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
