Chapter 12 The Trunk and Spinal Column

Chapter 12 The Trunk and Spinal Column Manual of Structural Kinesiology R.T. Floyd, EdD, ATC, CSCS Vertebral Abdominal 24 31 most column complex some intricate & complex articulating vertebrae do pairs of spinal nerves The not complex sections attach muscles part linked of by body fascia other & than tendinousbands CNS Trunk from and bone Spinal to bone Column Many vertebral assist too deep small in column, spinal to intrinsic palpate stabilization & thorax muscles or respiration act head, 2007 McGraw-Hill Higher Education. All rights reserved. 12-1 2007 McGraw-Hill Higher Education. All rights reserved. 12-2 24 7 12 articulating cervical thoracic (neck) (chest) & 9 fused vertebrae First lumbar (lower back) vertebrae allow of 5 vertebrae sacrum (posterior pelvic girdle) backward 4 head coccyx 2 for cervical to extensive movement (tail side, bone) vertebrae as well rotary vertebrae as -shapes movements forward & From Seeley RR, et al: Anatomy & physiology, ed 3, St. Louis, 1995, Mosby. 2007 McGraw-Hill Higher Education. All rights reserved. 12-3 3 Thoracic normal curves spine curves within anteriorly spine Vertebrae Cervical Spinal shockscurves & increase lumbar enable spine to curve absorb posteriorly blows & to having lumbar to support region due more to size weight lower from back cervical 2007 McGraw-Hill Higher Education. All rights reserved. 12-4 First Vertebrae architecture body 2 cervical C2 through vertebrae L5 -atlas -similar & axis central transverse -anterior vertebral process bony foramen blockfor spinal cord spinousprocess projecting posteriorly out laterally Cervical vertebrae From Anthony CP, Kolthoff NJ: Textbook of anatomy and physiology, ed 9, St. Louis, 1975, Mosby. 2007 McGraw-Hill Higher Education. All rights reserved. 12-5 2007 McGraw-Hill Higher Education. All rights reserved. 12-6 1

Thoracic vertebrae Lumbar vertebrae From Anthony CP, Kolthoff NJ: Textbook of anatomy and physiology, ed 9, St. Louis, 1975, Mosby. From Anthony CP, Kolthoff NJ: Textbook of anatomy and physiology, ed 9, St. Louis, 1975, Mosby. 2007 McGraw-Hill Higher Education. All rights reserved. 12-7 2007 McGraw-Hill Higher Education. All rights reserved. 12-8 Lordosis-increased Kyphosis-increased Lumbar of thoracic lumbar & cervical curves posterior anterior concavity lordoticcurve, kyphosis-reduction curveresulting of normal of Scoliosis appearance deviations -lateral of spine curvatures in a flat-back or sideward 12 7 5 attach sternum directly true ribs 3 pairs ribs indirectly of attach false to to ribs 2 sternum ribs pairs -ends of floating are free 2007 McGraw-Hill Higher Education. All rights reserved. 12-9 2007 McGraw-Hill Higher Education. All rights reserved. 12-10 Sternum All Manubrium, to sternum, thoracic ribs attached & vertebrae xiphoidprocess body posteriorly of Key muscles mastoid transverse bony landmarks spinousprocesses of process neck processes cervical of cervical spine spine manubriumof medial vertebrae claviclesternum of upper 4 thoracic From Shier D, Butler J, Lewis R: Hole s human anatomy & physiology, ed 9, New York, 2002, McGraw-Hill. 2007 McGraw-Hill Higher Education. All rights reserved. 12-11 2007 McGraw-Hill Higher Education. All rights reserved. 12-12 2

