Rib Cage The Trunk

The Trunk● Vertebral Column

● Mobility● Protects Spinal Cord

● Pelvis● Rib Cage

Landmarks of the trunk

Vertebral Column● Back View - Extended Pyramid● Side View - S Shaped curve● Occupies about ½ the diameter of the body● Provides support for whole body

Vertebral Column ● Alignment● Balance of weights● Efficiency and ease of

movement

Vertebral Column❏Development of curves❏ Newborn - straight spine❏ Lumbar 1st ❏ Curves develop in

response to desire to move

Movement of Vertebral Column● Flexion● Extension● Lateral Flexion● Rotation

● ROM - determined by shape of vertebrae, thickness of disk, attachment to rib cage (thoracic)

Vertebral Column❏4 Curvatures or

Regions❏ Cervical❏ Thoracic

❏ Kyphosis

❏ Lumbar❏ Lordosis

❏ Sacral

Vertebral Column❏Kyphosis❏ An exaggeration of the thoracic

curve❏Lordosis❏ An exaggeration of the lumbar

curve

Vertebral Column ● 7 Cervical - neck, hold up head● 12 Thoracic - connect to ribs● 5 Lumbar - largest, lower back● Sacrum - 5 fused vertebrae● Coccyx - 3-4 fused vertebrae, tailbone

*Numbered from top to bottom (ex. C1-C7)

Vertebral Column● Analyze spinal curves ● Side view

○ Shape of curves● Back view

○ Shape ○ Muscles on Right and Left side

● ID C7● Roll Down

○ Curves in Motion

Vertebral Structure

Vertebral Structure

❏ Intervertebral Foramina❏ 3 joints

❏ Bodies connected by intervertebral disks

❏ Articular facets

Disks● Shock absorption and movement● Material in disks● Annulus Fibrosus - concentric rings

of fibrocartilage● Nucleus Pulposus - gelatinous

substance

Ligaments● 3 ligaments extending length of vertebral

column● Anterior Longitudinal Ligament● Posterior Longitudinal Ligament● Supraspinous Ligament

● Other ligaments● Ligamentum Flavum● Interspinous Ligaments● Intertransverse Ligaments

Ligaments

Vertebral Movement● What happens to Disks, Bones and

Ligaments in motion● Flexion● Extension● Lateral Flexion● Rotation

Disks/Nucleus

Bones Ligaments

Flexion Compressed anteriorly nucleus moves posteriorly

Arches and articular facets move apart

-Anterior longitudinal ligament relaxed-Posterior ligaments stretched

Extension Compressed posteriorly nucleus moves anteriorly

Arches and articular facets move closer together

-Anterior longitudinal ligament stretched-Posterior ligaments relaxed

Lateral Flexion

One side compressed nucleus moves in opposite direction

Ipsilateral transverse processes and articular facets move closer together

-Ipsilateral ligaments relaxed -Contralateral ligaments stretched

Rotation Reduction in overall height, some compression of nucleus

Transverse and spinous processes moved apart

-All ligaments stretched

Pelvis● Basin● Sacrum + Coccyx + 2 innominate bones ● Ilium, Ischium, Pubis

● Greater (false) and Lesser (true) Pelvis● Pelvic Inlet and Pelvic Outlet● 3 joints ● 2 sacroiliac and pubic symphysis

● Receives weight from upper body and lower body

Landmarks (Pelvis – Right Lateral View)

Pelvis

Pelvis: LandmarksIlium

Iliac CrestAnterior Superior Iliac Spine (ASIS)Anterior Inferior Iliac SpinePosterior Superior Iliac SpineExternal Iliac FossaInternal Iliac FossaGreater Sciatic NotchArcuate Line (Iliopectineal Line)

Pelvis: LandmarksIschium

Ischial SpineIschial TuberosityLesser Sciatic Notch

PubisIschiopubic RamusPubic TuberclePubic Symphysis

Pelvis: LandmarksAcetabulumObturator Foramen

Landmarks (Pelvis – Right Lateral View)

Landmarks (Pelvis – Right Medial View)

Sacrum● 5 Fused Vertebrae● Between 2 Ilia● Articulates with L5

SacrumLandmarks

Superior Articular ProcessSacral BaseSacral PromontoryAnterior Sacral Foramina (Intervertebral Foramen)Transverse ridge (Intervertebral Disks)ApexSacral CanalArticular FacetPosterior Sacral ForaminaMedian Sacral Crest (Spinous Process)Lateral Sacral Crest (Transverse Process)Auricular Surface

