腰椎间盘突出英文幻灯ppt课件.pptx
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1、病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程 LumbarHerniatedDiscs病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程lWhycalledherniateddisclWhyspecialfocusforlumbarlIncidenceandsocialfactorMorphalogyMostcommonMostdisturbingIntroduction病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病
2、理生理过程ObjectivesIdentifytheanatomyofthelowerbackUnderstandthetypesoftraumathatcancauseaherniateddiscIdentifythesignsofaherniateddiscBeabletoevaluatepatientswithpotentialherniateddiscsAlsoabletofollowatypicaltreatmentprogramforlumbarherniateddiscs病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程
3、Lumbar Anatomy The lumbar section of the spine is made up of the lower 5 vertebrae Commonly referred to as L1 to L5 L5 connects to the top of the sacrum病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Anatomy of Lumbar VerebraThe vertebral body is a The vertebral body is a thin ring of dense b
4、onethin ring of dense boneConsisting of the body,Consisting of the body,pedicles and liminaepedicles and liminaeVertebral foramen is a Vertebral foramen is a whole in vertebral body whole in vertebral body that spinal cord runs that spinal cord runs throughthrough病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部
5、位生长繁殖,引起不同程度的病理生理过程l Gel like Tissue between each vertebral fibro cartilaginous cushionsl serve as the spines shock absorbing systeml protect the vertebrae,brain,and other structuresl The discs allow some vertebral motion extension and flexion.Discs function病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,
6、引起不同程度的病理生理过程The disc is made up of 3 structures the Nucleus pulposus,gelatinous center Annulus Fibrosus.Its job is to contain the nucleus Vertebral end plates that attach the disc to the vertebrae Discs structure病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Herniated diskOccurwhenthereisen
7、oughpressurefromthevertebraeaboveandbelowThiscanforcenucleuspulposusthroughaweakenedortornpartoftheannulusfibrosus.Therupturednucleuswilloftencomeincontactwithandpressonnervesnearthedisc.Herniateddisksareoneofthemostcommoncausesofbackpain病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Mechani
8、sm of injurylAged-diskshaveworndownovertimeloverweight-extrapressureontheintervertebraldiskslImproperliftingform,Twistingviolently-suddenstrainthatcouldpossibleherniateadisk病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Symptomsl Lower back pain,sharp and shooting pain the runs down low back
9、,buttocks and down the thighl Pain,weakness,numbness or tingling in the legs,buttocks and feet l Problems with bowel,bladder or erectile function,in severe casesHow can we recognize a herniated disk?病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程SignsLumbarcurvatureisflattenedorevenkyphoticS
10、idebendingtowardtheoppositesideofthepainusuallyrelievesthepainThestraightleg-raising(SLR)testwithradiatingpainbelowkneelevelseemsreasonablyassociatedtodischerniation病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Obviouslyneurologicsignsalteredsensibility,reflexes,musclestrength,andmuscleatro
11、physhouldbetested.Neurologic signs Located nerve root and involved segment病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Neurologic signsl Quads/Tibialis Anteriorl Patellar reflexl Sensory Great toe and medial legL4病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Neurologic signsL5l St
12、rength of Ankle and great toe dorsiflexionl Extensor Hallucis Longusl Sensory to dorsum of foot病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Neurologic signsS1l Ankle reflexes and sensation of posterior calf and lateral footl Peroneals/Gastrocl Achilles reflexl Sensory to lateral and planta
13、r foot病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Diagnosis Generally is based on the symptoms of lower back pain.examine your sensation,reflexes,gait and strength X-ray-High-energy radiation is used to take pictures of the spine.Magnetic Resonance Imaging(MRI)-An MRI provides detailed pi
14、ctures of the spine that are produced with a powerful magnet linked to a computer.Computed Tomography(CT)Scan-A CT scan uses a thin X-ray beam that rotates around the spine area.A computer processes data to construct a three-dimensional,cross-sectional image.Electromyography(EMG)-This test measures
15、muscle response to nervous stimulation.病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程MR IMAGE Diagnosis HerniatedDisc(“slippeddisc”)病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Types of herniationlDegeneration:chemicalchangesassociatedwithagingcausedehydrated,collapsedandweak,butw
16、ithoutafrankherniation.lProlapse:thediscbulgesandmaycauseslightnarrowingofthespinalcanal,alsoknownasbulgeorprotrusion.lExtrusion:nucleuspulposusrupturesthroughtheannulusfibrosusbutremainswithinthedisc.lSequestration:nucleuspulposussqueezedout,liesoutsidethediscandwithinthespinalcanal.病原体侵入机体,消弱机体防御机
17、能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程L4vertebraL5vertebraL4exitsaboveherniationL5&lowerarecompressedL4/L5 disc L4/L5 discherniation herniationTypes of herniationCentralPosterlateralLateral病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程DifferenciationCategories of Low Back Pain(CAMPBELLS)E
18、xtrinsic lesions Urogenital system,gastrointestinal system,vascular system,endocrine system,nervous system not localized to the spine,extrinsic musculoskeletal system Infections,tumors,metabolic disturbances,congenital abnormalities,associated diseases of agingIntrinsic lesions Spinal musculoskeleta
19、l system,local hematopoietic system,local neurologic system Trauma,tumors,infections,diseases of aging,immune diseases病原体侵入机体,消弱机体防御机能,破坏机体内环境的相对稳定性,且在一定部位生长繁殖,引起不同程度的病理生理过程Differential Diagnosis of Low Back Pain Diseaseorcondition Patientage(years)Backstrain 20to40discherniation 30to50Osteoarthriti
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