- Special tests for the C spine
- Distraction
- +) relief of the pain
- nerve root involvement
- Compression
- W/ rotation —- Jackson’s
- w/ side bending —– Spurling’s
- +) radiating pain down the arm
- nerve root involvement
- Valsalva test
- hold breath and bear down
- +) increase in pain
- possible spinal lesion or nerve root impingement
- space occyping lesion – herniated disc, tumor, osteophytes
- vertebral artery test
- dizzy confuse
- cervical vertebral artery is being partially occluded due to some abnormal compression
- swallowing test
- have patient swallow forcefully
- brachial plexus
- increase pain (shoulder abduction test – S&S decrease
- traction or stretch injury
- Tinel’s sign
- Erb’s point
- neurological signs
- traction or stretch injury
- Distraction
- Special tests for lumber spine
- forward bending
- stretch PLL
- one PSIS moves further than the other
- PSIS motion restriction on side that moves most or moves first
- backward bending
- stretches ALL
- restriction or pain
- disk problem or spondylolysis / spondylolisthesis
- Side bending
- sidebend towards side of irritation
- increased or decreased pain
- increased – lumbar lesion or SI dysfunction
- decreased – herniated disk
- Rotation
- AT rotates trunk with athlete’s arms folded to his/her chest
- Tension sign Bowstring’s test
- flex the hip to 90 degrees and passively extend knee while palpating over popliteal fossa
- Bowstrings —- flex knee until pain disapperars
- point tenderness with possible duplication of symptoms
- sciatic nerve irritation
- Slump test
- sciatic pain
- compression of dural lining, spinal cord, or nerve roots
- quadrant test
- extends spine as far as possible
- then side bends to affected side
- then rotates to affected side
- reproduction of symptoms
- dural irritation (radiating pain)
- facet joint irritation (local pain)
- SI pain
- extends spine as far as possible
- single leg stance/stork test
- hyperextends trunk in single leg stance
- possible spondylolysis / spondylolisthesis
- Scoliosis test
- asymmetrical hump along lateral thoracolumbar spine & ribcage
- scoliosis —- function ? disappears during flexion, structural does not disappear ここでのfunctionとはどのことをいうておる。
- Rib compression test
- pain, palpable defect
- rib fracture
- SI provocation
- patient prone lying
- provide anterior glide on superior & inferior ends of sacrum
- FADIR
- flexion adduction IR
- pain
- irritation in lumbar area
- FABER / patrick’s test
- flexion, abduction & ER of the hip
- pain
- hip or SI joint
- SI dysfunction chech
- FABER
- Gaeslen’s
- SI compression — distraction
- long sit
- Spring test
- AP glide and feel for spring of vertebrae
- hypomobility of vertebrae
- Milgram test
- have patient perform a bilateral SLR and hold heels off table for 30 sec
- unable to hold position
- nerve root impingement
- Hoover’s test
- no sense of pressure on opposite side
- Straight leg raise Lasegue’s test
- passively SLR of involved leg until pain or full ROM achieved
- pain 30 – hip problem
- pain 30-60 – sciatic nerve involvement – DF foot increases pain Lasegue’s sign
- pain at 70-90 SIJ dysfunction
- Well SLR test
- SLR of uninvolved leg
- pain experienced in opposite leg
- nerve root impingement
- Kernig-Brudzinski’s test
- unilateral SLR until pain occurs
- Kernig’s —- if pain occurs, have patient flex knee —– should release symptom? if the problem arises from the irritation of dural sheath
- Brudzinski’s —- if no pain with active SLR, passively flex patient’s neck to increase neural tension
- lumbar pain that is relieved with knee flexion
- nerve root impingement due to herniated disc, irritation of dural sheath
- Femoral nerve stretch test
- flex knee to 90 extend the hip
