Alexander Zhdanov. Ligaments and muscles. Massage for back pain. Capsular ligamentous apparatus

Neck strain can occur due to any careless movement. The cause of the symptoms that accompany this pathological condition is microtrauma of soft tissue fibers. These areas accumulate lymphatic exudate, blood. As a result, an inflammatory process develops. Its intensity depends on the degree of soft tissue damage.

Causes of stretching

The cervical region contains 7 vertebrae. They are connected by intervertebral discs and ligaments. Muscles provide mobility of the head and neck. Such soft tissues are located near the spine. All this musculoskeletal system allows you to hold the spinal column. This department is not only the most mobile, but it is also the most vulnerable. This means that most often injuries occur on the soft tissues of the neck.

The main reasons for the development of pathology:

• injuries of any nature: as a result of a fall, impact, loss of consciousness, accident;
• sudden muscle spasm, which can occur under the influence of external factors, for example, if a person is in a draft;
• a sharp turn of the head;
• long stay in an uncomfortable position;
• heavy physical labor or active sports;
• dislocation and subluxation of the neck joints.

However, not only external influence leads to stretching. Such a pathology also develops as a result of degenerative and dystrophic processes occurring in the joints of this spine. With more intense exposure, soft tissue rupture occurs. In old age, muscles and ligaments lose their elasticity, which makes them more vulnerable. For this reason, a careless fall, in which the head assumes an unnatural position, can lead to rupture of the ligaments.

Symptoms

Stretching the muscles of the neck is always accompanied by pain. This is the main symptom of pathology. The intensity of pain may vary. It all depends on the condition of the tissues, the degree of their damage. Other symptoms:

• numbness of the upper limbs;
• limitation of head movement;
• with damage to certain muscles and ligaments, as well as with dislocation, subluxation, the head may be in an unnatural position;
• edema develops, its intensity is also determined by the degree of soft tissue damage;
• the color of the skin changes, more often such a symptom manifests itself when the ligaments are torn;
• muscle spasms.

Sometimes a neck injury is reflected in other parts of the body: a headache appears, and discomfort in the shoulder joint also occurs. This is due to the redistribution of loads on soft and hard tissues, compression of nerve endings and blood vessels. In addition, if there is dysfunction of some muscles, other parts of the cervical region are affected more intensely.

Degrees of damage

There are several stages of pathology:

1. Microtrauma. They provoke pain of moderate intensity. In this case, edema does not always develop. There may be a slight decrease in mobility or discomfort when attempting to move the head. Recovery from microtrauma of soft tissues occurs in 5-7 days.
2. Significant muscle strain that accompanies a strong sprain. In this case, recovery can take 1.5-2 weeks. Symptoms in this condition: intense pain, a clear limitation of movement.
3. Rupture of tissues. This pathology is treated under the supervision of a doctor, recovery may take several months. Symptoms: unbearable pain, severe swelling, discoloration of the skin: redness, cyanosis, inability to move the head.

How to relieve the condition immediately after an injury?

If you are interested in the answer to the question of what to do with such a pathology, you need to know that first aid is to relax the muscles. You can not actively move your head and arms, as this involves the soft tissues of the cervical spine. It is recommended to lie on a horizontal flat surface and place a homemade roller, twisted from improvised materials, under the neck. This will contribute to an even distribution of the load on the spinal column, and at the same time on the muscles.

With sprains of the neck ligaments and microtraumas of muscle fibers, it is recommended to make a cold compress. This measure reduces the intensity of swelling and pain. It is not recommended to apply ice directly to the outer covers, it should be wrapped in a woven material. If possible, you should consult a doctor yourself. Otherwise, the specialist should conduct an examination at home.

At your own discretion, it is impossible to develop muscles immediately after injury, as this can provoke a deterioration in the condition.

Diagnosis and treatment methods

The doctor collects an anamnesis, examines the patient by palpation. Available diagnostic measures: X-ray, MRI, CT, ultrasound. An x-ray will show the condition of the bone tissue, but it will not be possible to assess the degree of intensity of damage to the ligaments. The most informative methods: MRI, CT. Treatment must be comprehensive. Main steps:

• drug therapy;
• massage;
• physiotherapy.

First of all, you need to immobilize the cervical spine, for which they use the Shants splint. This is a universal method that allows you to restore the function of soft and hard tissues in case of injuries, muscle strain, degenerative and dystrophic processes. The collar provides a smooth, almost imperceptible stretching of the cervical vertebrae, and with them the muscles and ligaments. This measure allows you to reduce the load on the deformed tissue areas, provides expansion of the articular joints.

When stretching muscles and ligaments, different types of drugs are prescribed:

• non-steroidal anti-inflammatory drugs;
• analgesics;
• decongestants.

If the question is how to treat a sprain, you need to remember that hot compresses should not be used immediately after injury. This measure contributes to the development of the intensity of the inflammatory process. With micro-ruptures, after a few days, you can begin to develop soft tissues with the help of exercise therapy and massages (point and general).

Exercises are performed only after the pain has passed.

The goals of these measures are: blood flow to the affected area, restoration of mobility of the cervical spine.

With a weak stretching, moderately warm compresses can be applied after a day. It is important to make sure that the inflammatory process has subsided.

Along with the tablet form of anti-inflammatory drugs, ointments and gels with similar properties are used. Such drugs help to quickly eliminate symptoms. You can use them a few days after injury. It is not recommended to do this right away, since at the initial stage, when stretching, any load on the neck should be excluded, including the effect on the muscles that occurs when rubbing. Examples of anti-inflammatory drugs for external use: Fastum-gel, Teraflex.

