Spinal Injuries
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Transcript Spinal Injuries
Spinal
CHAPTER 11 Injuries
ANATOMY OF THE SPINE
Five Divisions
Cervical Division (7)
Thoracic Division (12)
Lumbar Division (5)
Sacral Division (5)
Coccygeal Division (4)
Four Curvatures
Cervical Curvature
Thoracic Curvature
Lumbar Curvature
Sacral Curvature
CERVICAL VERTEBRAE (ATLAS – C1)
Parts to know:
Vertebral Foramen
Transverse Foramen
Transverse Process
Anterior Arch
Posterior Arch
Lateral Mass
Superior Articular
Facet
Articular Surface for
the Dens
Inferior Articular Facet
(not pictured)
CERVICAL VERTEBRAE (AXIS – C2)
Parts to know:
Vertebral Foramen
Transverse Foramen
Transverse Process
Dens (Odontoid
Process)
Superior Articular
Facet
Lamina
Bifed Spinous Process
Inferior Articular Facet
CERVICAL VERTEBRAE (C3 – C7)
Parts to know:
Vertebral Foramen
Transverse Foramen
Transverse Process
Body (Centrum)
Superior Articular
Facet
Pedicle
Lamina
Spinous Process
Inferior Articular Facet
THORACIC VERTEBRAE (T1 – T12)
Parts to know:
Body
Spinous Process
Superior Demifacet
Inferior Demifacet
Transverse Costal
Facet
Transverse Process
Superior Articular
Facet
Inferior Articular
Facet
Prominent Lamina
Vertebral Foramen
LUMBAR VERTEBRAE (L1 – L5)
Parts to know:
Body
Vertebral Foramen
Transverse Process
Spinous Process
Superior Articular
Facet
Inferior Articular
Facet
Superior Vertebral
Notch
Inferior Vertebral
Notch
SACRUM AND COCCYX
Parts to Know:
Sacrum
Base of the Sacrum
Sacral Canal
Median Sacral Crest
Sacral Cornua
Sacral Hiatus
Sacral Foramen
Ala
Lateral Sacral Crest
Apex of the Sacrum
Coccyx
Coccygeal Vertebrae
Coccygeal Cornu
Transverse Processes
INTERVERTEBRAL DISCS
Made up of
fibrocartilage.
Lie in between each
vertebrae.
Parts to know:
Annulus Fibrosus
Nucleus Pulposus
RANGES OF MOTION FOR THE SPINE
Flexion
Extension
Rotation
Lateral Flexion
Lumbar ROM
DERMATOMES & MYOTOMES
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.
INTRINSIC MUSCLES OF THE SPINE
A deep layer of muscles
3 layers of the muscles
Deepest (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.
DEEP LAYER - TRANSVERSOSPINALIS
GROUP
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
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
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
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
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
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
1 st lumbar to the sacrum.
Action – Extension of the
spine.
DEEP LAYER - TRANSVERSOSPINALIS
GROUP
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.
INTERMEDIATE LAYER – ERECTOR
SPINAE GROUP – MEDIAL COLUMN
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 Cspine.
INTERMEDIATE LAYER – ERECTOR
SPINAE GROUP – MEDIAL COLUMN
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
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 – INTERMEDIATE COLUMN
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
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
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 – LATERAL COLUMN
Iliocostalis Cervicis
Origin – Superior borders of the
angles of rib 3 – 6.
Insertion – The posterior
tubercles of the transverse
processes of the 4 th, 5 th, 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
Iliocostalis Thoracis
Origin – 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
Iliocostalis Lumborum
Origin – Anterior surface of a
broad and thick tendon
which originates from the
sacrum, spinous processes
of the lumbar and 11 th and
12 th 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.
SUPERFICIAL LAYER
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
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.
POSTURAL CONCERNS
Kyphosis
Lordosis
Scoliosis
Forward head
Flatback
Swayback
COMMON INJURIES
Brachial Plexus Neurapraxia
(Burner/Stinger)
Low Back Strains
Sciatica
Herniated Lumbar Disk
Spondylosis and
Spondylolisthesis
Scheuermann’s Disease
(Dorsolumbar Kyphosis)
Lumbar Vertebrae Fracture
and Dislocation
Myofascial Pain Syndrome
Lumbar Sprains
Back Contusions
Cervical Fracture
Cervical Dislocation
Acute Strains of the Neck and
Upper Back
Cervical Sprain (Whiplash)
Acute Torticollis (Wryneck)
Cervical Cord and Nerve Root
Injuries
Cervical Spine Stenosis
Cervical Disk Injuries
BRACHIAL PLEXUS NEURAPRAXIA
(BURNER/STINGER)
Etiology
Signs & Symptoms
Stinger
Management
LOW BACK STRAINS
Etiology
Signs & Symptoms
Management
SCIATICA
Etiology
Signs & Symptoms
Management
HERNIATED LUMBAR DISK
Etiology
Signs & Symptoms
Management
SPONDYLOLYSIS AND
SPONDYLOLISTHESIS
Etiology
“Scotty Dog” Fracture
Signs & Symptoms
Management
SCHEUERMANN’S DISEASE
(DORSOLUMBAR KYPHOSIS)
Etiology
Signs & Symptoms
Management
LUMBAR VERTEBRAE FRACTURE AND
DISLOCATION
Etiology
Compression Fracture
Fracture Dislocation
Signs & Symptoms
Management
MYOFASCIAL PAIN SYNDROME
Etiology
Signs & Symptoms
Management
LUMBAR SPRAINS
Etiology
Signs & Symptoms
Management
BACK CONTUSIONS
Etiology
Signs & Symptoms
Management
CERVICAL FRACTURE
Etiology
Louisville Injury
Signs & Symptoms
Management
Rutgers Injury
Fear the Spear
CERVICAL DISLOCATION
Etiology
Signs & Symptoms
Management
ACUTE STRAINS OF THE NECK AND
UPPER BACK
Etiology
Signs & Symptoms
Management
CERVICAL SPRAIN (WHIPLASH)
Etiology
Signs & Symptoms
Management
ACUTE TORTICOLLIS (WRYNECK)
Etiology
Signs & Symptoms
Management
CERVICAL CORD AND NERVE ROOT
INJURIES
Etiology
Signs & Symptoms
Spinal Cord
Hemorrhage (C2-C7)
Spinal Cord
Contusion
Management
CERVICAL SPINE STENOSIS
Etiology
Signs & Symptoms
Similar to cervical
fracture – like football
videos we watched
Management
CERVICAL DISK INJURIES
Etiology
Signs & Symptoms
Management
FOR YOUR QUIZZES
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.