- pain along anterior and lateral thigh
- nerve root impingement L2,3,4
- Knees to chest tests
- pulling single knee to chest
- pain in posterolateral thigh
- indications irritation to the sacrotuberous ligament
- Press ups
- press-ups in order to extend the spine
- pain that radiates into buttocks/thigh herniated disk
- localized pain – conservative tx
- generalized pain – surgety
- Reverse SLR tests
- Athlete lies prone and lifts affected leg
- low back pain
- Prone knee flexion test
- athlete prone with knees extended, also prone with knees flexed 90
- compare lengths by inspecting the heels
- short side – posteriorly rotated SI
- forward bending
- Professional development and responsibilities
- Athletic trainer as a health care provider
- Health care organization and administration in AT
- Legal concerns and insurance issues
- Risk management
- Fitness and conditioning techniques
- Nutrition and supplements
- Environmental considerations
- Protective equipment
- Wrapping and taping
- Pathology of sports injury
- Mechanism of characteristics of musculoskeletal and nerve trauma
- Tissue response to injury
- Management skills
- Psychology intervention for sports injuries and illnesses
- On the field acute care and emergency procedures
- Off the field injury evaluation
- Infectious diseases, bloodborne, pathogens, and universal precautions
- Using therapeutic modalities
- Using therapeutic exercise in rehabilitation
- Pharmacology, drugs, and sports
- Musculoskeletal conditions
- The foot
- The knee
- The thigh, hip, groin, and pelvis
- The shoulder complex
- The elbow
- The forearm, wrist, hand, and fingers
-
The spine
- General medical conditions
- The head, face, eyes, ears, nose, and throat
- The thorax and abdomen
- Skin disorders
Ch25 The spine
- Anatomy of the spine
- Bones
- Intervertebral disks
- annulus fibrosis
- nucleus pulposus
- Intervertebral articulations
- Ligamentous structures
- ALL: anterior surface of the vertebral bodies / restricts extension
- PLL: contained within the vertebral canal / limit flexion
- Supraspinous ligament
- Interspinous ligament: limit rotation and flexion
- Sacrotuberous ligament – continuous with hamstrings? adductor magnus?
- Muscles of the spine
- Iliocostalis
- L / T / C
- Longissimus
- T / C / capitis
- Spinalis
- T / C
- Multifidus
- Rotators
- Interspinales
- Semispinalis
- T / C / capitis
- Splenius
- capitis / C
- Iliocostalis
- Spinal cord
- Spinal nerves and peripheral branches
- anterior – motor nerve
- posterior – sensory nerve ——- dorsal ganglion が gate control theory の要所?
- Cervical plexus – C1-C4
- Brachial plexus – C5-T1
- Axillary – C5-C6 posterior cord
- Deltoid
- Radial – C5-T1 posterior cord
- M – Trciesps, anconeus, brachialis, brachioradialis, supinator, ECRL. ECRB, ECU, Ext Digitorum, Ext Digiti Minimi, Ext indicis,
- Abd pollicis L, Ext pollicis lons, Ext pollicis brevis
- Musculocutaneous C5-C7 lateral cord
- Coracobrachialis
- BB
- Brachialis
- Ulnar – C8 T1 Medial cord
- FCU
- FDP – distal phalanges of little and ring finger
- Interossei
- Adductor pollicis
- Hypothenar
- FDMB
- Abd D M
- Opp D M
- 2 medial lumbricles
- interossei
- Median C8-T1
- Pronator teres
- Pronator quadratus
- FCR
- FDP
- FDS
- Abd pollicis brevis
- Opp pollicis
- FPB
- Axillary – C5-C6 posterior cord
- Lumbar plexus – L1-L4
- Obturator L2-L4
- Add magnus
- Add L
- Add B
- Gracilis
- Obturator externus
- Femoral L2-L4
- Iliacus
- psoas major
- pectineus
- sartorius
- Rectus femoris
- VL / VM / VI
- Tibial L4-S3
- BF, Semi tend, Semi memb, Add magnus
- Popliteus
- Gastroc
- Soleus
- Plantaris
- tibialis posterior
- FHL
- FDL
- Medial and lateral plantar
- Sural
- no motor – lateral and posterior 1/3 of the leg
