Kinesiology Chapter 5 Function and movement of the trunk and neck

Thoracic Curve has what kind of curve?

Concave curve, projects posteriorly and is located in the middle section of your back.

What causes scoliosis?

Congenital anomalies, neuromuscular disorders, neurofibromatosis, dysplasia, or latrogenic causes.

Vertebral Column

Considered a triaxial joint, which allows for movement in 3 planes (Sagittal, frontal and horizontal).

What is a critical aspect of visual observation for function?

Considering the relationship of the head and trunk.

Lumbar curve has what kind of curve?

Convex curve or anterior. "Lower back"

Cervical Curve has what kind of curve?

Convex curve, as it projects anteriorly at your neck.

Anterior longitudinal ligament

Covers the vertebral column on the anterior surface of the the vertebral bodies.Helps to prevent excessive hyperextension of the spine.

Concave Curve

Curve that extends inward or anteriorly. Example: bowl or cup.

Convex Curve

Curve that extends outward or in relation to the body, posteriorly. Example: Ball.

Tranverse abdominus muscle

Deepest abdominal muscle. Runs horizontally and originates from the lateral portion of the inguinal ligament, the last 6 ribs, the iliac crest, and the thoralumbar fascia. Does not influence trunk movement but does have influence of trunk and pelvic stability.

What is Scoliosis?

Deformity in the frontal plane. lateral curvature of the vertebrae. Scoliosis can be structural or non structural.

Kyphosis

Deformity of spine characterized by extension.

Horizontal or transverse plane

Divides body at the waist. Top and bottom halves of the body.

Frontal or coronal plane

Divides front and back halves of entire body.

Sagittal or median plane

Divides left and right side of entire body.

Neutral Pelvic tilt

Equal weight distribution across the femurs in a sitting position. Natural and functional position for sitting activities with trunk extension. Allows weight shifting across stable base of support.

What are the muscles on the posterior side of the trunk?

Erector pinae group, which includes the transverse spinal group, the latissimus dorsi and quadratus lumborum. (Definitions on page 130, last paragraph)

Lumbar lordosis

Exacerbated curvature of the lumbar spine. Pelvis in an excessive anterior pelvic tilt. Abdomen protrudes forward and lumbar spine is barely in contact with the seat back. Also known as sway back.

Kyphosis spinal deformity

Excessive curvature in the thoracic spine. Trunk flexes where rib cage ends and the thoracic spine forms a C- shaped bond. Seen in elderly women and present in lumbar spine in children with Spina Bifida.

Posterior muscles of the neck cause what?

Extension

Annulus Fibrosis

External portion of the disk. Made of fibrocartilage rings.

What are the ribs not attached to the sternum known as?

False ribs.

Sensory Proprioception

First described in 1906 by Sherring, as sensations arising from deep areas of the body that contribute to conscious sensations, postural equilibrium and joint stability.

Intervertebral disk

Flat- plate like structure made of fibrocartilage between each of the 33 vertebrates.

Anterior muscles of the neck cause what?

Flexion

ROM for thoracolumbar?

Flexion = 105 degrees, extension = 60 degrees.

ROM for the cervical vertebral column?

Flexion = 40 degrees, Extension = 75 degrees, lateral flexion = 35-45 degrees and rotation =45-50 degrees.

Bilateral muscle contractions for the most part cause what?

Flexion or extension

Sagittal plane

Flexion, extension, and hyperextension occur in sagittal plane around multiple axis along the spine.

What are the last two ribs that do not attach to the sternum or costal cartilage called?

Floating ribs.

Rectus abdominus

Front aspect of the trunk and connect in the center called linea alba. Flexes trunk and aids in respiration and enables compression of internal organs.

What does head orientation affect?

Haptic perception.

Stability in sitting versus standing

In sitting, center of gravity is lower and base of support is greater than that of standing. The increasing stability of the body with proper support for the buttocks, the feet and the back will increase ones ability to perform fine motor activities with the hands.

Trunk extension in the rib cage?

