Kines: Spine/Trunk/ Respiration

Occur when the head suddenly and violently hyperextends and then flexes (whiplash).

Cervical sprains

Degenerative disorder of vertebral structure and function May result from bony spurs, thickening of ligaments It may lead to nerve root and SC compression

Spondylosis (spinal OA):

The trachea, bronchi, and their subdivisions are sometimes referred to as the _____________

'bronchial tree'

Action of all scalenes?

(B) Anterior/Middle: neck flexion (B) All: assist with inspiration via 1st and 2nd rib elevation(U) All: lateral neck flexion

Action of quadratus lumborum?

(B) Lumbar extension (U) Trunk lateral flexion

Action of internal oblique?

(B) Trunk flexion, posterior pelvic tilt, increases in intra-abdominal and intrathoracic pressure and also in thoracolumbar fascia tension (U) Trunk lateral flexion, and ipsilateral rotation

Action of external oblique?

(B) Trunk flexion, posterior pelvic tilt, increases intra-abdominal and intrathoracic pressure (U) Trunk lateral flexion and contralateral rotation

Action of iliocostalis?

(B) extension (U) lateral flexion

Action of splenius capitis?

(B) head and neck extension (U) head and neck ipsilateral rotation, lateral flexion

Action of splenius cervicis?

(B) neck extension (U) neck ipsilateral rotation, and lateral flexion

Costal Facet

- Located on sides of the bodies and transverse processes of thoracic vertebrae only - The ribs articulate with the vertebrae

Dens

-Anteriorly located on Axis C2 -Cervical rotation occurs through its articulation with the atlas Takes place where the vertebral body is located on other vertebra

The "true ribs" are attached directly to the sternum anteriorly. These ribs include ribs: A. 1 through 5 B. 1 through 7 C. 2 through 5 D. 2 through 8

1 through 7

During the Heimlich maneuver dislodging of a foreign object is an example of the mechanics of ______1_________. Where the diaphragm is forced _____2_______ causing the lungs to _________3________, and forcing the air and object out. Similar action as a ___________4___________________.

1. Expiration 2. upward 3. compress 4. forceful artificial cough

What are the muscles of Forced inspiration?

1. Sternocleidomastiod Muscle 2. Scalene Muscle Group 3. Subclavius 4. Pectoralis Major 5. Pectoralis Minor 6. Serratus Anterior 7. Costal Levators 8. Serratus Posterior Superior 9. Latissimus Dorsi

The most superficial layer of back muscles are the ________1__________muscles: ________2____ (lateral column), _____3___________ (middle column), and _____4______ (medial column)

1. erector spinae 2. iliocostalis 3. longissimus 4. spinalis

Inspiration has 3 phases:

1.) quiet 2.) deep 3.) forced

Quadratus Lumborum Insertion

12th rib, transverse processes of all 5 lumbar vertebrae

Quadratus Lumborum nerve

12th thoracic and 1st lumbar nerves

Insertion of middle scalenes?

1st rib

Insertion of scalenes anterior?

1st rib

The manubriosternal joint is attached to rib: A. 1 B. 2 C. 3 D. 4

2

How many AO joints are there?

2 occur at the right and left occipital condyle articulating with the superior articular facets of the atlas

How many AA joints are there

3

Ligaments and tendons lose 50% of their tensile strength after how long a period of immobilization?

8 weeks

Sternocleidomastoid Action

A: Bilaterally- Neck Flexion, Hyperextension Unilaterally- lateral Flexion, Rotation to opposite side

Cervical rotation as in shaking head "no" occurs at what joint?

AA joint- Atlantoaxial Joint C1&C2

The articulation between the head and C1

AO joint (atlanto-occipital)

Cervical flexion/extension as in head nodding when saying "yes" occurs at what joint?

AO joint- Atlanto-Occipital Joint C1 and occiput

A sheet like tendon connecting the oblique and transverse abdominis muscles to their attachments to the linea alba

Abdominal Aponeurosis

Sternocleidomastoid Innervation

Accessory Nerve

saclike clusters around the terminal bronchioles much like grape on a stem. They exchange oxygen for carbon dioxide and vice versa A double walled sac that encases each lung is called

Alveolus

iliocostalis I

Angles of ribs, upper ribs, and transverse processes of cervical vertebrae

A spinal pathology characterized by chronic inflammation of the vertebral column and SI joints is which of the following?

Ankylosing spondylitis

Is a chronic inflammation of the vertebral column and sacro-iliac joints Eventually leads to fusion Progressive rheumatic disease that leads to loss of spinal mobility

Ankylosing spondylitis

a spinal pathology characterized by chronic inflammation of the vertebral column and SI joints is which of the following?

Ankylosing spondylitis

the outer portion of the intervertebral disk consisting of several concentrically arranged fibrocartaginous rings that serve to contain the nucleus pulposus

Annulus Fibrosus

The anterior portion on the atlas

Anterior Arch

runs down the vertebral column on the anterior surface of the bodies and tends to prevent excessive hyperextension. It is thin superiorly and thick inferiorly, where it fuses to the sacrum. It is found in the thoracic and lumbar regions just deep to the aorta.

Anterior Longitudinal Ligament

Intercostal muscles location

Are located between the ribs and run at right angles to each other

What is the intercostal space?

Area between the ribs where the muscles are located

Projecting superiorly and inferiorly off the posterior surface of each lamina, and so named. Superior articular process face posteriorly and medially, whereas inferior process face anteriorly or laterally

Articular Process

Where is the Costal cartilage?

