Ed Bezkor DPT, OCS, MTC Orthopedic Neurologic Evaluation 2 Week 9.
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Transcript of Ed Bezkor DPT, OCS, MTC Orthopedic Neurologic Evaluation 2 Week 9.
![Page 1: Ed Bezkor DPT, OCS, MTC Orthopedic Neurologic Evaluation 2 Week 9.](https://reader036.fdocuments.in/reader036/viewer/2022062423/56649ea25503460f94ba6134/html5/thumbnails/1.jpg)
Ed Bezkor DPT, OCS, MTC
Orthopedic Neurologic Evaluation 2
Week 9
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GoalsGoals
• Understanding of lumbar spine anatomy and patho-anatomy
• Perform lumbar spine Active Range of Motion (AROM) with/without overpressure
• Assess Passive Intervertebral Motion (PIVM) of lumbar spine
• Perform lumbar spine special tests
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Intervertebral DiscIntervertebral Disc
•Annulus fibrosus
•Nucleus polposus
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Intervertebral DiscIntervertebral Disc
•Allows movement
•Provides shock absorption
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Method of InjuryMethod of Injury
•Posterior annular fibers are less and thinner
•Posterior longitudinal ligament is weaker and narrower than anterior longitudinal ligament
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Disc InjuryDisc Injury
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Spinal StenosisSpinal Stenosis
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Stenosis vs HerniationStenosis vs Herniation
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Lumbar Contractile TissueLumbar Contractile Tissue
• Extensors– 3 layer – superficial to
deep• Erector Spinae
• Multifidus
• Intrinsics
• Flexors– Ilio Psoas
• Iliacus
• Psoas Major
• Psoas Minor
– Rectus Abdominus
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NeuroanatomyNeuroanatomy
• Lumbosacral Plexus L4-S3
– Sciatic Nerve
• Nerve made of Lumbar and sacral plexus
• The Plexus
• L-4 to S-3
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SciaticaSciatica
– Pain and paresthesia into buttock post. thigh and lower leg
– Compression on sciatic nerve
– 11% of people, the peroneal nerve splits from tibial nerve and goes through the piriformis
• Piriformis Syndrome
– 85% sciatic nerve passes posterior to external rotators
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NeuroanatomyNeuroanatomy
• Lumbar Plexus L1-4
– Lateral Femoral Cutaneous
– Femoral Nerve
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OsteoporosisOsteoporosis
• Factors
– Age
– Poor nutrition
– Lifestyle
• Lack of activity
• Lack of resistance weight bearing exercise
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AssessmentAssessment
•Posture
•AROM
•PIVM
•Special Tests
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Fear-Avoidance Beliefs QuestionnaireFear-Avoidance Beliefs Questionnaire
•Patients beliefs on how physical activity and work affect their low back pain
•Specific fear-avoidance beliefs about work are strongly related to work loss due to low back pain
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The End The End