Surgical intervention is required in cases where the injury is serious (torn ligaments) and there is no way to restore mobility to the cervical spine. In addition, the operation is performed if there is instability of the vertebrae. In most cases, conservative treatment is sufficient.

Folk remedies

To restore the functionality of the cervical spine and muscles, it is recommended to use products containing collagen. This substance is actively involved in metabolic processes, helps to restore the level of protein in the muscles. For this reason, a gelatin-based agent is used during stretching: it is diluted with water and applied to the affected area. Other folk recipes:

1. Chicken protein. It must be carefully separated from the yolk and applied to pre-folded gauze several times. Make a compress on the affected area, hold it for at least 1 hour.
2. Blue clay. The powder is mixed with water to a creamy consistency, then the substance is applied to the outer integument where pain is felt. The duration of treatment is 2 hours.

Complications and prevention

Any microtrauma leads to a decrease in muscle elasticity. With stronger ruptures of fibers in the musculoskeletal system, the load on the joints and tissues is redistributed, which leads to the development of degenerative and dystrophic processes. As a result, the risk of injury increases even with a slight external impact. In addition, the mobility of the head may decrease.

In order to prevent the occurrence of more serious pathologies in the future, preventive measures should be taken:

• move more;
• if working at a computer interferes with an active lifestyle, you should regularly do exercises aimed at developing neck muscles;
• before playing sports, it is necessary to warm up, while a short warm-up is performed, aimed at increasing muscle tone.

Care must be taken when moving in dangerous places, during sleep you need to take a comfortable position.

Clinical picture damage to the interspinous and supraspinous ligaments depends on the duration of the injury and concomitant injuries of the spine. At the same time, the clinical diagnosis of these injuries is rather complicated: palpation injury is often not always detected, since the displacements in the vertebral region are insignificant, and radiographs can not always help in making a diagnosis. This is especially true for quite common sprains in the region of the upper segment of the cervical spine. In the next sequence, the articular joints of the median and lower parts of the cervical spine are damaged. Depending on the location of damage, they are defined as post-traumatic suboccipital syndrome, median and lower cervical syndrome. The clinical picture is characterized by the appearance of typical neurological pain in the occipital region with poor objective signs. The cause of occipital neuralgia is compression of the occipital nerves, which, being formed from the posterior roots of the two cervical segments, "pierce the yellow ligament" between the arch of the atlas and the epistrophy, next to the intervertebral joints. On spondylograms, no changes are detected.

PAIN

For damage to the interspinous and supraspinous ligaments in the late stages after the injury, persistent pain in the area of ​​damage is characteristic of the type of cervicalgia, lumbago. Patients note rapid fatigue of the muscles of the neck and back. In the future, radicular pain may also appear, which more often depend on secondary degenerative changes in the intervertebral disc at the level of damage with the formation of posterior and posterolateral disc herniations.

FORCED POSITION

It is known that the lateral joints of the bodies of the cervical vertebrae are located in an oblique plane passing from back to front and from bottom to top. The deviation from the horizontal plane increases from top to bottom: it is less pronounced in the joints between the vertebrae C1-C2, more between C7-Th1. Therefore, the displacement of the vertebra forward (with hypermobility or instability) is accompanied by its elevation until the lower articular process of the vertebral body slips into the upper vertebral notch of the underlying vertebra, when the displaced vertebra again approaches the underlying one.

With various types of displacements, the head takes a characteristic position. which is considered typical. The maximum height of displacement of the lower articular process with hypermobility (instability) - I - III st. does not exceed 0.7 cm. If there is a forced inclination of the head anteriorly, then already upon examination, kyphosis is clearly visible, the top of which is formed by the spinous process of the affected vertebra. The so-called typical head positions are not always clearly expressed in chronic sprains, as they are masked by compensatory displacements in adjacent intact joints.

For diagnosis in unclear cases of “head tilt”, it is recommended to navigate according to the height of the angles of the lower jaw with a straightened neck ("unbent head"). On the convex side of the curvature, the angle of the lower jaw occupies a higher position on the side of the injury, especially if the patient first makes several nodding movements.

Better forced position of the head is detected when examining the patient in the initial position - standing, which is not always possible and acceptable, especially in recent cases. therefore, many authors emphasize the unreliability of diagnosis based on the symptoms of a typical head position. However, the detection of a forced position of the head is a sufficient basis for an in-depth clinical and radiological examination, without which the assumption of damage to the ligamentous apparatus of the cervical region cannot be rejected.

HEAD INSTABILITY

The instability of the head is a consequence of disorders of the spine tilt due to a violation of the relationship between the vertebrae, damage to the ligamentous apparatus, displacement of the load axis and the direction of muscle traction. The degree of instability can be different, which depends both on the severity of the damage and on the development of compensatory phenomena.

In severe lesions of the ligamentous apparatus (III degree), instability of the head is detected immediately after the injury and is retained for a long time (weeks, months). In milder cases (I - II degree of damage), this symptom is less pronounced, disappears faster due to scarring of damaged tissues and compensatory devices in the ligamentous-muscular apparatus of the neck. In a number of patients, instability of the head remains constantly in an upright position, or it occurs when the body position changes, with a more or less prolonged load (for example, when walking, sitting for a long time, especially with the head tilted forward).

