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CERVICAL SPINE INJURIES. Care and Prevention of Athletic Injuries Ms.Herrera MS, ATC/L. Bony Anatomy. Bony Anatomy Cont’d. Vertebrae Anatomy. Demonstrate importance of atlas and axis. Soft Tissue Anatomy. Importance of ligaments. Cervical Spine FACTS. Made of 7 vertebrae
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CERVICAL SPINE INJURIES Care and Prevention of Athletic Injuries Ms.Herrera MS, ATC/L
Vertebrae Anatomy Demonstrate importance of atlas and axis
Soft Tissue Anatomy Importance of ligaments
Cervical Spine FACTS • Made of 7 vertebrae • 8 cervical nerves • Sensory vs motor • dermatome vs myotomes • Atlas supports base of skull on spine • Atlas-Axis relationship
Cervical Spine FACTS cont’d • Transverse foramen • Opening allows the nerves to go through • Capable ROM: • Flexion • Extension • Lateral Flexion • Lateral Rotation
Intervertebral Disk • Disk made of fibrocartilage • Function: • Shock absorber • Nucleus Pulposus: • Think of “jelly doughnut”
HX Essentials: MOI Parathesia in extremities Hit someone with the top of your head? Loss of strength? LOC? Observation Essentials: Head tilted to one side Shoulder higher than other side Scapula protruding/atrophied Forward posture History & Observation
Cervical Fx MOI: Axial load Flexion Hyperextension S&S: Parathesia TTP over C-Spine Loss of movement Loss of bladder control Management: EMS In-line stabilization Cervical Dislocation MOI: Flexion and dislocation I.e. diving, football tackles S&S: Head tilted to dislocated side Pain Numbness/loss of function Management: Same as C-spine fx Cervical Fracture & Dislocation
Cervical Sprain (Whiplash) • MOI: sudden snap of the neck • Examples? • Can cause… • Sprain of ligaments • Strain of neck muscles • Isolated incident • S&S • Pain on transverse and spinous processes • Inflammation • Muscle spasms • Why? • Management: • ER to r/o serious injury • NSAIDS • Rest for 48-72 hours • Ice, heat, massage
Acute Torticollis (Wryneck,stiff neck) • MOI: small piece of synovium trapped within facet joint • Demonstrate on anatomy • Holding head to 1 side for extended time • S&S • TTP • Muscle Spasm • Restricted movement • Which side? • Management: • Modalities to break pain-spasm cycle
Brachial Plexus Neurapraxia • A.k.a “burners” or “stingers” • MOI: Compression or distraction of brachial plexus. • Examples of MOI’s? • S&S • “elephant trunk” • Burning/numbness/ tingling down arm to hand • Weakness (temporary)
Burners Management • Assess myotomes/dermatomes • Determine location of weakness • Ice over brachial plexus for 10-15 minutes • Re-assess • Recurrent? • Neck collar/roller for fb players • Strengthening program of neck and shoulder muscles • Stretching
Herniated Disks • MOI: • Repetitive loading on C-Spine • Common in sports • Disk commonly herniated posteriorly. • S&S • Pain • Limited ROM • Motor weakness • Parathesia down arms • Management: • Conservative tx • Examples? • If fails, then SX.