Download HEALTH SCIENCES 365

HEALTH SCIENCES 365
Chapter 12 – The Trunk & Spinal Column
Bones of the Trunk, Spinal Column, and Rib Cage
Vertebral Column
General Structures
1. Body
2. Pedicle
3. Transverse Processes
4. Articular Processes
5. Lamina
6. Spinous Process
7. Vertebral Foreman
8. Intervertebral Foreman
 Neural Arch
Cervical (7)
1. Bifed Spinous Process
2. Transverse Foreman
3. Atlas (Articular Fossa)
4. Axis (Odontoic Process)
Thoracic (12)
1. Superior & Inferior Costal Facets
2. Transverse Costal Facet
Lumbar (5)
Sacral (5)
1. Median Sacral Crest
2. Sacral Canal
3. Sacral Foramen
4. Sacral Hiatus
5. Superior Articular Facet
6. Superior Sacral Notch
Coccyx (4)
Sternum
 Manubrium
 Clavicular Notch
 Jugular Notch
 Sternal Angle
 Body of Sternum
 Costal Notches
 Transverse Ridge
 Xiphoid Process
Ribs
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True (7)
False (3)
Floating (2)
Head
Neck
- Articulating facet
Tubercle
- Articular part
- Nonarticular part
Superior Border
Inferior Border
Costal Groove
Shaft
Costal Angle
Joints & Range of Motion of the Vertebral Column
Atlantooccipital (condyloidial)
 Occiptial condyles of skull sitting on the articular fossa of the atlas
 Approx. 15° flexion/extension
Atlantoaxial (trochoid)
 Rotation of atlas (C1) around the fingerlike process (odontoid process - dens) of
the axis (C2) during rotation of the head
 75° rotation, 14° extension, 24° lateral flexion
Vertebral Facet Joints (articulation between the superior & inferior articular processes)
Intervertebral Disks
Acts as cushions and shock absorbers and produces the natural curves of the spines
 Annulus Fibrosus
 Nucleus Pulposus
 Intervertebral Discs and Movement
- During bending
- During compression loads
- Nutrient supply
Ligaments
Ligamentum Nuchae
 Connects spinous processes, runs from external occipital protuberance to C7
Supraspinal
 Connects tips of spinous process from C7 to sacrum
Ligamentum Flavum
 Connects lamina from adjacent vertebrae from axis to sacrum
Interspinal
 Connects inner surface of spinous processes of adjacent vertebrae
Intertransverse
 Connects transverse processes of adjacent vertebrae
Anterior Longitudinal
 Connects adjacent vertebral bodies, runs from axis to sacrum on anterior aspect
Posterior Longitudinal
 Connects adjacent vertebral bodies, runs from axis to sacrum on posterior aspect
Movements & Range of Motion (ROM)
Cervical Region: Flexion 45°, Extension
45°, Lateral Flexion 45°, Rotation 60°
Lumbar Region: Flexion 20° 30°,
Extension 20° to 30°, Lateral Flexion 35°,
Rotation 45°
Selected Major Muscles of the Spine
Sternocleidomastoid
O. Manubrium
Anteriosuperior surface of medial clavicle
I. Mastoid process
A. ________________________________________________________
________________________________________________________
N. Spinal Accessory
Splenius Cervicis
O. Spinous processes of T3-T6
I. Transverse processes of C1-C3
A. ________________________________________________________
________________________________________________________
N. Cervical nerves 4-8
Splenius Capitis
O. Lower half of ligamentum nuchae, spinous processes C7-T3
I. Mastoid process and occipital bone
A. ________________________________________________________
________________________________________________________
N. Cervical nerves 4-8
Erector Spinae: Spinalis
O. Ligamentum nuchae, spinous process C-7, spinous process T11-12,
spinous process L1-2.