Key posterior bony landmarks anterior spinousprocesses transverse posterior muscles of spine borders trunk of ribs lower processes musclesthoracic of spine spine costal iliac pubic crest cartilages of 8 ribs Atlantooccipitaljoint Atlantoaxialjoint first formed allows sitting vertebra flexion by articularfossa occipital & extension condylesof of the 1st skull Atlas Trochoidor Most cervical mobile (C1) sits pivot-type joint rotation on of axis any occurs joint (C2) two here vertebraefrom Lindsay DT: functional human anatomy, St Louis, 1996, Mosby. 2007 McGraw-Hill Higher Education. All rights reserved. 12-13 2007 McGraw-Hill Higher Education. All rights reserved. 12-14 Minimal vertebrae Cumulative Vertebral movement allows movement for (except substantial from effect several of atlantoaxialjoint) between combined movements vertebrae any 2 Gliding-type arthrodialarticulations joints due classified to as gliding & joints inferior movements articularprocesses between limited superior of facets From Lindsay DT: functional human anatomy, St Louis, 1996, Mosby. Intervertebraldisks between annulus nucleus cartilage fibrosus-outer of & adhering vertebral to bodies articular compressed dense gelatinous, fibrocartilage pulposus-central pulpy elastic substance material rim of become compression with injury, a weakened torsion less improper annulus resilient in all directions use, fibrosus with resulting age, allows along in From Thibodeau GA, Paton KT: Anatomy & physiology, ed 9, St. Louis, 1993, Mosby; Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 7, New York, 2006, McGraw-Hill. 2007 McGraw-Hill Higher Education. All rights reserved. 12-15 2007 McGraw-Hill Higher Education. All rights reserved. 12-16 Intervertebraldisks herniated (herniated nucleus annulus substantial combined nucleus pulposus protrusion or slipped disk) on protruding through causing resulting from tingling, weakening and/or with compression extremity spinal weakness radiating numbness, nerve puts pressure root, pain, lower From Thibodeau GA, Paton KT: Anatomy & physiology, ed 9, St. Louis, 1993, Mosby; Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 7, New York, 2006, McGraw-Hill. 2007 McGraw-Hill Higher Education. All rights reserved. 12-17 Most Some Movements Movement movement slight of thoracic head occurs movement in cervical & lumbar Referred within other as between cervical cranium vertebrae& 1stcervical and Trunk Lumbar motion movements in motion thoracic terminology & lumbar movements describes combined 2007 McGraw-Hill Higher Education. All rights reserved. 12-18 3

Cervical Flexes Extends Laterally Rotate 45 approximately 45 flexes degrees 45 degrees 60 degrees region Lumbar Flexes Extends spine approximately 20 to including 30 degrees 80 trunk degrees movement 2007 McGraw-Hill Higher Education. All rights reserved. 12-19 2007 McGraw-Hill Higher Education. All rights reserved. 12-20 Lumbar Lumbar Rotation spine lateral approximately including flexion to 45 trunk 35 degrees movement Movements Spinal movements are often preceded by the name given to the region of movement Ex. flexion of trunk at lumbar spine is known as lumbar flexion, & extension of neck is cervical extension Pelvic girdle rotates as a unit due to movement occurring in hip & lumbar spine 2007 McGraw-Hill Higher Education. All rights reserved. 12-21 2007 McGraw-Hill Higher Education. All rights reserved. 12-22 Spinal flexion Movements anterior movement of spine; in cervical region the head moves toward chest; in lumbar region the thorax moves toward pelvis Spinal extension Movements return from flexion or posterior movement of spine; in cervical spine, head moves away from the chest & thorax moves away from pelvis 2007 McGraw-Hill Higher Education. All rights reserved. 12-23 2007 McGraw-Hill Higher Education. All rights reserved. 12-24 4

