Taxi Driver

Taxi Driver

1. -Mr.Singh -43 years old

2. Anatomy of the back

   • Ligaments
   • Muscles
     • SUPERFICIAL LAYER
     • INTERMEDIATE LAYER
     • DEEP LAYER
       • SPLENIUS
         • SPLENIUS CAPITIS
         • SPLENIUS CAPITIS
       • ERECTOR SPINAE
         • SPINALIS
         • LONGISSIMUS
         • ILIOCOSTALIS
       • TRANSVERSO-SPINALIS
   • Regions of spinal column
   • Dermatomes
   • Vertebral disc
   • Spinal cord
   • Nerve innervation

3. Pain

   • Visual Analogue Scale
   • Referred
     • felt in a separate location from its physical cause
   • Radiated
     • from one area to the other
   • Radicular
     • in the spinal cord caused by
       • Compression
       • Inflammation
       • Injury
   • Pathological causes
     • Muscle Strain
     • Osteoarthritis
     • Spinal Stenosis
     • Discogenic Disorders
     • Spondylolisthesis
     • Vertebral Fracture
     • Ankylosing Spondylitis
     • Neoplasms
     • Infections
     • Diseases of the Viscera
     • Atherosclerosis

4. Claudication

   • Intermittent vascular
   • Spinal or neurogenic

5. Disorders

   • Discogenic Disorders
     • Degenerative Disk Disease
       • discs in the spine start to dry out
     • Herniated Disk / Ruptured Disk
       • soft nucleus leaks out of the disc
   • Sciatica
     • Sings and symptoms:
       • Sharp shooting pain
       • Numbness
       • Burning
       • Tingling
     • Aggravating factors:
       • Sitting
       • Moving
       • Sneezing
       • Coughing
     • Causes :
       • 1-Lumbar spinal stenosis
       • 2-Degenerative disc disease
       • 3-Muscle spasm in the back or buttocks
       • 4-Pregnancy
       • 5-Spondylolisthesis
     • Diagnosis :
       • Full medical history
       • Physical examination
       • Sometimes X-rays and other tests
     • Management :
       • Avoiding sitting
       • Steroid injections
       • Physiotherapy
       • manual manipulation
       • Acupuncture

6. Alternative medicine

7. Clinical Features of Back Pain

   • Muscle ache
   • Shooting or stabbing pain
   • Pain that radiates down the leg
   • Limited flexibility
   • bowel or bladder problems
   • fever
   • weakness
   • numbness
   • unexplained weight loss

8. In the clinic

   • 1- Introduction
     • 2- History taking
       • 3- Physical examination
         • Inspection
           • symmetry
           • skin
           • shape
         • Palpation
           • Bony land mark
           • skin
           • Muscles
           • Joints
         • Range of Motion
           • Flexion / Extension
           • chin up and down
           • Lateral Flexion
           • Rotation Rt / Lt
         • Special Tests
         • 4- Special Tests
           • Spurling test

9. Radiologic features of scoliosis

10. When to See a Surgeon for Low Back Pain?

    • Loss of sensation
    • Muscle wasting

11. PLACEBO

    • A treatment with no active therapeutic effect.

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