MHQExaminationofspineandExtremities2讲义.ppt

Chapter VIII :Examination of spine and Extremities 原南京中大附属医院神内科主任、硕士生导师 佛山大学医学院医学系孟红旗教授、主任医师 Professor、Doctor director 、Neurologist Section 1 、Examination of Spine 颈神经(cervical nerve) 8对， cervical vertebra= 7 胸神经(thoracic nerve) 12对， thoracic vertebra = 12 腰神经(lumbar nerve) 5对， lumbar vertebra = 5 骶神经(sacral nerve) 5对， sacral vertebra = 5 尾神经(coccygeal nerve) 1对， Coccygeal vertebra = 4 (二) curvature of Pathological 1.脊柱后凸(kyphosis) kyphosis This condition usually occurs in thoraci spine. Causes: rachitis: more in children. tuberculosis Rheumatoid spondylitis Osseous retrograde degeneration Others: trauma, dysplasia, or spondylous osteochondritis. a curving of the spine that causes a bowing of the back, such that the apex of the angle points backwards leading to a hunchback驼背 or slouching posture. a spinal deformity that can result from trauma, developmental problems, or degenerative disease. can occur at any age, although it is rare at birth. 1.脊柱后凸： 驼背，多发生于胸段。 1）佝偻病： 小儿，胸段明显均匀性向后弯曲，卧位时弯曲可消失。 2）脊柱结核： 棘突明显向后凸，成角畸形，病变常累及下胸段及腰段。 3）强直性脊柱炎： 成年人。脊柱胸段成弧形后凸，常有脊柱强直性固定，仰卧位时也不能伸直。 4）老年人脊柱后凸：退行性变，胸椎椎体被压缩引起。胸椎明显后凸，胸段上半部。 5）其他：发育期姿势不良、外伤压缩性骨折、脊椎骨软骨炎。 2.脊柱前凸 Lordosis Lordosis is excessive curvature in the lumbar portion of the spine, which gives a swayback 背部过份凹陷appearance. 多发生于腰椎。腹部明显向前突，臀部明显向后突。妊娠晚期、大量腹水、腹腔巨大肿瘤、髋关节结核及先天性髋关节后脱位等 3.scoliosis脊柱侧凸 Scoliosis is an abnormal curve of the spine (backbone). With scoliosis, the spine isnt straight. Instead, the spine is crooked and curves to the side. If the spine is very crooked, the ribs or hips may stick out more on one side than the other side. Also, one shoulder may be lower than the other. scoliosis It is divided into three types as scoliosis of thoracic, lumber, and thoracolumbar segment, based on the developing site; or it can be divided into posture and organic scoliosis, based on the nature of the disease. posture scoliosis The bending of this type is no