Movements Lateral flexion (left or right) sometimes referred to as side bending; head moves laterally toward the shoulder & thorax moves laterally toward pelvis Reduction return movement from lateral flexion to neutral Movements Spinal rotation (left or right) rotary movement of spine in horizontal plane; chin rotates from neutral toward shoulder & thorax rotates to one side 2007 McGraw-Hill Higher Education. All rights reserved. 12-25 A Erector largest extends few large muscles & many small muscles divided region spinae(sacrospinalis) to muscle into on cranium each 3 muscles side of spinal column from pelvic Trunk & Spinal Column Sternocleidomastoid& Spinalis, longissimus, & iliocostalis large movements From Actually lumbar, muscles medial thoracic, made involved to up lateral & of cervical 9 in splenius muscles side, cervical regions has & muscles attachments head in 2007 McGraw-Hill Higher Education. All rights reserved. 12-27 Some muscles have multiple segments Many one perform segment movement of a in one region while another & function segment another region muscles region of same to perform muscle may movements be located in that in Trunk in & moving of trunk & spinal column Spinal spine Column & aiding All respiration thoracic muscles are primarily involved respiration in 2007 McGraw-Hill Higher Education. All rights reserved. 12-26 Numerous Large movements Rectus internal abdominis,, muscles external & -lumbar quadratuslumborum, Trunk & Spinal Column Grouped Many Important vertebra originate according small functioning muscles one to vertebra location of spine& & insert function next 2007 McGraw-Hill Higher Education. All rights reserved. 12-28 Abdominal bone aponeurosis(fascia) abdominisarea wall muscles do not go from external to bone but attach into an Trunk,, & around transversus internal rectus & Spinal Column 2007 McGraw-Hill Higher Education. All rights reserved. 12-29 2007 McGraw-Hill Higher Education. All rights reserved. 12-30 5

Anterior Posterior Rectus Longus that move the head Longissimuscapitis Obliquuscapitissuperior capitisanterior Trunk Obliquuscapitisinferior & Spinal Column Rectus Trapezius, Splenius Semispinaliscapitis capitisposterior superior fibers -major& minor Lateralthat move the head Superficial Rectus Sternocleidomastoid Trunk Erector of capitislateralis & spinae(sacrospinalis) the vertebral column Spinal Column Spleniuscervicis Spinalis-cervicis, Longissimus-capitis, Iliocostalis-cervicis, thoracis thoracis, cervicis, lumborum thoracis 2007 McGraw-Hill Higher Education. All rights reserved. 12-31 Deep Longus Interspinales-entirespinal of the vertebral column Intertransversales-entirespinal Trunk Multifidus-entirespinal verticalcolli-superior, column inferior, column & Spinal Column Psoasminor Rotatores-entire Semispinalis-cervicis, thoracis column 2007 McGraw-Hill Higher Education. All rights reserved. 12-32 Diaphragm Intercostalis-external, Levatorcostarum of the thorax Subcostales Scalenus-anterior, internal Trunk & Spinal Column medius, posterior Serratus Transversusthoracis posterior -superior, inferior 2007 McGraw-Hill Higher Education. All rights reserved. 12-33 Rectusabdominis External of the wall Internal Transverse externusabdominis) internusabdominis) (obliquus Trunk & Spinal abdominis(transversus Column Quadratuslumborum 2007 McGraw-Hill Higher Education. All rights reserved. 12-34 C4 Cranial & Sternocleidomastoid C3 muscles spinal nerve nerves 11 and C2 lateral Splenius through branches muscles C8 posterior Nerves Posterior the Entire group spinal erector branches nerves spinaeof 2007 McGraw-Hill Higher Education. All rights reserved. 12-35 2007 McGraw-Hill Higher Education. All rights reserved. 12-36 6

Intercostalnerves nerve Rectus Internal (T12, abdominis L1), &(T8-T12), ilioinguinalnerve of T7 through iliohypogastric (L1) T12 Same innervationbegins for & transverse external abdominisexcept muscles Nerves Branches Quadratuslumborum from T12 with & L1 T-7 intercostalnerve All on 3 rectus lateralis originate occipital cervical vertebrae & insert All anterior vertebral bone of muscles skull (capitisname) longus capitis, Rectus spine are capitisanterior, flexors capitislateralis of head & rectus & upper cervical that Move the Head laterally assists stabilizing rectus flexes atlantooccipitaljoint capitisanterior head in 2007 McGraw-Hill Higher Education. All rights reserved. 12-37 All insert name) originate on occipital on cervical bone of vertebrae skull (capitis & that Move the Head 2007 McGraw-Hill Higher Education. All rights reserved. 12-38 Posterior Rectus All Obliquuscapitissuperior capitisposterior muscles major & minor, Rectus obliquuscapitissuperior semispinaliscapitis capitisinferior lateralisin are extensors capitisposterior which of flexion head rotates of & assists except inferior, atlasobliquus rectus and capitis that Move major the rotates Head Semispinaliscapitisrotates Upper contralateralside ipsilateralside Trapeziusextend head head & rotate to head its to to 2007 McGraw-Hill Higher Education. All rights reserved. Modified from Lindsay DT: Functional human anatomy, St. Louis, 1996, Mosby. 12-39 Posterior muscles that Move the Head 2007 McGraw-Hill Higher Education. All rights reserved. 12-40 Splenius Remaining capitis& sternocleidomastoid grouped Much larger & more powerful in moving column head & with cervical cervical muscles spine spine of vertebral muscles are that Move the Head 2007 McGraw-Hill Higher Education. All rights reserved. Modified from Lindsay DT: Functional human anatomy, St. Louis, 1996, Mosby. 12-41 2007 McGraw-Hill Higher Education. All rights reserved. 12-42 7

