Health sciences 365 Chapter 12 – The Trunk & Spinal Column

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HEALTH SCIENCES 365

Chapter 12 – The Trunk & Spinal Column

Bones of the Trunk, Spinal Column, and Rib Cage

Vertebral Column

General Structures

Body
Pedicle
Transverse Processes
Articular Processes
Lamina
Spinous Process
Vertebral Foreman
Intervertebral Foreman

Neural Arch

Cervical (7)

Bifed Spinous Process
Transverse Foreman
Atlas (Articular Fossa)
Axis (Odontoic Process)

Thoracic (12)

Superior & Inferior Costal Facets
Transverse Costal Facet

Lumbar (5)

Sacral (5) Median Sacral Crest Sacral Canal Sacral Foramen Sacral Hiatus Superior Articular Facet Superior Sacral Notch Coccyx (4)
Sternum Manubrium Clavicular Notch Jugular Notch Sternal Angle Body of Sternum Costal Notches Transverse Ridge Xiphoid Process

Ribs

True (7)
False (3)
Floating (2)
Head
Neck

- Articulating facet

Tubercle
- Articular part
- Nonarticular part
Superior Border
Inferior Border
Costal Groove
Shaft
Costal Angle

Joints & Range of Motion of the Vertebral Column

Atlantooccipital (condyloidial)

Occiptial condyles of skull sitting on the articular fossa of the atlas
Approx. 15° flexion/extension

Atlantoaxial (trochoid)

Rotation of atlas (C1) around the fingerlike process (odontoid process - dens) of the axis (C2) during rotation of the head
75° rotation, 14° extension, 24° lateral flexion

Vertebral Facet Joints (articulation between the superior & inferior articular processes)
Intervertebral Disks

Acts as cushions and shock absorbers and produces the natural curves of the spines

Annulus Fibrosus
Nucleus Pulposus
Intervertebral Discs and Movement
- During bending
- During compression loads
- Nutrient supply

Ligaments

Ligamentum Nuchae

Connects spinous processes, runs from external occipital protuberance to C7

Supraspinal

Connects tips of spinous process from C7 to sacrum

Ligamentum Flavum

Connects lamina from adjacent vertebrae from axis to sacrum

Interspinal

Connects inner surface of spinous processes of adjacent vertebrae

Intertransverse

Connects transverse processes of adjacent vertebrae

Anterior Longitudinal

Connects adjacent vertebral bodies, runs from axis to sacrum on anterior aspect

Posterior Longitudinal

Connects adjacent vertebral bodies, runs from axis to sacrum on posterior aspect

Movements & Range of Motion (ROM)

Cervical Region: Flexion 45°, Extension 45°, Lateral Flexion 45°, Rotation 60°

Lumbar Region: Flexion 20° 30°, Extension 20° to 30°, Lateral Flexion 35°,

Rotation 45°

Selected Major Muscles of the Spine
Sternocleidomastoid O. Manubrium Anteriosuperior surface of medial clavicle I. Mastoid process A. ________________________________________________________ ________________________________________________________ N. Spinal Accessory
Splenius Cervicis O. Spinous processes of T3-T6 I. Transverse processes of C1-C3 A. ________________________________________________________ ________________________________________________________ N. Cervical nerves 4-8
Splenius Capitis O. Lower half of ligamentum nuchae, spinous processes C7-T3 I. Mastoid process and occipital bone A. ________________________________________________________ ________________________________________________________ N. Cervical nerves 4-8
Erector Spinae: Spinalis O. Ligamentum nuchae, spinous process C-7, spinous process T11-12, spinous process L1-2. I. Spinous process C2, spinous process T5-12, occipital bone A. ________________________________________________________ ________________________________________________________ N. Spinal nerves
Erector Spinae: Longissimus O. Posterior/medial iliac crest, thoracolumbar aponeurosis, transverse processes L1-5, transverse processes T1-5, articular processes C5-7 I. Spinous processes C2-6, transverse processes T1-12, lower 9 ribs, mastoid process A. ________________________________________________________ ________________________________________________________ N. Spinal nerves
Erector Spinae: Iliocostalis O. Posterior/medial iliac crest, thoracolumbar aponeurosis, posterior ribs 3-12 I. Posterior ribs 1-12, transverse processes C4-7 A. ________________________________________________________ ________________________________________________________ N. Spinal nerves
Quadratus Lumborum O. Posterior inner lip of iliac crest I. Medial inferior surface of 12^th rib, transverse processes of L1-4 A. ________________________________________________________ ________________________________________________________ N. T12, L1 nerves

