spinal column and thorax university of minnesota duluth脊柱和胸廓明尼苏达大学德卢斯课件

The Spinal Column and Thorax ESAT 3600 Fundamentals of Athletic Training Main Functions nSkull nProtect brain nThorax nAbsorb forces of impact nMuscle attachment nVertebral column nProvides framework and foundation for most movements of body and extremities nMuscle attachment nProtects spinal cord Vertebral Column n7 cervical n12 thoracic n5 lumbar n5 sacral n4-5 coccygeal nSacral and coccygeal are fused Shapes of Normal Spine nCervical lordosis nContributes to mobility of head nThoracic kyphosis nLumbar lordosis nContributes to “springiness” of spine nSacral kyphosis nHelps to transmit forces of body weight through trunk Bony Anatomy Review nVertebral body nVertebral arch nTransverse processes nSpinous process nArticulating surfaces nfacets Vertebral Column Structure nAll vertebrae are similar in general structure n2 factors change when view from cervical to lumbar nStructures become progressively larger nDirection of articulating surfaces change Facets nDifferent orientations allow for: nvaried degrees of movement between 2 adjacent vertebrae nChange amounts of tension, compression, and shear forces Vertebral Column Structure nBody of vertebra are load bearing portion of vertebra nLumbar region bears more load than cervical region nLumbar region has larger vertebrae Cervical Vertebrae nBody is more rectangular shaped nFacets are flat and tilted anteriorly nAxis and atlas do not follow basic rules Thoracic Vertebrae nBody has triangular shape nFacets are set oblique, and angle toward each other slightly Lumbar Vertebrae nBody is rounder nBean shaped nFacets are almost vertical and face each other Intervertebral Disks nConsists of annulus fibrosis and nucleus pulposus Annulus fibrosis nOutermost layer is regular fibrous tissue nInner portion is fibrocartilage nConcentric layers Nucleus Pulposus nDistributes stresses between vertebrae during flexion and extension nLateral movements also nForward bending = backward movement nBackward bending = forward movement Disk Damage nCompression and shear of vertebral discs is associated with LBP n3 factors that increase shear and compression nAmount of weight lifted nDistance held from the vertebral column nAmount of trunk flexion used when lifting Ligaments of Vertebral Column nAnterior longitudinal ligament nPosterior longitudinal ligament Ligaments of Vertebral Column nSupraspinous ligament nInterspinous ligament Ligaments of Vertebral Column nLigamentum flavum nIntertransverse ligament Ligaments of Vertebral Column nLigamentum nuchae nAtlantoaxial ligament nTransverse ligament nHangmans ligament nTransverse process to transverse process of atlas Movement in the Spine nMovement between individual vertebrae nMovement of entire region nMovement of entire spine Movements of the Spine Vertebral Column Stability nWeak bony stability nMost stability from ligaments and muscles nMuscle stabilizers nAbdominals nPrevent hyperextension nErector spinae nCompresses column Thorax n12 Thoracic vertebrae n12 pairs of ribs n1st 7 have direct cartilaginous connection to sternum nLower 5 connected to sternum by cartilaginous connection to the 7th costal cartilage or not at all Trunk and Movement nTrunk helps to contribute force to movement nMovement of intervertebral joints position trunk so that the upper extremity is in optimal position nThrowing tasks Spinal Muscles nSpinal muscle group nO I on spinous process nSpinotransversal muscle group nO on spinous process; I on transverse process Role of Muscles in Trunk Alignment nRectus abdominis nPrevents lumbar hyperextension unilaterally flexes and rotates head and neck to same side Splenius cervicis nO: spinous process of 3rd- 6th thoracic vertebrae nI: posterior transverse processes of the 1st, 2nd, 3rd cervical vertebrae, sometimes 4th cervical vertebrae nA: bilaterally extends head and neck; unilaterally laterally flexes and rotates neck to same side Erector Spinae - Iliocostal Branch (Iliocostalis lumborum) nO: anterior surface of tendon arising from sacrum, spinous processes of lumbar