© 2007 McGraw-Hill Higher Education. All rights reserved. 12-1 Chapter 12 The Trunk and Spinal...

© 2007 McGraw-Hill Higher Education. All rights © 2007 McGraw-Hill Higher Education. All rights reserved. reserved. 12-12-11

Chapter 12Chapter 12The Trunk and Spinal The Trunk and Spinal

ColumnColumnManual of Structural KinesiologyManual of Structural Kinesiology

R.T. Floyd, EdD, ATC, CSCSR.T. Floyd, EdD, ATC, CSCS


The Trunk and Spinal ColumnThe Trunk and Spinal Column

• Vertebral column – complexVertebral column – complex– 24 intricate & complex articulating vertebrae24 intricate & complex articulating vertebrae– 31 pairs of spinal nerves31 pairs of spinal nerves– most complex part of body other than CNSmost complex part of body other than CNS

• Abdominal musclesAbdominal muscles– some sections linked by fascia & tendinous bandssome sections linked by fascia & tendinous bands– do not attach from bone to bonedo not attach from bone to bone

• Many small intrinsic muscles act on head, Many small intrinsic muscles act on head, vertebral column, & thoraxvertebral column, & thorax– assist in spinal stabilization or respirationassist in spinal stabilization or respiration– too deep to palpatetoo deep to palpate


BonesBones

• 24 articulating & 9 fused vertebrae 24 articulating & 9 fused vertebrae – 7 cervical (neck) vertebrae7 cervical (neck) vertebrae– 12 thoracic (chest) vertebrae12 thoracic (chest) vertebrae– 5 lumbar (lower back) vertebrae5 lumbar (lower back) vertebrae– 5 sacrum (posterior pelvic girdle) 5 sacrum (posterior pelvic girdle)

vertebraevertebrae– 4 coccyx (tail bone) vertebrae4 coccyx (tail bone) vertebrae

• First 2 cervical vertebrae - shapes First 2 cervical vertebrae - shapes allow for extensive rotary allow for extensive rotary movements of head to side, as well movements of head to side, as well as forward & backward movementas forward & backward movement

From Seeley RR, et al: Anatomy & physiology, ed 3, St. Louis, 1995, Mosby.


BonesBones

• 3 normal curves within spine3 normal curves within spine– Thoracic spine curves anteriorlyThoracic spine curves anteriorly– Cervical & lumbar spine curve posteriorlyCervical & lumbar spine curve posteriorly– Spinal curves enable it to absorb blows & Spinal curves enable it to absorb blows &

shocksshocks

• Vertebrae increase in size from Vertebrae increase in size from cervical to lumbar region due to lower cervical to lumbar region due to lower back having to support more weightback having to support more weight


BonesBones

• First 2 cervical vertebrae - atlas & axisFirst 2 cervical vertebrae - atlas & axis• Vertebrae C2 through L5 - similar Vertebrae C2 through L5 - similar

architecturearchitecture– body - anterior bony blockbody - anterior bony block– central vertebral foramen for spinal cordcentral vertebral foramen for spinal cord– transverse process projecting out laterally transverse process projecting out laterally – spinous process projecting posteriorlyspinous process projecting posteriorly


BonesBones

• Cervical vertebraeCervical vertebrae

From Anthony CP, Kolthoff NJ: Textbook of anatomy and physiology, ed 9, St. Louis, 1975, Mosby.


BonesBones

• Thoracic vertebraeThoracic vertebrae



BonesBones

• Lumbar vertebraeLumbar vertebrae



BonesBones

• Lordosis - increased posterior Lordosis - increased posterior concavity of lumbar & cervical curvesconcavity of lumbar & cervical curves

• Kyphosis - increased anterior Kyphosis - increased anterior concavity of thoracic curveconcavity of thoracic curve

• Lumbar kyphosis - reduction of Lumbar kyphosis - reduction of normal lordotic curve, resulting in a normal lordotic curve, resulting in a flat-back appearanceflat-back appearance

• Scoliosis - lateral curvatures or Scoliosis - lateral curvatures or sideward deviations of spine sideward deviations of spine

© 2007 McGraw-Hill Higher Education. All rights © 2007 McGraw-Hill Higher Education. All rights reserved. reserved.

