spine

spine

1. anatomy

   • joints
     • intervertebral discs
     • zygopophyseal joint
     • atlanto-occipital joint
     • lumbosacral joint
     • sacrococcygeal joint
   • bones
     • cervical vertebra
       • typical
         • small body + foramen transversarium
       • atypical
         • axis
           • has a dens
         • atlas
           • no body
     • thoracic vertebra
       • heart-shaped body + costal facets
     • lumber vertebra
       • thick body + stout pedicles + thick lamina
     • sacrum
       • forms
         • sacroiliac joints
         • sacrococcygeal joint
         • lumbosacral joint
     • coccyx
       • 3-5 fused vertebrae
   • ligaments
   • veins
   • muscles
     • Deep layer
       • move the trunk
     • intermediate layer
       • respiratory muscles
     • superficial layer
       • move the upper extrimiteis
   • discs
     • annulus fibrosis
     • nucleus polposus

2. movement

   • flextion
   • extension
   • rotation
   • lateral flextion

3. suffer from PAIN in

   • occupation that needs long time sitting
   • because of
     • diseases
       • discogenic disorder
       • muscle or ligament strain
       • arthritis
       • affecting sciatica nerve root
         • sciatica
           • investigation
             • x ray
             • CT scan
             • MRI scan
           • managment
             • pharmagology
               • NSAIDS
               • Acetaminophen
               • physiotherapy
               • sever cases
                 • surgery
                 • absolute
                   • increase neurological deficit
                   • bladder incontinence
                 • relative
                   • failing treatment
                   • disabling pain
             • alternative
               • massage
               • chairopractor
               • acupuncture
           • examination
             • history taking
               • physical examinatiom
                 • curvature
                 • spines , muscle tenderness
                 • range of motion
                 • special test
               • age , job , daily activity , symptoms , place , timr , radiation , severity
                 • measure severity of pain
                   • VAS
                     • 100mm , compare within patient's visits
           • natural history
             • pain leads to disability
               • improvement within average 12 weeks
           • by degeneration of
             • discs
               • disc prolapse
                 • disc bulging
                   • disc protrution
                     • disc extrusion
                       • disc sequestration

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