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The Spinal Column and Thorax

The Spinal Column and Thorax

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The Spinal Column and Thorax

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  1. The Spinal Column and Thorax ESAT 3600 Fundamentals of Athletic Training

  2. Main Functions • Skull • Protect brain • Thorax • Absorb forces of impact • Muscle attachment • Vertebral column • Provides framework and foundation for most movements of body and extremities • Muscle attachment • Protects spinal cord

  3. Vertebral Column • 7 cervical • 12 thoracic • 5 lumbar • 5 sacral • 4-5 coccygeal • Sacral and coccygeal are fused

  4. Shapes of Normal Spine • Cervical lordosis • Contributes to mobility of head • Thoracic kyphosis • Lumbar lordosis • Contributes to “springiness” of spine • Sacral kyphosis • Helps to transmit forces of body weight through trunk

  5. Bony Anatomy Review • Vertebral body • Vertebral arch • Transverse processes • Spinous process • Articulating surfaces • facets

  6. Vertebral Column Structure • All vertebrae are similar in general structure • 2 factors change when view from cervical to lumbar • Structures become progressively larger • Direction of articulating surfaces change

  7. Facets • Different orientations allow for: • varied degrees of movement between 2 adjacent vertebrae • Change amounts of tension, compression, and shear forces

  8. Vertebral Column Structure • Body of vertebra are load bearing portion of vertebra • Lumbar region bears more load than cervical region • Lumbar region has larger vertebrae

  9. Cervical Vertebrae • Body is more rectangular shaped • Facets are flat and tilted anteriorly • Axis and atlas do not follow basic rules

  10. Thoracic Vertebrae • Body has triangular shape • Facets are set oblique, and angle toward each other slightly

  11. Lumbar Vertebrae • Body is rounder • Bean shaped • Facets are almost vertical and face each other

  12. Intervertebral Disks • Consists of annulus fibrosis and nucleus pulposus

  13. Annulus fibrosis • Outermost layer is regular fibrous tissue • Inner portion is fibrocartilage • Concentric layers

  14. Nucleus Pulposus • Distributes stresses between vertebrae during flexion and extension • Lateral movements also • Forward bending = backward movement • Backward bending = forward movement

  15. Disk Damage • Compression and shear of vertebral discs is associated with LBP • 3 factors that increase shear and compression • Amount of weight lifted • Distance held from the vertebral column • Amount of trunk flexion used when lifting

  16. Ligaments of Vertebral Column • Anterior longitudinal ligament • Posterior longitudinal ligament

  17. Ligaments of Vertebral Column • Supraspinous ligament • Interspinous ligament

  18. Ligaments of Vertebral Column • Ligamentum flavum • Intertransverse ligament

  19. Ligaments of Vertebral Column • Ligamentum nuchae • Atlantoaxial ligament • Transverse ligament • Hangman’s ligament • Transverse process to transverse process of atlas

  20. Movement in the Spine • Movement between individual vertebrae • Movement of entire region • Movement of entire spine

  21. Movements of the Spine

  22. Vertebral Column Stability • Weak bony stability • Most stability from ligaments and muscles • Muscle stabilizers • Abdominals • Prevent hyperextension • Erector spinae • Compresses column

  23. Thorax • 12 Thoracic vertebrae • 12 pairs of ribs • 1st 7 have direct cartilaginous connection to sternum • Lower 5 connected to sternum by cartilaginous connection to the 7th costal cartilage or not at all

  24. Trunk and Movement • Trunk helps to contribute force to movement • Movement of intervertebral joints position trunk so that the upper extremity is in optimal position • Throwing tasks

  25. Spinal Muscles • Spinal muscle group • O & I on spinous process • Transversospinal muscle group • O on transverse process; I on spinous process • Spinotransversal muscle group • O on spinous process; I on transverse process

  26. Role of Muscles in Trunk Alignment • Rectus abdominis • Prevents lumbar hyperextension & anterior pelvic tilt • Erector spinae group • Prevent lumbar flexion • Iliopsoas and rectus femoris • Prevent hip extension • Hamstrings and gluteals • Prevent hip flexion

  27. Splenius capitis • O: spinous processes of C7-T3, inferior half of ligamentum nuchae • I: mastoid process and lateral 1/3 of superior nuchal line • A: bilaterally extends head and neck; unilaterally flexes and rotates head and neck to same side

  28. Splenius cervicis • O: spinous process of 3rd-6th thoracic vertebrae • I: posterior transverse processes of the 1st, 2nd, 3rd cervical vertebrae, sometimes 4th cervical vertebrae • A: bilaterally extends head and neck; unilaterally laterally flexes and rotates neck to same side

  29. Erector Spinae - Iliocostal Branch (Iliocostalis lumborum) • O: anterior surface of tendon arising from sacrum, spinous processes of lumbar and 11th & 12th thoracic vertebrae, medial lip of the iliac crest • I: inferior borders of angles of the lower 6 or 7 ribs • A: bilaterally extends spine; unilaterally lateral flexion of spine

  30. Erector Spinae - Iliocostal Branch (Iliocostalis thoracis) • O: superior borders of the angles of the lower 6 ribs • I: into the angles of the upper 6 or 7 ribs and into the transverse process of the C7 • A: bilaterally extends spine; unilaterally lateral flexion of spine