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BonesBones

• 12 pairs of ribs12 pairs of ribs– 7 pairs of true ribs 7 pairs of true ribs

attach directly to attach directly to sternumsternum

– 5 pairs of false 5 pairs of false ribsribs• 3 pairs attach 3 pairs attach

indirectly to indirectly to sternumsternum

• 2 pairs of floating 2 pairs of floating ribs - ends are freeribs - ends are free


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BonesBones

– All ribs attached All ribs attached posteriorly to thoracic posteriorly to thoracic vertebraevertebrae

• SternumSternum– Manubrium, body of Manubrium, body of

sternum, & xiphoid sternum, & xiphoid process process

From Shier D, Butler J, Lewis R: Hole’s human anatomy & physiology, ed 9, New York, 2002, McGraw-Hill.


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BonesBones

• Key bony landmarksKey bony landmarks– muscles of neckmuscles of neck

•mastoid processmastoid process•transverse processes of cervical transverse processes of cervical

spinespine•spinous processes of cervical spinespinous processes of cervical spine•spinous processes of upper 4 spinous processes of upper 4

thoracic vertebraethoracic vertebrae•manubrium of sternummanubrium of sternum•medial claviclemedial clavicle


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BonesBones

• Key bony landmarksKey bony landmarks– posterior muscles of spineposterior muscles of spine

• spinous processes of thoracic spine spinous processes of thoracic spine • transverse processes of thoracic spinetransverse processes of thoracic spine• posterior ribs posterior ribs

– anterior trunk musclesanterior trunk muscles• borders of lower 8 ribsborders of lower 8 ribs• costal cartilages of ribscostal cartilages of ribs• iliac crestiliac crest• pubic crestpubic crest


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JointsJoints

• Atlantooccipital joint Atlantooccipital joint – first joint first joint – formed by occipital condyles of formed by occipital condyles of

skull sitting on articular fossa of the skull sitting on articular fossa of the 11stst vertebra vertebra

– allows flexion & extensionallows flexion & extension

• Atlantoaxial jointAtlantoaxial joint– Atlas (C1) sits on axis (C2)Atlas (C1) sits on axis (C2)– Most cervical rotation occurs hereMost cervical rotation occurs here– Trochoid or pivot-type jointTrochoid or pivot-type joint– Most mobile joint of any two Most mobile joint of any two

vertebraevertebrae

From Lindsay DT: functional human anatomy, St Louis, 1996, Mosby.


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JointsJoints

• Minimal movement between any Minimal movement between any 2 vertebrae (except atlantoaxial 2 vertebrae (except atlantoaxial joint)joint)– Cumulative effect of combined Cumulative effect of combined

movement from several vertebrae movement from several vertebrae allows for substantial movementsallows for substantial movements

– Vertebral articulations classified as Vertebral articulations classified as arthrodialarthrodial

– Gliding-type joints due to limited Gliding-type joints due to limited gliding movements gliding movements

– Gliding movement between Gliding movement between superior & inferior articular superior & inferior articular processes of facets jointsprocesses of facets joints From Lindsay DT: functional human anatomy, St

Louis, 1996, Mosby.


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JointsJoints

– Intervertebral disksIntervertebral disks• between & adhering to articular between & adhering to articular

cartilage of vertebral bodiescartilage of vertebral bodies• annulus fibrosus - outer rim of annulus fibrosus - outer rim of

dense fibrocartilagedense fibrocartilage• nucleus pulposus - central nucleus pulposus - central

gelatinous, pulpy substancegelatinous, pulpy substance• compressed elastic material compressed elastic material

allows compression in all allows compression in all directions along with torsiondirections along with torsion

• become less resilient with age, become less resilient with age, injury, or improper use, resulting injury, or improper use, resulting in a weakened annulus fibrosusin a weakened annulus fibrosus

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.


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JointsJoints

– Intervertebral disksIntervertebral disks• herniated nucleus pulposus herniated nucleus pulposus

(herniated or “slipped” (herniated or “slipped” disk) – nucleus protruding disk) – nucleus protruding through annulus resulting through annulus resulting from substantial weakening from substantial weakening combined with combined with compressioncompression

– protrusion puts pressure protrusion puts pressure on spinal nerve root, on spinal nerve root, causing radiating pain, causing radiating pain, tingling, numbness, tingling, numbness, and/or weakness in and/or weakness in lower extremitylower extremity 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.


