Injuries to the Thoracic Through Coccygeal Spine Chapter 10 Injuries to the Thoracic Through Coccygeal Spine

Pre-Write Take out a sheet of paper and write whatever you want about the following question. Please write as much as you want but no less than 3 complete sentences How has learning about how the body works and heals itself help strengthen your faith in God? If it hasn’t write about that as well.

Anatomy Review of the Thoracic Spine Thoracic spine is composed of 12 vertebrae that articulate with the cervical and lumbar spines. The thoracic spine, corresponding 12 pairs of ribs, and sternum form the thoracic cage.

Common Sports Injuries Are rare but consist of both soft and skeletal injuries. Skeletal Injuries of the Thoracic Vertebrae Compression fractures of the vertebral body are most common injury. Such fractures usually occur at junction of thoracic and lumbar spine. Athlete with recent history of trauma to the region in conjunction with pain or numbness should be referred to a physician.

Common Sports Injuries Scheuermann’s disease is adolescent condition characterized by kyphosis. Children with chronic thoracic pain should be evaluated.

Scoliosis

Lordosis

Vertebrate Fractures

Rib Fractures Such fractures are associated with direct blows to lateral or posterior thorax and can occur anywhere along the rib. The ribs commonly fracture near the anatomic angle, which is the weakest point.

Rib Fractures (cont.) Signs and symptoms include: Painful respiration. Deformity in the region of the injury, including a protruding rib or depression where the normal contour of the rib should be.

Rib Fractures (cont.) Pain when rib cage is gently compressed Swelling and discoloration Posterior rib fractures can potentially result in a pneumothorax (collapsed lung)or a hemothorax. (blood in pleural cavity)

Hemothorax

Pneumothorax

Rib Fractures (cont.) First Aid Immediate application of RICE. Treat for shock. Refer athlete to physician.

Sprains Sprains occur whenever a joint is forced beyond its normal ROM resulting in damage to ligaments and joint capsules. Evaluation of a sprain to the thoracic spine is difficult. A consistent symptom is painful respiration.

Sprains First Aid Apply RICE. If dyspnea (difficulty or painful breathing) persists for more than 24 hours, refer the athlete to a physician.

Strains Strains: Involve contractile tissue and their support structures, such as the erector spinae and intercostals. Are related to maximal exertions. Result in muscle spasm and point tenderness. First Aid Application of RICE to the injured area.

Lumbar Spine Region Anatomy Review Five vertebrae are in lumbar spine. Lumbar vertebrae are the largest moving vertebrae. The major ligaments are the anterior and posterior longitudinal.

Lumbar Spine Region The sacrum consists of five fused vertebrae. The sacrum connects the spinal column to the pelvis. Right and left sacroiliac (SI) joints are formed by the union of the sacrum and pelvis. Coccyx (tailbone) is most distal portion of the vertebral column.

3 Major Joints in the Lumbar Spine. The lumbosacral The sacroiliac Sacrococcygeal.

Spondylolysis and Spondylolisthesis Spondylolysis is a defect in the neural arch (pars interarticularis). Such defects compromise the articulation between two vertebrae. If the condition is bilateraI, the affected vertebra can slip forward resulting in spondylolisthesis.

Spondylolysis and Spondylolisthesis (cont.) Symptoms include lower back pain that worsens during hyperextension, and radiating pain to the buttocks and upper thighs. Treatment includes rest, drug therapy, lumbar bracing, exclusion from certain sports, and surgery.

Traumatic Fractures: Lumbar Spine Such fractures are uncommon in sports. External blows may result in internal injury. Deep abdominal pain, hematuria (blood in the urine), and shock are signs and symptoms of internal injury. Immobilize on spine board and transport to medical facility.

Broken Coccyx Blows to the coccyx can result from landing on the buttocks. Fractures of the coccyx result in severe pain, point tenderness, swelling, and bruising. Refer athlete to physician for evaluation.

Lumbar Region -- Strains & Sprains Strains and sprains are the most common soft-tissue injuries in the lumbar spine. Major joints include: Lumbosacral. Sacroiliac. Sacrococcygeal.

Lumbar Strains & Sprains (cont.) Signs and symptoms include: Localized muscle spasm. Pain that does not radiate into buttocks or lower extremity. Acute postural abnormalities associated with recent trauma. First Aid Have athlete maintain a supine position with soft support for lumbar region and application of ice. If not improved in 24 hours, refer to physician.

Lumbar Disk Injuries A serious form of soft tissue injury is a “herniated disk.” Most commonly occurs at L4 or L5. Anatomy of a disk includes annulus fibrosis (outer ring) and nucleus pulposus (inner ring).

Lumbar Disk Injuries (cont.) Herniation results from a weakened annulus that allows nucleus pulposus to protrude through the wall of the annulus.

Herniated Disk Protrusion may put pressure directly on spinal nerves resulting in: Intense local or radiating pain. Sensory loss or burning/tingling sensation in lower extremity. Muscle spasm and postural abnormalities.

Lumbar Disk Injuries (cont.) First Aid Place athlete in supine or most comfortable position. Support lumbar region with rolled towel or other soft material. Apply crushed ice to lumbar region. Arrange for transport to medical facility.