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CHAPTER 9:PART 1 THE SPINAL COLUMN AND THORAX KINESIOLOGY Scientific Basis of Human Motion, 12th edition Hamilton, Weimar & Luttgens Presentation Created by TK Koesterer, Ph.D., ATC Humboldt State University Revised by Hamilton & Weimar McGraw-Hill/Irwin Copyright © 2012 by The McGraw-Hill Companies, Inc. All rights reserved. OBJECTIVES 1. Name, locate, & describe the structure & ligamentous reinforcements of the joints of the spinal column. 2. Name & demonstrate movements possible. 3. Name & locate muscles & muscle groups, and name their primary actions. 4. Analyze the fundamental movements with respect to joint & muscle actions. 5. Describe common injuries. 9A-2 SPINAL COLUMN: STRUCTURE 7 Cervical Vertebrae 12 Thoracic Vertebrae 5 Lumbar Vertebrae Sarcrum Coccyx (7 ) (12 ) (5 ) Fig 9.1 (5 ) 9A-3 ARTICULATION OF VERTEBRAL BODIES Cartilaginous joint. Intervertebral discs of fibrocartilage. Outer fibrous rim (annulus fibrosus). Nucleus pulposus Permits compression in any direction & some torsion. Shock absorbers. Fig 9.2 9A-4 LIGAMENTOUS REINFORCEMENT Anterior longitudinal ligaments. Posterior longitudinal ligament. Fig 9.3a & 9.4a 9A-5 ARTICULATION OF VERTEBRAL ARCHES Facets are nonaxial. Enclosed in a capsule. Permit gliding. Motion determined by the direction that the facets face. Motion between vertebrae only a few degrees. Cummulative motion from 40º to 70°. Fig 9.5 9A-6 ARTICULATION OF VERTEBRAL ARCHES: CERVICAL Slant at about 45° Favors rotation & lateral flexion. Movements are flexion & hyperextension, lateral flexion, & rotation. Rotation moderate from C2 down. Fig 9.6a 9A-7 ARTICULATION OF VERTEBRAL ARCHES: THORACIC Facets face backward, slightly upward & laterally. Permit rotation & lateral bending. Fig 9.6b 9A-8 ARTICULATION OF VERTEBRAL ARCHES: LUMBAR Facets face inward & slightly backward. Locked against rotation. Permits flexion & hyperextension. Fig 9.6c 9A-9 ARTICULATION OF VERTEBRAL ARCHES: LIGAMENTS Fig 9.7 9A-10 ATLANTO-OCCIPITAL ARTICULATION Condyles of occipital bone articulate with articular fossa of the atlas. The two joints act like a hinge joint. Permit flexion & extension. Fig 9.8 9A-11 ATLANTOAXIAL ARTICULATION Perfect example of a pivot joint. Sole function is rotation. Odontoid process projects upward from axis, held in place by transverse ligament. Fig 9.9 9A-12 MOVEMENTS OF THE SPINE AS A WHOLE Flexion Fig 9.11a & b Hyperextension 9A-13 MOVEMENTS OF THE SPINE AS A WHOLE Lateral flexion Fig 9.11c & d Rotation 9A-14 REGIONAL CLASSIFICATION OF SPINAL MOVEMENTS Atlanto-occipital joint Flexion & extension, hyperextension. Slight lateral flexion. Atlantoaxial joint Rotation Remaining cervical joints Flexion & extension, hyperextension. Lateral flexion. Rotation 9A-15 REGIONAL CLASSIFICATION OF SPINAL MOVEMENTS Thoracic region Moderate flexion Slight hyperextension Moderate lateral flexion Rotation Lumbar Flexion & extension, hyperextension Lateral flexion Slight rotation 9A-16 FACTORS INFLUENCING STABILITY & MOBILITY OF THE SPINE Pressure & Tension Stresses: Discs push vertebrae apart & ligaments pull them together. Anteroposterior Curves: Influence the nature & degrees of motion in different regions. Relative Thickness & Shape of Discs: Greater freedom of motion where discs are thick. Thickness & Strength of Ligaments: Regional differences influence motions permitted. 9A-17 FACTORS INFLUENCING STABILITY & MOBILITY OF THE SPINE Direction & Obliquity of Articular Facets: Regional characteristics determine motion permitted. Size & Obliquity of Spinous Processes: Thoracic overlap & limit hyperextension; lumbar are horizontal & do not restrict motion. Articulations of Ribs with Vertebrae: Limit lateral flexion in thoracic region. 