Dorsal (dorsal) disc protrusion: symptoms, causes, diagnosis, treatment

Axes of the human body

There are three axes of the human body, they intersect with each other at an angle of 90 degrees:

The vertical axis is the longest, it is directly perpendicular to the support on which the person stands.
The transverse axis is parallel to the support.
The sagittal axis divides the body from front to back.

Conventionally, it is possible to draw any number of transverse and sagittal axes through the human body. There is only one vertical axis, so it is also known as the main one.

The axes correspond to the planes of the body - sagittal, frontal and horizontal.

Planes of the human body

Let us briefly describe all planes:

The sagittal plane coincides with the axis of the same name. The transverse is perpendicular to it.
The frontal plane coincides with the vertical axis; it divides the body into two halves: anterior and posterior. Runs at right angles to the support. It got its name because the front parts of the body (front), in particular the forehead, are parallel to it.
The horizontal plane runs along the transverse axis. It conventionally divides the body into upper and lower parts.

Sagittal plane

This plane, like the other two, is widely used in the anatomy of both humans and animals. The sagittal plane of the body is divided by an imaginary line into the right and left sides. As already mentioned, an arbitrary number of such planes can be drawn through a body.

The line that passes through the main axis is the midsagittal plane or medial. It divides the human body into two equal halves - left and right. Symmetry is observed not only externally, but also with regard to internal organs. For example, left and right kidney, left and right lung. Unpaired organs violate it. The heart, for example, is located closer to the left side of the sternum, the stomach and spleen also gravitate towards this side of the abdominal region.

Position of organs relative to planes

Depending on the proximity of their location to a particular plane, organs are described by the following terms:

cranial: those closest to the skull, head;
lateral: external, lateral, distant from the medial plane;
caudal: organs that are located closer to the lower half of the body;
medial: located closer to the main axis;
ventral: organs that are located on the abdominal, anterior half;
dorsal: located on the dorsal, back part of the body.

If we talk about limbs, the following formulations apply:

distal: distant from any part of the body;
proximal: on the contrary, closer to it.

Caudal

CAUDAL

, caudalis (oT lat. cauda - tail), anatomical. term, 1) denoting the location of a particular part in the tail region, for example, the aorta caudalis of caudate amphibians, caudal vertebrae; 2) indicating the location of any part in the body in the direction of the longitudinal axis running from the skull to the tail (cranio-caudal direction), for example. location of the Wolffian body in the caudal direction from the head kidney, caudal part of the vertebra; 3) denoting a part of an organ that looks like a tail: caudal part epididymis, nuclei caudati.

In connection with the widespread pathology of the hooves in industrial animal husbandry technology, knowledge of the vascularization of these organs is of particular practical interest. The hooves of the thoracic limb are supplied with blood by the middle dorsal metacarpal artery, which is divided into the III and IV dorsal digital arteries. They pass along the edges of the interdigital fissure of the dorsal surfaces of the hooves and branch at the base of their skin.

The hooves, in addition, receive arterial blood from the branches of the superficial palmar branch: the hooves of the third finger - from the medial III palmar digital artery itself, and the hooves of the IV finger - from the actual lateral IV palmar digital artery.

Since vessels from the claw bone pass into the base of the skin of the claws, it must be remembered that branches from the medial and lateral III common palmar digital artery penetrate through its vascular openings. The arteries of the digital crumbs arise from the lateral III and medial IV special digital arteries. Their branches widely anastomose with the arteries of the dermis of the claws. In horses, thin dorsal metacarpal arteries - aa - emerge from the dorsal network of the wrist onto the dorsal surface of the hand.

metacarpeae dorsales, which run in the groove between the slate and III metacarpal bones; above the fetlock joint they pass to the palmar surface and anastomose with the deep palmar metacarpal arteries. On the palmar side of the wrist (Fig. 304), the continuation of the ulnar and median radial arteries are the thin lateral and medial deep palmar metacarpal arteries, which pass along the palmar surface of the metacarpal in the grooves between the III metacarpal and slate bones; above the fetlock joint they receive the dorsal metacarpals arteries and a common trunk flow into the lateral digital artery.

The median artery in the area of the palmar surface of the wrist gives off the median radial artery and passes into the large superficial palmar metacarpal branch.

It runs along the medial edge of the digital flexor tendons, without reaching the fetlock joint, penetrates under the above-mentioned tendons and is divided here into the lateral and medial palmar digital arteries.