Bars of hyaline cartilage that connect the ribs to the sternum. They provide the elasticity allowing the rib cage mobility needed during the phases of respiration.

refers to the base, or inferior portion of the occiput

Basilar Area

Action of longissimus?

Bilaterally - Extension of Vertebral Column, Unilaterally - Lateral Flexion of Vertebral Column

Action of spinalis?

Bilaterally - Extension of Vertebral Column, Unilaterally - Lateral Flexion of Vertebral Column

Longissimus A

Bilaterally: extend neck and trunk Unilaterally: rotate head and laterally bend neck and trunk to the same side

Spinalis A

Bilaterally: extend neck and trunk Unilaterally: rotate head and laterally bend neck and trunk to the same side

iliocostalis A

Bilaterally: extend neck and trunk Unilaterally: rotate head and laterally bend neck and trunk to the same side

Transversospinalis A

Bilaterally: extend neck and trunk Unilaterally: rotate head, neck and trunk to opposite side

Internal Oblique A

Bilaterally: trunk flexion; compression of abdomen Unilaterally: lateral bending ; rotation to same side

External Oblique A

Bilaterally: trunk flexion; compression of abdomen Unilaterally: lateral bending to same side; rotation to opposite side

Being primarily a cylindrical mass of cancellous bone, it is the anterior portion of the vertebra and the major weight bearing structure. It is not present in the atlas. Between C3 and S1, the bodies progressively become larger

Body of vertebrae

Innervation of splenius capitis?

C2-C8 Dorsal rami

Innervation of splenius cervicis?

C2-C8 Dorsal rami

Innervation of all scalenes?

C3-C7 ventral rami

Also known as the vertebra prominens; because of its long and prominent spinous process. It resembles a thoracic vertebra and can be easily palpated in the neck in flexion

C7

pneumothorax

Collapsed lung

a common type of fracture seen in those with osteoporosis is which of the following?

Compression fracture

Result in the collapse of the anterior (body) portion of the vertebrae Usually caused by trauma in the lumbar region or by OP in the thoracic region

Compression fractures

This type of fx does not commonly cause SC damage and paralysis, because the fx is usually stable A stable fx does not have progressive displacement or dislocation

Compression fractures

Anterior view of spine convex or concave? Thoracic

Concave

What makes up the Oral Cavity?

Consists of the bony hard palate and the fibrous soft palate

Anterior view of spine convex or concave? Cervical

Convex

Anterior view of spine convex or concave? Lumbar

Convex

Located on the sides of the bodies and the transverses processes of thoracic vertebrae only. It is here that the ribs articulate with the vertebrae

Costal Facet

Origin of quadratus lumborum?

Crest of ilium

A person needs more O2 and therefore breathes harder.

Deep Inspiration

Muscles that can pull the ribs up assist during deep inspiration

Deep Inspiration

also called the odontoid process; large vertical projection located anteriorly on the axis. Cervical rotation occurs through its articulation with the atlas. It takes place of the vertebral body that exists at the other levels of the spine.

Dens

What are the muscles used in Quiet Inspiration?

Diaphragm, External Intercostals

External Oblique N

Eight through 12th intercostal, iliohypogastric, and ilioinguinal nerves

Internal Oblique N

Eighth through 12th intercostal, iliohypogastric and ilioinguinal nerves

Internal Oblique I

Eighth through twelfth ribs, linea alba

Which muscle originates on the transverse process of a vertebra and inserts on the spinous process of the vertebra above?

Erector spinae

Vertebral Column

Establishes and maintains the longitudinal axis of the body Encases the spinal cord and protects it Provides effective shock absorption and transmission

What is Cervical protraction?

Extending the head on C1 and flexing the neck (C2-C7)

the erector spinae are prime movers in which of the following motions?

Extension and lateral bend

Insertion of posterior scalenes?

External surface of 2n

The lungs consist of the Right and Left lobe. T/F: The Left portion has 3 lobs (upper/middle/lower) and the Right portion has 2

False

T/F The thorax is wider from front to back than it is from side to side

False - wider side to side, than front to back

occurs when four or more ribs are fracture that causes part of the chest wall to collapse rather than expand during inspiration

Flail Chest

Abnormally decreased lumbar curve

Flat back

Which is the best instruction to most effectively stretch the left sternocleidomastoid muscle?

Flex and laterally bend to the right; rotate to the left side

Where and what motions occur when tucking your chin in?

Flexing the AO joint or C1; as well as the neck (C2-C7)

Opening in the occipital bone through which the spinal cord enters the cranium

Foramen Magnum

Muscles pull down on the rib as well as muscles that can compress the abdomen, forcing the diaphragm upward

Forced expiration

Occurs when an individual is working very hard, needs a great deal of O2, and is in a state of 'air hunger'

Forced inspiration

The muscles of quiet and deep inspiration are working, as are muscles that stabilize or elevate the shoulder girdle

Forced inspiration

Cervical lateral bending takes place in what plane and around what axis

Frontal plane around sagittal axis

What is the function of the oral cavity?

Functions of the soft palate: to close off the opening between the nasal and oral pharynx during swallowing, blowing, speech

What is the function of the nasal cavity?

Functions: to warm, filter, and moisten the air

the portion of the sarcomere that contains only myosin fibers without overlap

H band

What are the three parts of the pharynx, what are they responsible for?

