Spinal Injuries Chapter 11 - PowerPoint Presentation

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Spinal Injuries

Chapter 11

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Five Divisions

Cervical Division (7)Thoracic Division (12)

Lumbar Division (5) Sacral Division (5)Coccygeal Division (4)

Four CurvaturesCervical CurvatureThoracic CurvatureLumbar Curvature

Sacral Curvature

Anatomy of The Spine

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Parts to know:

Vertebral ForamenTransverse Foramen

Transverse ProcessAnterior ArchPosterior ArchLateral Mass

Superior Articular FacetArticular Surface for the DensInferior Articular Facet (not pictured)

Cervical Vertebrae (Atlas – C1)

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Parts to know:

Vertebral ForamenTransverse ForamenTransverse Process

Dens (Odontoid Process)Superior Articular FacetLaminaBifed Spinous Process

Inferior Articular Facet

Cervical Vertebrae (Axis – C2)

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Parts to know:

Vertebral ForamenTransverse Foramen

Transverse ProcessBody (Centrum)Superior Articular FacetPedicle

LaminaSpinous ProcessInferior Articular Facet

Cervical Vertebrae (C3 – C7)

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Parts to know:

BodySpinous ProcessSuperior Demifacet

Inferior DemifacetTransverse Costal FacetTransverse Process

Superior Articular FacetInferior Articular FacetProminent LaminaVertebral Foramen

Thoracic Vertebrae (T1 – T12)

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Parts to know:

BodyVertebral ForamenTransverse Process

Spinous ProcessSuperior Articular FacetInferior Articular Facet

Superior Vertebral NotchInferior Vertebral Notch

Lumbar Vertebrae (L1 – L5)

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Parts to

Know:Sacrum

Base of the SacrumSacral Canal

Median Sacral CrestSacral CornuaSacral Hiatus

Sacral Foramen

Ala

Lateral Sacral CrestApex of the Sacrum

CoccyxCoccygeal VertebraeCoccygeal CornuTransverse ProcessesSacrum and Coccyx

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Made up of fibrocartilage.

Lie in between each vertebrae.Parts to know:Annulus Fibrosus

Nucleus Pulposus

Intervertebral Discs

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FlexionExtension

RotationLateral Flexion

Lumbar ROM

Ranges of Motion for the Spine

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Dermatome

An area of the skin supplied by nerves from a single spinal root.Myotome

A myotome is the group of muscles that a single spinal nerve root innervates.

Dermatomes & Myotomes

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A deep layer of muscles

3 layers of the musclesDeepest (Transversospinalis

Group) layer – Semispinalis, multifdus and rotator muscles.Intermediate (Erector Spinae

Group) layer – divided into 3 columns:Spinalis

muscles

- medial column closest to spine.

Longissimus muscles – intermediate column; next closest to the spine.

Iliocostalis muscles – lateral column; furthest from the spine.Superficial Layer – Splenius muscles.Intrinsic Muscles of the Spine

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Semispinalis Capitis

Origin –C7 and T1 – T6 transverse processes and C4 – C6 articular processes.

Insertion – Between the superior and inferior nuchal lines of the occipital bone.Action – Extension and lateral flexion of the cervical neck and head, and rotation to the opposite side.

Deep Layer -

Transversospinalis

Group

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Semispinalis Cervicis

Origin – Transverse processes of T1 – T6.

Insertion – Spinous processes of C2 – C5.Action – Acting bilaterally, extension of the cervical spine. Acting unilaterally, lateral flexion of the neck and head and rotation to the opposite side.

Deep Layer -

Transversospinalis

Group

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Semispinalis Thoracis

Origin – The transverse processes of T6 – T10.Insertion – The spinous processes of T1 – T4 and C6 – C7.

Action – Extends the spine and rotates it towards the opposite side.

Deep Layer - Transversospinalis Group

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Multifidus Group

Origin – Posterior surface of the sacrum, the dorsal end of the iliac crest, the transverse processes of L1 – L5, T1 – T12 and the articular processes of C4 – C7.

Insertion – Spinous processes of all of the vertebrae except for C1.Action – Acting unilaterally, lateral flexion and rotation to the opposite side. Acting bilaterally, extension of the spine.