They give off dorsal and palmar branches along the way to nearby organs located in the area of each phalanx of the finger, and penetrate into the semicircular canal of the third phalanx of the finger. Thus, in horses, two dorsal metacarpal arteries follow along the dorsal surface of the metacarpus, and three along the palmar one: two deep palmar metacarpals and one of the most powerful superficial palmar branches. In pigs, three dorsal metacarpal arteries emerge from the dorsal carpal network: II, III, IV.

They pass along the dorsal surface of the metacarpal in the grooves between the II and III metacarpals (II dorsal metacarpal), between III and IV (III dorsal metacarpal), between the IV and V metacarpal bones (IV dorsal metacarpal).

The third dorsal metacarpal artery gives off a perforating branch - r. perforans, which passes to the palmar surface and anastomoses with the median artery. In the area of the fetlock joints, each of the three dorsal metacarpal arteries is divided into two dorsal digital arteries - lateral and medial, which follow the edges of the dorsal surfaces of the fingers to the third phalanx of the finger and claw.

Posture: concept, norm

Ozhegov describes posture as a manner of holding oneself. Medical dictionaries characterize this concept as a habitual, relaxed, relaxed posture of a standing person. Two important factors determine posture: the level of muscle development and the position of the pelvis.

The sagittal plane of posture should be symmetrical. Correct, normal posture is characterized by:

strictly vertical position of the head, slightly raised chin;
strictly horizontal passage of the line of the forearms: angles symmetrical relative to each other, which form the lateral surfaces of the neck and the outlines of the shoulder girdles;
a chest symmetrical relative to the medial plane, which does not protrude or sink;
vertical abdominal region: the navel is located strictly on the line of the middle plane;
shoulder blades pressed to the body, symmetrical with respect to the spine;
parallelism of lines drawn through the popliteal fossa and gluteal folds;
when viewed from the side: retracted abdomen, raised chest, straight lower limbs, the angle of inclination of the pelvic region is no more than 30-35 degrees.

Medially and laterally it's like

Rice. 6-20. Femur - posterior view of the lateral region of the medial condyle. It is better visible on a lateral radiograph with slight rotation of the distal femur and knee. The presence of this tubercle on the lateral condyle allows the radiologist to correctly assess the degree of bone rotation to obtain a true lateral view. This is shown on the x-ray, in Fig. 6-33 (p. 206).

On the outer surface of the condyles there are rough projections, the medial and lateral epicondyles, which serve as attachment points for the ligaments and are easily palpated from the outside. The medial epicondyle, together with the tubercle of the adductor muscle, is more prominent.

Distal femur and patella (lateral view)

The lateral view (Fig. 6-21) shows the location of the patella in relation to the patellar surface of the distal femur. The patella, the largest sesamoid bone in the skeleton, lies within the tendon of the quadriceps femoris muscle. When the knee is bent, the patella moves downwards towards the intercondylar groove. With partial flexion, at an angle of approximately 45°, as shown in the figure, the patella is only partially displaced, but with 90° flexion, the patella moves significantly lower in relation to the distal femur. This displacement, as well as the relationship of the patella and the distal femur, is important when positioning the knee joint and when performing a tangential projection of the patellofemoral joint (the articulation between the patella and the distal femur).

On the posterior surface of the distal femur, immediately above the intercondylar fossa, is the popliteal surface, under which the popliteal vessels and nerves pass.

Distal femur and patella (axial view)

An axial or end view of the distal femur shows the location of the patella in relation to the patellar surface (intercondylar or trochlear groove). In this projection, the articular space in the articulation between the patella and the femur is clearly visible (Fig. 6-22). Other parts of the lower part of the femur are also clearly visible.

In the posterior part of the thigh, a deep intercondylar fossa (notch) is visible. In the upper parts of the outer surface of the medial and lateral condyles, uneven projections of the epicondyles are visible.

Patella

The patella (kneecap) is a flat, triangular-shaped bone, approximately 5 cm in diameter. The patella appears upside down because its pointed tip forms the lower edge and its rounded base forms the upper edge. The outer side of the anterior surface is convex and rough, and the inner oval-shaped posterior surface, articulating with the femur, is smooth. The patella protects the front of the knee joint from injury, in addition, it acts as a lever that increases the lifting force of the quadriceps femoris muscle, the tendon of which is attached to the tibial tuberosity of the leg. The patella in its upper position with a fully straightened limb and a relaxed quadriceps muscle is a mobile and easily displaced formation. If the leg is bent at the knee joint and the quadriceps muscle is tense, the patella moves down and is fixed in this position. Thus, it can be seen that any displacement of the patella is associated only with the femur and not with the tibia.