Lifts and migrates anteriorly, while spinal flexion of the rib cage moves posteriorly, depressing the ribs. Thus, in a sitting position, maintaining thoracic extension is important to hold the rib cage upright, which will allow for proper breathing.

Lumbar ROM

Limited because the articular processes are more pronounced. except in the 5th lumbar vertebral which articulates with the sacrum. Has more ROM than the thoracic but less than the cervical.

Where is the spinal cord located and what is its purpose?

Located in center of the vertebral column and also known as the vertebral foramen. Serves to provide a pivot point for the head and neck and an anchor point into the pelvis. Allows for both stability and mobility.

5 vertebrae, L1- L5

Lumbar Vertebrae.

Lumbosacral Joint

Most important articulation in the pelvic girdle, all pelvic movements involve this joint and every pelvic movement involves the vertebral column.

Observation of the trunk, pelvic girdle and neck are often ?

Observed with client sitting down.

Thoracic verterbrae

Occurs below or inferior to cervical spine. The 12 vertebrates make up the most stable aspect of the spine.

Pelvic Obliquity abnormality

One side of the hip being higher than the other. Deviation of the pelvis in the frontal plane. Lateral pelvic tilting may be accompanied by rib cage displacement and lateral spinal flexion maybe cause by or accompanying scoliosis (Spine Curves)

Anterior joint

Pubic Symphysis.

Posterior Joints

Right and left sacroiliac joint.

What is a superior surface?

Two large concavities that articulate with the occipital condyles of the skull.

What are the joints of the sacrum?

Two sacroiliac joints and the symphysis pubis.

Pelvic Girdle

Unites the sacrum and two hip bones at several different joints. Unites with the vertebrae at the lumbosacral joint.

Sensory processes

Visual, vestibular and somatosensory systems, as well as, central sensory strategies of limb orientation.

Dynamic System theory (DST) Views postural control as what?

a product of cognitive information as well as, synergistic organization of neuromuscular systems, morphological, biochemical and environmental information.

Motor processes

emergence of neuromuscular response synergies to maintain stability of neck, trunk and legs.

Supraspinatus ligament

extends from the 7th cranial vertebrae to the sacrum and runs posteriorly over the tips of the spinous processes. This ligament works with the posterior longitudinal ligament to limit forward flexion of the trunk.

Facet joints in the lumbar allow for what?

extension and flexion but limits rotation.

Internal oblique muscles

orginate on the inguinal ligament, iliac crest and the thoracolumbar fascia. This muscle performs two major functions.

Facet joints

articulation of the spine to the ribs and limits ability for flexion and lateral flexion. Provides stability of spine, while ribs protect internal organs.

During inhalation what do the intercostal muscles help with?

lifting the rib cage and allowing lungs room to expand.

What is the purpose of the vertebral column?

maintain longitudinal axis of the body and also serve as a protective covering for the spinal cord, which is composed of nerves.

The last lumbar vertebral L-5 articulates with what?

the sacrum at the lumbosacral joint.

The pelvic girdle is composed of what bones?

two iliac bones and the sacrum.

What is the C2 cervical vertebrae called?

Axis, and is a sort protrusion known as odontoid foramen or dens. Extends into vertebral foramen of C1 and is the pivot point or cervical spine and head.

The spine is formed with how many bones?

33

What two major functions does the internal oblique muscles perform?

Acts as antagonist to the diaphragm during exhalation. In other words, when the diaphragm contracts it pulls the lower chest cavity down, which allows the lungs to expand and when contracted allows air to come out of the lungs. The second major function is rotation and laterally bending of the trunk which pulls the rib cage toward the hip on the same side.

Where does the most available spinal flexion occur?

At the end point where the rib cage ends. While sitting, spinal flexion compresses the diaphragm, making it difficult to breathe

What is the joint called that articulates the head and C1?

Atlanto-occipital joint. Allows for flexion and extension but no rotation.

What is the (C1) first vertebrae called?

Atlas, and supports the cranium. Has no body but has spinous process and long transverse process.

