Know why many people complain lower extremity symptoms when CPA to cervical spine is administered

-
Discovery of Dural Attachments in the Cervical Spine:

The cervical spine is stabilized posteriorly by the ligamentum nuchae and other ligaments. While previous research has described the ligamentum nuchae in general terms. A study (byMitchell BS, Humphreys BK, O'Sullivan E) attempted to describe more detailed attachments to the cervical posterior spinal dura and to posterolateral parts of the occipital bone.
10 cadavers were sectioned to reveal the ligamentum nuchae and its connection to the cervical posterior spinal dura, allowing for particular attention and reference to the deep aspects of the suboccipital triangle and upper cervical region.
In the midline between the first and second cervical vertebrae, researchers found a fibroelastic ligamentous attachment to the cervical posterior spinal dura derived from the ligamentum nuchae. As the ligamentum passed cranially, part of it passed bilaterally to the posterior aspect of the base of the occipital bone, as far superiorly as the inferior nuchal line and as far laterally as the sutures with the temporal bones.This study reveals a more complex morphology of the ligamentum nuchae than has previously been described. The bilateral attachments of the nuchae to the occipital bone reaffirm its role in stabilizing the head during rotation of the cervical spine.
These findings may have implications in the understanding of facial and cervical pain and associated disorders.
Reference:
Attachments of the ligamentum nuchae to cervical posterior spinal dura and the lateral part of the occipital bone. Journal of Manipulative and Physiological Therapeutics, March/April 1998;21(3), pp145-48.

Comments

Post a Comment

Popular posts from this blog

Entrapment of medial calcaneal nerve (MCN)

-
Image
Peripheral nerve entrapment is a rare, but important, cause of foot and ankle pain that often is underdiagnosed and mistreated. A peripheral nerve may become entrapped anywhere along its course, but certain anatomic locations are characteristic (2). The medial calcaneal nerve (MCN) The Tibial nerve is called the planter nerve in the sole. The tibial nerve passes to the sole of the foot takes a turn on the medial side of the calcaneum is called MCN. The medial calcaneal nerve arises from tibial nerve of the inner side of the ankle, perforates the laciniate ligament, travels downwards passing below the bony projection on the inner side of the ankle, and supplies the skin over the medial aspect of the heel. Hence it is the most important nerve for heel sensations. MCN have 2 branches. The anterior branch dominate the cutaneous sensation of the anterior part of the medial calcaneal and heel weight loading field, while the posterior branch dominate the sensation of the posterior an...
Read more

Differential diagnosis of Anatomic (Radial) snuffbox pain: It is not always DeQuervain’s tenosynovitis.

-
Image
Tendon, Bone & Ligament causes: 1. DeQuervain’s tenosynovitis: Swelling of tendon of APL (Abductor pollicis longus) & extensor pollicis brevis at lateral wrist near anatomic snuff box.  The primary complaint is radial sided wrist pain that radiates up the forearm with grasping or extension of the thumb. The pain has been described as a “constant aching, burning, pulling sensation." Pain is often aggravated by repetitive lifting, gripping, or twisting motions of the hand. Swelling in the anatomical snuff box, tenderness at the radial styloid process, decreased CMC abduction ROM of the 1st digit, palpable thickening of the extensor sheaths of the 1st dorsal compartment and crepitus of the tendons moving from the extensor sheath may be found upon examination. Other possible findings include weakness and paresthesia in the hand. Finkelstein’s diagnostic test will present positive provoking the patient’s symptoms. If left untreated, the inflammation and progressive narro...
Read more

Chronic fatigue syndrome

-
Introduction: Severe fatigue is a common complaint among patients. Often, the fatigue is transient or can be attributed to a definable organic illness. Some patients present with persistent and disabling fatigue, but show no abnormalities on physical examination or screening laboratory tests. In these cases, the diagnosis of chronic fatigue syndrome (CFS) should be considered. According to Centers for Disease Control and Prevention (CDC, USA) Chronic fatigue syndrome (CFS) currently is defined as: (1) fatigue of at least 6 months' duration, seriously interfering with the patient's life; and (2) without evidence of various organic or psychiatric illnesses that can produce chronic fatigue. The World Health Organization classifies myalgic encephalomyelitis/chronic fatigue syndrome (ME/cfs) as a nervous system disease. Together with other diseases under the G93 heading, ME/cfs shares a triad of abnormalities involving elevated oxidative and nitrosative stress (O&NS), activat...
Read more