High loads are espeically present in the ______ spine
the movements that are allowed in the psine are guided by _____ orientation
movements of the back are influenced by:
1) Thickness of vertebral discs - enhance movement
2) orientation of articular facets - limit movement to ertain directions
Thoracic - permit rotation in _____ ___
Lumbosacral - LIMIT movement in ______ plane
lumbar - permit flexion/extension in ____ plane
Flexion of back caues the nucleus of IV disc to project ________
what movement places a great deal of stress on the facet joints?
There is a small degree of Lateral flexion in the _____ spine, but limited by ribs.
Most LF occurs in ____ spine
There is a small degree of Lateral flexion in the thoracic spine, but limited by ribs.
Most LF occurs in lumbar spine
Erector spina muscles are ___ ____
they are responsible for contrentrically returning the ____trunk to the upright (_______) posture
they also work __________in controlling flexion
They are _______ "quiet" in full fleion - this why you lift with ____ knees
Erector spina muscles are prime movers
They are responsible for contrentrically returning the flexed trunk to the upright (extended) posture
they also work eccentrically in controlling flexion
They are electrically "quiet" in full fleion - this why you lift with bend knees
Transversospinalis are ___ to erector spinae
they run between the _______process and the _______ process
they are short - hence they are ________
Transversospinalis are deep to erector spinae
they run between the transverse process and the spibous process
they are short - hence they are stabilisers
transversospinalis act together with deep abdominal muscles to form a "corset" around truck connecting via ______ _____
transversospinalis act together with deep abdominal muscles to form a "corset" around truck connecting via lumbar fascia
Low back pain can be dvided into two main types:
1 ) mechanicl type pain - Muscle strains, disc prolapse
2) compressive type pain - typically a nerve root
What are he conditions for inducing a disc prolapse?
- 15 degree lumbar fleion - forces nucles posteriorly
- 15 degree rotation - max torsion in annulus
- light LF forces nucleus postero-laterally
- Be fat or overweight
- contract trunk muscles
- keep lower limbs fully extended
- pick up heavy object near opposite foot
The 3 types of disc prolapse are:
herniation - posterolaterally
posterior rami innervate:
- facet joints
- deep back muscles
- overlying skin
There is a dics prolapse between L4/5, which nerve root will be spared and why?
L4 - Its already emerged and pass, via the intravertebral foramen, to the exterior
L5/S1 Disc prolapse - affects ___ nerve root
How is pain, movement & signs expressed?
Pain - over hip, postero-lateral thigh, partial sensory loss in s1 dermatome
movement - restricted and painful - weakened plantar flexion (S1 myotome)
signs - limited straight leg raise, diminsed sensation
What nerve roots supply the diaphragm /
3,4,5 - keeps the diaphragm alive
What is spondylosis, osteophytes and stenosis?
With aging bones tend to lose water and become less dense
may cause overgrowth of bone producing bony spurs (osteophytes that can extend into the foramina, narrowing then (stenosis) and compressing exiting nerve roots
Compression fractures are often associated with ________
Compression fractures are often associated with osteoporosis
What is Ankylosing spondylitis?
Affects spine, joints of pelvis ultimately leading to fusion (ankylosis)
Non-mechanical low back pain sign?
type of Pain
Injury - none
type of pain - deep aching, continuous, unrelenting
Onset - insidious (awaiting a chance to entrap : treacherous.)
Aggravation - lifting, movement
relief from - analgesia
Other features -fatigue, recent weight loss, urinary symptoms
What could be some systemic causes to back pain?
aortic aneurism, metastasis of cancer cells to back
Fascia layers create spaces, ____, __, ____can spread throughout
Fascia layers create spaces, infection, puss, blood can spread throughout