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JointsJoints

• Most movement occurs in cervical & Most movement occurs in cervical & lumbarlumbar

• Some slight thoracic movementSome slight thoracic movement• Movements of headMovements of head

– Movement between cranium & 1Movement between cranium & 1stst cervical cervical and within other cervical vertebraeand within other cervical vertebrae

– Referred as cervical movementsReferred as cervical movements

• Trunk movementsTrunk movements– Lumbar motion terminology describes Lumbar motion terminology describes

combined motion in thoracic & lumbarcombined motion in thoracic & lumbar


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JointsJoints

• Cervical regionCervical region– Flexes 45 degreesFlexes 45 degrees– Extends 45 degreesExtends 45 degrees– Laterally flexes 45 degreesLaterally flexes 45 degrees– Rotate approximately 60 degreesRotate approximately 60 degrees


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JointsJoints

• Lumbar spine including trunk Lumbar spine including trunk movementmovement– Flexes approximately 80 degreesFlexes approximately 80 degrees– Extends 20 to 30 degreesExtends 20 to 30 degrees


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JointsJoints

• Lumbar spine including trunk Lumbar spine including trunk movementmovement– Lumbar lateral flexion to 35 degreesLumbar lateral flexion to 35 degrees– Rotation approximately 45 degreesRotation approximately 45 degrees


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MovementsMovements

• Spinal movements are often preceded Spinal movements are often preceded by the name given to the region of by the name given to the region of movementmovement

• Ex. flexion of trunk at lumbar spine is Ex. flexion of trunk at lumbar spine is known as lumbar flexion, & extension of known as lumbar flexion, & extension of neck is cervical extensionneck is cervical extension

• Pelvic girdle rotates as a unit due to Pelvic girdle rotates as a unit due to movement occurring in hip & lumbar movement occurring in hip & lumbar spine spine


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MovementsMovements

• Spinal flexionSpinal flexion– anterior movement of spine; in anterior movement of spine; in

cervical region the head cervical region the head moves toward chest; in lumbar moves toward chest; in lumbar region the thorax moves region the thorax moves toward pelvistoward pelvis


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MovementsMovements

• Spinal extensionSpinal extension– return from flexion or posterior return from flexion or posterior

movement of spine; in cervical movement of spine; in cervical spine, head moves away from spine, head moves away from the chest & thorax moves away the chest & thorax moves away from pelvisfrom pelvis


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MovementsMovements

• Lateral flexion (left or right)Lateral flexion (left or right)– sometimes referred to as side sometimes referred to as side

bending; head moves laterally bending; head moves laterally toward the shoulder & thorax toward the shoulder & thorax moves laterally toward pelvismoves laterally toward pelvis

• ReductionReduction– return movement from lateral return movement from lateral

flexion to neutral flexion to neutral


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MovementsMovements

• Spinal rotation (left or right)Spinal rotation (left or right)– rotary movement of spine in rotary movement of spine in

horizontal plane; chin rotates horizontal plane; chin rotates from neutral toward shoulder from neutral toward shoulder & thorax rotates to one side& thorax rotates to one side


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• A few large muscles & many small musclesA few large muscles & many small muscles• Erector spinae (sacrospinalis)Erector spinae (sacrospinalis)

– largest musclelargest muscle– extends on each side of spinal column from pelvic extends on each side of spinal column from pelvic

region to craniumregion to cranium– divided into 3 musclesdivided into 3 muscles

• Spinalis, longissimus, & iliocostalisSpinalis, longissimus, & iliocostalis• From medial to lateral side, has attachments in From medial to lateral side, has attachments in

lumbar, thoracic, & cervical regionslumbar, thoracic, & cervical regions• Actually made up of 9 musclesActually made up of 9 muscles

• Sternocleidomastoid & splenius musclesSternocleidomastoid & splenius muscles– large muscles involved in cervical & head large muscles involved in cervical & head

movementsmovements


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Large abdominal muscles - lumbar Large abdominal muscles - lumbar

movementsmovements– Rectus abdominis, external oblique Rectus abdominis, external oblique

abdominal, internal oblique abdominal, & abdominal, internal oblique abdominal, & quadratus lumborumquadratus lumborum