- Common peroneal L4 S2
- Extends hip, flexes knee, biceps femoris (short head)
- Deep peroneal
- Tibialis anterior
- peroneus tertius
- EHL
- EDL
- Superficial peroneal
- Peroneus longus
- peroneus brevis
- EDB
- Obturator L2-L4
- Sacral plexus – S4 S5
- Surface anatomy
- Functional anatomy
- Movements of the vertebral column
- Prevention of injuries to the spine
- Cervical spine
- Muscle strengthening
- ROM
- Using correct techniques
- Lumbar spine
- Avoiding stress
- Correction of biomechanical abnormalities
- Using correct lifting techniques
- Core stabilization
- Cervical spine
- Assessment of the spine
- History
- Observation
- Kyphosis
- Forward head posture
- Swayback – anterior shift of the entire pelvis
- Lordosis
- Scoliosis
- Flatback posture
- C spine observation
- T spine observation
- L spine and SI joint observation
- Palpation
- Special tests for C spine
- Brachial plexus test
- lateral flexion overpressure
- Sn 83
- C compression and Spurling’s test
- Vertebral artery test
- Shoulder abduction test (Bakody’s sign)
- Brachial plexus test
- Special tests for the lumbar spine and SI joint
- standing position
- Forward bending
- Backward bending
- Side bending
- Stork test
- A lesion in the pars interarticularis on the side opposite the raised leg
- spondylolysis
- Gillet test
- PSIS
- + ) if the PSIS does not move inferiorly indicating SI joint hypomobility
- sitting position
- Forward bending
- Rotation
- Hip rotation
- PROM IR – irritate piriformis
- Slump test
- supine position
- SLR (Lasegue’s test)
- P! hip fle 30 – hip problem – inflamed nerve
- P! 30-60 – sciatic nerve
- P! AK DF – L3-L4, S1-S3, sciatic nerve (Lasegue’s sign)
- P! 70-90 – SIJ problem
- Kernig’s test
- Hip 90 / Knee 90 —- PROM KN EXT
- +) nerve root irritation or sign of meningitis
- Brudzinski’s test
- Crossed SLR Well test
- Milgram test
- Hoover test
- Bowstring test
- FABER test
- FADDIR test
- supine
- flexion, adduction, IR
- +) increase pain
- indicate lumbar pathology
- Gaeslen’s test
- Knees to chest tests
- SI compression tests
- SI distraction test
- Pelvic tilt tests
- Thigh thrust test
- SLR (Lasegue’s test)
- Tests done in a prone position
- Sacral thrust
- Press-ups
- Prone hip extension test
- Spring test
- Prone knee flexion test
- Prone instability test
- Tests done in a sideluing position
- Posterior rotation stress test
- Iliotibial band stretch test
- QL lumborum stretch test
- Piriformis muscle test
- Femoral nerve traction test
- standing position
- Neurological exam
- Sensation testing
- Reflex testing
- Recognition and management of speficic injuries and conditions
- C spine conditions
- Cervical fx
- Cervical dx
- Acute strains of the neck and upper back
- Cervical sprain (whiplash)
- Acute torticollus (Wryneck) 斜頸、斜頚、筋性斜頸、筋性斜頚
- Cervical cord and nerve root injuries
- Cervical spine stenosis
- Brachial plexus neuropraxia (burner)
- Cervical disk injuries
- Thoracic spine conditions
- Scheuermann’s disease (Dorsolumbar kyophosis)
- Lumbar spine conditions
- MOI of LBP
- Mechanical defects of the spine
- Recurrent and chronic LBP
- Lumbar vertebrae fx and dislocation
- low back muscle strains
- Myofascial pain syndrome
- Lumbar sprains
- Back contusions
- Sciatica
- herniated lumbar disk
- Spondylolysis / spondylolisthesis
- SIJ dysfunction
- SI sprain
- Coccygeal injuries
- C spine conditions
- Rehabilitation techniques for the neck
- Joint mob
- Flexibility exercises
- Strengthening exercise
- Rehabilitation techniques for the low back
- General body conditioning
- Joint mobilizations
- Traction
- Flexibility exercises
- Strengthening exercises
- PNF
- Neuromuscular control (core stabilization)
- Functional progressions
ATC/CSCS for motorsports 