Lower Back

Lower Back

1. Anatomy

   • Bones
     • Atlas
     • Cervical
     • Thoracic
     • Lumbar
     • Sacrum
   • Muscles
     • Erector Spinae
       • Spinalis
       • Longismuss
       • Iliocostalis
   • Ligaments
     • Post. long. ligament
     • Ant. long. ligament
     • Supraspinous ligament
     • Interspinous ligament
     • Ligamentum flavum
     • Intertransverse ligament
   • Joints
     • Facet Joint
     • Atlanto Occipital Joint
     • Atlanto Axial Joint

2. Movements of the back

3. Curvatures of the back

   • Abnormal Spine Curvature
     • Scoliosis
       • Scoliosis is a disorder in which there is an abnormal curving of the spine.
       • Causes
         • Idiopathic
         • Congenital
         • Neuromuscular
         • Injury
       • Clinical Presentation
         • Backache or low-back pain.
         • Tired feeling in the spine after sitting or standing for a long time.
         • Spine curves more to one side
         • One shoulder blade that appears more prominent than the other.
       • Treatment
         • Brace
         • Surgery

4. Dermatomes

5. Referred Pain

   • Radiating Pain
     • starts in one place but travels to another, usually along the path of a nerve.
   • referred pain tends to be pain that is less focal and contained to a general area, an area usually close to the source of the pain.
     • Dermatomal Rule
     • Convergence Rule

6. Pain of the Lower Back

   • lumbar strain
   • disc herniation
   • Lumbar radiculopathy
   • nerve irritation
   • Joint and bones problems

7. Physical Exam

   • inspection
     • posture
     • Swelling
     • skin
       • trauma
       • discoloration
     • wasting
   • Tests
     • Straight leg test
     • Crossed SLRT

8. VAS

9. Sciatica

   • Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve
   • Causes
     • Herniated disc
     • Stenosis
     • Tumor
   • Clinical Presentation
     • Shooting pain from the lower back
     • mild soreness to a sharp pain

10. Management

    • Prevention
    • Stretching and exercise
    • Take a break
    • Bed rest
    • Surgery
      • Indications of surgery
        • herniated disk
        • Symptoms are getting worse
        • Significant muscle weakness
        • neurological deficit
        • Bowel or bladder dysfunction
    • NSAIDs
    • Physiotherapy
      • The Schroth Method
    • Epidural
      • Epidural anesthesia can be used as a sole anesthetic for procedures involving the lower limbs, pelvis, perineum and lower abdomen
      • Space between L3 and L4 is ideal for performing lumbar puncture and epidural
      • Efficiency for lower back pain
        • Temp. relief before surgery
        • Temp. relief to start exercise
    • Spinal manipulation
      • Practiced using hands or special devices to apply a controlled force to a joint of the spine

Bilder und Dateien der Mindmap