intra-spongy hernitation
protrusion
prolapse/ extrusion
sequestrian
where do 90% of disc herniations occur?
L4/5 OR L5/S1
pt profile: sudden onset (but possibly after repetitive bending or frequent lifting), increased pain in AM, poorly localized dull ache, buttock pain, unloads spine with sit>stand, flexion= most pain, walking and sneeze/cough hurt. eased with lying down
HNP
why do posterior herniations hurt worse than anterior ones?
bc the PLL has so many more nocioceptive fibers, the ALL barely has any