CLASSIFICATION OF DEGREES OF HEAD INSTABILITY
(Epifanov V.A., Epifanov A.V., 2002)

mild (I) degree of instability (damage to 1 vertebral motor segment)

clinical picture: tension of the muscles of the neck, holding the head in a forced position; with movements of the trunk and limbs, the position of the head remains unchanged (due to the tension of the muscles of the neck); the patient makes movements carefully, slowly; if compensation is observed, then it is not stable, it is easily disturbed during work, especially associated with tilting the head forward

medium (II) degree of instability (damage to 1 - 2 vertebral motor segments)

clinical picture: tension of the neck muscles holding the head; the patient supports his head with his hands in a vertical position of the body, when trying to get up or lie down, while bending the torso forward (Thomsen's symptom); the patient can get up and lie down without supporting the head with his hands, but only sideways to the horizontal plane (preservation of lateral stability)

severe (III) degree of instability (damage to 2 or more vertebral motor segments)

clinical picture: muscle tension of the neck, shoulder girdle and paravertebral muscles; the patient constantly supports his head with his hands; the patient's head is not held and falls when lifting the "lying" patient (symptom of "guillotining")

Head instability is a frequent and important symptom of damage to the ligamentous apparatus of the cervical spine, but it can also be observed with fractures of the vertebral bodies, damage to the intervertebral discs, osteochondrosis of the spine, paresis and atrophy of the muscles of the neck, and some developmental anomalies. Therefore, this syndrome cannot serve as an independent test in the differential diagnosis of traumatic injuries of the spinal ligaments.

DISTURBANCE OF MOVEMENTS IN THE CERVICAL SPINE

Displacement in the lateral joints of the cervical region at any localization is accompanied by a violation of movements. These violations are expressed the more clearly, the less time has passed since the injury. Later, with the development of compensatory processes, head instability decreases and range of motion increases.

There are three variants of movement disorders in the cervical spine (Epifanov V.A., Epifanov A.V., 2002): 1. complete immobility; 2. restriction of movements in all directions; 3. restriction of movement towards damage.

When examining movements, keep in mind that:
violation of movements in the same patient is more pronounced in the vertical position than in the horizontal;
in the initial supine position, the limitations of inclination and rotation of the head are more accurately determined in cases where the patient's head is located along the axis of the body, since when the cervical spine is extended, these movements can be limited without damage;
simultaneously with impaired movement in case of damage to the ligamentous apparatus, there is tension in the muscles of the neck and crepitus during movements; muscle tension in this case may be a consequence of their reflex tension or tension with an increase in the distance of attachment points;
crunching, clicking or crepitus during movements in the cervical spine experienced by the patient or determined by palpation of the affected area - perhaps this is a manifestation of degenerative-dystrophic changes in the lateral joints, intervertebral discs and ligaments of the spine, not accompanied by other clinical symptoms.

Disturbance of movements in the cervical spine is a common symptom of damage or violation of compensation, in some diseases of the spine and cannot serve as a reliable basis for differential diagnosis between damage to the ligamentous apparatus and other injuries and diseases. Nevertheless, the study of movements in the cervical spine can confirm the assumption of a spinal injury, and the restoration of movements after treatment with exercise therapy is the most valuable clinical sign of the onset of recovery.

Symptoms of ligament injury, detected by palpation:
deviation of the spinous processes in one direction or another, as a result of which the location in one sagittal plane is disturbed; however, the identification of such a displacement is possible only in some cases (this depends on the unequal length of the spinous processes, on the unequal form of bifurcation of their ends, on the masking effect of the supraspinous ligament in case of its separation from the spinous processes, on the large thickness of the muscles and their tension); curvature of the line of the spinous processes is more easily detected only in the region of C6-7 and C2-3;
on palpation of the area of ​​damage to the vertebral motor segment of the spine, pain is determined, and in the first hours, or even days, it can be detected only outside the affected area; it depends on the greater extent of the damage to the ligament, on the displacement of damaged tissues that occurs during palpation of mobile formations (supraspinous ligament, muscles) and away from the site of damage;
with anterior displacements of the vertebral bodies (hypermobility, instability), accompanied by their anterior inclination, the posterior ligaments are ruptured and the distance between the spinous processes of the affected and underlying vertebrae increases.

For damage to the interspinous and supraspinous ligaments in the later stages after injury, persistent pain in the area of ​​damage is characteristic of the type of cervicalgia, lumbago. Patients note rapid fatigue of the muscles of the neck, back. In the future, radicular pain may also appear, which more often depend on secondary degenerative changes in the intervertebral disc at the level of damage with the formation of posterior and posterolateral disc herniations.

forced position

It is known that the lateral joints of the bodies of the cervical vertebrae are located in an oblique plane passing from back to front and from bottom to top. The deviation from the horizontal plane increases from top to bottom: it is less pronounced in the joints between the vertebrae From 1 - C 2 , more between C 7 -Th 1 . Therefore, the displacement of the vertebra forward (with hypermobility or instability) is accompanied by its elevation until the lower articular process of the vertebral body slips into the upper vertebral notch of the underlying vertebra, when the displaced vertebra again approaches the underlying one.

With various types of displacements, the head assumes a characteristic position, which is considered typical. The maximum displacement height of the lower articular process with hypermobility (instability) - I-III st. does not exceed 0.7 cm. If there is a forced inclination of the head anteriorly, then already upon examination, kyphosis is clearly visible, the top of which is formed by the spinous process of the affected vertebra.

The listed so-called typical head positions are not always clearly expressed in sprains in chronic cases, as they are masked by compensatory displacements in adjacent intact joints.

