Advanced Anatomy 16 PDF - Basic Vertebral Column Structure

Review - Basic structure of vertebral column breared - 24 mobile vertebrae: Zygapophyseal (facet) joints lots of the...

Review - Basic structure of vertebral column breared - 24 mobile vertebrae: Zygapophyseal (facet) joints lots of the paired (L and R) movement cervical  non midline coordinated  multi-axial plane synovial joints vertebra (7) i a war between inferior articular facet (IAF) of immobile fused vertebrae one vertebra and the superior articular (in an adult): thoracic facet (SAF) of the adjacent vertebra vertebra (12) sacrum 23 interbody vertebral joints with (5) intervertebral discs (IVDs) separate lumbar  one each level, midline (except 0/C1, vertebrae vertebra (5) C1/C2 or in sacrum or coccyx) in teenagers  fibrocartilaginous or younger coccyx (symphyses) (4) Uncovertebral joints C3-C7  Unlabelled figure from Mediclip Human Anatomy 1, 2 & 3 Williams & Wilkins A Waverley Group 1996 Intervertebral disc region variation and spinal curves Disc provide curves Shape Height thicker anteriorly lordosis thinnest C/S – lordosis support Secondary a thicker posteriorly flexible kyphosis T/S – kyphosis support rod lordosis L/S thicker anteriorly thickest – lordosis support kyphosis concave Line of gravity posterorly Palastanga et al 2012 5 Intervertebral disc – effects of hydration and posture water art pushed fram pressure , causing desc to Shrink misse of tearing herniated arguer to desc ligaments expose https://musculoskeletalkey.com/ageing-of-the-lumbar-spine/ dis  movements Spin- Vertebral column function important posture + rotate lateral na flexin i  Weight bearing – Suspends and supports the upper body weight loads (i.e. upper limbs, trunk, head & neck)  Protects - spinal cord, spinal nerves and arteries, intervetebral disc lots  Movement - allows spinal and trunk mobility of jonts -  Attachment - provides anchorage for many muscles of the pectoral & pelvic girdles as well as spinal column  Shock absorber – Absorbs and also transmits forces received from one body area to another.  Spine movements combined movements order J shaped rotate + movement star back muscles - of fascets - at of eccentrically Manjunatha, N. S. (2020). Advanced control spinal movements (ASM) as manipulative treatment in back pain and promotion of spinal column. World Journal of Advanced Research and. to Reviews, 8(3), 413-419. eg &  Closed kinetic chain motions ie. feet fixed Coronal/frontal plane motion pelvic drop  ipsilateral hip abduction CKC ↑ contralateral hip adduction contralateral lumbar lateral flexion Sagittal plane motions anterior pelvic tilt  hip flexion lumbar spine extension H crC posterior pelvic tilt  hip extension c lumbar spine flexion Horizontal/transverse plane motion pelvic rotation  ipsilateral hip medial rotation cra contralateral hip lateral rotation contralateral trunk rotation Movement terminology review Contralateral (from Latin contra 'against'): on the side opposite to another structure. For example, the right transversospinales creates a contralateral trunk rotation (ie to the left) Ipsilateral (from Latin ipse 'same'): on the same side as another structure. For example, contraction of the left internal oblique creates left trunk rotation Bilateral (from Latin bis 'twice'): on both sides of the body. For example, bilateral erector spinae contraction produces lumbar extension Unilateral (from Latin unus 'one'): on one side of the body. For example, unilateral of the erector spinae causes lateral flexion By BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. - Own work, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=31339201 review – planes, axes and motion terms https://teachmeanatomy.info/the- Kwok, B. C., Lim, J. X. L., & Kong, P. W. (2021). The theoretical framework of basics/anatomical-terminology/planes/ the clinical pilates exercise method in managing non-specific chronic low back pain: a narrative review. Biology, 10(11), 1096.  