Download Spinal Injury Note sheet

Spinal Injuries
Introduction
• Spine consists of __________________ bones, supported by muscles and ligaments
• Also includes other structures like __________________ and __________________
• Injuries to the spine can be life __________________ because the spine __________________
the spinal cord.
• Most spinal cord injuries in the __________________ and __________________ regions.
Anatomy of the Spine
• Complex structure of bones with four segments
1. __________________ (tailbone area)
2. __________________ (lower spine)
3. __________________ (middle spine)
4. __________________ (upper spine)
**__________________-spinal curves of lumbar, thoracic, and cervical region are curved neither too
much nor too little.
Bones
• Bones in the spine are __________________ by disks and held __________________ by
ligaments.
• Called __________________
• ______ cervical
• ______ thoracic
• ______ lumbar
• ______ sacral
• All vertebrae have a __________________, __________________ process, and a __________________ through which the spinal cord passes
• Bony spinal column has several functions:
– __________________ the spinal cord
– Holding the body __________________ for walking
– Serving as a __________________ for muscular attachments
Disks
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Aka __________________
Lie __________________ the vertebrae to __________________ shock and resist __________________ during activity
• Keep vertebrae __________________, which allows movement and __________________ and
provides space for nerves to exit the spinal cord to the rest of the body.
• Two distinct parts
1. __________________-jellylike core
2. __________________-layers of cartilage
*disks do not receive any __________________ supply
*do not have the same __________________ potential as some other body tissues
*__________________
Muscles
• Muscles of trunk and neck are __________________ to spine
• Provide wide range of __________________ and s__________________
• __________________ muscles help support __________________ movement
– Especially rectus abdominis and the internal and external obliques
– Work with spinal extensors to keep the body upright
• __________________extends cervical spine
• Cervical flexion accomplished by the __________________ muscles
– Attach to cervical vertebrae and run down to the first and second ribs (3 muscles in all)
– Also help with __________________
• Cervical side bending and rotation accomplished by the _______________________________
muscle
– Rotates the head to the direction opposite the attachment
Normal Posture
• ATC can determine if someone has normal posture by viewing him from the __________________
• Imagine a straight line dropping from the ceiling…the line would pass…
– just __________________ the ear
– Through the __________________ of the shoulder
– Down through the __________________ of the greater trochanter of the hip
– Just behind the __________________
– Down to just in __________________ of the lateral malleolus
Abnormal Posture
• _______________________________________-ear projected in front of the line
– Puts great deal of stress at the back of the neck
• __________________-thoracic spine somewhat curved
– Line passes through back of shoulders instead of middle
• __________________-lumbar spine has too much forward curve
• If athlete cannot maintain proper posture, the ability of the spine to absorb shock is __________________
– Eventually results in injury
• __________________-side to side curvature of the spine
Preventing Postural Problems
• Imagine a balloon attached to your head pulling it __________________ up
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__________________ carrying book bag, sports bag, purse, etc. on opposite shoulders
Stay __________________
Exercise __________________ to prevent stiffness
Preventing Spinal Injuries
• Preventing injuries to cervical and lumbar spinal regions is __________________ process
– Participate in exercise and __________________ programs
– Maintain proper __________________
– Learn to __________________ properly
– Use back __________________ when lifting
Lumbar Ligament Injuries
• __________________ commonly occur when athletes are forced into __________________
trunk flexion or attempt to __________________ the spine and __________________ at the
same time
– Posterior aspect of the vertebral joints can separate and stretch over the ligaments
• Characteristics: pain to one side of spine, __________________ movement due to pain, muscle
__________________
• ATC test: stress test where you gently __________________ on each vertebrae
– __________________ if joint is sprained, not painful if __________________ is present
• Treatment: __________________
– Heat can be used after 48 hours
Lumbar Muscle and Tendon Injuries
• Rarely see ruptured muscle at lumbar spine
• Mild to moderate strains are c__________________
• Characteristics: pain to one side of spine, __________________, lack of movement
– Pain will be on __________________ side from the direction in which she bends
• Pain associated with __________________ is __________________; pain associated with s__________________ usually __________________ up and down the length of the muscle
• Treatment: apply ice, gentle __________________ using knees to chest routine
• Once pain is decreased, flexibility and strength can be restored using normal strengthening and
flexibility routines
Lumbar Bone Injuries
• Fractures hard to determine without an __________________
– Can be __________________ if ATC knows mechanism of injury, finds a great deal of
back pain, muscle spasm, and tenderness
• If ATC suspects lumbar fracture, athlete should be treated __________________
– Placed on a backboard with help of appropriate emergency medical personnel and
taken to nearest hospital
• __________________-stress fracture or bone degeneration of the vertebrae
•
__________________ of bone degeneration is important because if fracture fails to heal, it can
separate, causing the spine to become unstable
– Allows vertebrae to __________________ (slip forward) on the vertebrae below it
(called __________________)
– most common location: __________________slipping forward on the 1st sacral
Bulging Disk
• Aka __________________
• Jellylike nucleus pulpous (at center of disk) __________________ through the rings of cartilage
• Disks __________________ bulge forward
– Front of spine covered with very thick _______________________________________
– Most individuals have postures that __________________ the spine, which puts more
pressure on the front of the disk and this pushes the nucleus pulpous to the back
• Can be disabling, cause __________________, tingling, pain can occur down the leg, and pain in
lower back that __________________ with sitting
• Treatment: understand the cause, active rest, __________________ poor posture, help athlete
move into spinal extension
Cervical Ligament Injuries
• Subject to sprains when __________________ moved beyond its normal range
• Usually result of __________________ or __________________
• Symptoms: neck and arm pain
• Treatment: __________________ …no compression with elastic bandage…the “C” should really
be support
• Rehab: strengthening exercises to regain __________________ and full ROM needs to be
established
• Before returning to participation, athlete must have the following:
– __________________
– __________________
– __________________
– __________________
– __________________
Cervical Muscle and Tendon Injuries
• Most common: __________________
• Characteristics: muscle __________________, restricted ROM, weakness against resistance,
pain, __________________
• Treatment: same as ligament sprain
• Return to play: same as ligament sprain
Cervical Bone Injuries
• Fractures and dislocations
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Fractures often result of an __________________ load
– Imagine pressing on the end of a drinking straw until it bends
Dislocations often result of combination of excessive __________________ and
__________________
Symptoms: pain around cervical spine, __________________, numbness, __________________
down arms
Dislocations: often visible __________________
Treatment: emergency care procedures, neck immobilized, athlete placed on backboard.
Helmet should be left in place
Cervical Disk Bulge
• Not as common as lumbar
• Report more neck pain with __________________ and while flexing the neck
__________________, discomfort down back and between shoulder blades
• Treatment: improving neck posture and then progressing to cervical extension exercises
• Cervical traction can be used
• Full neck mobility and strength should gradually be regained
Brachial Plexus Injuries
• _________________________ -network of nerves that exit cervical spine and run a course
through the shoulder and down the arm
• Athlete who f__________________, runs into, or attempts to t__________________ another
player can stretch the brachial plexus
• Results in __________________, tingling, numbness, and __________________ sensations of
the arm and shoulder
– Aka “__________________ “or “__________________”
– May last matter of seconds or minutes
• Treatment: neck strengthening, ROM stretching
• Before returning to play, athlete must have the following:
– __________________
– __________________
– __________________
– Problem-free neck and shoulder evaluation by ATC and team physician