For diagnosis in unclear cases of “head tilt”, it is recommended to focus on the height of the lower jaw angles with a straightened neck (“straightened head”). On the convex side of the curvature, the angle of the lower jaw occupies a higher position on the side of the injury, especially if the patient first makes several nodding movements.

Better forced position of the head is revealed when examining a patient in SP. - standing, which is not always possible and acceptable, especially in recent cases. Therefore, many authors emphasize the unreliability of diagnosis based on the symptoms of a typical head position. However, the detection of a forced position of the head is a sufficient basis for an in-depth clinical and radiological examination, without which the assumption of damage to the ligamentous apparatus of the cervical region cannot be rejected.

head instability

The instability of the head is a consequence of disorders of the support of the spine due to a violation of the relationship between the vertebrae, damage to the ligamentous apparatus, displacement of the load axis and the direction of muscle traction.

The degree of instability can be different, which depends both on the severity of the damage and on the development of compensatory phenomena.

In severe lesions of the ligamentous apparatus (III degree), instability of the head is detected immediately after the injury and is retained for a long time (weeks, months). In milder cases (stages I-II of damage), this symptom is less pronounced, disappears faster due to scarring of damaged tissues and compensatory devices in the ligamentous-muscular apparatus of the neck. In a number of patients, instability of the head remains constantly in an upright position, or it occurs when the body position changes, with a more or less prolonged load (for example, when walking, sitting for a long time, especially with the head tilted forward).

A classification of degrees of "head instability" is proposed, based on clinical studies.

Classification of degrees of head instability (Epifanov V.A., Epifanov A.V., 2002)

Movement disorders in the cervical spine

Head instability is a frequent and important symptom of damage to the ligamentous apparatus of the cervical spine, but it can also be observed with fractures of the vertebral bodies, damage to the intervertebral discs, osteochondrosis of the spine, paresis and atrophy of the muscles of the neck, and some developmental anomalies. Therefore, this syndrome cannot serve as an independent test in the differential diagnosis of traumatic injuries of the spinal ligaments.

Movement disorders in the cervical spine

Displacement in the lateral joints of the cervical region at any localization is accompanied by a violation of movements. These violations are expressed the more clearly, the less time has passed since the injury. Later, with the development of compensatory processes, head instability decreases and range of motion increases.

There are three types of movement disorder.

When examining movements, keep in mind that:

• Disturbance of movements in the same patient is more pronounced in the vertical position than in the horizontal one.
• In the initial supine position, the limitation of the tilt and rotation of the head is more accurately determined in cases where the patient's head is located along the axis of the body, since when the cervical spine is extended, these movements can be limited without damage.
• Simultaneously with the violation of movements in case of damage to the ligamentous apparatus, there is tension in the muscles of the neck and crepitus during movements.
• Simultaneously with impaired movements in case of damage to the ligaments of the cervical spine, patients experience tension in the muscles of the neck, crunching or crepitus during movements. Muscle tension in this case may be due to their reflex tension or tension with an increase in the distance of attachment points.
• A crunch, clicking or crepitus during movements in the cervical spine, experienced by the patient or determined by palpation of the affected area, is possibly a manifestation of degenerative-dystrophic changes in the lateral joints, intervertebral discs and ligaments of the spine, not accompanied by other clinical symptoms.

Disturbance of movements in the cervical spine is a common symptom of damage or violation of compensation in some diseases of the spine and cannot serve as a reliable basis for differentiated diagnosis between damage to the ligamentous apparatus and other injuries and diseases. Nevertheless, the study of movements in the cervical spine can confirm the assumption of a spinal injury, and the restoration of movements after treatment with exercise therapy is the most valuable clinical sign of the onset of recovery.

Symptoms of ligament injury, detected by palpation

• Deviation of the spinous processes in one direction or another, as a result of which their location in one sagittal plane is disturbed. However, the identification of such a displacement is possible only in individual cases, and this depends on the unequal length of the spinous processes, on the unequal form of bifurcation of their ends, on the masking effect of the supraspinous ligament in case of its separation from the spinous processes, on the large thickness of the muscles and their tension. The curvature of the line of the spinous processes is easier to detect only in the region of C 6 - 7 and C 2 - 3 .
• On palpation of the area of ​​damage to the SMS of the spine, pain is determined, and in the first hours, or even days, it can be detected far beyond the affected area. It depends on the greater extent of the ligament injury, on the displacement of damaged tissues that occurs during palpation of mobile formations (supraspinous ligament, muscles) and away from the injury site.
• With anterior displacements of the vertebral bodies (hypermobility, instability), accompanied by their anterior inclination, rupture of the posterior ligaments occurs and the distance between the spinous processes of the affected and underlying vertebrae increases.

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Ligaments and muscles

Ligaments and muscles

Ligaments (dense connective tissue structures) firmly connect the vertebrae, directing and limiting their movements in different directions. The ligaments can withstand heavy loads and are strong in tension so that they do not rupture during injury (usually, a portion of the bone is torn off at the site of attachment of the ligaments). Numerous back muscles - superficial, deep, long and short - along with ligaments provide a reliable connection of the vertebrae and spinal mobility.

The bodies of neighboring vertebrae are connected with the help of intervertebral discs, and the arches and processes are connected with the help of ligaments.

Human muscles are divided into smooth, cardiac and striated.

Smooth muscles are located in the walls of internal organs, blood vessels and in the skin. They are part of the arteries and veins, almost all organs of the digestive tract, gall and urinary bladders, fallopian tubes, uterus, etc. The contractions of smooth muscles are subordinate to the autonomic nervous system, which means that they are involuntary, that is, they are not controlled by consciousness.

