Download Chapter 10

Chapter 10
Injuries to the Thoracic Through Coccygeal Spine
In Your Notebooks:
• How many vertebrae make up the Spine?
• How Many ribs make up the rib cage?
In Your Notebooks:
• What three sections is the spine broken down
into?
Vertebrae Anatomy Review
•
•
•
•
•
•
•
What is the Vertebral Body?
What is the Lamina?
What is the Spinous Process?
What is the Transverse Process?
What are the Facet Joints?
What are the Intervertebral discs?
What are the 2 parts of the Intervertebral
discs?
In Your Notebooks:
• What are the four important parts of the
vertebrae we talked about yesterday?
• What are the two parts of the intervertebral
discs?
Sacral Anatomy Review
• What is the most distal portion of the vertebral
column?
• How many Sacral vertebrae are there?
• Are the Sacral vertebrae moveable?
Lumbar Anatomy Review
• How many lumbar vertebrae are there?
• What are the names of the large, strong
ligaments that support the spine?
• What type of curve do the lumbar vertebrae
create?
Thoracic Anatomy Review
• How many Thoracic Vertebrae are there?
• What type of curve do the Thoracic Vertebrae
create?
• What three parts make up the “Thoracic
Cage”?
• What is the function of the Thoracic Cage?
• Is the Thoracic cage very mobile?
• Where does most movement of the Thoracic
Cage occur?
• Are Thoracic Injuries common in sports?
In Your Notebooks:
• What type of curve does the lumbar spine
create? What is the Anatomical name given to
this type of curve?
• What type of curve does the thoracic spine
create? What is the Anatomical name given to
this type of curve?
In Your Notebooks:
• What problems do you think could arise from
an excessive kyphotic or lordotic curve of the
spine?
Terms:
•
•
•
•
•
Kyphosis
Lordosis
Hyper
Hypo
Scoliosis
Number Your Paper 1-10
1. Student’s Name
Hyper/Hypo Kyphosis?
Hyper/Hypo Lordosis?
Scoliosis? S curve or C curve?
Anatomy Review of the
Thoracic Spine
• Thoracic spine is
composed of 12
vertebrae that
articulate with the
cervical and lumbar
spines.
• The thoracic spine,
corresponding 12
pairs of ribs, and
sternum form the
thoracic cage.
In Your Notebooks:
• What types of injuries do you think can
happen to the Thoracic and Lumbar Spine?
• List 3…
Common Sports Injuries
Skeletal Injuries of the Thoracic Vertebrae
• Compression fractures of the vertebral body
are most common injury.
• Such fractures usually occur at junction of
thoracic and lumbar spine.
• Athlete with recent history of trauma to the
region in conjunction with pain or numbness
should be referred to a physician.
• Scheuermann’s disease is adolescent
condition characterized by kyphosis. Children
with chronic thoracic pain should be
evaluated.
Rib Fractures
• Such fractures are associated with direct
blows to lateral or posterior thorax and can
occur anywhere along the rib.
• The ribs commonly fracture near the
anatomic angle, which is the weakest point.
• Posterior rib fractures can potentially result in
a pneumothorax or a hemothorax.
Rib Fractures (cont.)
Signs and symptoms include:
• Painful respiration.
• Deformity in the region of the injury,
including a protruding rib or depression
where the normal contour of the rib should
be.
• Swelling and discoloration.
• Pain when rib cage is gently compressed.
Rib Fractures (cont.)
First Aid
• Immediate application of RICE.
• Treat for shock.
• Refer athlete to physician.
Sprains
Sprains occur whenever a joint is forced beyond
its normal ROM resulting in damage to
ligaments and joint capsules.
• Evaluation of a sprain to the thoracic spine
is difficult.
• A consistent symptom is painful respiration.
First Aid
• Apply RICE.
• If dyspnea persists for more than 24 hours,
refer the athlete to a physician.
Strains
Strains:
• Involve contractile tissue and their
support structures, such as the erector
spinae and intercostals.
• Are related to maximal exertions.
• Result in muscle spasm and point
tenderness.
• First Aid
• Application of RICE to the injured area.
Lumbar Spine Region
Anatomy Review
• Five vertebrae are
in lumbar spine.
• Lumbar vertebrae
are the largest
moving vertebrae.
• The major ligaments
are the anterior and
posterior
longitudinal.
Lumbar Spine Region
• The sacrum consists of
five fused vertebrae.
• The sacrum connects the
spinal column to the
pelvis.
• Right and left sacroiliac
(SI) joints are formed by
the union of the sacrum
and pelvis.
• Coccyx (tailbone) is most
distal portion of the
vertebral column.
Spondylolysis and
Spondylolisthesis
• Spondylolysis is a defect in
the neural arch (pars
interarticularis). Such
defects compromise the
articulation between two
vertebrae.
• If the condition is bilateraI,
the affected vertebra can
slip forward resulting in
spondylolisthesis.
Spondylolysis and
Spondylolisthesis
• Symptoms include
(cont.)
lower back pain that
worsens during
hyperextension, and
radiating pain to the
buttocks and upper
thighs.
• Treatment includes
rest, drug therapy,
lumbar bracing,
exclusion from certain
sports, and surgery.
Traumatic Fractures: Lumbar
Spine
• Such fractures are uncommon in sports.
• External blows may result in internal injury.
• Deep abdominal pain, hematuria, and shock
are signs and symptoms of internal injury.
• Immobilize on spine board and transport to
medical facility.
• Blows to the coccyx can result from landing on
the buttocks.
• Fractures of the coccyx result in severe pain,
point tenderness, swelling, and bruising. Refer
athlete to physician for evaluation.
Lumbar Region -- Strains &
Sprains
• Strains and sprains
are the most common
soft-tissue injuries in
the lumbar spine.
• Major joints include:
• Lumbosacral.
• Sacroiliac.
• Sacrococcygeal.
Lumbar Strains & Sprains
(cont.)
Signs and symptoms include:
• Localized muscle spasm.
• Pain that does not radiate into buttocks or
lower extremity.
• Acute postural abnormalities associated
with recent trauma.
First Aid
• Have athlete maintain a supine position
with soft support for lumbar region and
application of ice.
• If not improved in 24 hours, refer to
physician.
Lumbar Disk Injuries
• A serious form of soft
tissue injury is a
“herniated disk.”
• Most commonly occurs
at L4 or L5.
• Anatomy of a disk
includes annulus fibrosis
(outer ring) and nucleus
pulposus (inner ring).
Lumbar Disk Injuries (cont.)
• Herniation results from a weakened annulus
that allows nucleus pulposus to protrude
through the wall of the annulus.
• Protrusion may put pressure directly on spinal
nerves resulting in:
• Intense local or radiating pain.
• Sensory loss or burning/tingling sensation
in lower extremity.
• Muscle spasm and postural abnormalities.
Lumbar Disk Injuries (cont.)
First Aid
• Place athlete in supine or most comfortable
position. Support lumbar region with rolled
towel or other soft material.
• Apply crushed ice to lumbar region.
• Arrange for transport to medical facility.