Astri - Neck Cailliet Exercise

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  • Neck Cailliet ExercisePresentan : Setia Wati Astri Arifin Pembimbing : Prof. Dr. dr. Angela B.M. Tulaar, SpKFR-K

  • Introduction

  • Vertebra CervicalForamen transversumProcessus articularis pendekForamen vertebra segitiga, lebih besar dari corpusProcessus spinosus pendek dan bercabang

  • Cervical Vertebral ColumnNeumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 2e. 2 edition. St. Louis, Mo: Mosby; 2009. 725 p

  • C1= AtlasBagian superior ada faset luas, (berartikulasi dengan occipital)Tidak memiliki corpus & processus spinosusGerakan rocking YES Joint (fleksi ekstensi)

    C2= AxisBentuk seperti gigi proc.odontoid (dens)Bersendi dengan atlasGerak : rotasi = NO JointRotasi terbesar mencapai 50% (total rotasi leher)

    Tidak terdapat diskus antara C1 - occiput & antara C1 C2Reyes, Tyrone M. Kinesiology. Vol 4. Manila; U.S.T Printing Office

  • Sendi Atlanto OccipitalSendi antara faset superior atlas dan condilus occipitalDisebut YES JointsRocking motionSendi Atlanto AxialRotasi pada bidang longitudinalDisebut NO JointsRotasi 50% (total rotasi leher)

    Reyes, Tyrone M. Kinesiology. Vol 4. Manila; U.S.T Printing Office

  • C 7 Vertebra ProminensProcessus spinosus : panjang, tebal, hampir horizontal, tidak bifidaProcessus transversus lebih luasForamen transverum lebih kecilReyes, Tyrone M. Kinesiology. Vol 4. Manila; U.S.T Printing Office

  • Membentuk 5 persendian :Vertebra-diskus (true joint)Sepasang Sendi Luschka (false joint)Sepasang articulasi posterior faset (true joint)Reyes, Tyrone M. Kinesiology. Vol 4. Manila; U.S.T Printing Office

  • Arunachalam Kumar VK. UNCO VERTEBRAL JOINTS OF LUSCHKA: AN OSTEOLOGICAL STUDY. Nitte Univ J Health Sci. 2012;2(4):579

  • A paired of Luschka Joints (unco-vertebral joints) important in the pathology of neck painReyes MT, Reyes OBL. Kinesiology, Volume Four of The Philippine Physical Therapy. U.S.T. Printing Office, Manila, Phillipines; 1978. (2) 27-31.

  • Caillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.

  • Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 2e. 2 edition. St. Louis, Mo: Mosby; 2009. 725 p

  • Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 2e. 2 edition. St. Louis, Mo: Mosby; 2009. 725 p

  • Muscles of The NeckReyes MT, Reyes OBL. Kinesiology, Volume Four of The Philippine Physical Therapy. U.S.T. Printing Office, Manila, Phillipines; 1978. (2) 27-31.Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 2e. 2 edition. St. Louis, Mo: Mosby; 2009. 725 p

  • http://www.slideshare.net/ananthatiger/muscles-of-the-neck-1Superficial

  • SuperficialLippert, S. Lynn. Clinical Kinesiology and Anatomy. 4th Ed. Philadelphia; F.A Davis Company

  • FlexorsSCMScalenusLippert, S. Lynn. Clinical Kinesiology and Anatomy. 4th Ed. Philadelphia; F.A Davis Company

  • FlexorsLippert, S. Lynn. Clinical Kinesiology and Anatomy. 4th Ed. Philadelphia; F.A Davis Company

  • ExtensorsLippert, S. Lynn. Clinical Kinesiology and Anatomy. 4th Ed. Philadelphia; F.A Davis Company

  • ExtensorsLippert, S. Lynn. Clinical Kinesiology and Anatomy. 4th Ed. Philadelphia; F.A Davis Company

  • SpinalisExtensorsLippert, S. Lynn. Clinical Kinesiology and Anatomy. 4th Ed. Philadelphia; F.A Davis Company

  • Kinesiologi Faset pada prosesus articularis cervikal berorientasi pada :Bidang oblique 45Arah kemiringan dari atas depan ke bawah-belakangMembentuk sadel joint

    GerakanFleksiEkstensiLateral fleksiRotasi

    karena posisi persendian yang khas, trauma (dislokasi) tanpa fraktur tulang sering terjadi

    WHIPLASH INJURY

    C4 s/d C6Paling aktif bergerak fleksi dan ekstensiPaling sering mengalami kondisi patologis

    Reyes, Tyrone M. Kinesiology. Vol 4. Manila; U.S.T Printing Office

  • FORAMEN INTERVERTEBRALISFleksi membukaEkstensi menyempitLateral fleksi Foramina ipsilateral mengecil & foramina kontralateral membesar dan sebaliknyaCANALIS CERVICALISFleksi MemanjangEkstensi MemendekTetapi syaraf/medulla spinalis tidak memanjang/memendekReyes MT, Reyes OBL. Kinesiology, Volume Four of The Philippine Physical Therapy. U.S.T. Printing Office, Manila, Phillipines; 1978. (2) 27-31.Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 2e. 2 edition. St. Louis, Mo: Mosby; 2009. 725 p