Vertebrae Curves

Cervical, Thoracic, Lumbar, Sacral or Coccygeal vertebrae.

The process of providing a wheelchair requires an OT or OTA to consider what?

Clients anatomical characteristics to include: Orthopedic abnormalities , motor and sensory processes, functional skills, and individual needs. Clients posture, skin integrity and ability to perform movements and occupational tasks are also considered.

Coccygeal vertebrae

Coccyx or tail bone. Formed of 4 rudimentary vertebrae and has no movement. Common injury is falling down on hard surface.

Axial extension or cervical retraction occurs with what?

Combined movements of the C1 neck flexion and the C2-C7 neck extension. Example: Upright posture encourages cervical retraction.

what components are needed for a vertebrae to be movable?

Composed of body, facet, foramen, inter-vertebral foramen, lamina, neural arch, spinous process, transverse process and vertebral foramen. ( definitions of each on page 125, table 5-4)

The Rib cage

Composed of sternum. Dorsal aspect of 12 thoracic vertebrae and 12 ribs. Encloses the heart and lungs.

Syndesmosis

Indicates fibrous joint where the ligaments provide the stability. Movement at this joint is limited because it is a nonaxial joint with cartilage in between the bony aspects of the joint.

What muscles are between the ribs that allow the ribs to move up and down during respiration?

Intercostal muscles.

What are the two types of ligaments in the vertebral column?

Intrasegmental and Intratransverse ligaments. The intrasegmental ligaments hold the individual vertebrae together and include the ligamentum flavum, the interspinous and the intertranverse ligaments.

Structural scoliosis

Irreversible, lateral curve of the spine with fixed rotation of the vertebrae. As the curvature or rotation increases, the internal organs decline in their ability to function normally. ( Lungs and heart)

External Oblique muscles

Large, thin muscles that assist in trunk flexion and when bilaterally contracted aid in exhalation. this muscle originates in the lower ribs, runs inferiorly and medially to insert on the iliac crest and at the midline onto the linea alba.

ROM for lumbar vertebral column?

Lateral flexion = 20 degrees, Rotation = 5 degrees.

Frontal plane

Lateral flexion occurs in this plane around a sagittal axis and involves some degree of rotation.

Postural control requires the integration of what?

Motor processes, sensory processes and musculoskeletal components.

During exhalation the rib cage does what?

Moves down, forcing air out of the lungs.

Optimal seated posture includes?

Neutral pelvic tilt with trunk and cervical extension.

What are the different types of pelvic motions?

Neutral pelvic tilt, anterior and posterior pelvic tilt, pelvic rotation, and pelvic obliqulty also known as lateral tilt.

What is the inner aspect of the Annulus fibrosis?

Nucleus pulposus.

Kyphotic

Orthopedic deformity caused by maintaining abnormal posture for a long period of time.

Anterior Pelvic tilt

Pelvis "dipping" forward, lifting buttocks upward and creating hyperlordosis in lumbar spine. Often seen in pregnant women or people with excessive weight in abdomen or muscle imbalance in abdomen, lower limbs or pelvis.

Pelvic rotation abnormality

Position of one anterior superior iliac spine (ASIS) in relation to the other ASIS. in other words, deviation in the frontal plane, meaning if one ASIS is situated further back from the other then the pelvis is rotated. ( In some cases, while seated, one leg may be longer than the other).

what does the skull provide?

Provides a covering for the brain and is composed of cranial bones. The nerves that innervate the sense organs, of hearing, sight, taste, smell and vestibular responses that are located in the skull, also known as the cranium.

Horizontal Plane

Rotation occurs around a vertical axis and has some degree of lateral flexion of the spine. Rotation does not specifically occur at C1 and skull.

Atlantoaxial joint allows what?

Rotation of the head. Axis and atlas allows head to turn left and right, rotation and nodding as well as tucking the chin.

unilateral muscle contractions cause what?

Rotation or lateral bending.