• Numerous small musclesNumerous small muscles– Many originate on one vertebra & insert on Many originate on one vertebra & insert on

next vertebranext vertebra– Important in functioning of spineImportant in functioning of spine

• Grouped according to location & Grouped according to location & functionfunction


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Some muscles have multiple segmentsSome muscles have multiple segments

– one segment of a muscle may be located & one segment of a muscle may be located & perform movement in one region while perform movement in one region while another segment of same muscle may be another segment of same muscle may be located in another region to perform located in another region to perform movements in that regionmovements in that region

• Many muscles of trunk & spinal column Many muscles of trunk & spinal column function in moving spine & aiding function in moving spine & aiding respirationrespiration– All thoracic muscles are primarily involved All thoracic muscles are primarily involved

in respirationin respiration


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Abdominal wall muscles do not go Abdominal wall muscles do not go

from bone to bone but attach into from bone to bone but attach into an aponeurosis (fascia) around an aponeurosis (fascia) around rectus abdominis arearectus abdominis area– external oblique abdominal, internal external oblique abdominal, internal

oblique abdominal, & transversus oblique abdominal, & transversus abdominisabdominis


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Muscles that move the headMuscles that move the head

– AnteriorAnterior• Rectus capitis anteriorRectus capitis anterior• Longus capitisLongus capitis

– PosteriorPosterior• Longissimus capitisLongissimus capitis• Obliquus capitis superiorObliquus capitis superior• Obliquus capitis inferiorObliquus capitis inferior• Rectus capitis posterior - major & minorRectus capitis posterior - major & minor• Trapezius, superior fibersTrapezius, superior fibers• Splenius capitisSplenius capitis• Semispinalis capitisSemispinalis capitis


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Muscles that move the headMuscles that move the head

– LateralLateral• Rectus capitis lateralisRectus capitis lateralis• SternocleidomastoidSternocleidomastoid

• Muscles of the vertebral columnMuscles of the vertebral column– SuperficialSuperficial

• Erector spinae (sacrospinalis)Erector spinae (sacrospinalis)– Spinalis - cervicis, thoracisSpinalis - cervicis, thoracis– Longissimus - capitis, cervicis, thoracisLongissimus - capitis, cervicis, thoracis– Iliocostalis - cervicis, thoracis, lumborumIliocostalis - cervicis, thoracis, lumborum

• Splenius cervicisSplenius cervicis


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Muscles of the vertebral columnMuscles of the vertebral column

– DeepDeep• Longus colli - superior oblique, inferior Longus colli - superior oblique, inferior

oblique, verticaloblique, vertical• Interspinales - entire spinal columnInterspinales - entire spinal column• Intertransversales - entire spinal columnIntertransversales - entire spinal column• Multifidus - entire spinal columnMultifidus - entire spinal column• Psoas minorPsoas minor• Rotatores - entire spinal columnRotatores - entire spinal column• Semispinalis - cervicis, thoracisSemispinalis - cervicis, thoracis


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Muscles of the thoraxMuscles of the thorax

– DiaphragmDiaphragm– Intercostalis - external, internalIntercostalis - external, internal– Levator costarumLevator costarum– SubcostalesSubcostales– Scalenus - anterior, medius, posteriorScalenus - anterior, medius, posterior– Serratus posterior - superior, inferiorSerratus posterior - superior, inferior– Transversus thoracisTransversus thoracis


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Trunk & Spinal Column MusclesTrunk & Spinal Column Muscles• Muscles of the abdominal wallMuscles of the abdominal wall

– Rectus abdominisRectus abdominis– External oblique abdominal (obliquus External oblique abdominal (obliquus

externus abdominis)externus abdominis)– Internal oblique abdominal (obliquus Internal oblique abdominal (obliquus

internus abdominis)internus abdominis)– Transverse abdominis (transversus Transverse abdominis (transversus

abdominis)abdominis)– Quadratus lumborum Quadratus lumborum


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NervesNerves• Cranial nerve 11 and Cranial nerve 11 and

C2 & C3 spinal nervesC2 & C3 spinal nerves– Sternocleidomastoid Sternocleidomastoid

musclesmuscles

• C4 through C8 C4 through C8 posterior lateral posterior lateral branchesbranches– Splenius musclesSplenius muscles