Muscles of the Abdominal Wall
Rectus Abdominis O. Pubic crest, pubic symphysis I. Styloid process, cartilage of 5^th, 6^th, 7^th ribs A. ________________________________________________________ ________________________________________________________ N. Intercostals T7-T12
External Oblique O. External surfaces of 5^th -12^th ribs (dovetailing the Serratus Anterior) I. Anterior half of iliac crest, Inguinal ligament, pubic crest, fascia of Rectus Abdominus A. ________________________________________________________ ________________________________________________________ N. Intercostal nerves T8-T12, Iliohypogastic, ilioinguinal nerve
Internal Oblique O. Inner lip anterior half of iliac crest, upper half of inguinal ligament, lumbar fascia I. Inferior borders of 10th -12th ribs, linea alba A. ________________________________________________________ ________________________________________________________ N. Intercostal nerves T8-T12, Iliohypogastic, ilioinguinal nerve
Transverse Abdominis O. Inner rim of the iliac crest, inner surfaces of ribs 7^th – 12^th, upper half of inguinal ligament, lumbar fascia I. Linea alba, pubic crest, iliopectinal line A. ________________________________________________________ ________________________________________________________ N. Intercostal nerves T7-T12, Iliohypogastic, ilioinguinal nerve

Tendinous Connective Tissue Associated with the Abdominals – connecting or supporting

the abdominal arrangement of muscles in lieu of bony attachments.

Linea Alba: __________________________________________________________
Linea Semilunaris: ____________________________________________________

_____________________________________________________________________

Tendinous Inscriptions: ________________________________________________

_____________________________________________________________________

Functions of the Abdominal Wall

Abdominal Considerations

Protection ____________________________

Support of Viscera _____________________

Elimination ___________________________

Forced Expiration ______________________

Stabilization of Trunk and Pelvis __________

Trunk Movement ______________________

Parturation ___________________________

Causes for weakness of the abdominal wall

Developmental
Pathological

Abdominal Ptosis: _____________________

Beever’s Sign: ________________________

Kinesiology of the Abdominal Muscles: List in order the importance or degree of involvement of

the abdominals in the following activities.

_____ Straight leg raises (unilateral) _____ Sit-ups _____ Pull-ups _____ Ambulation

_____ Straight leg raises (bilateral) _____ Push-ups _____ Curl-ups

Lordosis – Excessive anterior curvature of the lumbar spine (Anterior Pelvic Tilt)

Relationship of ASIS to PSIS

Causes

Congenital deformity
Poor body mechanics
Muscle imbalance (disuse or disease)
Overtraining in certain sports
Compensatory deformity to a kyphosis

or other deformities of foot, knee, or hip

________________________________

Considerations

More common in tall ectomorphs
More common in child and adolescents
Asymptomatic unless due to trauma
Relationship to low back pain

______________________________

Changes in intervertebral body distance

______________________________

Bony changes uncommon

Loose/Weak Muscles/Ligament _______________________________ _______________________________ ________________________ ligament	How Strengthen (isolate)? Pelvic Roll
Tight/Inflexible Muscles/Ligaments _______________________________ _______________________________ ________________________ ligament	How Stretch (isolate)?

Scoliosis – Lateral deviation(s)/curve(s) of the spine

Causes

Known: (20%) Hemivertebrae,

Congenital spinal deformities, neuron-

muscular problems, leg length difference

cerebral palsey, muscular dystrophy

2. Unknown: Idiopathic (80%)

Considerations

Most common in adolescence 10-18
Onset, typically during puberty
Affects 2% women, .5% men
Usually asymptomatic

Classification: Simple “C”

Classification: Compound “S”

Signs of Scoliosis

Unilateral problems
Rotation of trunk (one shoulder forward)
Contour of trunk (waistline), skin folds
Distance from arm to thorax
Asymmetry of scapula
Deviations of spinous processes
Chest flatness on side of convexity

Adam’s Forward Bend Test

Asymmetry of erector spinae
Rotation of vertebrae with rib

Angulation (Razor back sign)

Level of fingertips
Trunk contour

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