S1-S5

Sacral vertebrae. sacrum represents fusion of 5 sacral vertebrae. Posterior to the pelvis, fused together in triangular shape to fit between the two hip bones.

Haptics

Science concerned with the tactile sense" Or a persons ability to control his or her hand movements related to orientation of his or her head over trunk.

The vertebrae column is divided into what?

Segments and arranged to form anterior/posterior (Concave/ Convex) curves in the veretbral column.

Soft nucleus pulposus that bulges out through a weak area of an annulus fibrosis is called?

Slipped disk, herniated disk or disk prolapse. May compress spinal cord and cause weakness and pain in legs.

Mucsuloskeletal includes:

Soft tissue, Muscle strength, ROM and Sensory proprioception.

How does the thoracic spine differ from the other vertebraes?

Spinous process points inferiorly, which limits the thoracic spine from hyperextension.

Spinal Curves offer what?

Structural support, stability, strength of vertebral column. balance, movement, shock absorption, and upright posture.

What are the two ligaments of the pubis symphysis that provide support called?

Superior pubic and the arcuate pubic ligaments.

Posterior Pelvic tilt

Talibone tucking beneath the body or posterior superior iliac spine (PSIS) shifting backward. Causes lumbar spine to flatten and thoracic to flex or become kyphotic.

The last vertebral in the sacrum articulates with what?

The Coccyx or the tail bone.

Tilting head may influence what?

The ability to write or control fine motor movements. Positioning of the head can also influence tasks, such as swallowing, reading and eye contact.

Acetabulum

The fossa where the femoral head articulates to form the hip joint. The ischial tuberosities or the protuberances of the hip bones support body weight in the seated position and particularly vulnerable to pressure ulcers.

What is the base of support when in a seated position?

The pelvis, which is in conjunction with with the trunk and provides a more stable support system to allow functional movement. Proper measurement of the pelvis and hips is crucial to provide appropriate sitting.

Intercostal muscles and facet joints allow for what?

The ribs to expand during respiration.

What does the lumbar vertebrae support?

The weight of the body and is the largest movable vertebrae. Lumbar is the most frequently injuried because it supports the body weight.

What are the 7 ribs that are attached to the sternum known as?

True ribs.

Sitting balance involves what?

ability to maintain a seated posture without falling forward and refers to the ability to reach. Base of support is provided by the pelvis, thighs and feet.

Where do most head movements occur?

at the C1 and C2 joints.

Where is proprioception input generated?

at the pelvic region in sitting posture, the input to the hips helps to elicit a muscular response from the trunk ex tensors to improve trunk posture.

Posterior longitudinal ligament

covers the vertebral bodies posteriorly inside the vertebral foramen and limits excessive flexion.

Valsalva Maneuver

involuntary action that occurs during activities such as defecation, child birth, lifting, vomiting and sneezing.

Sitting balance or postural control

is a complex interaction of coordinating numerous factors involving the CNS.

SI Joint

is part of the synovial and part syndesmosis.

ROM for thoracic vertebral column?

lateral flexion = 20 degrees, Rotation = 35 degrees.

Posture combining activity

requires many anatomical body parts, such as the pelvis, spine, feet and head and neck. Posture is also dependent upon the sensory system. The vestibular and visual systems are linked to posture and postural adjustment.

Non structural scoliosis

reversible, lateral curve of the spine. May be corrected if adequate support and muscle re-education are provided. Most Pelvic Obliquities will present with some degree of scoliosis.

What does head stabilization provide?

stable gravitational reference for vestibular system and facilitates visual information.

Nuchal ligament

takes place of the supraspinatus and interspinal ligaments in the cervical region , extends from the external occipital protuberance to the spinous process of the 7th vertebrae. This ligament limits flexion and serves as attachment for the trapezius and splenius capitis muscles.

What are the hip bones formed by?

the intersection of the pubis, ilium, and ischium. Anteriorly the hip bones are bound together by the symphysis pubis and posteriorly by the sacroiliac articulation known as the sacroiliac joint. (SI joint)