Taxi driver

Taxi driver

1. anatomy of the vertebrae

   • we have 33 vertebrae
     • consisting of a body and arch
     • their type of bone is irregular
   • what is a vertebrae?
     • It is the backbone that forms the central axis of the skeleton.
   • the strength of the vertebrae is due to:
     • Size and shape of the bony elements
     • The ligaments and muscles holding the vertebrae
   • curvatures
     • Cervical region: convex forward When and how does it occur
     • Lumbar region: convex forward When and how
     • thoracic and sacral stay the same
   • intervertebral disc
     • Made up of annulus fibrosis ( collagen bundles)
     • nucleus pulposus (gelatinous material) act as shock absorber
     • Elasticity decreases and it dehydrates with age, whihc might lead to herniation

2. joints

   • zygapo-physeal/facet joints their variety is synovial plane
     • found between inferior articular process of superior vertebra and superior art. process of inferior
       • responsible for flexion, extension, and rotation of cervical and lumbar vertebrae
   • atlanto-occipital, its variety is condyloid synovial
     • found between superior articular facets on lateral masses of C1 (atlas) and occipital condyles of skull
       • responsible for flexion and extension of the neck
   • atlantoaxial, its variety is synovial, 2 lateral plane joints, 1 medial pivot joint
     • responsible for holding the dens in contact with atlas

3. the back muscles have 3 layers

   • superficial
     • latismass dorsi, trapezius, levator scapulae and the rhomboids and they move the upper limbs
   • intermediate
     • respiratory muscles which move the thoracic cage
   • deep
     • move the trunk and back, supplied by the dorsal primary rami spinal nerves
       • Erector spinae (contains 3 muscles) → outermost = iliocostalis; middle = longissimus; innermost = spinalis

4. movements of the vertebral column

5. what can cause lower back pain

   • Herniation
     • The jelly-like center of a lumbar disc can break through the tough outer layer and irritate a nearby nerve root and compress it
   • spondylosis
     • the general degeneration of the spine that can occur in joints, discs, and bones of the spine as we age
   • trauma
     • Acute fractures or dislocations of the spine can lead to pain
   • sprain/strain
   • degenerative disc disease
     • As people age over time, discs lose hydration and wear down which can lead to herniation and pain
   • inflammation

6. sciatic nerve

   • The sciatic nerve is the largest nerve in the human body
     • Exits through greater sciatic foramen
   • derived from the sacral plexus.
     • It originates from the anterior rami of the lower lumbar (L4-L5) and upper sacral spinal nerves (S1, S2, S3).
   • The sciatic nerve arises in the lumbosacral region. It descends through the posterior aspect of the thigh and gives off several small motor muscular branches
     • once it enters the popliteal fossa, it terminates by splitting into 2 branches: the tibial nerve and common fibular nerve.

7. Sciatica

   • sciatica refers to pain that radiates along the path of the sciatic nerve
     • Typically, sciatica affects only one side of your body.
   • Sciatic nerve pain is usually caused by impairments related to a spinal nerve root at L4, L5 or S1 level from a disc disorder or any sudden pressure on the disks.
   • common causes:
     • muscle wear and tear due to aging
     • muscle spasms
     • herniated disc
   • signs and symptoms
     • Pain that radiates from your lower spine to your buttock and down the back of your leg is the hallmark of sciatica.
     • Most common symptoms of sciatica in patients is feeling numbness and tingling or muscle weakness in the affected leg.

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