I. Spinous process C2, spinous process T5-12, occipital bone
A. ________________________________________________________
________________________________________________________
N. Spinal nerves
Erector Spinae: Longissimus
O. Posterior/medial iliac crest, thoracolumbar aponeurosis, transverse
processes L1-5, transverse processes T1-5, articular processes C5-7
I. Spinous processes C2-6, transverse processes T1-12, lower 9 ribs,
mastoid process
A. ________________________________________________________
________________________________________________________
N. Spinal nerves
Erector Spinae: Iliocostalis
O. Posterior/medial iliac crest, thoracolumbar aponeurosis, posterior
ribs 3-12
I. Posterior ribs 1-12, transverse processes C4-7
A. ________________________________________________________
________________________________________________________
N. Spinal nerves
Quadratus Lumborum
O. Posterior inner lip of iliac crest
I. Medial inferior surface of 12th rib, transverse processes of L1-4
A. ________________________________________________________
________________________________________________________
N. T12, L1 nerves
Muscles of the Abdominal Wall
Rectus Abdominis
O. Pubic crest, pubic symphysis
I. Styloid process, cartilage of 5th, 6th, 7th ribs
A. ________________________________________________________
________________________________________________________
N. Intercostals T7-T12
External Oblique
O. External surfaces of 5th -12th ribs (dovetailing the Serratus Anterior)
I. Anterior half of iliac crest, Inguinal ligament, pubic crest, fascia of
Rectus Abdominus
A. ________________________________________________________
________________________________________________________
N. Intercostal nerves T8-T12, Iliohypogastic, ilioinguinal nerve
Internal Oblique
O. Inner lip anterior half of iliac crest, upper half of inguinal ligament,
lumbar fascia
I. Inferior borders of 10th -12th ribs, linea alba
A. ________________________________________________________
________________________________________________________
N. Intercostal nerves T8-T12, Iliohypogastic, ilioinguinal nerve
Transverse Abdominis
O. Inner rim of the iliac crest, inner surfaces of ribs 7th – 12th, upper half of
inguinal ligament, lumbar fascia
I. Linea alba, pubic crest, iliopectinal line
A. ________________________________________________________
________________________________________________________
N. Intercostal nerves T7-T12, Iliohypogastic, ilioinguinal nerve
Tendinous Connective Tissue Associated with the Abdominals – connecting or supporting
the abdominal arrangement of muscles in lieu of bony attachments.
 Linea Alba: __________________________________________________________
 Linea Semilunaris: ____________________________________________________
_____________________________________________________________________
 Tendinous Inscriptions: ________________________________________________
_____________________________________________________________________
Functions of the Abdominal Wall
Protection ____________________________
Support of Viscera _____________________
Elimination ___________________________
Forced Expiration ______________________
Stabilization of Trunk and Pelvis __________
Trunk Movement ______________________
Parturation ___________________________
Abdominal Considerations
Causes for weakness of the abdominal wall
 Developmental
 Pathological
Abdominal Ptosis: _____________________
Beever’s Sign: ________________________
Kinesiology of the Abdominal Muscles: List in order the importance or degree of involvement of
the abdominals in the following activities.
_____ Straight leg raises (unilateral) _____ Sit-ups
_____ Pull-ups
_____ Ambulation
_____ Straight leg raises (bilateral) _____ Push-ups
_____ Curl-ups
Lordosis – Excessive anterior curvature of the lumbar spine (Anterior Pelvic Tilt)
 Relationship of ASIS to PSIS
Causes
Considerations
1. Congenital deformity
1. More common in tall ectomorphs
2. Poor body mechanics
2. More common in child and adolescents
3. Muscle imbalance (disuse or disease)
3. Asymptomatic unless due to trauma
4. Overtraining in certain sports
4. Relationship to low back pain
5. Compensatory deformity to a kyphosis
______________________________
or other deformities of foot, knee, or hip
5. Changes in intervertebral body distance
________________________________
______________________________
6. Bony changes uncommon
Loose/Weak Muscles/Ligament
a. _______________________________
b. _______________________________
c. ________________________ ligament
How Strengthen (isolate)?
Tight/Inflexible Muscles/Ligaments
a. _______________________________
b. _______________________________
c. ________________________ ligament
How Stretch (isolate)?
Pelvic Roll
Scoliosis – Lateral deviation(s)/curve(s) of the spine
Causes
Considerations
1. Known: (20%) Hemivertebrae,
1. Most common in adolescence 10-18
Congenital spinal deformities, neuron2. Onset, typically during puberty
muscular problems, leg length difference
3. Affects 2% women, .5% men
cerebral palsey, muscular dystrophy
4. Usually asymptomatic
2. Unknown: Idiopathic (80%)
Classification: Simple “C”
Classification: Compound “S”
Signs of Scoliosis
Adam’s Forward Bend Test
1. Unilateral problems
1. Asymmetry of erector spinae
2. Rotation of trunk (one shoulder forward)
2. Rotation of vertebrae with rib
3. Contour of trunk (waistline), skin folds
Angulation (Razor back sign)
4. Distance from arm to thorax
3. Level of fingertips
5. Asymmetry of scapula
4. Trunk contour
6. Deviations of spinous processes
7. Chest flatness on side of convexity