  31. Erector Spinae - Iliocostal Branch (Iliocostalis cervicis) • O: superior borders of the angles of the 3rd-6th ribs • I: posterior tubercles of transverse processes of the 4th, 5th, & 6th cervical vertebrae • A: bilaterally extends spine; unilaterally lateral flexion of spine

  32. Erector spinae - Longissimus Branch (Longissimus thoracis) • O: common tendon w/ iliocostalis lumborum, fibers from transverse and accessory processes of lumbar vertebrae and thoracolumbar fascia • I: tips of transverse process of all thoracic vertebrae and the lower 9 or 10 ribs between the tubercles and angles • A: bilaterally extends vertebral column; draws ribs down; unilaterally laterally flexes vertebral column

  33. Erector spinae - Longissimus Branch (Longissimus cervicis) • O: transverse processes of T 1-5 • I: transverse processes of C 2-6, sometimes transverse process of atlas • A: bilaterally extends neck; unilaterally laterally flexes neck

  34. Erector spinae - Longissimus Branch (Longissimus capitis) • O: transverse processes of T 1-5, articular processes of C 4-7 • I: posterior margin of mastoid process • A: bilaterally extends head; unilaterally laterally flexes and rotates head to same side

  35. Erector spinae - Spinalis Branch (Spinalis thoracis) • O: spinous processes of L 1-2, T11-12 • I: spinous processes of upper thoracic vertebrae • A: bilaterally extends spine; unilaterally laterally flexes spine

  36. Erector spinae - Spinalis Branch (Spinalis cervicis) • O: lower portion of ligamentum nuchae, spinous processes of C7 and sometimes T1-2 • I: spinous processes of axis and sometimes spinous processes of C3-4 • A: bilaterally extends spine; unilaterally laterally flexes spine

  37. Quadratus lumborum • O: iliolumbar ligament, posterior part of iliac crest • I: inferior border of 12th rib and transverse processes of upper 4 lumbar vertebrae • A: lateral flexion of lumbar spine, assist with inspiration

  38. Multifidus • A series of pairs of small muscles extending the full length of the spine just superficial to the rotatores and each spanning 2 or 3 intervertebral spaces • O: posterior surface of sacrum, dorsal end of iliac crest, mamillary and transverse processes of L & T vertebrae, articular processes of C4-7 • I: spinous processes of all vertebrae except atlas • A: unilaterally laterally flexes and rotates spine to opposite side; bilaterally extends spine

  39. Rotator brevis • Series of pairs of small muscles extending from sacrum to axis • O: transverse processes of vertebrae • I: bases of spinous processes of 1st vertebrae above • A: unilaterally rotation of spine to opposite side; bilaterally extends spine

  40. Rotator longus • Series of pairs of small muscles extending from sacrum to axis • O: transverse processes of vertebrae • I: bases of the spinous processes of 2nd vertebrae above • A: unilaterally rotation of spine to opposite side; bilaterally extends spine

  41. Scalenus anterior • O: scalene tubercle and ridge on superior surface of 1st rib • I: anterior tubercles of transverse of C3-6 • A: bilaterally flexes neck and raises 1st rib; unilaterally laterally flexes and rotates C spine to opposite side

  42. Scalenus medius • O: superior surface of 1st rib behind subclavial groove • I: posterior tubercles of transverse processes of C2-7 • A: bilaterally flexes neck and raises 1st rib; unilaterally laterally flexes and rotates C spine to opposite side

  43. Scalenus posterior • O: outer surface of 2nd rib behind attachment of serratus anterior • I: posterior tubercles of transverse processes of C4-6 • A: bilaterally flexes neck and raises 2nd rib; unilaterally laterally flexes and rotates C spine to opposite side

  44. Sternocleidomastoid • O:Sternal head – anterior surface of manubrium; Clavicular head – superior surface of medial 1/3 of clavicle • I: lateral surface of mastoid process, lateral ½ of the superior nuchal line • A: bilaterally flexes head; unilaterally draws head to ipsilateral shoulder, rotates head to opposite side

  45. External Oblique • O: external surfaces and inferior borders of ribs 5-12 • I: linea alba, inquinal ligament and anterior half of iliac crest along outer lip • A: unilaterally rotates trunk to opposite side, laterally flexes to same side; bilaterally flexes trunk anteriorly, anterior support to organs and lumbar spine, prevents anterior tilt of pelvis

  46. Internal Oblique • O: lateral 2/3 of inquinal ligament and anterior 1/3 of middle line of iliac crest; middle 1/3 of iliac crest and thoraco lumbar fascia • I:crest of pubis and linea alba; inferior border of ribs 10-12 • A: unilaterally rotates and laterally flexes trunk to same side; bilaterally flexes spine

  47. Rectus Abdominis • O: pubic crest and symphysis pubis • I: costal cartilage of ribs 5-7 and side of xiphoid process • A: flexion and lateral flexion of trunk, anterior support to organs and lumbar spine, prevents anterior tilt of pelvis

  48. Transverse abdominis • O: lateral 1/3 of the inquinal ligament, anterior 2/3 of inner lip of iliac crest, thoracolumbar fascia, inner edges of lower 6 costal cartilages • I: linea alba • A: constricts abdominal contents, assists in forced expiration