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Lecture 9

PNB 2264 Lecture Notes - Lecture 9: Dislocated Shoulder, Connective Tissue, Stenosis

Physiology and Neurobiology
Course Code
PNB 2264

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Notes Day 9
Examples of Joints
Clinical measures
- Range of motion
o Around the X, Y and Z axis, degrees of movement
o Active ROM muscle actions
o Passive ROM external force
- Affected by disease and injury
o Diagnostic
- Ball and socket: greatest ROM
- Fibrous: least ROM
Did you know what back pain is
- Leading cause of disability worldwide
- Most common reason for missing work
- 50% of Americans have back pain each year
- costs US $50 billion a year
- so what is the issue?
- Reasons
o Not stretching, wear and tear
o Weekend warriors
o Not lifting with your legs
o Sitting at a desk all day, movement keeps back happy
Standing desks
Normal movement
- Cervical significant movement
o Rotation, side-bending, flexion and extension
- Thoracic limited by rib cage and spinous processes
o Rotation, limited flexion and extension
- Lumbar
Where is the problem
- Intervertebral discs
o Between vertebral bones
o Synovial joint btw superior and inferior articular processes
o Allows for flexion, extension and rotation
o Biaxial joint
Intervertebral disc
- Between vertebrae
o Outer annulus fibrosus, inner nucleus pulposus, no direct blood supply in adults
- Annulus fibrosus
o Strong annular fibers
- Nucleus pulposus
o Loose fivers suspended in jelly like mucoprotein
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o Acts as shock absorber
Age related changes
- Before 40, 25% of people have disc degeneration; >40 yrs old more than 60% have disc
- As one ages the disc loses water, decreasing its ability to absorb shock
- The annulus fibrosus weakens with age and is easier to tear
Herniated disc
- Tear in the annulus fibrosus allows material from nucleus pulposus to push out
(pushed by weight of tissues above)
- Extreme pain
- Treated by surgery or bed rest
Back spasm
- Spontaneous, abnormal contraction of a muscle, if near spinal cord or nerve roots, it can
be very painful
- After muscle injury, falling on icy sidewalk, lifting the wrong way
o The muscle all of a sudden contract and squeeze the nerves
- Made worse
o Arthritis, weak back or stomach muscles, poorly stretched hamstrings
- Narrowing of the space between the vertebrae
o Compression of the nerves leaving the spinal cord
o Very painful to lower extremities and back
Weakness and leg tingling
o Congenital and degenerative
More common degenerative Is commonly due to changes in the
intervertebral discs
- Back problems usually caused by changes in discs or putting pressure on spinal nerves
- Very painful and very common
- Humerus head and glenoid fossa
o Ball and socket
o Increase in mobility at expense of stability
o 120 degrees, most in the body
- supported by 3 ligaments, tendons and muscles
shoulder movement
- flexion/estension
o deltoid, pc, biceps
o eltoid, lat and teres
- rotation
o infraspinatus, delt, teres, lat
- ab and ad
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