Has 3 parts: nasopharynx: has respiratory function oropharynx: which receives food from the mouth); laryngopharynx: between the base of the tongue and the entrance to the esophagus

When you instruct a client in a "chin tuck" exercise, which of the following is occurring with the head muscles?

Head flexors are being strengthened; head extensors are being stretched

involuntary spasms of the diaphragm accompanied by rapid closure of the glottis

Hiccups

Action of iliopsoas?

Hip flexion, trunk flexion, and anterior pelvic tilt

Transverse Foramen

Holes/openings in the transverse process of each cervical vertebra - through which the vertebral artery passes

Sternocleidomastoid Insertion

I: Mastoid process

Insertion of external oblique?

Iliac crest and linea alba

Origin of internal oblique?

Iliac crest, inguinal ligament, thoracolumbar fascia

Origin of transverse abdominis?

Iliac crest, thoracolumbar fascia, cartilages of ribs 6-12 and inguinal ligament

Origin of iliopsoas?

Iliacus: iliac fossa Psoas Major: T12-L5 transverse processes

What are the three muscles of the Erector Spinae group?

Iliocostalis, longissimus, and spinalis

Action of transverse abdominis?

Increases intra-abdominal pressure and thoracolumbar fascia tension

Transverse abdominis O

Inguinal ligament, iliac crest, thoracolumbar fascia, and costal cartilages of the last seven ribs

Internal intercostal muscles nerve

Intercostal nerve (T2 thrugh T6)

runs between the spinous processes.

Interspinal ligament

Opening formed by the superior vertebral notch of the vertebra below and the inferior vertebral notch of the vertebra above

Intervertebral Foramen

Diaphragmatic breathing:

Is the most efficient method of breathing Requires the least amount of energy The diaphragm lowers when it contracts, causing the abdomen to move out, the lungs to expand, and air to flow into the lungs When the diaphragm relaxes, it raises, the abdomen moves in, the lungs recoil, and air flows out of the lungs

Abnormally increased thoracic curve

Kyphosis

Insertion of quadratus lumborum?

L1-L4 transverse processes and 12th rib

Innervation of iliopsoas?

L2-L4 Femoral

________________ are the most common sites for disk lesions and the _____________ & ___________ nerve roots are the most commonly affected

L4-L5 4th and 5th lumbar

posterior portion of the neural arch that nuites from each side in the midline

Lamina

Function: passageway for air between the pharynx and trachea; prevention of food/water from passing into the trachea; generating speech sounds.

Larynx

Located between the pharynx and the trachea (C4 through C6 anteriorly)

Larynx

The two of them are between the articular processes of C1 and C2 vertebrae

Lateral atlanto axial joints

The quadratus lumborum is a prime mover in which of the following trunk motions?

Lateral bending

Origin of external oblique?

Lateral side of ribs 4-12

The __________ bronchus is longer and narrower; it subdivides into two lobar bronchi

Left

Insertion of iliopsoas?

Lesser trochanter of the femur

creates the posterior border fo the vertebral canal by connecting adjacent laminae anteriorly. It is highly elastic so it can effectively lengthen during movement of the nearby facet joints but an also assist the PLL in preventing excessive flexion.

Ligamentum flavum

takes the place of the suprapinal and interspinal ligaments int he cervical region.

Ligamentum nuchae (nuchal ligament)

A fibrous band running vertically in the midline from the xiphoid process to the pubic symphysis. It provides attachment for the transverse abominis and two oblique muscles

Linea Alba

Insertion of transverse abdominis?

Linea alba

Abnormally increased curve of the lumbar spine AKA 'swayback'

Lordosis

Origin of splenius capitis?

Lower 1/2 of ligamentum nuchae and C7-T3 spinous processes

Having a client bend the hips and knees to do sit-ups for abdominal strengthening instead of keeping the legs straight serves what purpose?

Makes the stronger hip flexors actively insufficient

Bony prominence behind the ear to which the sternocleidomastoid muscle attaches

Mastoid Process

Insertion of splenius capitis?

Mastoid process and lateral 1/3 of superior nuchal line

consists of a synovial artiulation between the odontoid process (dens) of the axis and the anterior arch of the atlas anteriorly and the transverse ligament posteriorly.

Median atlantoaxial joint

Also called the vertebral arch, it is the posterior portion of the vertebra, with many different parts

Neural Arch

The ridge running horizontally along the back of the head from the occipital protuberance toward the mastoid process

Nuchal Line

gelatinous substance with a high water content in the center of the intervertebral disk. At birth it is approximately 80% water, decreasing to less than 70% at 60 years of age. This explains the individuals loses height with advance age.

Nucleus Pulposus

Sternocleidomastoid Origin

O: Sternum (Manubrium), 1/3 medial clavicle

Diaphragm O/I/A/N

O: Xiphoid process, ribs, lumbar vertebrae I: central tendon A: inspiration N: phrenic nerve (C3-5)

External Intercostals O/I/A/N

O: rib above I: rib below A: elevate ribs N: intercostal n. (T2 through T6)

Internal Intercostals O/I/A/N

O: rib below I: rib above A: depress ribs N: intercostal n. (T2 though T6)

Also called the occiput, it forms the posterior inferior part of the cranium

Occipital Bone

Located lateral to the foramen magnum on the occiput; provides articulation with the atlas (C1)

Occipital Condyles

The tall prominence in the center of the occiput

Occipital Protuberance

Herniated disks:

Occur when there is a weakness or degeneration of the annulus fibrosus (outer layer) This allows a portion of the nucleus pulposus to bulge, or herniate, through the annulus It becomes symptomatic when the herniation puts pressure on the spinal cord or on the nerve root L4-5 are the most common sites for disk lesions and the 4th and 5th lumbar nerve roots are the most commonly affected

Bone is removed faster than it can be laid down, resulting in decreased bone mass and density, making the bone more prone to fracture

Osteoporosis (OP)

Portion of the neural arch just posterior to the body and anterior to the lamina

Pedicle

The bony landmark of the vertebra that makes up the anterior portion of the neural arch is called the

Pedicle

Diaphragm Nerve

Phrenic C3, 4, 5

a quiet, painful condition caused by inflammation of the pleura

Pleurisy

costochondral joint

Primary cartilaginous joint between distal end of rib and cartilage 1-10

Which of the following is the best position to achieve eccentric strengthening of the trunk extensors?

Prone, raise head and shoulders with focus on the "down" part of the exercise

Origin of the rectus abdominis?

Pubic crest

Transverse abdominis I

Pubic crest, abdominal aponeurosis, and linea alba

What are the accessory expiratory muscles?

QL, External oblique, Transverse abdominis, Internal Oblique, Rectus abdominis

the muscle that originates on the iliac crest and inserts on the 12th rib and transverse processes of T12 to L5 is the?

Quadratus lumborum

Occurs when an individual is resting or sitting quietly The diaphragm and external intercostal muscles are the prime movers

Quiet Inspiration

Mostly a passive action, it occurs through relaxation of the diaphragm and the external intercostal muscles No muscle action occurs (gravity pulls the rib cage down)

Quiet expiration

_________________ is the most superficial in the midline

Rectus abdominis

There are 4 layers of muscles on the abdominal trunk wall

Rectus abdominis, External/Internal obliques, and transverse abdominis

Chest breathing

Requires greater effort Less efficient Draws a smaller volume of air into the lungs The individual must breathe more rapidly A person who chest breathes is more prone to hyperventilate and faint Extremely obese people and women in the later stages of pregnancy cannot effectively contract the diaphragm; therefore, they also tend to chest breathe

________________ is the result of changes in thoracic volume

Respiration

Insertion of internal oblique?

Ribs 9-12 and linea alba

The ____________ bronchus is shorter and wider and subdivides into 3 lobar bronchi with one going to each lobe of the lung

Right

What are the accessory inspiratory muscles?

SCM, Upper Trap, Lev Scap, Scalenes, Pec Major, Rhomboinds, Pec Minor

Cervical Flexion takes place in what plane and around what axis?

Sagittal Plane around frontal axis

Cervical extension takes place in what plane and around what axis?

Sagittal Plane around frontal axis

Cervical hyperextension takes place in what plane and around what axis

Sagittal Plane around frontal axis

The facet joints of the lumbar spine primarily run in which plane to allow good spinal flexion and extension

Sagittal plane

Which muscle originates on the transverse processes of the cervical vertebra and inserts on the first and second ribs?

Scalene

Is pain that tends to run down the posterior thigh and leg Caused by pressure on the nerve roots May be caused by herniated lumbar disc

Sciatica

rectus abdominis N

Seventh through 12th intercostal nerves

Transverse abdominis N

Seventh through 12th intercostal, iliohypogastric, and ilioinguinal nerves

Which is the best position and instruction for a scoliosis client to strengthen lateral benders of the right side of the trunk?

Side-lying over an exercise ball, laterally bend to right

Longissimus N

Spinal nerves

Spinalis N

Spinal nerves

iliocostalis N

Spinal nerves

Narrowing of the vertebral canal that houses the SC

Spinal stenosis

the most posterior projection on the neural arch located at the junction of the two laminae. It serves as a point of attachment for many muscles and ligaments and can be palpated throughout the length of the vertebral column

Spinous process

Origin of splenius cervicis?

Spinous processes of T3-T6

The muscle that originates on the spinous processes of T3 through T6 and inserts on the transverse processes of C1 through C3 is the?

Splenius Cervicis

Usually results from a fx, or giving way, of a defective pars interarticularis. One vertebra slips forward in relation to an adjacent vertebra, usually L5 slipping anterior on S1

Spondylolisthesis

A vertebral defect in the pars interarticularis (the part of the lamina between the superior and inferior articular processes) This defect is most commonly seen in L5

Spondylolysis

Which cervical muscle, when contracted unilaterally, rotates the head to the opposite side?

Sternocleidomastoid

Flat bone in the midline of the anterior chest wall Has 3 parts: manubrium, body, and xiphoid process

Sternum

The posteriorly located muscles that primarily serve to extend, laterally bend, and rotate the head are called the

Suboccipital muscles

Some ribs articulate partially with two adjacent bodies; the ________ & __________ part of the body, and they are called?

Superior & Inferior; Demifacets

extends fromt he seventh cervical vertebra distally to the sacrum attaching posteriorly along the tips of the spinous processes.

Supraspinal ligament

Innervation of quadratus lumborum?

T12-L3 Ventral rami

Innervation of rectus abdominis?

T7-T12 Intercostal nerves

Innervation of transverse abdominis?

T7-T12 Intercostal nerves

Innervation of external oblique?

T8-T12 Intercostal nerves

Innervation of internal oblique?