The heart muscle, unlike other muscles, contracts automatically, involuntarily and does not stop its work throughout a person's life.

Striated (skeletal) muscles are attached to the bones and set them in motion, participate in the formation of the walls of some internal organs (pharynx, upper esophagus, larynx), as well as body cavities, such as oral, thoracic, abdominal, pelvic, are among the auxiliary organs eyes (oculomotor muscles), act on the auditory ossicles in the tympanic cavity. With the help of skeletal muscles, respiratory and swallowing movements are carried out, facial expressions are formed, and the human body is maintained in balance and moves in space. Up to 80% of the total muscle weight falls on the muscles of the limbs (Fig. 2.3).

Rice. 2.3. Human muscular system: a - in front: 1 - sternocleidomastoid muscle; 2 - serratus anterior; 3 - external oblique muscle of the abdomen; 4 - biceps muscle; b - behind: 1 - trapezius muscle; 2 - the latissimus dorsi muscle; 3 - gluteus maximus; 4 - biceps femoris; 5 - calf muscle

All skeletal muscles are divided into muscles of the trunk, head and limbs. The muscles of the body, in turn, are divided into posterior (muscles of the back and neck) and anterior (muscles of the neck, chest and abdomen).

Muscles consist of muscle fibers, the main properties of which are excitability and contractility. Due to this, they can be considered a special sense organ that transmits signals to the central nervous system. On the way back, the nerve impulse, passing through the neuromuscular ending, promotes the formation of acetylcholine. This substance causes and transmits nervous excitation from one cell to another, so its increased formation during massage increases the overall performance of the muscles.

author Maxim Vasilievich Kabkov

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From the book Diabetes author S. Trofimov (ed.)

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Digestive apparatus Very often in patients with untreated diabetes mellitus, diseases of the oral cavity can often be detected: - caries, - periodontal disease, - periodontal infection, - gingivitis, etc. In severe diabetes, the tongue of patients is dry and red. periodontal disease

From the book A healthy man in your home author Elena Yurievna Zigalova

Device in the ear Modern hearing aids have changed incredibly compared to even the end of the 20th century. Moreover, the technologies for their creation are improved literally every year. The devices of previous models evenly amplified the sound on all ranges by an average of 30 decibels. it

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Genitourinary apparatus Kidney (right, left) - ren (dexter, sinister) Renal hilum - hilum renalis Renal sinus - sinus renalis Fibrous capsule of the kidney - capsula fibrosa renis Kidney cortex - cortex renis Kidney medulla - medulla renis Renal pyramid - pyramis renalis Renal papilla - papilla

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Juxtaglomerular Apparatus The juxtaglomerular (JGA) or periglomerular apparatus is a collection of cells that synthesize renin and other biologically active substances. Morphologically, it forms, as it were, a triangle, the two sides of which are

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Musculoskeletal system Skeletal system One of the most important functions of the human body is movement in space. It is performed by the musculoskeletal system, which consists of two parts: passive and active. The first includes bones that connect between

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Genitourinary apparatus The genitourinary apparatus combines two organ systems, anatomically and physiologically different, but closely related topographically and in their origin (Fig. 48, 49). Rice. 48. Genitourinary apparatus of a man, front and right view. 1 - kidney;

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Genitourinary apparatus The urinary and reproductive systems are closely related in their origin and location of organs.

A chest contusion is a condition that occurs after an injury to the upper torso. A fracture of the ribs can occur even after a slight impact on a horizontal surface. In this case, soft tissue injury with edema and inflammatory changes often occurs.

A strong blow can damage the lungs and mediastinum.

There are situations when blows are not accompanied by fractures of the ribs, but swelling of the lung tissue and impaired blood supply lead to hematomas (local limited accumulation of blood). If these injuries are not treated in a timely manner, serious consequences occur with restriction of breathing and blood supply.

Symptoms

Chest contusion occurs immediately after injury. Main symptoms:

• sharp soreness at the site of injury, and when inhaling, the pain intensifies;
• bruises and bruises occur at the site of injury;
• due to hemorrhage in soft tissues, swelling appears.

In pathology, it is not necessary that all the symptoms of the disease be expressed. Only one or more of the above symptoms may be observed.

Chest contusion according to the international classification of diseases of the 10th revision (ICD 10) is marked with the code S22. With it, any attempt to touch the site of damage causes a sharp pain.

In Russia, ICD 10 is accepted as a single standard for reporting morbidity. According to the international classification of diseases of the 10th revision, the following categories of chest wall injuries are distinguished:

1. Superficial injury (S20).
2. Open wound (S21).
3. Fracture of rib and sternum (S22).
4. Dislocation and stretching of the capsular-ligamentous apparatus (S23).
5. Spinal cord and nerve injury (S24).
6. Injury to blood vessels (S25).
7. Damage to the heart (S26).
8. Injury to other organs or unspecified (S27).
9. Chest crush (S28).
10. Injuries unspecified (S29).

Depending on the etiology, the doctor in the diagnosis indicates the disease code according to the ICD. However, he may not describe the disease according to clinical standards. It is enough to indicate the pathology code according to the international classification.

If the symptoms of the disease are combined with a rib fracture, urgent treatment of the disease is necessary. The danger of pathology should not be underestimated, as it can lead to collapse of the lungs (atelectasis).

Due to the likelihood of a rapid development of a secondary pathology when hitting the upper body on the left after an injury, doctors must prescribe an X-ray examination of the ribs and chest organs. It allows you to detect the accumulation of fluid and blood in the left pleural sinus (hemothorax).

