Chapter 9-Sports Med
Exercise and flexibility programs are necessary for the muscles surrounding and supporting the spine, especially what muscles?
Abdominal Muscles
What part of the disk are the several layers of cartilage that surround it called?
Annulus Fibrosus
What ligament prevents bony separation during extension?
Anterior Longitudinal Ligament
What's the name of the thick, tough ligament on the anterior aspect of the vertebral segments?
Anterior Longitudinal Ligament
If the hip is tilted forward, the spine will move into ________, and if the hip is tiled backward, the spine will move into ________.
Extension; Flexion
If an athlete's ear were projected in front of the imaginary normal posture line, what would they have? What does this cause?
Forward Head Posture; a great deal of stress at the back of the neck
Disks rarely bulge to the front or back of the spine? Why?
Front; Front of the spine is covered with a thick ligament and most people have postures that flex the spine forward which puts more pressure on the front of the disk pushing the nucleus pulposus backwards
Since not a lot of exercise equipment is designed for the neck, what should be used to strengthen the neck?
Manual Resistance
What part of the disk is a jellylike core called?
Nucleus Pulposus
If the disk bulge is putting pressure on a nerve, what will the patient feel?
Numbness, tingling, and pain down the leg and pain in the low back that increases with sitting
What are the signs and symptoms of a cervical spine fracture?
Pain around the spine, weakness, numbness, and tingling
What is located on a thin portion of the vertebrae between the superior and inferior facets?
Pars Interarticularis
Identify three strategies for preventing spine injuries.
Perform exercises to maintain strength and flexibility, maintain proper posture, and use proper lifting mechanics
The muscles of the spine do what two things?
Permit movement and stabilize the spine
What is the name of the ligament on the posterior aspect of the spine that runs from the posterior regions of the vertebral bodies?
Posterior Longitudinal Ligament
Brachial Plexus injuries occur when the shoulder is ____________ and the neck is ______________.
Pressed downward; forced into a stretch in the opposite direction
When one vertebra slips forward on the vertebra below it it's called what?
Spondylolisthesis
What is often described as a stress fracture or bone degeneration of the vertebrae, specifically at the location referred to as the pars interarticularis?
Spondylolysis
______________________ is often described as a stress fracture or bone degeneration of the vertebrae, specifically at a location referred to as the pars interarticularis.
Spondylolysis
What muscle is responsible for cervical side bending and rotation?
Sternocleidomastoid Muscle
Which muscle is attached to the top of the sternum and runs up the neck attaching to the mastoid process just behind the ear?
Sternocleidomastoid Muscle
What is a brachial plexus injury often called?
Stinger or Burner
What is the name of the ligament that passes from the tip of one spinous process to another?
Supraspinous Ligament
What is the thin ligament on the posterior aspect of the spine?
Supraspinous Ligament
What ligaments (there are two) support the vertebral segments as the as the spine flexes?
Supraspinous Ligament & Posterior Longitudinal Ligament
Describe when an athlete can return to competition if he has suffered a brachial plexus or cervical ligament injury.
The athlete should be symptom free, have full strength, have full range of motion in the neck and shoulders, and have clearance from the AT and team physician.
What is the brachial plexus and how is it injured?
The brachial plexus is a network of nerves that exit the cervical spine and run a course down the arm. It is often injured by being stretched such as when a football player tackles an opponent and the neck is pushed one direction and the shoulder is depressed in the opposite direction.
Cervical muscle strain
whiplash
What steps can a person take to prevent poor postural habits?
• Imagine balloons are attached to your head and are pulling you upright • Alternate carrying your book bag or gym bag on opposite shoulders • Stay fit and exercise regularly
Brachial plexus injury
head moving away from the shoulder
Disk bulge
pushing through annulus fibrosus
Compression fracture
spondylolisthesis
When one vertebra slips or shunts forward on another due to instability, it is called ____________________________.
spondylolisthesis
What often results from a combination of excessive neck flexion and rotation?
Dislocation of the cervical vertebra
Which posture is identified in the following statements? 1. A lateral curve to one side 2. When the ear is in front of the line of the body 3. A forward curvature of the lumbar spine 4. When the ear, shoulder, hip, and ankle are in alignment 5. Rounded shoulders
1. Scoliosis 2. Forward head 3. Lordosis 4. Normal posture 5. Kyphosis
What is the most common location for Spondylolisthesis?
5th Lumbar Vertebra slipping forward on the first sacral vertebra
According to the NATA position statement, what is the key mechanism for catastrophic injuries in football?
Axial Loading
Why can an injury to the spine be life threatening?
Because it protects the spinal cord
Each vertebra is made up of what parts?