and 11th unilaterally lateral flexion of spine Erector Spinae - Iliocostal Branch (Iliocostalis thoracis) nO: superior borders of the angles of the lower 6 ribs nI: into the angles of the upper 6 or 7 ribs and into the transverse process of the C7 nA: bilaterally extends spine; unilaterally lateral flexion of spine Erector Spinae - Iliocostal Branch (Iliocostalis cervicis) nO: superior borders of the angles of the 3rd-6th ribs nI: posterior tubercles of transverse processes of the 4th, 5th, unilaterally lateral flexion of spine Erector spinae - Longissimus Branch (Longissimus thoracis) nO: common tendon w/ iliocostalis lumborum, fibers from transverse and accessory processes of lumbar vertebrae and thoracolumbar fascia nI: tips of transverse process of all thoracic vertebrae and the lower 9 or 10 ribs between the tubercles and angles nA: bilaterally extends vertebral column; draws ribs down; unilaterally laterally flexes vertebral column Erector spinae - Longissimus Branch (Longissimus cervicis) nO: transverse processes of T 1-5 nI: transverse processes of C 2-6, sometimes transverse process of atlas nA: bilaterally extends neck; unilaterally laterally flexes neck Erector spinae - Longissimus Branch (Longissimus capitis) nO: transverse processes of T 1-5, articular processes of C 4-7 nI: posterior margin of mastoid process nA: bilaterally extends head; unilaterally laterally flexes and rotates head to same side Erector spinae - Spinalis Branch (Spinalis thoracis) nO: spinous processes of L 1-2, T11-12 nI: spinous processes of upper thoracic vertebrae nA: bilaterally extends spine; unilaterally laterally flexes spine Erector spinae - Spinalis Branch (Spinalis cervicis) nO: lower portion of ligamentum nuchae, spinous processes of C7 and sometimes T1-2 nI: spinous processes of axis and sometimes spinous processes of C3 -4 nA: bilaterally extends spine; unilaterally laterally flexes spine Quadratus lumborum nO: iliolumbar ligament, posterior part of iliac crest nI: inferior border of 12th rib and transverse processes of upper 4 lumbar vertebrae nA: lateral flexion of lumbar spine, assist with inspiration Multifidus nA 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 nO: posterior surface of sacrum, dorsal end of iliac crest, mamillary and transverse processes of L bilaterally extends spine Rotator brevis nSeries of pairs of small muscles extending from sacrum to axis nO: transverse processes of vertebrae nI: bases of spinous processes of 1st vertebrae above nA: unilaterally rotation of spine to opposite side; bilaterally extends spine Rotator longus nSeries of pairs of small muscles extending from sacrum to axis nO: transverse processes of vertebrae nI: bases of the spinous processes of 2nd vertebrae above nA: unilaterally rotation of spine to opposite side; bilaterally extends spine Scalenus anterior nO: scalene tubercle and ridge on superior surface of 1st rib nI: anterior tubercles of transverse of C3-6 nA: bilaterally flexes neck and raises 1st rib; unilaterally laterally flexes and rotates C spine to opposite side Scalenus medius nO: superior surface of 1st rib behind subclavial groove nI: posterior tubercles of transverse processes of C2-7 nA: bilaterally flexes neck and raises 1st rib; unilaterally laterally flexes and rotates C spine to opposite side Scalenus posterior nO: outer surface of 2nd rib behind attachment of serratus anterior nI: posterior tubercles of transverse processes of C4-6 nA: bilaterally flexes neck and raises 2nd rib; unilaterally laterally flexes and rotates C spine to opposite side Sternocleidomastoid nO:Sternal head anterior surface of manubrium; Clavicular head superior surface of medial 1/3 of clavicle nI: lateral surface of mastoid process, lateral of the superior nuchal line nA: bilaterally flexes head; unilaterally draws head to ipsilateral shoulder, rotates head to opposite side External Oblique nO: external surfaces and inferior borders of ribs 5-12 nI: linea alba, inquinal ligament and anterior half of iliac crest along outer lip nA: unilaterally rotates trunk to opposite side, laterally flexes to