For several weeks after the stroke, it is important to monitor the condition of the person. To avoid shortness of breath, hemorrhage, loss of consciousness, the patient constantly takes medications prescribed by the doctor.

In case of damage to the heart (code S26), it is advisable to perform a heart massage, but it must be carried out very competently. To prevent the patient's condition from worsening, physiotherapy and manual therapy are performed.

How to determine the consequences

The consequences of a blow to the chest can be determined on the basis of clinical symptoms:

• damage to the pleura;
• destruction of lung tissue;
• air entering the pleural cavity;
• subcutaneous emphysema (accumulation of air in soft tissues);
• weakening of breathing;
• decrease in heart rate;
• increase in pressure;
• general deterioration.

Due to the risk of formidable complications, treatment should be started as early as possible. To reduce the risk of complications, a pressure bandage should be used. It limits the mobility of the chest and prevents pain.

The consequences of a blow without serious damage usually disappear in 2-3 weeks. Nevertheless, there are situations in which serious complications arise in the form of pneumothorax, hydrothorax, subcutaneous emphysema (ICD 10 codes S21 and S25).

At the site of a bruise or hematoma, a small seal in the chest may remain for a long time. Most often, such seals remain with fractures of the ribs on the left. An anti-inflammatory ointment will help eliminate them.

Clinical studies prove that some people have a predisposition to this phenomenon. The danger of pathology lies in the fact that the lungs and respiratory system can be damaged. And irregular pain without adequate treatment can develop into a chronic pain syndrome.

An interesting fact is that in women who hit their left side, hemothorax occurs extremely rarely.

With a bruise on the right, an accumulation of blood is often formed in the right pleural sinus, accompanied by pain.

Injury treatment

A bruised chest is usually treated at home. After applying the bandage, the doctor will prescribe the necessary medications and the time of the return visit. If serious consequences are observed after the disease, the pathology will have to be treated in a hospital. You may need surgery to remove blood clots, stitching large vessels. After drainage, a course of anti-inflammatory and analgesic drugs is prescribed.

Classical treatment involves a course of physiotherapy to accelerate the healing process of injured tissues and resorption of lesions.

After establishing the type of injury according to ICD 10, you should immediately provide assistance to the victim in accordance with the clinical protocol.

The algorithm of actions may be as follows:

1. provide the patient with peace;
2. apply a cold compress to the injured area;
3. apply an anti-inflammatory bandage every 15 minutes;
4. anesthetize with drugs.

For local treatment, doctors, depending on the symptoms, prescribe the following ointments:

• analgesic (to relieve pain);
• anti-inflammatory (to relieve swelling);
• thrombolytic (to eliminate blood clots in the veins).

In case of serious injuries with damage to blood vessels and lungs (according to ICD 10 codes S26-S28), a puncture of the pleural cavity may be necessary to remove blood and infiltrative fluid.

Treatment of a bruise according to a medical algorithm:

1. Cold compresses are done for 1-2 days after the injury. It is necessary to apply cold daily for 15-20 minutes.
2. Warm compresses are used to get rid of hematomas (heating pad and warm bath).
3. Anti-inflammatory and analgesic ointments are used constantly.
4. It is necessary to limit the mobility of the body with a special bandage.
5. Electrophoresis for the speedy healing of tissues.
6. Damage to blood vessels is repaired surgically.

There are also folk remedies for the treatment of chest injuries, but only proven medical methods will completely get rid of the disease.

What are neck trainers and why are they needed

The cervical region is the most mobile part of the spine. Every day he experiences the strongest load, which in turn provokes the development of diseases such as arthritis, arthrosis, osteochondrosis and chronic vasospasm. Various devices, including neck trainers, help to avoid these problems.

Thanks to him, you can restore the health of the most mobile part of the spine without the intervention of medicine. The device gently stretches the capsular-ligamentous apparatus of the cervical region, neutralizes the autogravitational effect on it, eliminates disturbances, releases compressed vessels and returns the neck to its original flexibility.

Indications for use

It is necessary to stretch the spine constantly. Only daily stimulation of this part of the body helps to maintain its mobility and strength. In achieving this goal in its upper part, a large role is assigned to the neck simulator.

• arthritis and arthrosis (read about how arthritis differs from arthrosis here);
• osteochondrosis;
• intervertebral hernia;
• protrusion of the disc beyond the vertebrae (protrusion);
• unstable condition of the cervical spine.

Types of simulators and a set of exercises

The simulator for the cervical spine looks like a regular helmet, which is made of straps and two hanging loops. A chain with a weighting agent (barbell, dumbbells, discs) is attached to them.

Currently, there are several types of simulators.

spring

This fixture is equipped with a set of springs. They are located under the chin, which rests on the top of the equipment. The lower part of the simulator is under the chest. It must be well anchored.

When choosing this neck and chin trainer, pay attention to the integrity of the device and its strength. It is desirable that the nozzles are made of a material that does not slip. Don't forget the springs too. They must be of high quality and made of stainless steel.

It is easy to exercise on it.

• When practicing on this device, you must stand up straight or sit on a chair.
• The simulator is positioned so that its widest part is under the chest, and the upper one rests against the chin.
• Then you need to tilt your head forward until it stops, pressing on the piston.

First, the spring will compress under the pressure of the chin, and then it will “want” to return to its original position. At this point, you will have to make an effort to stay at the starting point for a while. After that, you need to return to the starting position.

It is necessary to do several approaches from twenty to one hundred repetitions.

Elastic (neck harness)

Consists of straps and elastic part. Thanks to the straps, it is attached to the head, and the elastic part provides muscle development, stretching and contracting.

