Download Laukka Back + Upper Limb Clinical Correlations BACK Excessive

Laukka Back + Upper Limb Clinical Correlations
BACK
Excessive Kyphosis—hunch back, may impinge brachial nerve plexus (thoracic)
Excessive Lordosis—hollow back (lumbar)
Scoliosis—abnormal Left-Right curvature; due to asymmetric weakness of intrinsic back muscles and/or
differences in length of the legs
T12-L1 = most common site of VC body fracture (where curve changes)
Spina Bifida Occulta—neural tube defect (lack folate during pregnancy); L5 and/or S1 lamina fail to fuse;
dural sac and sometimes nerves bulge out posteriorly.
Spondylolysis—broken pars interarticularis (neck of “scottie dog” of lumbar); typically at L5 and makes
it shift anteriorly at L5/S1 jx.
Degenerative Disc Disease—begins to show signs of wear and tear as your discs dry out and shrink with
age; can lead to arthritis, disc herniation, or spinal stenosis; makes intervertebral foramen reduce in size
and impinge spinal nerves (both sensory and motor dysfunction).
IVD Herniation:
Protrusion = disc contents protrude beyond normal confines but stays at level of disc
Extrusion = extends below and above disc level (compresses 2 nerves: at the disk level and one below it)
Focal Disc protrusion: < 90 deg
Broad-based Disc Protrusion: 90-180 deg
Disc bulge: > 180 deg
Disc Extrusion (ruptured disc): nucleus pulposus leaks out of annular fibrosis crack
Most occur between L4—L5--S1
Protrudes posterolaterally and compress spinal nerves passing through intervertebral foramen
Jefferson Fracture—fracture both the anterior and posterior arch of atlas on right and left side (4
fractures widening the vertebral foramen) caused from huge force to head along longitudinal axis of
spine.
Zygapophyseal joint inflammation (arthritis)—irritates spinal nerves in intervertebral foramen; cause
segmental pain and numbness in skin, skeletal muscle weakness and muscle spasms.
Lumbar Puncture/Spinal Tap—extract CSF from subarachnoid space at L4-L5 (or L2-L3 in child)
Requires hyperflextion of lumbar (fetal position) to spread them apart
Needle passes through Ligamentum Flava (L or R), dura mater, and arachnoid mater
Epidural—put anesthesia in epidural space right outside dura mater
Vertebral Venous Plexus of Batson—communicates with prostate venous plexus and contributes to
spreading cancer
Physiology
Primary Curvature = thoracic + sacral curve out; due to difference in anterior-posterior height of VB
Secondary Curvature = cervical + lumbar in; due to difference in anterior-posterior thickness of IVD
Movement of spine
Zygapophyseal joints different orientation in each section of spine limits/allows type of
movement for each region
IVD-to-body thickness ratio is greatest in cervical region = larger range of motion
Uncovertebral Joints—uncinate process of C2-C3 + C6-C7 frequent sites of bone spur formation