Deep Layer -

Transversospinalis

Group

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Rotators Group

Origin – Transverse processes of the vertebrae.Insertion – Bases of the spinous processes (lamina) 1-2 vertebrae above.

Action – Acting unilaterally, rotation of the spine to the opposite side. Acting bilaterally, extension of the spine.

Deep Layer - Transversospinalis Group

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Interspinales

Origin & Insertion – Pairs of small muscles joining the spinous processes of adjacent vertebrae, one on each side of the interspinous ligament. Continuous in the cervical region extending from the axis to the 2

nd thoracic vertebra and in the lumbar region from the 1st lumbar to the sacrum.

Action – Extension of the spine.

Deep Layer -

Transversospinalis

Group

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Intertransversarii

Origin & Insertion – Pairs of small muscles, anterior and posterior, on each side of the spine joining the transverse processes of adjacent vertebrae. They extend from the Atlas (C1) to the first thoracic vertebra (T1) and from the 10

th thoracic (T10) to the last lumbar vertebra (L5).Action – Acting unilaterally, lateral flexion of the spine.

Deep Layer -

Transversospinalis

Group

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Spinalis Capitis

Origin – C5 – C7 and T1 – T3 vertebrae (

spinous processes).Insertion – Occiput

between the superior and inferior nuchal lines.Action -

Extension, rotation,

and

lateral bending of C- spine.

Intermediate Layer – Erector Spinae Group – Medial Column

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Spinalis Cervicis

Origin – The lower portion of the ligamentum nuchae, spinous processes of C7 and sometimes T1 - T2.

Insertion – The spinous process of the Axis (C2) and sometimes the spinous processes of C3 - C4.Action – Acting unilaterally, lateral flexion of the C-spine. Acting bilaterally, extension of the spine.

Intermediate Layer – Erector Spinae

Group – Medial Column

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Spinalis Thoracis

Origin – The spinous processes of L2, L1, T12, T11.Insertion – The spinous processes of the upper thoracic vertebrae (T4 – T8).

Action – Acting unilaterally, lateral flexion or the thoracic spine. Acting bilaterally, extension of the thoracic spine.

Intermediate Layer – Erector Spinae Group – Medial Column

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Longissimus Capitis

Origin – Transverse processes of T1 - T5 and the articular processes of C4 – C7.

Insertion – The posterior margin of the mastoid process.Action – Acting bilaterally, extends the head; acting unilaterally, laterally flexes and rotates the head to the same side.

Intermediate Layer –

Erector Spinae

Group –

Intermediate Column

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Longissimus Cervicis

Origin – Transverse processes of T1 – T5.Insertion – Transverse processes of C2 – C6 and sometimes the Atlas (C1).

Action – Acting unilaterally, laterally flexes the neck. Acting bilaterally, extension of the neck.

Intermediate Layer – Erector Spinae

Group – Intermediate Column

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Longissimus Thoracis

Origin – The common broad, thick tendon with the iliocostalis lumborum, fibers from the transverse and accessory processes of the lumbar vertebrae and thoracolumbar fascia.

Insertion – The tips of the transverse processes of all thoracic vertebrae and the lower 9-10 ribs between the tubercles and the angles.

Action – Acting unilaterally, laterally flexes the vertebral column. Acting bilaterally, extension of the vertebral column; draws ribs down.

Intermediate Layer –

Erector Spinae

Group – Intermediate Column

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Iliocostalis Cervicis

Origin – Superior borders of the angles of rib 3 – 6.Insertion – The posterior tubercles of the transverse processes of the 4

th, 5th, and 6

th cervical vertebrae (C4 – C6).Action – Acting bilaterally, extension of the spine. Acting unilaterally, laterally flexes the vertebral column.

Intermediate Layer –

Erector Spinae

Group –

Lateral Column

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Iliocostalis

ThoracisOrigin – Superior borders of the angles of the lower 6 ribs medial to the tendons of insertion of the iliocostalis lumborum.