T8-T12 Intercostal nerves

forms part of the base and lateral inferior sides of the cranium

Temporal bone

Which of the following is NOT correct about the thoracodorsal fascia? A. Tension on the thoracodorsal fascia via abdominal muscle contraction will cause it to decrease spinal stiffness. B. The anterior portion is part of the quadratus lumborum surrounding the fascia. C. The erector spinae is surrounded by it. D. The posterior portion has attachments to the latissimus dorsi.

Tension on the thoracodorsal fascia via abdominal muscle contraction will cause it to decrease spinal stiffness.

runs along the vertebral bodies posteriorly, inside and long the anterior border of the vertebral foramina. Its purpose is to prevent excessive flexion and to act as a barrier between the intervertebral disk and the spinal cord.

The Posterior Longitudinal Ligament

The articulations of the ribs and sternum are what type of joints, and allow for how much movement?

The articulations of the ribs and the sternum are non-axial, diarthrodial, gliding joints. There is little movement Elevation and depression of the rib cage occur (associated w/ inspiration/expiration)

What are the 2 areas that the ribs articulate with the vertebrae and what is the name of the joint?

The bodies of the vertebrae The transverse processes these are called 'costovertebral joints'

What makes up the Nasal Cavity?

The ethmoid, sphenoid, and a small part of the frontal bone form the roof of the nasal cavity

An opening between the vocal cords and the area where sound is produced; It is also an important part of the cough mechanism.

The glottis

'voice box'

The larynx:

What part of the respiratory system is wider and concave at the bottom?

The lungs

What lies between the lungs and contains several structures such as the heart, esophagus, and vital blood vessels /nerves?

The mediastinum

AKA the 'windpipe'

The trachea

Similar to the abdominal aponeurosis, it provides a broad area of fascial attachment posteriorly for the erector spinae and the latissimus dorsi muscles.

Thoracolumbar Fascia

Located anterior to the esophagus and vertebrae C6 though T4

Trachea

Made up of C-shaped cartilage on all sides, except posteriorly; and divides into R and L main stem bronchi

Trachea

What is considered part of the lower respiratory tract?

Trachea, bronchial tree (Bronchus/Bronchi/ bronchioles/ alveoli)

Holes or openings in the transverse process of each of the cervical vertebra through which the vertebral artery passes

Transverse Foramen

runs from one side of the atlas and the other and divides the atlas into an anterior and posterior compartment. The dens projects upward into the anterior compartment of the atlas, whereas the spinal cord passes through the posterior compartment.

Transverse Ligament

Formed at the union of the lamina and pedicle, the lateral projections of the arch to which muscle and ligaments attach

Transverse Process

Cervical rotation takes place in what plane and around what axis

Transverse plane around a vertical axis

Origin of middle scalenes?

Transverse processes C2-C7

Origin of scalenes anterior?

Transverse processes C3-C7

Origin of posterior scalenes?

Transverse processes C5-C7

Longissimus O

Transverse processes at lower levels

Longissimus I

Transverse processes at upper levels, mastoid process

Insertion of splenius cervicis?

Transverse processes of C1-C3

The trunk muscle whose primary function is compression of abdominal contents is the

Transversus abdominis

T/F The outer wall of the pleura lines the chest wall and covers the diaphragm

True

T/F 11th & 12th rib (floating ribs) has no anterior attachments

True

T/F As the bronchi continue to divide, they become smaller, narrower, and more numerous

True

T/F The inside of the lungs are in communication with the outside atmosphere and are subject to its pressure

True

T/F The internal intercostal muscles, which run in the opposite direction, form the shape of an inverted 'V'

True

T/F The fibers of the L and R external intercostals form a 'V'

True

Action of rectus abdominis?

Trunk flexion, posterior pelvic tilt; increases intra-abdominal and intrathoracic pressure

opening formed by the joining of the body and the neural arch through the which the spinal cord passes

Vertebral Foramen

Depressions located on the superior and inferior surfaces of the pedicle, and are so named

Vertebral Notches

sternochondral joint

Where the costal cartilage articulates with the sternum Ribs 1-8

diaphragm origin

Xiphoid process, ribs, lumbar vertebrae

It the AO joint a synovial joint?

Yes

Sitch

a temporary condition common in runners; a localized sharp pain, usually felt in the diaphragm.

when one moves the leg away from the midline, the motion is called

abduction

The clavicular portion of the pectoralis major muscle CANNOT: A. aid in exhalation if the arms are overhead B. aid in humeral horizontal adduction C. aid in inhalation if the arms are overhead D. be an accessory muscle of respiration

aid in exhalation if the arms are overhead

"The humeral head rolls up and glides down on the glenoid fossa" is an example of:

an arthrokinematic description of what happens during shoulder abduction

The outermost portion of the intervertebral disc is known as the:

annulosum fibrosum

During deep inspiration, the upper rib cage expands more in a(n) ____ direction and the lower rib cage expands more in a(n) ____ direction. A. anterior; lateral B. inferior; superior C. lateral; anterior D. superior; inferior

anterior; lateral

Which of the following DOES NOT limit thoracic flexion? A. approximation of anterior vertebral bodies B. facet joint capsule C. interspinous ligaments D. posterior longitudinal ligament

approximation of anterior vertebral bodies

What makes up a facet joint?

articulation between the superior articular process of the vertebra below with the inferior articular process of the vertebra above

ligaments attach bone to _____ and are composed of primarily _____

bone, collagen

The smallest bronchi (less than 1mm in diameter) are called __________

bronchioles

Insertion of the rectus abdominis?

cartilage of ribs 5-7 and xiphoid process

Intervertebral articulations are composed of _____________ & ________________

cartilaginous joints (intervertebral joints) and facet joints

diaphragm insertion

central tendon

In the human adult spine, lordotic curves naturally occur in the:

cervical and lumbar regions

o AO Flexion usually occurs with

cervical flexion

AO Lateral bending usually occurs with

cervical lateral bending

Axial extension is also known as what?

cervical retraction

AA rotation with

cervical rotation

The spinous process is bifid in the:

cervical spine

If ankle dorsiflexion range of motion is limited,

closed chain knee flexion will be limited.

