腰椎中英文ppt课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,*,腰椎中英文课件,腰椎中英文课件,We clarify how lumbar spine,moves from a biomechanical point of view,in order to estimate the related osteopathic dysfunctions.,为了更好地探究与腰椎有关的整骨术，我们将从生物力学的角度弄清它们是如何运动的,2,We clarify how lumbar spine mo,LUMBAR VERTEBRA,Body:,Most voluminous;,High increase from L1 to L5;,The inferior articular facet is more extended than the lower one,The pedicles,:,Very thick,sagittal,they graft from the bodys lateral posterior upper part;,Lower edges are very hollowed on low part(foramen).,Plates,:,thick,larger than higher;,Oblique behind/inside/.,Spinous process:,very thick,almost horizontal;,External border very thick.,Transverse process,:,Long and narrow;,Direction outside/behind.,Articular process,Higher ones are flat.Direction behind-inside;,Lower ones are cylindrical segment.Direction ahead outside;,Articular interline is vertical,almost sagittal;,Spinal canal,:,Triangle structure;,3,LUMBAR VERTEBRA3,腰椎,椎体,：,所有脊椎中最大,；,从1到5腰椎逐渐增大,；,下关节面更加延展,椎弓根,：,厚，矢状面，从椎体后外侧上部连接,；,边缘切迹，上下形成椎间孔,椎板,:,厚，宽而不是高,；,斜向后/内,棘突,:,非常厚，几乎水平,；,外边缘厚,横突,:,狭长,；,方向外/后,关节突,:,上两个为平面状，方向后内,；,下两个为圆柱状，方向前外,；,关节间线垂直，几乎在矢状面,椎管,:,三角形结构,4,腰椎4,L1:,shows transverse processes low developed;横突伸出不多,L5:,vertebral body is higher ahead than behind(structural adaptation to bipedia);椎体前高后,低,（双足动物的适应性结构进化）,transverse processes are very short;横突短,lower articular processes are more external in order to match with coccyx ones;下关节突偏向外以对应尾骨突起,D12:,concerning lumbar vertebral for its lower articular processes;通过下关节突与腰椎联系,transitional vertebra(lumbar spine hinge).,转移过度性的椎体（腰椎转接枢纽）,ANATOMO-PHYSIOLOGICAL CHARACTERISTICS,解剖生理特性,5,L1:shows transverse processes,LUMBOSACRAL HINGE,腰骶转接枢纽,Its an important transition area:at this level,the forces on work,through long and complex levers,are remarkable despite the flexibility is ensured by the deep facets;,这是非常重要的过渡区域：尽管深部的小关节面保证了足够的弹性，但在这个平面上因为身体复杂的长杠杆作用，这个区域还是承受着巨大的应力,Sacral plate is inclined 30 more than the horizontal line;,骶锥平面较水平线倾斜,30,The inferior plate L5 is inclined about 20 than the horizontal line;,L5,下方平面较水平线倾斜约,20,Both parameters make intervertebral disc L5-S1 twice thicker ahead than behind(structural adjustment to bipedia);,这两个性质使,L5与S1,之间的椎间盘前部分比后部分厚两倍（两足生物的结构性适应）,interapophyseal joints interlinea between L5-S1 is based at more frontal level:although L5 body could slide ahead,blocked by the oblique fibers of the annulus of the disc and the paravertebral muscles;,L5与S1,之间相联系的关节间线更偏向前方：虽然,L5,的椎体可以向前滑动，但被椎间盘环面的斜向纤维与椎旁的肌肉阻挡,Sacral vertebral angle is about 130(R S E R S,19,When motion is introduced in o,SYMMETRIC-BILATERAL DYSFUNCTIONS双侧对称性功能失常,FLEXURE POSITION:,-the vertebra is in 2 fluxure position against the underlying one:the lower articular processes are divergent against the underlyng vertebra higher ones.;,屈曲位置：相对于下面的椎骨有2度的屈曲：下关节突相对于下面椎骨的上关节突呈分叉状,-cannot be back on neutrality position;不能回到正中位,-ligaments and discs follow the described laws in permanent and pathologic way.韧带与椎间盘会永久地病理性地遵循前述的法则,STRECH POSITION:,-the vertebra is in strech position against the underlying one:the lower articular processes are convergent against the underlying vertebra higher ones;,伸展位置：相对于下面的椎骨为伸展位：下关节突相对于下面椎骨的上关节突呈聚合状,-cannot be back on neutrality position;不能回到正中位,-ligaments and discs follow the laws mentioned in permanent and pathologic way韧带与椎间盘会永久地病理性地遵循前述的法则,20,SYMMETRIC-BILATERAL DYSFUNCTIO,FRS dx,FRS sx,NEUTRALLITY,ERS dx,ERS sx,21,FRS dxFRS sxNEUTRALLITYERS dxE,MOBILITY TEST移动性测试,Please consider:请思考,facets blocked or in divergent state(flexure)or convergence(stretch);,小关节面被锁住或者处于分叉（屈曲）或聚合（伸展）状态,The facet in divergent state or in convergence works as fulcrum,around which the vertebra moves;小关节面处于分叉或聚合状态时，像杠杆的支点一样，椎骨会绕着它运,The interspinous space to value is between vertebra on dysfunction and the underlying below.椎骨间隙是用来评估功能失常的椎骨和它下方紧挨的椎骨,The rotation of a vertebral segment could be created with three positions:,椎骨某部分的旋转可以是在3个位置,-neutrality state;正中位,-iper flexure state;屈曲位,-stretch.伸展位,when the palpation shows a bilateral symmetric dysfunction we find the spinous process of corrispondent vertebra alligned with the spinous process,superior and underlying,but separated from the underlying spinosa(stretch)or from the over one(stretch);当触诊时发现双侧对称性功能失常，会有相应椎骨的棘突按照椎骨顺序排列，但是会与下一块椎骨（伸展）或者上一块椎骨（伸展）分离,Now we can identify the lesion type.现在我们可以区别不同的功能失常,。,22,MOBILITY TEST移动性测试Please consi,There are two methods:有两种思路,Breathing mobility test:pz prone,please consider before the performance in opening and closure of both interspinous space(up and down)during inhaling(flexure at lumbar level and stretch at dorsal level and during expiration(stretch at lumbar level and flexure at dorsal level);,呼吸移动性测试,：患者俯卧，先想象在吸气（腰椎屈曲位,，,胸椎伸展位）和呼气（腰椎伸展位,，,胸椎屈曲位）时椎骨间隙的开合（上下）运动,Mechanical mobility test:pz seated,cross arms,hands on shoulders,please consider the performance in opening and closure of both interspinous spaces(up and down)making a flexure and a stretch of all the trunk.,机械性移动测试,：患者坐位，双臂交叉，双手放置于肩上，