9A-18 MUSCLES OPERATING SPINAL COLUMN: ANTERIOR ASPECT Cervical Region Prevertebral muscles (longus capitis & coli, rectus capitis anterior & lateralis). Hyoid muscles (suprahyoids & infrahyoids). Thoracic Abdominal muscles: Obliquus externus & internus abdominis Rectus abdominis Transverse abdominis 9A-19 MUSCLES OPERATING SPINAL COLUMN: POSTERIOR ASPECT Cervical Region Only Splenius capitis & cervicis. Suboccipitals Cervical, Thoracic & Lumbar Region Erector spinae. Deep posterior spinal muscles. Semispinalis thoracis, cervicis, and capitis 9A-20 MUSCLES OPERATING SPINAL COLUMN: LATERAL ASPECT Cervical Region Scalenus anterior, posterior, & medius. Sternocleidomastoid. Levator scapulae. Lumbar Region Quadratus lumborum. Psoas major. 9A-21 MUSCLES OPERATING SPINAL COLUMN Prevertebral Muscles Function: Singly: laterally flex & rotate to opposite side. Together: flex head & neck. Fig 9.13 9A-22 MUSCLES OPERATING SPINAL COLUMN Hyoid Muscles Function: Flex head & neck, aid swallowing. Fig 9.14 9A-23 MUSCLES OPERATING SPINAL COLUMN Obliquus Externus Abdominis Function: Singly: laterally flex & rotate spine to opposite side. Together: flex thoracic & lumbar spine. Fig 9.15 9A-24 MUSCLES OPERATING SPINAL COLUMN Obliquus Internus Abdominis Function: Singly: laterally flex & rotate spine to the same side. Together: flex thoracic & lumbar spine. Obliquus Internus abdominis Thoracolumbar fascia Rectus sheath (anterior leaf) Inguinal ligament Fig 9.16 9A-25 MUSCLES OPERATING SPINAL COLUMN Rectus Abdominis Function: Singly: laterally flex spine. Together: flex thoracic & lumbar spine. Fig 9.17 9A-26 MUSCLES OPERATING SPINAL COLUMN Transversus Abdominis Function: Stabilize trunk. Fig 9.18 9A-27 MUSCLES OPERATING SPINAL COLUMN Splenius Capitis & Cervicis Function: Singly: laterally flex head & neck, and rotate them to the same side. Together: extend & hyperextend head & neck. Fig 9.19 9A-28 MUSCLES OPERATING SPINAL COLUMN Levator Scapulae Function: Singly: laterally flex neck. Together: stabilize neck. Fig 9.19 9A-29 MUSCLES OPERATING SPINAL COLUMN Suboccipital Group Function: Singly: laterally flex head, or rotates it to the same side. Together: extend & hyperextend head. Fig 9.20 9A-30 MUSCLES OPERATING SPINAL COLUMN Erector Spinae Function: Bilateral: extends head & spine. Unilateral: rotates spine to same side. Fig 9.21 9A-31 MUSCLES OPERATING SPINAL COLUMN Deep Posterior Spinal Muscles Function: Symmetrical: extends & hyperextends spine. Asymmetrical: rotates spine to opposite side and assists in lateral flexion. Fig 9.22 9A-32 MUSCLES OPERATING SPINAL COLUMN Semispinalis Thoracis, Cervicis, & Capitis Function: Singly: lateral flexion & rotates spine to opposite side. Together: extend & hyperextend thoracic & cervical spine. Fig 9.23 9A-33 MUSCLES OPERATING SPINAL COLUMN Scalenus Anterior, Posterior, & Medius Function: Singly: laterally flex neck. Together: flex cervical spine. Elevate upper ribs in forced inspiration. Fig 9.24 9A-34 MUSCLES OPERATING SPINAL COLUMN Sternocleidomastoid Function: Together: flex neck & head. Singly: laterally flex head & neck, and rotate to opposite side. Fig 9.25 9A-35 MUSCLES OPERATING SPINAL COLUMN Quadratus Lumborum Function: Singly: laterally flex lumbar spine. Together: stabilize pelvis & lumbar spine. Fig 9.26 9A-36 MUSCLES OPERATING SPINAL COLUMN Psoas Function: Singly: laterally flex lumbar spine. Together: stabilize spine. Fig 7.14 9A-37 MUSCULAR ANALYSIS OF FUNDAMENTAL MOVEMENTS OF HEAD & SPINE Cervical Spine & Atlanto-Occipital Joint: Flexion: Sternocleidomastoid, scalenes, prevertebral muscles. Extension & Hyperextension: Splenius capitis & cervicis, erector spinae capitis & cervicis, semispinalis, deep posterior spinal muscles, suboccipitalis. Lateral flexion: Splenius capitis & cervicis, erector spinae, semispinalis, scalenes, sternocleidomastoid. Rotation: Sternocleidomastoid, deep posterior spinal muscles, splenius, erector spinae, occipitalis. 9A-38 MUSCULAR ANALYSIS OF FUNDAMENTAL MOVMENTS OF HEAD & SPINE Thoracic & Lumbar Spine Flexion: Abdominals. Extension & Hyperextension: Erector spinae, semispinalis thoracis, deep posterior spinal muscles. Lateral flexion: Erector spinae, oblique abdominals, quadratus lumborum. Rotation to Left: Left internal oblique & erector spinae, right external oblique, semispinalis thoracis, other deep posterior spinal muscles. 9A-39