Transverse abdominis A

compression of abdomen

The central tendon of the diaphragm becomes stabilized by: A. compression on the abdominal viscera B. its bony attachments to the ribs C. its bony attachment to the sternum D. its bony attachment to the vertebral bodies

compression on the abdominal viscera

The best description of the atlanto-occipital joint is: A. concave superior joint surface on concave inferior joint surface B. concave superior joint surface on convex inferior joint surface C. convex superior joint surface on convex inferior joint surface D. convex superior joint surface on concave inferior joint surface

convex superior joint surface on concave inferior joint surface

Diarthrodial planar type of synovial joint that the rib head articulates with the demifacet on vertebra

costovertebral joint Ribs 1-12

The transverse atlantal ligament is part of the: A. alar ligament B. anterior atlanto-occipital membrane C. cruciform ligament D. tectorial membrane

cruciform ligament

A characteristic unique to the thoracic spine is:

demifacets

Internal intercostal muscles Action

depress ribs during expiration

The diaphragm muscle _________ when it contracts; this makes the thoracic cavity larger and the abdominal cavity smaller, causing inspiration

descends

The primary muscles during respiration are the ________ and the ______________.

diaphragm & intercostal muscles

The thoracic cavity is separated from the abdominal cavity by the _______________.

diaphragm muscle

What are the muscles used in Deep inspiration?

diaphragm, external intercostals, SCM, Scalenes, Pectoralis major, Levator costarum, Serratus posterior superior, and the accessory muscles

The zagapophyseal joints are:

diarthordial

the upper 7 ribs (true ribs)= attach _______________

directly to the sternum

As you exhale your ribs move __

down and in

when a muscle lengthens under load it is known as a/an _______ action

eccentric

when the biceps is used to lower the elbow to a straight position, it is called

eccentric contraction

The active contribution of the lateral pterygoid in relation to the disc is it: A. concentrically controls anterior translation of the disc during depression. B. concentrically controls posterior translation of the disc during depression. C. eccentrically controls anterior translation of the disc during elevation. D. eccentrically controls posterior translation of the disc during elevation.

eccentrically controls posterior translation of the disc during elevation.

External intercostal muscles Action

elevate ribs during inspiration

Actions of the medial pterygoid include

elevates and contra laterally deviates

Actions of the medial pterygoid include: A. depresses and contralaterally deviates B. depresses and ipsilaterally deviates C. elevates and contralaterally deviates D. elevates and ipsilaterally deviates

elevates and contralaterally deviates

individual muscle fibers are surrounded by

endomysium

3 openings in the diaphragm muscle allow passage of the _______, ___________, and ___________.

esophagus, the aorta, and the inferior vena cava

During _________ the thoracic cavity returns to its smaller size, pressure in the thorax increases, and air is forced out of the lungs

expiration

Anteriorly, the ______________ muscles run in the same direction as the external oblique muscles

external intercostal

The most superficial muscles are the _____________, which run inferiorly and medially from the rib above to the rib below

external intercostal muscles

The ______________ muscle is superficial on the sides of the abdominal wall

external oblique

The articulating surface on the vertebral body, the ________________ is located laterally and posteriorly on the body

facet

often called an apophyseal joint, is the articulation between the superior articular process of the vertebra below with the inferior articular process of the vertebra above.

facet joint

The seventh rib articulates with the ______ and ______ vertebral bodies. A. fifth; sixth B. fifth; seventh C. seventh; eighth D. eighth; ninth

fifth; seventh

which is the best instruction to most effectively stretch the left sternocleidomastoid muscle?

flex and laterally bend to the right; rotate to the left side

The orientation of the lumbar zygapophyseal joints favors what motions?

flexion and extension

The orientation of the lumbar zygapophyseal joints favors what motions? A. axial elongation and compression B. flexion and extension C. lateral flexion D. rotation

flexion and extension

What motions occur at the AO joint?

flexion and extension (capital motions) head motions

The intervertebral disc DOES NOT consists of:

granulosum centrosome

when you instruct a client in a "chin tuck" exercise, which of the following is occurring with the head muscles?

head flexors are being strengthened; head extensors are being stretched

The air flows from ________ pressure to________ pressure until pressure is equalized

higher , lower

A muscle fiber that fires more slowly typically has a _______ capillary density and is called a type _______.