Anteroposterior axis – coronal/frontal plane Lateral Flexion occurs in the coronal plane about an anteroposterior axis. Muscles acting concentrically to laterally flex the spine will all be located on the side the person is flexing to (ipsilateral), because muscles don’t cross the midline. Lowering very slowly into lateral flexion may involve eccentric control contraction of muscles on the contralateral side Fascia connects the two sides, anteriorly and posteriorly https://www.bbc.co.uk/bitesize/guides/z24b9qt/revision/3#:~:text=Longitudinal%20axis%20 %2D%20this%20line%20runs,rotating%20around%20the%20longitudinal%20axis. https://www.yogaclassplan.com/yoga-pose/side-bending-pose/ https://www.quora.com/How-do-you-perform-a-cartwheel Transverse axis –sagittal plane Flexion and extension occur in the sagittal plane about a transverse axis. Muscles that flex will be located anterior to the transverse axis of rotation of a given joint. Muscles that extend will be located posterior to the transverse axis of rotation of a given joint. https://www.bbc.co.uk/bitesize/guides/z24b9qt/revision/3#:~:text=Longitudinal%20axis% Yeadon, M.R. (2017). Airborne Movements: Somersaults and Twists. In: Müller, B., et al. Handbook of Human 20%2D%20this%20line%20runs,rotating%20around%20the%20longitudinal%20axis. Motion. Springer, Cham. https://doi.org/10.1007/978-3-319-30808-1_128-1  Longitudinal axis - transverse plane Rotation occurs about a https://www.health.harvard.edu/heart-health/move- transverse action in the of-the-month-double-knee-torso-rotation longitudinal plane. Trunk rotation direction is described relative to the pelvis, whether the pelvis moves and the trunk is still, or whether the trunk moves and the pelvis remains in place https://www.bbc.co.uk/bitesize/guides/z24b9qt/revision/3#:~:text=Longitudinal%20axis% 20%2D%20this%20line%20runs,rotating%20around%20the%20longitudinal%20axis. https://golfshane.blogspot.com/2014/01/torso-turn_4.html https://www.lboro.ac.uk/microsites/ssehs/biomechanics/papers/twistfast99.pdf  Line of gravity in standing The line of gravity is a result of a reaction between the ground and an ideal dynamic alignment. The closer the line of gravity to the centre of base of support, the easier the balance is (i.e. more stable). The line of gravity usually passes through: mastoid process or the tragus of the ear (horizontal line of sight) just anterior to the shoulder joint through bodies of lumbar and cervical vertebrae and anterior to thoracic vertebrae through or just posterior to the hip joint Hasegawa, K., Okamoto, M., Hatsushikano, S., just anterior to the knee joints Shimoda, H., Ono, M., Homma, T., & Watanabe, K. (2017). Standing sagittal alignment of the whole axial skeleton with anterior to the ankle joint reference to the gravity line in humans. Journal of anatomy, 230(5), 619-630.  Line of gravity during activities When the line of gravity falls outside of the base of support, they need to add corrective muscle action, which could be via movement, to prevent falling (i.e. more unstable position) Corrective actions include: increasing the base of support lowering the centre of gravity Increased back pain risk of falls, etc can be nigh associated with poor alignment due to the riste increased load on musculoskeletal structures of injury · lower COG Image courtesy of Glynda Rees Doyle and Jodie Anita McCutcheon, 2015/ Wikimedia Commons ⑥ https://pdhpe.net/the-body-in-motion/how-do-biomechanical-principles- influence-movement/balance-and-stability/line-of-gravity/ Review - Spine passive stability structures  Curves of spine  Line of gravity/ centre of gravity  Joints: interbody (discs) zygopophyseal uncovertebral  Ligaments: anterior / posterior longitudinal ligamentum flava supraspinous  Thoracic cage Pelvis ANTERIOR fig 4.2 p.408 Palastanga  Local versus Global Muscles can act in various ways. Smaller deeper muscles spanning small distances usually stabilise joints, while those spanning larger distances usually mobilise joints (create movement) intersegmental muscles - local usually more of a