Exercises on an elastic simulator for neck muscles look like this:

• The harness is put on the head.
• An elastic cable is attached to a Swedish wall or something similar.
• Then you need to step back so that the elastic cable stretches.
• Next, you need to tilt your head forward so that your chin touches your chest.

Performed twenty times in several approaches

Rubber expander simulator

Its difference from an elastic simulator is that rubber is used instead of a load. Movements are performed not only from the bottom up, but also from top to bottom and in both directions. This helps to pump muscles better. The device is light and small. It can be used daily.

Professional

For those who want to seriously engage in strengthening the muscles of the neck and pumping them up, you will need professional equipment. Only thanks to him you can get the desired result. The device is made of wheel steel. Classes on it can be performed with maximum load, without fear of injury.

There are a variety of professional simulators, exercises on which are performed in different ways:

Contraindications and warnings

Although the neck exerciser helps to improve health, it may not be suitable for everyone. There are some restrictions on doing exercises on it.

People who have the following pathologies will have to refuse gymnastics for the neck:

• crystal disease;
• trauma, even if it happened a very long time ago;
• stretching of the bags located near the joints;
• severe inflammatory diseases.

For those who are just starting to practice on neck simulators, you need to listen to the following recommendations:

• The room must be well ventilated.
• Starting the exercise, be sure to take the starting position.
• Warm up before exercising by exercising.
• Do not perform any sudden movements and fast muscle contractions.
• Rest between exercises. Lower your head to your chest and relax.
• Clothing should be cotton with a wide neckline.
• If you experience pain, stop exercising and rest.
• If the pain does not subside, see a doctor.
• Training should not last more than ten minutes and no muscle strain should occur during it.

Starting to exercise, use only one chain. The weighting agent should also have a small weight. Over time, the weight of the load increases. Training with a simulator will help not only make your posture beautiful, but is also an excellent prophylactic against diseases associated with the cervical spine.

We make a neck simulator with our own hands

You can make a neck simulator with your own hands. To do this, you will need: leather belts (preferably stitched); disk or dumbbells; chain, rivets; riveting tool.

It will take six rivets, 10 millimeters long and 4.8 in diameter; washers for rivets 5 mm in diameter.

Get several belts, preferably leather. One of them is divided into two pieces. These will be two side straps. Find metal ears. They can be removed from an old school bag.

Use a drill to make a hole in the belt. Its diameter is five millimeters. Bend each of the side straps on one side and fasten it with rivets and a riveting device.

Let's move on to the top layer. It will be located from ear to ear, on top of the head. This piece of leather, on the inside, it is desirable to sheathe with foam rubber or an ordinary soft cloth. A hole is made at the edges of the upper strap. Its diameter is five millimeters.

We turn to the design of the strap, which will go around the head. Side and upper "bridles" cling to it. We cut off the required size from the belt. This bezel also needs to be sheathed with foam rubber from the inside.

To the side straps along the edges where there was a bend, we attach metal devices (lugs) for hooking chains with a weighting agent. We attach the side rims to the upper part of the belt where the hole was made. For these purposes, rivets are used.

After that, we connect the entire structure with a belt around the head.

Trainer done. It remains to fix the chain and add discs or dumbbells to it.

Knees crunch and hurt when bending: what to do and how to treat

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The knee is the most flat joint. It does not have large recesses for fixing the articulating bones. Complete freedom of movement appears due to special structures that consist of soft tissue: muscles, tendons, menisci and capsular-ligamentous apparatus. They are able to securely fix the bones of the knee joint in the correct anatomical position.

Everything is so well thought out by nature that the knee joint can bend and unbend 180 degrees, and this is possible in several planes at once. If the body is healthy, then the person does not feel pain, and even more so extraneous sounds in the joints and knees.

When there is a crunch in the knee, it is important to understand why this happens. Often, the sound is associated with a violation in the hyaline cartilage, located on the surface of the bone tissue, at the site of the formation of the joint. The weight of a person constantly acts on the knees, and the load varies depending on the type of activity: when walking, swimming, running, cycling.

A crunch from time to time and only in one knee is a direct signal that pain will soon begin. The knees hurt and crunch when bending unpleasantly, significantly limiting the freedom of movement of a person. In the absence of adequate treatment, the patient may remain disabled.

Causes of a crunch in the knees

Why the knee hurts and sometimes crunches, only a doctor can answer. Sometimes crackling or crunching makes itself felt during physical activity. Doctors distinguish two types of crunch:

• pathological;
• natural (natural).

If the knee crunches for natural reasons, then this does not provide for medical treatment. For the purpose of prevention, the use of folk remedies is shown.

The occurrence of such a crunch is caused by factors:

1. dissolved gas bubbles burst in the joint fluid (synovial);
2. ligaments are touched over the protruding places of the bone if there is a slight violation of their anatomical location. This sometimes happens if the patient sits or sleeps in an uncomfortable body position for a long time.

The consequences are much worse as a result of a pathological crunch in the knee joint when flexed, but the problem can be solved with medicines.

Why does pathological crunch occur?

This type of sound is dangerous because it usually accompanies severe diseases of the knee joints and requires long-term medical or even surgical treatment. First of all, it crunches due to the onset of destruction of the cartilaginous layer on the bones of the joints. The causes of this process are gonarthrosis or osteoarthritis. In this case, it crunches in the knees against the background:

• pain;
• puffiness;
• redness;
• an increase in the temperature of the integument around the affected joint.