higher ; type 1

Common sites for fx are: the ______________________________

hip, the thoracic vertebral column, the wrist

the articular cartilage covering bone in a synovial joint is

hyaline cartilage

All of the following occur in response to exercise except: A. bone deposition increases B. high magnitude loading induces fibrocartilage formation C. hyaline cartilage damage repairs itself to the previous structure D. number of collagen fiber cross linkages increases in the tendons

hyaline cartilage damage repairs itself to the previous structure

quadratus lumborum origin

iliac crest

iliocostalis O

iliac crest, lower ribs

External Oblique O

iliac crest, pubic tubercle, and linea alba

Active muscle force increases with all of the following EXCEPT: A. increased length of muscle B. increased number of cross-bridges formed C. increased number of motor units recruited D. increased speed of eccentric action

increased length of muscle

ribs 8-10 (false ribs)= attach _____ __ ________

indirectly to thee sternum via the costal cartilage of the 7th rib

External intercostal muscles Origin

inferior border of rib above T1-T11

The structure that tethers the disc from moving too far anteriorly is the: A. connection to the lateral pterygoid B. connection to the medial pterygoid C. inferior retrodiscal lamina D. superior retrodiscal lamina

inferior retrodiscal lamina

Internal Oblique O

inguinal ligament, iliac crest, thoracolumbar fascia

Contraction of the diaphragm causes: A. exhalation B. inhalation C. trunk flexion D. trunk extension

inhalation

During __________, the thoracic cavity increases, causing the pressure within the thorax to decrease and forcing air into the lungs

inspiration

diaphragm action

inspiration

External intercostal muscles nerve

intercostal n. (T2 through T6)

The fibers of the ________________, lie deep and at a 90-degree angle to the external intercostal muscles

internal intercostal muscles

Directly under the external oblique muscle lies the___________________

internal oblique

The ligament that connects spinous processes above and below is the:

interspinous

Between the vertebrae is an _______ that articulates with the bodies of the vertebrae

intervertebral disk

The vertebrae are separated anteriorly by the ________________

intervertebral disk

The muscle that has attachments to the articular disc is the: A. masseter B. medial pterygoid C. lateral pterygoid D. temporalis

lateral pterygoid

The Facets are located where on the vertebral body?

laterally and posteriorly on the body

Which muscles contract concentrically to produce right thoracic rotation? A. right external oblique and left internal oblique B. right external oblique and right internal oblique C. left external oblique and right internal oblique D. left external oblique and left internal oblique

left external oblique and right internal oblique

Muscles contracting during mandibular deviation to the right include: A. left medial and lateral pterygoid B. left temporalis and medial pterygoid C. right masseter and lateral pterygoid D. right medial and lateral pterygoid

left medial and lateral pterygoid

External Oblique I

lower eight ribs laterally

Anterior pelvic tilt is often accompanied by:

lumbar extension and hip flexion

Anterior pelvic tilt is often accompanied by: A. lumbar extension and hip extension B. lumbar flexion and hip flexion C. lumbar extension and hip flexion D. lumbar flexion and hip extension

lumbar extension and hip flexion

having a client bend the hips and knees to do sit-ups for abdominal strengthening instead of keeping the legs straight serves what purpose?

makes the stronger hip flexors actively insufficient

large motor unit has ______ muscle fiber contractions and the muscle it is part of typically has a relatively _______ number of motor units.

many ; small

Muscles of mandibular elevation include: A. masseter and temporalis B. medial pterygoid and lateral pterygoid C. sternocleidomastoid and digastric D. tensor tympani and mylohyoid

masseter and temporalis

Muscles that can cause ipsilateral deviation. A. masseter and temporalis B. medial and lateral pterygoid C. lateral pterygoid and masseter D. temporalis and thyrohyoid

masseter and temporalis

The plane that splits the body into 2 symmetrical halves

midsagittal

The main respiratory muscles are the deepest, while the accessory muscles lie ___________

more superficial

"Ball and socket," "saddle," and "hinge" joints are _____, _____, and _____, respectively.

multiaxial, biaxial, uniaxial

the thick filament portion of a myofilament is the

myosin

What makes up the upper respiratory tract?

nasal cavity, oral cavity, pharynx, larynx

The air passes from the nasal cavity, to the pharynx via _______________

nasopharynx

Interspinales A

neck and trunk extension

Intertransversarii A

neck and trunk lateral bending to the same side

Contraction of the diaphragm results in all the following EXCEPT: A. negative pressure results in the lungs. B. negative pressure results on the abdominal viscera. C. the dome-shaped muscle descends. D. the lower ribs expand laterally.

negative pressure results on the abdominal viscera.

The deepest muscles of the trunk are the ______________ and _____________ muscles

one-joint interspinal & intertransversarii

fibroblasts that specialize to create bone are called

osteoblast

Muscles NOT attached to the superior and inferior borders of the ribs. A. external intercostal B. innermost intercostal C. internal intercostal D. outermost intercostal

outermost intercostal

The lungs are ___________ during the process of breathing

passive

the bony landmark of the vertebra that makes up the anterior portion of the neural arch is call the?

pedicle

From a lateral view, the ________________ covers all but the upper half of the SCM muscle

platysma muscle

It participates in facial expression and has no function at the neck

platysma muscle

The most superficial muscle is the very broad, thin ______________.

platysma muscle

This muscle covers a large portion of the anterior and lateral neck

platysma muscle

What encases each lung?

pleura

the spinal ligament that runs posteriorly along the vertebral bodies inside the vertebral foramen is called the?

posterior longitudinal ligament

Muscles having the most control over the head and neck are the _________ muscles anteriorly and the ______________muscles posteriorly

prevertebral & suboccipital

When turning a screwdriver in a clockwise direction with the right hand, the supinator is the ______ and the pronator teres is the ______.

prime mover ; antagonist

which of the following is the best position to achieve eccentric strenghtening of the trunk extensors?