• Posterior branches of Posterior branches of the spinal nervesthe spinal nerves– Entire erector spinae Entire erector spinae

groupgroup


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NervesNerves• Intercostal nerves of T7 through T12Intercostal nerves of T7 through T12

– Rectus abdominisRectus abdominis• Intercostal nerves (T8-T12), Intercostal nerves (T8-T12),

iliohypogastric nerve (T12, L1), & iliohypogastric nerve (T12, L1), & ilioinguinal nerve (L1)ilioinguinal nerve (L1)– Internal & external oblique abdominal muscles Internal & external oblique abdominal muscles – Same for transverse abdominis except Same for transverse abdominis except

innervation begins with T-7 intercostal nerveinnervation begins with T-7 intercostal nerve

• Branches from T12 & L1Branches from T12 & L1– Quadratus lumborumQuadratus lumborum


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Muscles that Move the HeadMuscles that Move the Head• All originate on cervical vertebrae & All originate on cervical vertebrae &

insert on occipital bone of skull (capitis insert on occipital bone of skull (capitis name)name)– 3 anterior vertebral muscles – longus 3 anterior vertebral muscles – longus

capitis, rectus capitis anterior, & rectus capitis, rectus capitis anterior, & rectus capitis lateraliscapitis lateralis•All are flexors of head & upper cervical All are flexors of head & upper cervical

spinespine•Rectus capitis lateralisRectus capitis lateralis

– laterally flexes headlaterally flexes head– assists rectus capitis anterior in assists rectus capitis anterior in

stabilizing atlantooccipital jointstabilizing atlantooccipital joint


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Muscles that Move the HeadMuscles that Move the Head• All originate on cervical vertebrae All originate on cervical vertebrae

& insert on occipital bone of skull & insert on occipital bone of skull (capitis name)(capitis name)

Modified from Lindsay DT: Functional human anatomy, St. Louis, 1996, Mosby.


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Muscles that Move the HeadMuscles that Move the Head– Posterior musclesPosterior muscles

• Rectus capitis posterior major & minor, Rectus capitis posterior major & minor, obliquus capitis superior & inferior, and obliquus capitis superior & inferior, and semispinalis capitis semispinalis capitis

• All are extensors of head except obliquus All are extensors of head except obliquus capitis inferior which rotates atlascapitis inferior which rotates atlas

• Obliquus capitis superior assists rectus Obliquus capitis superior assists rectus capitis lateralis in lateral flexion of headcapitis lateralis in lateral flexion of head

• Rectus capitis posterior major rotates Rectus capitis posterior major rotates head to ipsilateral sidehead to ipsilateral side

• Semispinalis capitis rotates head to Semispinalis capitis rotates head to contralateral sidecontralateral side

• Upper Trapezius extend head & rotate its Upper Trapezius extend head & rotate its to ipsilateral side to ipsilateral side


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Muscles that Move the HeadMuscles that Move the Head– Posterior musclesPosterior muscles

Modified from Lindsay DT: Functional human anatomy, St. Louis, 1996, Mosby.


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Muscles that Move the HeadMuscles that Move the Head• Splenius capitis & Splenius capitis &

sternocleidomastoidsternocleidomastoid– Much larger & more powerful in Much larger & more powerful in

moving head & cervical spinemoving head & cervical spine

• Remaining cervical spine muscles Remaining cervical spine muscles are grouped with muscles of are grouped with muscles of vertebral column vertebral column


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Sternocleidomastoid MusclesSternocleidomastoid MusclesBoth sides:Both sides:extension ofextension ofhead athead atatlantooccipitalatlantooccipitaljoint & flexion joint & flexion

of neckof neck

Right side: Right side: rotation to left rotation to left & lateral & lateral flexion to rightflexion to right

Left side: Left side: rotation to rotation to right & lateral right & lateral flexion to left flexion to left


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Splenius Muscles (cervicis, Splenius Muscles (cervicis, capitis)capitis)

Right side: Right side: rotation & rotation & lateral flexion lateral flexion to rightto right

Left side: Left side: rotation & rotation & lateral lateral flexion to flexion to leftleft

Both sides: extension of head (splenius capitis) Both sides: extension of head (splenius capitis) & neck (splenius capitis and capitis) & neck (splenius capitis and capitis)


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Muscles of the Vertebral Muscles of the Vertebral ColumnColumn