KNEE-JOINT

The knee joint is a complex articulation that primarily includes the femorotibial joint between the two femoral condyles and their corresponding tibial condyles. The femoral-patellar joint is also involved in the formation of the knee joint, since the patella articulates with the anterior surface of the distal femur.

Posture defects

Posture disorders (deviations from its normal state) are functional changes in the human musculoskeletal system, characterized by the appearance of new conditioned reflex connections that reinforce abnormal body position.

Common causes of postural defects:

habit of sitting in incorrect positions;
weakened body: from rickets, bronchial asthma, childhood infections;
insufficient physical development.

Poor posture is visible in two planes: frontal and sagittal. The first type is associated with a lack of symmetry between parts of the body - the so-called asymmetrical posture. The second is with a deviation from the normal curvature of the spine. In particular:

Increased curvature of the spine: stooping, round or round-arched back.
Reduced curvature: flat and flat-concave back.

Let's take a closer look at these changes.

Functions of the medulla oblongata

1. Conductor. White matter fibers provide communication between the spinal cord and the overlying parts of the brain.

Reflex. The nuclei of gray matter are the centers:

a. Regulation of the function of the digestive, respiratory and cardiovascular systems (primarily the vagus nerve).

Congenital (unconditioned) reflexes: swallowing, sucking, sneezing, coughing, vomiting.

c. Centers for automatic regulation of posture and balance.

d. Centers for regulating the level of wakefulness and sensory flows.

Most of these reflexes are especially vegetative (unconditioned), called bulbar reflexes. The medulla oblongata lies at the base of the sphenoid bone. There is severe trauma when the vertebrae of the spine penetrate the vertebrae of the base of the skull and damage the medulla oblongata.

Considering that there is a respiratory center and a center for regulating cardiovascular activity, as a rule, this is instant death.

Poor posture in the sagittal plane

Characteristics of each defect:

Slouch. Increasing the forward curve of the spine while simultaneously decreasing its backward curve. The legs are slightly bent when walking, the angle of the pelvis decreases. Characterized by a protruding belly, wing-shaped shoulder blades, and raised shoulder girdles.
Round back. With this form, the increased curvature of the spine is visible to the naked eye. In addition to wing-shaped shoulder blades and a protruding abdomen, there is also a head tilted forward, a sunken chest, and arms hanging some distance in front of the body.
Round arched back. All physiological curves of the spine increase. The legs are slightly bent when walking, the stomach can not only protrude, but also hang. Raised forearms, wing-shaped shoulder blades are sometimes observed. The head is slightly pushed forward.
Flat back. Reduction of all curves of the spine, the angle of normal pelvic tilt. The chest moves forward, the lower abdomen protrudes slightly. A wing-like shape of the shoulder blades is often observed.
Flat-concave back. Decreasing the forward curve of the spine while maintaining the norm or increasing its posterior curve. The line of the cervical vertebra is often flattened, and the shape of the shoulder blades can be wing-shaped. The pelvis moves posteriorly, the legs are slightly bent when walking, and the knees are hyperextended in an unnatural direction.

Vertical, horizontal, sagittal plane - these concepts are often used in anatomy. They are also indispensable in characterizing the manifestations of a number of diseases, developmental defects, in particular, postural disorders.

Why is dorsal disc protrusion dangerous?

Dorsal protrusion is a dangerous disease of the spine that requires immediate treatment; otherwise, the consequences can be very disastrous. When the load increases, the fibrous ring ruptures, resulting in the formation of an intervertebral hernia. The danger is that the poked component of the disc is directed into the cavity of the spinal canal. Pinched nerve endings can lead to complete paralysis.

As already mentioned, most often protrusion forms in the lumbar region. In the absence of proper therapy, urinary and fecal incontinence may develop, and the lower limbs may weaken (leg paresis). A lumbago appears in the lower back. Over time, due to severe pain, it will be difficult for a person to walk or even sit.

In the cervical spine, dorsal protrusion disrupts blood circulation to the brain. The result is constant headaches, sleep disturbances, dizziness, and memory impairment.

In the thoracic region, pathology is extremely rare. A person experiences pain when inhaling, intercostal neuralgia develops.

Not treating the disease can lead to disability.