Chapter 25: The Spine

OBJECTIVES

When you finish this chapter you should be able to

• Describe the anatomy of the cervical, thoracic, and lumbar spine.

• Understand how the nerve roots from the spinal cord combine to form specific peripheral nerves.

• Organize a process to assess injuries of the cervical, thoracic, and lumbar spine.

• Explain how to evaluate and identify various postural deformities.

• Point out measures to prevent injury to the spine.

• Categorize specific injuries that can occur to the various regions of the spine in terms of their etiology, symptoms and signs, and management.

• Plan rehabilitation techniques for the injured neck.

• Create the rehabilitation goals for managing low back injuries.

CONNECT HIGHLIGHTS

Visit http://connect.mcgraw-hill.com for further exercises to apply your knowledge:

• Clinical application scenarios covering assessment and recognition of cervical, thoracic, and lumbar spine and nerve root injuries; etiology, symptoms and signs, and management of cervical, thoracic, and lumbar spine and nerve root injuries; and rehabilitation for the cervical, thoracic, and lumbar spine

• Click-and-drag questions covering structural anatomy of the cervical, thoracic, and lumbar spine and nerve roots; assessment of cervical, thoracic, and lumbar spine and nerve root injuries; and rehabilitation plan of the cervical, thoracic, and lumbar spine

• Multiple-choice questions covering anatomy, assessment, etiology, management and rehabilitation of cervical, thoracic, and lumbar spine and nerve root injuries

• Selection questions covering rehabilitation plan for various injuries to the cervical, thoracic, and lumbar spine and nerve roots

• Video identification of special tests for the cervical, thoracic, and lumbar spine and nerve root injuries; and rehabilitation techniques for the cervical, thoracic, and lumbar spine

• Picture identification of major anatomical components of the cervical, thoracic, and lumbar spine and nerve roots; rehabilitation techniques of the cervical, thoracic, and lumbar spine; and therapeutic modalities for management

INTRODUCTION

The spine is one of the most complex regions of the body.⁵⁰ It contains a multitude of bones, joints, ligaments, and muscles, all of which are collectively involved in spinal movement. The proximity and relationship of the spinal cord, the nerve roots, and the peripheral nerves to the vertebral column add to the complexity of this region. Low back pain is one of the most common ailments known to humans. Injury to the cervical spine has potentially life-threatening implications (see Chapter 12 for emergency management). Thus, the athletic trainer requires an in-depth understanding of the anatomy of the spine, the techniques to assess the spine, the various injuries that can occur to different regions of the spine, and rehabilitative techniques.

ANATOMY OF THE SPINE

Bones of the Vertebral Column

The spine, or vertebral column, is composed of 33 individual bones called vertebrae. Twenty-four are classified as movable, or true, and nine are classified as ...