Coccyx 3-5 fused vertebraeTailbone

LandmarksTransverse ProcessSuperior Cornua

Landmarks (Sacrum and Coccyx)

Landmarks (Sacrum and Coccyx)

Sacroiliac Joint● Ilium and sacrum connect at Auricular

surfaces● Adduction (Nutation)● Abduction (Counter-nutation)● Ligaments

● Posterior sacroiliac ligament● Sacrospinous ligament● Sacrotuberous ligament

Pubic Symphysis● Joint between 2 Pubic Bones● Fibrocartilage disk● Shock Absorber

● Surrounded by fibrous cuff and 4 ligaments

● Limited Mobility

Nutation Video

https://www.youtube.com/watch?v=-ZKgzMvWXVM



Sacroiliac Joint

Sacroiliac Joint

Detailed look at Lumbar Spine● Shape

● Body● Disk● Spinous Process● Transverse Process● Laminae● Pedicles● Articular facets

● Movement● Flexion● Extension● Lateral Flexion● Rotation

● Body ● Large

● Disk ● Thick

● Spinous Process● Angled posteriorly

● Transverse Process ● Long with

tubercles for muscle attachment

● Superior Articular Facets● Concave and

angled medially● Inferior Articular

Facets ● Convex and angled

laterally

Detailed look at Lumbar Spine● Movement● Facilitation● Flexion, Extension and Lateral Flexion

● Shape of articular facets● Transverse process● Spinous process● Thickness of disks

● Limitation ● Rotation

● Shape of articular facets

Lumbosacral Joint● Lumbar Spine meets Sacrum

● Sacral base tilted forward● Body of L5 and Disk between L5 & S1 thicker

anteriorly

Iliolumbar ligaments● Transverse Process of L4 and L5 to Iliac

Crest● Oppose Sidebending● Flexion – L4 stretched and L5 relaxed● Extension – L5 stretched and L4 relaxed

Iliolumbar ligaments

Detailed look at Thoracic Spine● Shape



Body -■ circular■ whole and demifacets

to articulate with RibsDisk ■ small

Spinous Process■ Angled inferiorly and

elongatedTransverse Process■ facets that articulate

with ribsSuperior Articular Facets■ round and flat, face

back, angle up and out

Inferior Articular Facets round and flat, face front, angle down and in

Detailed look at Thoracic Spine● Movement

● Facilitation● Flexion,Extension,Lateral Flexion and Rotation

● Shape and orientation of of articular facets ● Limitations

● Extension ● Spinous processes● Small Disks● Attachment to ribs

*Biggest limitation - T1-T7 who connect to “true ribs”8-10 “false ribs” connected to sternum with cartilage of rib 711-12 “floating ribs” no anterior attachment, most mobility

Detailed look at Cervical Spine● Shape



○ Body ■ Small and

concave○ Disk

■ Large relative to body

○ Spinous Process■ C2 & C7 long■ C3-C7 bifurcated

○ Transverse Process ■ Short and broad

○ Transverse Foramen and lateral groove

○ Superior Articular Facets■ Angled back and

up○ Inferior Articular

Facets ■ Angled front and

down

Detailed look at Cervical Spine● Movement

○ Facilitation■ Flexion, extension, and rotation

● Small body + thick disk● Shape of body● Short spinous processes on C3-C6 (extension)

○ Limitations■ Sidebending

● Rectangular shape of body ● Transverse Processes

Analyze ROM in Cervical SpineFlexionExtensionRight RotationLeft RotationRight Side BendLeft Side Bend

C1: Atlas● Atlas

○ Ring shaped○ No body or spinous process

■ Anterior and posterior arches and lateral masses

○ Transverse processes■ Transverse foramen

○ Transverse ligament○ Facets

■ Articulate with Occipital Condyles and C2 (Axis)

C1: Atlas

C2: Axis● Axis

○ Dens/Odontoid Process■ Represents missing body of C1

○ Articular facets■ Superior convex - Inferior facets of C1 also

convex ○ Spinous Process

■ Relatively long

C2: Axis

Atlantoaxial Joint

Occipital Bone● Foramen

Magnum● Occipital

Condyles● Atlanto-Occipital

Joint

Ligaments● 4

○ 2 lateral ○ 1 anterior ○ 1 posterior

■ link atlas to occipital bone■ Continue inferiorly to axis to help stabilize

axis-atlas joint

Ligaments

Flexion Extension Lateral Flexion

Rotation

Lumbar Fullest Second fullest

Second fullest

Least full

Thoracic Least full Least full Least full Second fullest

Cervical Second fullest

Fullest Fullest Fullest

Thoracic Cage● Thoracic Vertebrae● Sternum● Ribs

Sternum

Ribs

Ribs

Rib Cage

● Connects to● Vertebrae in back - via facets on vertebral body

and transverse processes● Sternum in front - via costal cartilage

● True Ribs: 1-7● False Ribs: 8-10● Floating Ribs: 11, 12

Rib Movement in Respiration

Inspiration/Inhalation Expiration/Exhalation● Ribs elevated● Sternum lifts● Lower rib cage lifts