  • Cervical ROM

    MovementDegree ()TotalAOJAAJC2-C7Flexion6010545Extension80251045Rotation (each side)75-4530Lateral flexion (each side)4551030

  • www.healthtap.com

  • Movements of The DiscSumber :Diunduh dari http://www.coreconcepts.com.sg/mcr/wp-content/uploads/2008/06/stretched-disc.jpg

  • Reyes MT, Reyes OBL. Kinesiology, Volume Four of The Philippine Physical Therapy. U.S.T. Printing Office, Manila, Phillipines; 1978. (2) 27-31.Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 2e. 2 edition. St. Louis, Mo: Mosby; 2009. 725 p

    MusclesFlexionExtensionLateral FlexionAxial RotationSternocleidomastoideus XXXX (upper)XXXXXX (CL)Scalenus anteriorXX-XXXX (CL)Scalenus mediusX-XXX-Scalenus posterior--XX-Longus colliXX-XX-Longus capitisXX-XX-Rectus capitis anteriorXX (AOJ)-X (AOJ)-Rectus capitis lateralis--XX (AOJ)-Splenius capitis -XXXXXXXX (IL)Splenius cervicis-XXXXXXXX (IL)Rectus capitis posterior mayor-XXX (AOJ & AAJ)XX (AOJ)XX (IL) (AAJ)Rectus capitis posterior minor-XX (AOJ)X (AOJ)-Oblikus capitis inferior-XX (AAJ)-XXX (IL) (AAJ)Oblikus capitis superior-XXX (AOJ)XXX (AOJ)-Keterangan: AOJ : atlanto-oksipital joint AA J : atlanto-aksial joint CL : contralateralIL : ipsilateral

  • Reyes MT, Reyes OBL. Kinesiology, Volume Four of The Philippine Physical Therapy. U.S.T. Printing Office, Manila, Phillipines; 1978. (2) 27-31.Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 2e. 2 edition. St. Louis, Mo: Mosby; 2009. 725 p

  • NECK PAIN

  • Epidemiology

  • Classification by Onset

  • Caillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.Tulaar ABM. Nyeri leher dan punggung. Maj Kedokt Indon 2008; 58(5): 169-180

  • The most common neck pain is non-specific mechanical neck pain caused by muscle strain, ligament sprain, spasm, or a combination No specific lesions, or findingsUsually caused by daily activitiesPhilip D. Sloan, Essentials of the family medicine , Chapter 37 Introduction , Wolters Kluwer , 6th edition

  • PatophysiologyIrritation or inflammation on cervical tissue can produce pain The nociceptive sites on cervical area are:Anterior & Posterior Longitudinal LigamentOuter Annulus Fibrosus DuramaterSpinal Nerve Root Facet Joint Capsule Muscles Caillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.

  • PatophysiologyTwo major mechanisms of neck pain are trauma and arthritisTrauma:External traumaPostural traumaTension traumaArthritis: Degenerative arthritis Sequelae of acute inflammation arthritisCaillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.

  • PatophysiologyExternal Trauma: The neck received external forces that cause abnormal cervical vertebrae position or movement that leading to injury and painCaillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.

  • PatophysiologyPostural Trauma:Wrong posture can cause various trauma to the musculoskeletal system, especially the vertebral column:Forward head postureDropping shoulder

    Image Source: Quora.comCaillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.

  • PatophysiologyTension Trauma: Emotional factor hypothalamic limbic system physiologic & neuromuscular system Tension within the neuromuscular system manifest as a sustained isometric muscular contraction No period of relaxation blood flow Ischemic pain lymphatic flow nutrient & O2 metabolic waste, lactic acidCaillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.

  • Penyebab Nyeri Leher

  • Clinical ManifestationPain on neck or pain from neck, with or without radiation to the head, back, shoulder and upper extremityFatigueSleep disturbanceHeadache Pain with movementLimited ROMPalpated trigger pointRadicular pain: Sharp or dull, burning sensation or shocking pain depend on ventral or dorsal nerve root involvementDistributes according to the dermatomal or myotomal areaNeurologic symptoms such as tingling sensation, paresthesia, numb or weakness Caillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.

  • Caillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.Tulaar ABM. Nyeri leher dan punggung. Maj Kedokt Indon 2008; 58(5): 169-180

  • PM & R Jackson C. TanDifferential Diagnoses

  • Caillet R. Neck and Arm Pain, 3rd ed., Philadelphia: F.A.Davis, 1991.Tulaar ABM. Nyeri leher dan punggung. Maj Kedokt Indon 2008; 58(5): 169-180

  • Neck Cailliet Exercises

  • Kontraindikasi

  • Isometric Neck Exercise

  • Isometric Neck Exercise

  • Thank You

  • Flynn TW, Cleland JA, Whitman JM. Users Guide to the Musculoskeletal Examination: Fundamentals for the Evidence Based Clinician. Evidence in Motion. 2008.

  • Axial (C2)Odontoid Process / Dens, Tooth-like projectionArticulates with anterior arch of atlas rotation in longitudinal plane Act as a PIVOTCalled NO JointsGreatest motion of neck rotation 50% total neck rotation

    NO joint

    MotionAtlanto AxialFlexion5Extension10Rotation (each side)