What are the five anatomic basis of back pain?
1) Fibroskeletal structures 2) Meninges 3) Synovial joints 4) Muscles 5) Nervous tissue
Where and what does a fracture pain mostly originate from?
Sharp pain in the periosteal region
Where and what does dislocation pain originate?
Is pain from meninges common?
No it is rare
What innervates fibroskeletal structures and meninges?
Recurrent meningeal branches of the spinal nerves.
What is localized lower back pain mainly?
Muscular, joint, or fibroskeletal
What is muscular pain?
usually related to muscular cramping (spasms) producing ischemia
What innervates synovial joints and deep back muscles?
Where does nervous tissue pain come from?
-Compression or irritation of spinal nerves or nerve roots -Typically referred pain
What are the muscles of the sub occipital triangle muscles?
-Rectus capitis posterior major -Obliquus capitis superior -Obliquus capitis inferior
What vessels run through the sub occipital region?
-Vertebral artery -Occipital artery
What can trauma do to the occipital artery?
Traumatic aneurysm of the occipital artery secondary to paintball injury.
What innervates the subcutaneous region of the head?
What are the nerves of the suboccipital region?
-Greater occipital nerve -Suboccipital nerve
What are general characteristics of the greater occipital nerve?
-Dorsal ramus C2 -Sensory to posterior head
What are the characteristics of the suboccipital nerve?
-Dorsal ramus C1 -Motor to suboccipital muscles -No sensory
What is Occipital Neuralgia?
-Can be cause of headache in the occipital region -Jabbing pain, possible numbness -Sensation in the posterior neck
What is the currently accepted view of the occurrence of occipital neuralgia?
Currently accepted view is that occipital neuralgia results from chronic entrapment of occipital nerves by the posterior neck/scalp muscles.
Where do you do an Interscalene nerve block?
Technique of anesthetizing the roots or trunks of the brachial plexus in the neck between the anterior and middle scalene muscles.