Spinal Conditions Chapter 9

Spinal Column Cervical 7 vertebrae Thoracic 12 vertebrae Lumbar 5 vertebrae Sacral 5 fused vertebrae Coccygeal 4 small fused vertebrae

Vertebrae Body Vertebral arch Several bony processes Articular processes (facet joints) Pedicles

Intervertebral Discs Fibrocartilaginous Poor circulatory supply Annulus Fibrosus Nucleous Pulposus (gelatinous) Poor circulatory supply

Ligaments of the Spine Anterior Longitudinal Ligaments Posterior Longitudinal Ligaments Supraspinous Ligament Ligamentum Flavum

Muscles of the Spine Erector Spinae muscles Provide: Lateral flexion Lateral rotation Flexion Extension

Spinal Nerves 31 pairs emanate from the cord Cervical 8 pairs Thoracic 12 pairs Lumbar 5 pairs Sacral 5 pairs Coccygeal 1 pair

Brachial Plexus C5 – T1 nerve roots Innervate: Arm Forearm Hand

Lumbar Plexus T12 – L5 nerve roots Innervate: Quadriceps Adductor muscle group

Sacral Plexus L4 – L5 Innervate: Muscles of the Buttocks Posterior muscles of the lower leg Anterior muscles of the lower leg Lateral muscles of the lower leg

Anatomical Variations Kyphosis- Accentuation of the thoracic curve Scoliosis- Lateral curve of the spine Lordosis- Abnormal exaggeration of the lumbar curve

Cervical Spine Injuries Cervical Sprains Cervical Strains Cervical Spinal Stenosis Spear Tacklers Spine Cervical Fractures and Dislocations

Cervical Spine Injuries cont. Brachial Plexus Injuries Acute Burners or Stingers Chronic Burners or Stingers Suprascapular Nerve Injury

Thoracic Spine Injuries Thoracic Contusions, Strains, and Sprains Thoracic Spinal Fractures and Apophysis Scheurmann’s Disease Spondylolisthesis

Lumbar Spine Injuries Lumbar Contusions, Strains, and Sprains Low Back Pain Sciatica Lumbar Disc Injuries Lumbar Fractures and Dislocations

Sacrum and Coccyx Injuries Sacroiliac Joint Sprain ASIS PSIS Sacrotuberous ligament Sacrospinous ligament Coccygodynia Direct blow to coccyx causing fracture or contusion to the area causing pain to the nerves.

Evaluation HOPS Active motion should not be performed when there is pain over the vertebrae or when there are motor or sensory deficits noted. Palpation- Warning signs should include temperature, swelling, point tenderness, deformity, crepitus, muscle spasm, and cutaneous sensation.