stability/proprioceptive role multisegmental muscles - global usually play more of a mobilising (movement) role local From: Moore, K., Dalley, A. & Agur A. Clinically Oriented Anatomy, 7th ed Lippincott Williams & Wilkins USA; 7th edition (31 January 2013) global https://clinicalgate.com/axial-skeleton-muscle-and-joint-interactions/  OO Spinal movements and the muscles Understanding the task required helps identify: the joints at which the movement should occur the muscles which can provide stability the muscle which can produce (or control) the required movements Manjunatha, N. S. (2020). Advanced spinal movements (ASM) as manipulative treatment in back pain and promotion of spinal column. World Journal of Advanced Research and Reviews, 8(3), 413-419.  REVIEW - General features of deep back muscles arranged in “sheets” which extend along the vertebral column erector spinae group vertical sheet superficial extend the length of vertebral column tranversospinalis group oblique sheet (inf TP to sup SP) deep to erector spinae mutifindns uni-segmental group deep to transversospinalis supplied by dorsal (posterior primary) rami of spinal nerves http://www.corpshumain.ca/en/images/Muscles _dos3_120_(FF)_en.jpg Anterolateral abdominal wall muscles – anterior view transverse abdominis (under rectus sheath) rectus abdominis internal oblique external oblique Rohen et al 2011  Posterior Abdominal wall muscles Bilateral – Extends L/S & trunk (ilium/pelvis stable) Anteriorly tilts pelvis (rib 12 & L/S stable) Unilateral – psoas major Ipsilateral lateral flexion (pelvis stable) Action: Hip flexor (trunk and L/Sp stable) Ipsilateral pelvic lift (rib 12 & L/S stable) Trunk and lumbar spine flexor quadratus (femur stable) lumborum iliacus psoas minor Open chain: hip flexion Weak lumbar spine flexor Closed chain: trunk flexion Rohen et al 2011  Sagittal plane spine movements: Extension Bilaterally: Erector spinae – iliocostalis, longissimus, spinalis Transversospinales - semispinalis, multifidus, rotatores Splenius muscles (Cervical spine) Interspinales (segmental – therefore mostly stability role) Quadratus lumborum Flexion Bilaterally: rectus internal abdominus oblique anterior abdominal wall muscle group - rectus abdominus, external and internal oblique (i.e. not TA) Pelvic tilt external anterior– iliopsoas, rectus femoris, ES oblique posterior – hamstrings, rectus abdominus Palastanga etal 12, fig Palastanga etal 12, fig 4.16, p424 4.18, p426 Combined sagittal actions of trunk and limb muscles work with Hip muscles back muscles Whitelaw, A., & Thoresen, M. (2002). Clinical assessment and therapeutic interventions for hypoxic-ischemic encephalopathy in the full-term infant. The Newborn Brain: neuroscience and clinical applications. Cambridge University Press, Cambridge, 415-442. https://www.facebook.com/healthystreet/photos/-abdominal-muscles-as-proximal-stabilizers-for-the-hip-flexorsthe-hip-flexor- https://clinicalgate.com/axial-skeleton-muscle-and-joint-interactions/ mus/628093539352097/?paipv=0&eav=AfbEPw75y3rVdjRHTJsziBJX_DF0F_aUkd7T9HCvropFqHmAUvdZ-1KbslPOg40Vhqw&_rdr O O Coronal plane spine movements: Ipsilateral lateral flexion Unilateral contraction of: erector spinae muscles transversospinales intertransversarii splenius, sternocleidomastoid longus colli quadratus lumborum https://clinicalgate.com/axial-skeleton-muscle-and-joint-interactions/ psoas major Other muscles such as levator rectus abdominus scapulae and the upper trapezius external and internal oblique can also act to create ipsilateral rectus capitis lateralis lateral flexion of the neck.  https://clinicalgate.com/axial-skeleton-muscle-and-joint-interactions/ of combination Transverse plane spinal movements muscle asce. Ipsilateral trunk rotation Contralateral trunk rotation Unilateral contraction of: Unilateral contraction of: iliocostalis (ES) transversospinales transversospinales (semispinalis, multifidus, rotatores) splenius cap & cervicis (head & neck) external oblique sternocleidomastoid (neck) internal oblique ac -