Sternocleidomastoid Both sides: extension of head at atlantooccipital joint & flexion of neck Right side: rotation to left & lateral flexion to right Left side: rotation to right & lateral flexion to left 2007 McGraw-Hill Higher Education. All rights reserved. 12-43 Splenius (cervicis, capitis) Both sides: extension of head (splenius capitis) & neck (splenius capitis and capitis) Right side: rotation & lateral flexion to right Left side: rotation & lateral flexion to left 2007 McGraw-Hill Higher Education. All rights reserved. 12-44 Cervical Posterior Longus area Erector collimuscles group, located flex cervical interspinal-intertransversegroup, spinaegroup, anteriorly & upper thoracic transversospinalis vertebrae of the Vertebral Column splenius All Location assist run vertically rotation enables parallel & them lateral to to extend flexion spine column and & Posterior Interspinal-intertransversegroup lie laterally do Interspinales deep not to rotatores»extensors»connect rotate flex & vertebrae extend of the from Vertebral spinous Column process to adjacent spinousprocess of vertebra one vertebra of From Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 7, New York, 2006, McGraw-Hill. 2007 McGraw-Hill Higher Education. All rights reserved. 12-45 2007 McGraw-Hill Higher Education. All rights reserved. 12-46 Posterior Interspinalintertransversegroup Intertransversarii muscles»flex»connect column vertebral of laterally to the Vertebral Column transverse processes adjacent vertebraeof From Involved Diaphragm Responsible As almost entirely respiration Posterior When increased pressure it contracts larger & air for & is breathing flattens, inspired thoracic during to equalize quiet volume the rest is amounts of of air the are needed, Thorax exercise, significant other role in thoracic inspiration muscle have a more as in Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 6, Dubuque, 2007 McGraw-Hill Higher Education. All rights reserved. IA, 2003, McGraw-Hill. 12-47 2007 McGraw-Hill Higher Education. All rights reserved. 12-48 8

Scalene External muscles Levatorcostarum& elevate increase volumefirst thoracic 2 ribs to Posterior of the Thorax Internal further serratus inspiration intercostals transversusthoracis, expand the chest subcostalescontract force expiration intercostals, posterior to & Modified from Van De Graaff KM: Human anatomy, ed 4, New York, 1995, McGraw-Hill. 2007 McGraw-Hill Higher Education. All rights reserved. 12-49 Erector Spinae (sacrospinalis) Iliocostalis (lateral layer) Longissimus (middle layer) Spinalis (medial layer) Extension, lateral flexion, & ipsilateral rotation of spine & head Anterior pelvic rotation Lateral pelvic rotation to contralateral side 2007 McGraw-Hill Higher Education. All rights reserved. 12-50 Rectus abdominis External Internal Transverse abdominis of the Abdominal Wall Rectus abdominis External Internal Transverse abdominis of the Abdominal Wall 2007 McGraw-Hill Higher Education. All rights reserved. 12-51 2007 McGraw-Hill Higher Education. All rights reserved. 12-52 Rectus Abdominis Muscle Both sides: lumbar flexion Posterior pelvic rotation Right side: weak lateral flexion to right Left side: weak lateral flexion to left 2007 McGraw-Hill Higher Education. All rights reserved. 12-53 External Oblique Abdominal Muscle Both sides: lumbar flexion Posterior pelvic rotation Right side: lumbar lateral flexion to right, rotation to left, & lateral pelvic rotation to left Left side: lumbar lateral flexion to left, rotation to right, & lateral pelvic rotation to right 2007 McGraw-Hill Higher Education. All rights reserved. 12-54 9