prone, raised head and shoulders with focus on the "down" part of the exercise

rectus abdominis O

pubic crest

With reciprocal clicking, the first click is ______ and the second is ______. A. dislocating; recapturing B. early dislocating; late dislocating C. medial dislocating; lateral dislocating D. recapturing; dislocating

recapturing; dislocating

Intertransversarii, scalene, and rectus abdominis, when contracted unilaterally, will produce lateral bend of the spine EXCEPT

rectus abdominis

The trunk muscle that originates on the pubis and inserts on the costal cartilages of the fifth, sixth, and seventh ribs is the?

rectus abdominis

Internal intercostal muscles Insertion

rib above

External intercostal muscles Insertion

rib below

The arthrokinematic motion during mandibular depression is ______ in the INFERIOR space and ______ in the SUPERIOR space. A. glide; glide B. glide; roll C. roll; glide D. roll; roll

roll; glide

What motion occurs at the AA joint?

rotation of the head on the neck; such as shaking your head "no"

The vertebral column contains fused vertebrae of the:

sacral spine

Cervical flexion occurs in what plane?

sagittal

The facet joints of the lumbar spine primarily run in which plane to allow good spinal flexion and extension?

sagittal plane

Any amount of lateral curve

scoliosis

The posterior trunk muscles are located deep to the ______________ and _______________muscles

shoulder girdle & shoulder joint

which is the best position and instruction for scoliosis client to strenghten lateral benders of the right side of the trunk?

side-lying over an exercise ball, laterally bend to right

Interspinales N

spinal nerves

Intertransversarii N

spinal nerves

Transversospinalis N

spinal nerves

Interspinales I

spinous process above

Interspinales O

spinous process below

Transversospinalis I

spinous processes of vertebra above

the muscle of the cervical spine that is innervated by cranial nerve XI is the?

sternocleidomastoid

The thorax consists of what?

sternum, ribs, costal cartilages, thoracic vertebrae

The deepest layer in the neck includes the shortest muscles: the ______________(near the head) and the____________ and _____________muscles

suboccipital , interspinales, intertransversarii

the posteriorly located muscles that primarily serve to extend, laterally bend, and rotate the head are called the?

suboccipital muscles

Which muscles would tend to be short and weak in a patient with forward head posture? A. suboccipitals B. longus capitus C. levator scapulae D. scalenes

suboccipitals

Internal intercostal muscles Origin

superior angle of rib below

Which of the following best describes the sacroiliac joint?

synovial joint anteriorly and syndesmosis posteriorly

Which of the following best describes the sacroiliac joint? A. suture anteriorly and synovial joint posteriorly B. syndesmosis anteriorly and suture posteriorly C. synovial joint anteriorly and posteriorly D. synovial joint anteriorly and syndesmosis posteriorly

synovial joint anteriorly and syndesmosis posteriorly

when a cross bridge forms in a muscle

tension is developed

AO Joint motion and AA joint movement are almost always combined with movement of ________________________________.

the C3-C7 cervical segments

AA joint (atlanto-axial)

the joint between C1 and C2

Emphyesema

the walls of the alveoli become distended and lose their elasticity due to chronic bronchial obstruction

Ribs 8 through 10 are "false ribs" because: A. they are primarily made of cartilage. B. they articulate with only one vertebral body. C. they do not attach directly to the sternum. D. they have no anterior attachment to the sternum.

they do not attach directly to the sternum.

The scalenes usually move the head and neck but as breathing accessory muscles they.....

they elevate the first and second ribs, assisting in inspiration

The thoracic (chest) cavity lies inside the __________

thorax

The trunk muscle whose primary function is a compression of abdominal contents is the?

transverse abdominis

The _______________ is the deepest of the abdominal muscles, and its fibers run in a _______________direction

transverse abdominis, horizontal

A characteristic unique to the cervical spine is:

transverse foramen

Intertransversarii I

transverse process above

Transversospinalis O

transverse processes

Deep to the erector spinae muscles are the intrinsic back muscles that belong to the___________________ group

transversospinalis

The vertebral column as a whole is considered to be able to move in how many planes?

triaxial

rectus abdominis A

trunk flexion, compression of abdomen

Quadratus Lumborum Action

trunk lateral flexion

As you inhale your ribs move ___

up and out

Cervical retraction is a combination of which cervical movements? A. upper cervical extension and lower cervical extension B. upper cervical flexion and lower cervical flexion C. upper cervical extension and lower cervical flexion D. upper cervical flexion and lower cervical extension

upper cervical flexion and lower cervical extension

The most superficial muscle in posterior neck is the ____________

upper trapezius

The costovertebral joint is an articulation between the ________ and the ________. A. inferior articular process; rib B. superior articular process; rib C. transverse process; rib D. vertebral body; rib head

vertebral body; rib head

The rib cage serves to attach the _____________ posteriorly to the ____________ anteriorly

vertebral column , sternum

what kind of pull does the pectoralis major muscle have?

vertical direction

rectus abdominis I

xiphoid process and costal cartilages of ribs 5-7

Innervations of the Muscles of Respiration

•Muscles of respiration receive innervation from spinal nerves at various levels, primarily in the thoracic region Diaphragm= phrenic n. (which arises from the 3rd, 4th, and 5th cervical nerves) An individual with a SCI at C3 or above cannot breathe unassisted (will depend on a respirator) Inspiration in individuals with a cervical SCI below C3 will have impaired respiration, but they can breathe unassisted, although activities such as coughing, yelling, or taking deep breaths will be limited