• Cervical areaCervical area– Longus colli musclesLongus colli muscles

• located anteriorlylocated anteriorly• flex cervical & upper thoracic vertebraeflex cervical & upper thoracic vertebrae

• PosteriorPosterior– Erector spinae group, Erector spinae group,

transversospinalis group, interspinal-transversospinalis group, interspinal-intertransverse group, & spleniusintertransverse group, & splenius• All run vertically parallel to spinal columnAll run vertically parallel to spinal column• Location enables them to extend spine Location enables them to extend spine

and assist in rotation & lateral flexionand assist in rotation & lateral flexion


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• PosteriorPosterior– Interspinal-intertransverse groupInterspinal-intertransverse group

• lie deep to rotatoreslie deep to rotatores• laterally flex & extendlaterally flex & extend• do not rotate vertebraedo not rotate vertebrae

– InterspinalesInterspinales» extensorsextensors» connect from spinous connect from spinous

process of one vertebra process of one vertebra to spinous process of to spinous process of adjacent vertebraadjacent vertebra From Seeley RR, Stephens TD, Tate P: Anatomy &

physiology, ed 7, New York, 2006, McGraw-Hill.


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• PosteriorPosterior– Interspinal-Interspinal-

intertransverse groupintertransverse group– Intertransversarii Intertransversarii

musclesmuscles» flex vertebral flex vertebral

column laterallycolumn laterally» connect to connect to

transverse transverse processes of processes of adjacent adjacent vertebraevertebrae

From Seeley RR, Stephens TD, Tate P: Anatomy & physiology, ed 6, Dubuque, IA, 2003, McGraw-Hill.


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Posterior Muscles of the ThoraxPosterior Muscles of the Thorax

• Involved almost entirely in Involved almost entirely in respirationrespiration– DiaphragmDiaphragm

• Responsible for breathing during quiet Responsible for breathing during quiet rest rest

• As it contracts & flattens, thoracic volume As it contracts & flattens, thoracic volume is increased & air is inspired to equalize is increased & air is inspired to equalize the pressurethe pressure

• When larger amounts of air are needed, as When larger amounts of air are needed, as in exercise, other thoracic muscle have a in exercise, other thoracic muscle have a more significant role in inspirationmore significant role in inspiration


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Posterior Muscles of the ThoraxPosterior Muscles of the Thorax• Scalene muscles Scalene muscles

elevate first 2 ribs to elevate first 2 ribs to increase thoracic increase thoracic volumevolume

• External intercostals External intercostals further expand the further expand the chestchest

• Levator costarum & Levator costarum & serratus posterior – serratus posterior – inspirationinspiration

• Internal intercostals, Internal intercostals, transversus thoracis, & transversus thoracis, & subcostales contract to subcostales contract to force expirationforce expiration Modified from Van De Graaff KM: Human anatomy, ed 4, New York, 1995, McGraw-Hill.


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Erector Spinae Muscles Erector Spinae Muscles (sacrospinalis)(sacrospinalis)• Iliocostalis Iliocostalis

(lateral layer)(lateral layer)• LongissimusLongissimus

(middle layer)(middle layer)• Spinalis Spinalis

(medial layer)(medial layer)

Extension, Extension, lateral flexion, lateral flexion, & ipsilateral & ipsilateral rotation of rotation of spine & head spine & head

Anterior pelvic Anterior pelvic rotation rotation

Lateral pelvic rotation to contralateral side Lateral pelvic rotation to contralateral side


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Muscles of the Abdominal WallMuscles of the Abdominal Wall

• Rectus Rectus abdominisabdominis

• External External oblique oblique abdominalabdominal

• Internal Internal oblique oblique abdominalabdominal

• Transverse Transverse abdominisabdominis


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Muscles of the Abdominal WallMuscles of the Abdominal Wall

• Rectus Rectus abdominisabdominis

• External External oblique oblique abdominalabdominal

• Internal Internal oblique oblique abdominalabdominal

• Transverse Transverse abdominisabdominis


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Rectus Abdominis Rectus Abdominis MuscleMuscle

Both sides: Both sides: lumbar flexionlumbar flexion

Right side: weak Right side: weak lateral flexion lateral flexion to rightto right

Left side: weak Left side: weak lateral flexion lateral flexion to left to left

Posterior pelvic Posterior pelvic rotationrotation


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External Oblique Abdominal External Oblique Abdominal MuscleMuscle

