下腰背疼痛培训课件

Ant. Longitudinal ligament前纵韧带 very dense & powerful attaches to ant disc & vert body limits hyperextension and fwd mvmt of vertebrae relative to each other 非常紧密和强大，附着在椎间盘前侧，防止 脊柱过伸和椎间盘向前脱出 Post. Longitudinal Ligament后纵韧带 travels inside the spinal canal connects to rim of vertebral bodies & center of disc , posterolateral aspect of segment not covered this is a common site for disc protrusion offers resistance to flexion 穿行于椎管内，连接椎体边缘和椎间盘的中心， 椎间盘后外侧没有覆盖，为椎间盘提供屈曲阻 力，这里常见椎间盘突出症
于躯干的后方
when these abdominals contract – added support for the low back is created 当这些腹部肌群参与共同活动时，增加了对 下腰背的支撑。
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Additional muscles contributing to trunk flexion 躯干屈曲的其他肌群
capable of withstanding compressive torsional and bending loads 能够承受挤压的扭转和压迫的负荷 role is to bear and distribute loads in vertebral column and restrain excessive motion in vertebral segment 承担和分配在脊柱上的负荷，抑制脊柱过度活动
capitis头夹肌
cervicis颈肌
thoracis胸肌
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IT
IS
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rectus abdominis 腹直肌
Abdominals 腹部肌群
transverse abdominus 腹横肌
internal oblique 腹内斜肌
external oblique 腹外斜肌
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腹腔内压 就像一个“气球”使脊柱扩大，从而降低压缩负 荷，反过来又减少了竖脊肌的活动
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Posterior Motion Segment 向后运动区域
Bone tissue in the pedicles and laminae is very hard providing good protection for spinal cord 椎弓和椎板内的骨骼组织很难对脊 髓提供良好的保护 Muscle attachments at spinous & transverse processes肌肉附着在棘突
Disc rarely fails under compression vertebral body will usually fracture before damage to disc occurs 椎间盘很少在压缩情况下损伤，且之前椎 体通常会发生骨折
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Anterior Motion Segment 向前运动区域
Inferior costal facet下肋关节面
Note: the facets are the articular surfaces. 注意：这些面都是关节面。
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Transverse process 横突
Body椎体 Vertebral foraman 椎孔
Spinous process棘突
Thoracolumbar junction Cervicothoracic junction
Sacrum - 5 fused vertebrae Coccyx - 4-5 fused vertebrae 骶椎-5块 尾椎4-5
Lumbosacral junction
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Vertebral Articulation椎关节
颈段
胸段
腰段
骶段
前面观
后面观
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The Vertebral Column脊柱
7 cervical vertebrae develop as an infant begins to lift its head7块颈椎在婴 儿时期开始发育，以支撑抬头 12 thoracic vertebrae present at birth12 块胸椎在出生时就存在 5 lumbar vertebrae develop in response to weight bearing5块腰椎发育来支撑身体 的重量
Atlas (C1) & axis (C2) account for 50% of rotation in the cervical region.寰椎C1和枢椎 C2占颈部扭转活动的50% Thoracic region is restricted, mainly due to connection to ribs.胸段活动受限，主要是与 肋骨连接。
脊柱弯曲 直立位
1st 50-60º in lumbar vertebrae L1 50-60° Flexion beyond 50º due to anterior pelvic tilting 由于骨盆前倾，屈曲大于50°
脊柱弯曲 骨盆前倾
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Regional ROM in Spine 脊柱的关节活动度范围
Superior articular process 上关节突
each articulation is a fully encapsulated synovial joint these are often called apophyseal joints
每一个关节完全由滑膜关节包 裹，通常被称为关节突关节
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Further depiction of vertebral shapes 脊椎形状进一步讲解
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Motion Segment: Functional unit of the vertebral column运动节段：脊柱的功能单位
Neural arches intervertebral joints transverse & spinous processes ligaments神经弓椎间和棘突韧带
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Spine - Posterior Muscular Support primarily produce extension and medial/lateral flexion 脊柱-后部肌肉，主要起 伸展和内外侧屈作用
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cervicis颈肌
thoracis胸肌
lumborum腰肌
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Semispinalis半棘肌
Intervertebral foraman椎间孔
Muscular Attachments 肌肉附着
muscular attachments on spinous and transverse processes 附着在横突和棘突上的肌肉
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Vertebral shape changes to reflect movements possible within a given region 椎体形状的变化，以反映可 能在一个给定的区域内的运 动
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Spinal Movement 脊柱运动
collectively -- LARGE ROM flex/ext 整体大幅度屈曲/伸展 L-R rotation 左右扭转 L-R lateral flexion 左右侧屈
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MOVEMENTS OF THE SPINE ACCOMPANIED BY PELVIC TILTING 伴随骨盆前倾的脊柱运动
Two bodies of vertebrae common vertebral disc ant & post longitudinal ligaments 椎间盘和后纵韧带
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Intervertebral Disks 椎间盘
‘shock absorbers’ of the spine脊柱的减震器
Internal & s & transverse abdominis attached to the thoracolumbar fascia covering the posterior region of the trunk内外斜肌及腹横肌附着在胸腰部覆盖
和横突上
articulation between vertebrae occurs at superior and inferior facets椎骨之间
上下有关节面
these facets are oriented at different angles related to spinal section accounting for functional differences 这些面以不同的角度连接着脊柱， 承担着不同的功能
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Spine - Posterior Muscular Support primarily produce extension and medial/lateral flexion 脊柱-后部肌肉，主要起伸展和内外侧 屈作用 Superficial to deep浅层至深层
肌肉
erector spinae 竖脊肌 Semispinalis 半棘肌 deep posterior 后侧深肌
TecnoBody Academy TecnoBody学院
SPINE 脊柱
The Trunk/Spine 躯干/脊柱