Taxi Driver

Taxi Driver

1. anatomy of the vertebral column

   • 5 regions
     • cervical
       • 7 vertebrae
     • thoracic
       • 12 vertebrae
     • lumbar
       • 5 vertebrae
     • sacral
       • 5 vertebrae
     • coccygeal
       • 4 vertebrae
   • joints
     • zygapophyseal joints (facet joints)
       • synovial joints
       • between the inferior articular process of superior vertebrae and the superior articular process of inferior vertevrae
       • control flexion, extension, rotation and cervical and lumbar bertebrae
     • atlanto occipital joint
       • between C1 (atlas) and occipital codyles (skull)
       • synovial
         • condyloid
       • flexion and extension of the neck (saying yes)
     • atlanto axial joint
       • synovial
         • pivot
       • rotation of the atlas and the skull around the axis (saying NO)
       • between C1 (atlas) and C2 (axis)
   • ligaments
     • anterior longit ligament
       • prevent hyperextension
     • posterior longit ligament
       • prevent hyperflexion
     • ligamentum flavum
       • preserve the normal curvature
     • interspinal ligament
     • supraspinous ligament
     • intertransverse ligament
   • muscles of the back
     • superficial layer
     • intermediate layer
     • Deep layer
       • Splenius
       • erector spinae
         • spinalis (medially)
         • longissmus (intermeiate)
         • iliocostalis (laterally)
       • transverso-spinalis
   • movements
     • extention
     • rotation
     • flexion
     • lateral flexion
   • curvatures of the back

2. sacral plexus

   • sciatic nerve
     • supplies sensation to the skin of the foot and the lower leg except for the inner side
     • roots
       • L4, L5, S1, S2, S3
     • sensation to skin to the sole of the feet
     • tibial nerve
       • supply the posterior compartment of the leg and sole of the foot (planter aspect)
     • common peroneal nerve (common fibular nerve)
       • supply the muscles of the anterior and lateral compartments
   • supply the pelvis and the lower limbs

3. lower back pain

   • alleviating factors
     • standing, walking
   • aggravating factors
     • sitting, lifting, coughing and sneezing
   • causes
     • disc breakdown
     • spasms
     • Ruptured disks
     • injuries ( fractures, falls)
     • pregnancy
     • spinal stenosis
     • scoliosis
       • abnormal curvature
       • causes
         • idiopathic
         • congenital
         • neuromusclar
       • types

4. visual analogue scale (VAS)

5. intervertebral disc

   • anatomy
     • between the bodies of vertebrae
     • 2 parts
       • outer: annulus fibrosis
         • parallel collagen bundles
       • inner: nucleus pulposus
         • soft gelatinous material
   • disorders
     • herniated disc
       • protrusions of the nucleus pulposus occur posterolaterlly
       • commonly occur in th lumbar region
       • symptoms
         • localised pain
         • if nerve root is compressed
           • sciatica
             • management
               • physiotherapy
                 • Electromagnetic
                 • thermal
                 • mechanical
               • Alternative management
                 • acupuncture
                 • massege
                 • chiropractic therapy
               • surgery
                 • indication for surgical intervention
                   • spinal cord compression
               • medication
                 • NSAIDs
                 • opioids
             • compression on the sciatic nerve
             • cause
               • general wear and tear
             • affect daily life
             • psychological effect
               • anxiety
               • depression
             • symptoms
               • Unilateral leg pain
               • burning sensation in the buttocks
               • numbness of lower leg
       • stages
         • degeneration
         • prolapse
         • sequestration
         • extrusion

6. placebo effect

   • defenition
     • a substance or other kind of treatment that looks just like a regular treatment but it is inactive
   • remembered wellness
   • nocebo effect
   • conditioning effect
   • expectation effect

7. physical examination

   • special tests
     • femoral nerve stretch test
     • straight leg raising
     • schober's test
   • look
   • feel
   • palpate

8. difference between radiating and referred pain

   • radiating
     • radiate to other places
   • referred pain
     • When a person feels pain in a part of the body is fairly distant from the actual tissue causing the pain

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