Internal Oblique Abdominal Muscle Both sides: lumbar flexion Posterior pelvic rotation Right side: lumbar lateral flexion to right, rotation to right, & lateral pelvic rotation to left Left side: lumbar lateral flexion to left, rotation to left, & lateral pelvic rotation to right 2007 McGraw-Hill Higher Education. All rights reserved. 12-55 Transversus Abdominis Muscle Forced expiration by pulling the wall inward 2007 McGraw-Hill Higher Education. All rights reserved. 12-56 Quadratus Lumborum Muscle Cervical Flexion Lateral flexion to ipsilateral side Extension of lumbar spine Stabilizes pelvis & lumbar spine Sternocleidomastoid Anterior pelvic rotation Lateral pelvic rotation to contralateral side 2007 McGraw-Hill Higher Education. All rights reserved. 12-57 2007 McGraw-Hill Higher Education. All rights reserved. 12-58 Erector Spinae Cervical Extension Cervical Lateral Flexion Sternocleidomastoid Erector Spinae 2007 McGraw-Hill Higher Education. All rights reserved. 12-59 2007 McGraw-Hill Higher Education. All rights reserved. 12-60 10

Cervical Rotation Sternocleidomastoid Rectus abdominis External Internal Lumbar Flexion 2007 McGraw-Hill Higher Education. All rights reserved. 12-61 2007 McGraw-Hill Higher Education. All rights reserved. 12-62 Erector spinae Lumbar Extension Erector spinae External Internal Lumbar Lateral Flexion 2007 McGraw-Hill Higher Education. All rights reserved. 12-63 2007 McGraw-Hill Higher Education. All rights reserved. 12-64 Rectus abdominis External Internal Lumbar Rotation 2007 McGraw-Hill Higher Education. All rights reserved. 12-65 Web Sites Radiologic Anatomy Browser http://radlinux1.usuf1.usuhs.mil/rad/iong This site has numerous radiological views of the musculoskeletal system. Loyola University Medical Center: Structure of the Human Body www.meddean.luc.edu/lumen/meded/grossanatomy/index.htm An excellent site with many slides, dissections, tutorials, etc. for the study of human anatomy University of Arkansas Medical School Gross Anatomy for Medical Students http://anatomy.uams.edu/anatomyhtml/gross.html Dissections, anatomy tables, atlas images, links, etc. Wheeless Textbook of Orthopaedics www.wheelessonline.com/ This site has an extensive index of links to the fractures, joints, muscles, nerves, trauma, medications, medical topics, lab tests, and links to orthopedic journals and other orthopedic and medical news. 2007 McGraw-Hill Higher Education. All rights reserved. 12-66 11

Web Sites Premiere Medical Search Engine www.medsite.com This site allows the reader to enter any medical condition and it will search the net to find relevant articles. Virtual Hospital www.vh.org Numerous slides, patient information, etc. Core Stability www.brianmac.demon.co.uk/corestab.htm The muscles of the trunk, training techniques, and exercises Become Healthy Now.com: The Spine www.becomehealthynow.com/category/bodyspine Anatomy and function of spine Web Sites Spine Universe www.spineuniverse.com Information on the spine for educating the public about technologies, services, treatments and research available on spinal disorders Stabilization Sensibility www.calainc.org/handouts/participant_handouts/05_04%20stab ilization.pdf A discussion on muscles of the Abdomen Hospital for Joint Disease Spine Center http://www.med.nyu.edu/hjd/hjdspine/musclesandligaments.htm and Ligaments of the Spine 2007 McGraw-Hill Higher Education. All rights reserved. 12-67 2007 McGraw-Hill Higher Education. All rights reserved. 12-68 12