Insertion – Into the angles of the upper 6 or 7 ribs and into the transverse process of the 7

th cervical vertebra.Action –

Acting bilaterally, extension of the spine. Acting unilaterally, laterally flexes the spine.

Intermediate Layer –

Erector Spinae

Group – Lateral Column

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Iliocostalis

LumborumOrigin – Anterior surface of a broad and thick tendon which originates from the sacrum, spinous processes of the lumbar and 11

th and 12th thoracic vertebrae, and from the medial lip of the iliac crest.

Insertion – Inferior borders of the angles of the lower 6 or 7 ribs.

Action –

Acting bilaterally, extension of the spine, acting unilaterally, laterally flexes the spine.

Intermediate Layer –

Erector Spinae Group – Lateral Column

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Splenius Capitis

Origin – Inferior one-half of ligamentum nuchae and spinous processes of C7 – T4.

Insertion – Mastoid process and lateral portion of the superior nuchal line.

Action – Unilaterally, rotate the head and neck to same side, laterally flex the head and neck to the same side; bilaterally, extend the head and neck.

Superficial Layer

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Splenius Cervicis

Origin – Spinous processes of T3 – T6.

Insertion – Transverse processes of C1 – C3.Action –

Unilaterally, rotate the head and neck to same side, laterally flex the head and neck to the same side; bilaterally, extend the head and neck.

Superficial Layer

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Kyphosis

LordosisScoliosisForward headFlatback

Swayback

Postural Concerns

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Brachial Plexus Neurapraxia (Burner/Stinger)

Low Back StrainsSciaticaHerniated Lumbar Disk

Spondylosis and SpondylolisthesisScheuermann’s Disease (Dorsolumbar Kyphosis)Lumbar Vertebrae Fracture and Dislocation

Myofascial Pain SyndromeLumbar SprainsBack Contusions

Cervical Fracture

Cervical Dislocation

Acute Strains of the Neck and Upper Back

Cervical Sprain (Whiplash)Acute Torticollis (Wryneck)Cervical Cord and Nerve Root InjuriesCervical Spine StenosisCervical Disk InjuriesCommon Injuries1/31/2017

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Etiology

Signs & SymptomsStinger

Management

Brachial

Plexus Neurapraxia (Burner/Stinger)

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Etiology

Signs & SymptomsManagement

Low back Strains

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Etiology

Signs & SymptomsManagement

Sciatica

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EtiologySigns & Symptoms

Management

Herniated Lumbar Disk

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Etiology

“Scotty Dog” FractureSigns & Symptoms

ManagementSpondylolysis and Spondylolisthesis

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EtiologySigns & Symptoms

Management

Scheuermann’s

Disease (Dorsolumbar Kyphosis)

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Etiology

Compression FractureFracture DislocationSigns & Symptoms

Management

Lumbar

Vertebrae Fracture and Dislocation

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Etiology

Signs & SymptomsManagement

Myofascial

Pain Syndrome

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EtiologySigns & Symptoms

Management

Lumbar Sprains

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Etiology

Signs & SymptomsManagement

Back Contusions

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Etiology

Louisville InjurySigns & SymptomsManagement

Rutgers InjuryFear the Spear

Cervical Fracture

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Etiology

Signs & SymptomsManagement

Cervical Dislocation

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Etiology

Signs & SymptomsManagement

Acute

Strains of the Neck and Upper Back

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Etiology

Signs & SymptomsManagement

Cervical Sprain (Whiplash)

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EtiologySigns & Symptoms

Management

Acute

Torticollis (Wryneck)

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Etiology

Signs & SymptomsSpinal Cord Hemorrhage (C2-C7)Spinal Cord Contusion

Management

Cervical

Cord and Nerve Root Injuries

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Etiology

Signs & SymptomsSimilar to cervical fracture – like football videos we watched

Management

Cervical Spine Stenosis

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Etiology

Signs & SymptomsManagement

Cervical

Disk Injuries

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You should be able to:Label the type of vertebrae and their different parts.

Label the different muscles of the spinal column.Identify the different types of vertebrae and their parts by using the vertebral models.

Identify the different types of injuries discussed for the cervical, thoracic, and lumbar regions of the spinal column/back.

For Your Quizzes

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