Body, Spinous Process, and canal through which the spinal cord passes
What is the network of nerves that exit the cervical spine and run through the shoulder and down the arm?
Brachial Plexus
When the brachial plexus gets stretched, what does the athlete feel?
Burning, Tingling, Numbness, and Stinging sensations in the arm and shoulder
How many bones are in each section of the spine?
Cervical - 7 Thoracic - 12 Lumbar - 5 Sacral - 5
List each of the regions of the spine and state how many vertebrae there are in each
Cervical = 7 vertebrae; thoracic = 12 vertebrae; lumbar = 5 vertebrae; sacrum = 5 vertebrae (fused together).
What can be done for a treatment for disk bulges of the cervical spine in addition to improving neck posture and exercises?
Cervical Traction
Bone injuries to the cervical spine include fractures and dislocations, which can have what?
Devastating results including permanent disabilities and death
What injury do people often incorrectly refer to as a slipped disk?
Disk Bulge
Explain how the intervertebral disks become injured.
Disks can be injured due to repeated compression of the structures caused by improper posture or poor lifting mechanics.
The bones of the spine are separated by _______ and held together by ________.
Disks, Ligaments
Cervical sprains are usually the result of what?
Hyperextension or Hyperflexion of the neck
What do back supports do?
Increase the pressure around the spine and decrease the amount of stress to the vertebrae
What is the name of the ligament that runs on each side of the spine from the transverse process above to the one below?
Intertransverse Ligament
What lies between the vertebrae to absorb shock and resist compression during activity?
Intervertebral disks
The spine has many muscles attached at various points that extend to the pelvis, legs, and arms. What do these muscles do?
Keep the spine stable we perform tasks such as throwing, catching, and kicking
Excessive roundness of the thoracic spine is called what?
Kyphosis
Describe the anatomy of the intervertebral disk.
Layers of annulus fibrosis surround the nucleus pulposus, which is a jellylike substance.
Too much forward curvature at the lumbar spine is called what?
Lordosis
Most spinal cord injuries are in what regions?
Lumbar and Cervical
What is proper lifting technique?
Maintaining a slight curve in the lumbar spine while lifting with the knees and hips rather than the spine and keep the head up
Fracture of cervical vertebrae
axial loading
What other muscles besides the abdominals should also be strengthened? Why?
Muscles around the hip because the hip directly influences the spine
The spine should have a normal curvature at each of these areas and normal alignment where the spinal curves of the lumbar, thoracic, and cervical region are curved just right and the spine is comfortable is known as what?
Neutral Spine
If the athlete is wearing a helmet and you suspect a cervical spine injury should you remove the helmet? Why or why not?
No, attempting to remove it may cause excessive movement of the neck which could lead to further damage
What are the functions of the bony spinal column?
Protecting the spinal cord, holding the body upright for walking, and serving as a site for muscular attachments
What abdominal muscles are especially crucial for supporting trunk movement?
Rectus abdominus and internal and external obliques
Which bones are fused together?
Sacral
What are the four segments of the spine?
Sacrum, Lumbar, Thoracic, and Cervical
What muscles also help with the breathing process?
Scalene Muscles
What muscles are responsible for cervical flexion?
Scalene Muscles
What muscles attach to the cervical vertebrae and run down to the first and second ribs?
Scalene Muscles
What's it called when the spine is curved from side to side?
Scoliosis
How long does the pain from a brachial plexus injury last?
Seconds, minutes, or even weeks
The network of nerves that exit the cervical spine and run a course through the shoulder and down the arm is called the ______________________.
brachial plexus
Why is it incorrect to call it a slipped disk?
The disk is attached to the body of the vertebra and rarely slips forward or backward
Why do the disks of the spine not have the same healing potentials as other tissues of the body?
The disks of the spine do not receive any blood supply
What is a disk bulge?
The jellylike nucleus pulposus at the center of the disk pushes through the rings of cartilage and when it presses against the outer layer it causes it to bulge
Fracture of the lumbar vertebrae
compression
What muscle extends the cervical spine attaches to the occipital bone and fans out to each side of the neck before attaching to the acromion process of the scapula?
Upper Trapezius
What are the bones of the cervical spine called?
Vertebrae
Because the disks are compressible, what happens to our height?
We are slightly taller first thing in the morning than later in the day and in old age we will become shorter
When do sprains at the lumbar joints commonly occur?
When athletes are forced into excessive trunk flexion or attempt to flex the spine and rotate at the same time
What is an axial load?
When force is applied to the head while the head is lowered into flexion
How should football players tackle?
With the shoulders while positioning the head in an upward position