Both sides: lumbar flexionBoth sides: lumbar flexion

Posterior pelvic rotationPosterior pelvic rotation

Left side: lumbar Left side: lumbar lateral flexion lateral flexion to left, rotation to left, rotation to right, & to right, & lateral pelvic lateral pelvic rotation to rightrotation to right

Right side: lumbar Right side: lumbar lateral flexion to lateral flexion to right, rotation to right, rotation to left, & lateral left, & lateral pelvic rotation to pelvic rotation to leftleft


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Internal Oblique Abdominal Internal Oblique Abdominal MuscleMuscle

Right side: lumbar Right side: lumbar lateral flexion to lateral flexion to right, rotation to right, rotation to right, & lateral right, & lateral pelvic rotation to pelvic rotation to leftleft

Left side: lumbar Left side: lumbar lateral flexion lateral flexion to left, rotation to left, rotation to left, & lateral to left, & lateral pelvic rotation pelvic rotation to rightto right

Posterior pelvic rotationPosterior pelvic rotation

Both sides: lumbar flexionBoth sides: lumbar flexion


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Transversus Abdominis MuscleTransversus Abdominis Muscle

Forced expiration Forced expiration by pulling the by pulling the abdominal wall abdominal wall inward inward


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Quadratus Lumborum MuscleQuadratus Lumborum Muscle

Lateral flexion to ipsilateral sideLateral flexion to ipsilateral side Stabilizes pelvis & lumbar spine Stabilizes pelvis & lumbar spine

Extension of Extension of lumbar lumbar spine spine

Anterior pelvic Anterior pelvic rotationrotation

Lateral pelvic Lateral pelvic rotation to rotation to contralateral contralateral sideside


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Cervical FlexionCervical Flexion• AgonistsAgonists

– SternocleidomastoidSternocleidomastoid


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Cervical ExtensionCervical Extension

• AgonistsAgonists– Erector SpinaeErector Spinae


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Cervical Lateral FlexionCervical Lateral Flexion

• AgonistsAgonists– SternocleidomastoidSternocleidomastoid– Erector SpinaeErector Spinae


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Cervical RotationCervical Rotation• AgonistsAgonists

– SternocleidomastoidSternocleidomastoid


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Lumbar FlexionLumbar Flexion

• AgonistsAgonists– Rectus Rectus

abdominisabdominis– External External

oblique oblique abdominalabdominal

– Internal Internal oblique oblique abdominalabdominal


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Lumbar ExtensionLumbar Extension

• AgonistsAgonists– Erector Erector

spinaespinae


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Lumbar Lateral FlexionLumbar Lateral Flexion

• AgonistsAgonists– Erector Erector

spinaespinae– External External




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Lumbar RotationLumbar Rotation

• AgonistsAgonists– Rectus Rectus

abdominisabdominis– External External




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Web SitesWeb SitesRadiologic 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 anatomyUniversity of Arkansas Medical School Gross Anatomy for Medical

Studentshttp://anatomy.uams.edu/anatomyhtml/gross.html – Dissections, anatomy tables, atlas images, links, etc.

Wheeless’ Textbook of Orthopaedicswww.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.


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Web SitesWeb SitesPremiere 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 Spinewww.becomehealthynow.com/category/bodyspine – Anatomy and function of spine


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Web SitesWeb SitesSpine Universe

www.spineuniverse.com– Information on the spine for educating the public about

technologies, services, treatments and research available on spinal disorders

Stabilization Sensibilitywww.calainc.org/Handouts/Participant_handouts/

05_04%20Stabilization.pdf – A discussion on muscles of the Abdomen

Hospital for Joint Disease Spine Centerhttp://www.med.nyu.edu/hjd/hjdspine/musclesandligaments.htm– Muscles and Ligaments of the Spine

http://www.med.nyu.edu/hjd/hjdspine/musclesandligaments.htm

http://www.med.nyu.edu/hjd/hjdspine/musclesandligaments.htm

© 2007 McGraw-Hill Higher Education. All rights reserved. 12-1 Chapter 12 The Trunk and Spinal...

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Transcript of © 2007 McGraw-Hill Higher Education. All rights reserved. 12-1 Chapter 12 The Trunk and Spinal...