As the disease progresses, pain and crunching increase during flexion and extension of the legs.

Another prerequisite for the appearance of a pathological crunch is injuries of any nature. They can be obtained as a result of impact, excessive load on the knee joint. Especially often such problems are diagnosed in professional athletes, people leading an active lifestyle.

When the knee is injured, the ligaments are torn, the menisci, patella and tendons are damaged. Some injuries cause chronic diseases that require long-term therapy. It happens that the knee hurts when bending so much that it is simply impossible to improve the patient's condition without surgery.

My knees also hurt from being overweight. The higher the weight of the patient, the more the joint suffers during flexion.

Other, less common causes of abnormal sounds and pain in the knee joint:

1. genetic predisposition to joint diseases;
2. natural aging, which leads to malnutrition of the tissues of the knee;
3. viral diseases that cause the progression of arthritis;
4. sedentary way of life (physical inactivity);
5. abuse of sweet, salty, spicy foods that provoke salt deposits and obesity;
6. diseases that contribute to the accumulation of salt in the joints (gouty arthritis, kidney failure);
7. increased stress on the joints when wearing the wrong shoes (high heels), lifting weights, standing for a long time;
8. endocrine disorders (diabetes mellitus, malfunctions of the thyroid gland and pancreas).

Crunch treatment with traditional methods

When a patient suffers from crunching and pain in the knee when bending, it is imperative to start treatment and understand why this is happening. At the first stages, it consists in observing certain rules.

To treat the knees, if they hurt, it is forbidden to lift weights. If you need to perform heavy physical work, you should rest as often as possible. If a person sits in an uncomfortable position for a long time, then it is important to take breaks while doing gymnastic exercises.

When extending the knee in the joint and when bending during squats, the joints are intensely saturated.

In addition, doctors strongly advise:

• try to protect your knees from temperature changes, but especially hypothermia;
• adhere to a healthy lifestyle, monitor weight indicators and walk in the fresh air as much as possible;
• with excess body weight, choose exercises that do not put too much strain on the knees when bending.

It happens that a person’s work is associated with kneeling, then it is necessary to use knee pads. It will not be superfluous to change the diet, to rely on plant foods.

Arthroscopy

You can get rid of the problem and its causes with the help of high-tech medical equipment. It makes it possible to diagnose (to see why the knee is bothering) and treat diseases of the bones and joints.

There is a direction, knee arthroscopy is an endoscopic examination of the knee. The method allows you to examine the affected area thanks to a miniature video camera, which is built into a special device - an arthroscope.

During the study, the doctor can visually control the operation on the monitor. It is possible to see minor defects of the knee joint with the help of:

• mirror systems;
• special lenses;
• directional light beam.

Modern equipment makes it possible to successfully carry out surgical intervention, but the skill of the surgeon is also important in this matter.

Complementing herbal treatments

You can also treat knees with the help of folk methods. Infusions, ointments, decoctions, compresses and lotions are very popular. It should be remembered that it is important to adhere to dosages and recipes as accurately as possible. It is good to combine folk remedies with therapeutic exercises. After treatment, it is useful to swim or do other exercises in the pool, but if there is no pain.

The causes of joint pain can be eliminated, but if the knees are treated in a complex way. Coniferous cones are shown to be used for treatment:

1. infusion. They take a dry cone, wash it thoroughly, put it in a glass, pour boiling water over it and let it stand for 12 hours. After that, the bump is removed, and the resulting infusion is drunk in 2 doses (morning and evening). The course of treatment will be 1 week;
2. lotions. 6 pieces of cones are crushed, pour 500 ml of vodka, but without additives or alcohol. The remedy for pain is insisted for 21 days, filtered, and the resulting liquid is poured into a dark bottle. Then a tablespoon of infusion is mixed with a teaspoon of bee honey, soaked in a napkin. It is necessary to make a lotion on the knee joint, wrapping it on top with a film and an elastic bandage. Additionally, you can wrap the compress with a woolen scarf or shawl. After 4 procedures, the patient's leg no longer hurts when the knee joint is extended.

Doctors advise supplementing treatment with tincture of cinquefoil. This medicinal plant is used not only to get rid of the crunch, but also puffiness, bruises, pain in arthrosis, gout, osteochondrosis and rheumatoid arthritis.

The recipe is simple: for every 25 g of cinquefoil roots, take 250 ml of alcohol. The mixture is placed in a dark place for a period of 3 weeks. The finished medicine is stored in a sealed container. Use tincture should be before eating 1 teaspoon, but after diluting the cinquefoil in a third of a glass of water.

An ointment can be made from horse chestnut. To do this, the fruits of horse chestnut are mixed with any vegetable oil and boiled for 15 minutes in a water bath.

No less effective is the tincture on calamus root (1 part), pine buds and lemon balm (2 parts each), oregano (3 parts). The components are crushed, mixed and boiled for 10 to 15 minutes on slow gas.

The liquid is taken at the rate of 1 liter for every 3 tablespoons of raw materials. Alternatively, you can use a water bath. Use the remedy 30 minutes before lunch, which should be followed every day.

Using the same technology, it is easy to make tincture from:

• linden flowers (1 part);
• birch leaves, hop cones, chamomile (3 parts);
• wild rosemary (5 parts).

Using folk remedies, if your knees hurt, you should figure out why this is happening and agree on treatment methods with the doctor. Not every plant can organically supplement medications. Only with a competent approach can you get a good result, get rid of the crunch.

• Relieves pain and swelling in the joints with arthritis and arthrosis
• Restores joints and tissues, effective for osteochondrosis

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