up laterally● Diameter of

thoracic cage increases

● Ribs depressed● Sternum lowers ● Lower rib cage

lowers medially● Diameter of

thoracic cage decreases

Posterior Muscles of Spine● Posterior Muscles of Trunk

● From Deep to Superficial● Review Origin and Insertion● Contraction brings origin and insertion

closer together● Direction of Muscle Fibers tells us what the

muscle can do

IntertransverseOrigin Insertion Action

Transverse Process

Transverse Process

Sidebending

*Attach posterior to intertransverse ligament

InterspinalisOrigin Insertion Action

Spinous Process Spinous Process Extension

*Attach on either side of interspinous ligament

Transversospinalis● Rotatores – Most Deep

● Span 1 vertebral level● Multifidus – Superficial to Rotatores

● Span 2-4 vertebral levels● Semispinalis – Most superficial

● Span 4-6 vertebral levels

Transversospinalis● Actions:● Bilateral Contraction - Extension● Unilateral Contraction - Sidebending or

Contralateral Rotation● Main Purpose: keep the trunk erect

TransversospinalisOrigin Insertion

Rotatores Transverse Process

Lamina

Multifidus Transverse Process

Spinous Process

Semispinalis Transverse Process

Spinous Process

Deep neck musclesOrigin Insertion Action

Rectus Capitus Posterior Minor

Posterior Arch C1

Inferior Occipital Ridge

Bilateral: -ExtensionUnilateral: -Sidebending -Rotation (Ipsilateral)


Rectus Capitus Posterior Major

Spinous Process of C2

Inferior Occipital Ridge lateral to minor

Bilateral: Extension

Unilateral: Sidebending Rotation (Ipsilateral)


Obliquus Capitis Superior

Transverse Process C1

Occiput lateral to Rectus Capitis Posterior Major

Bilateral: -ExtensionUnilateral: -Sidebending -Rotation (Contralateral)

Deep neck muscles cont.Origin Insertion Action

Obliquus Capitis Inferior

Spinous Process of C2

Transverse Process of C1

Extension, Sidebending Rotation

Intermediate Back and Neck Muscles● Erector Spinae● Splenius Capitis and Cervicis● Levator Scapulae● Rhomboids● Serratus Posterior● Latissimus Dorsi● Trapezius

Erector SpinaeIliocostalis

● Cervicis, Thoracis, LumborumLongissimus

● Capitis, Cervicis, ThoracisSpinalis

● Spinalis Capitis, Semispinalis capitis, Thoracis

Erector SpinaeOrigin Insertion

Iliocostalis Lumborum: Iliac Crest via Lumbar Fascia

Thoracis: Lower 6 Ribs

Cervicis: Upper 6 Ribs

L: Lower Ribs

T: Upper 6 Ribs

C: Transverse Processes of Lower Cervicals

Erector SpinaeAction

Iliocostalis -Spinal Extension-Assists in Lateral Flexion of Spine-Assists in Rotation

Origin InsertionLongissimus Thoracis:

-Lumbar Transverse Processes

Cervicis: -Transverse Processes of Upper Thoracic Vertebrae

Capitis: -Transverse Processes of Upper Thoracics and Lower Cervicals

Thoracis:-Thoracic Transverse Processes & Posterior Ribs 9 and 10Cervicis: -Transverse Processes of lower cervical vertebrae

Capitis: -Mastoid Process

ActionLongissimus -Spinal Extension

-Assists in Lateral Flexion of Spine-Assists in Rotation of Spine

Capitis: -Assists in Extension of Head-Assists in Lateral Flexion of Head

Origin Insertion

Spinalis Thoracis: -Spinous Processes of T1-T10

Capitis: -Spinous Processes of Lower Cervicals and Upper Thoracics

Semispinalis Capitis: -Transverse Processes of Lower Cervicals and Upper Thoracics

Thoracis: -Spinous Processes of T11-L2

Capitis and Semispinalis: -Occiput

Region Action

Spinalis Thoracis

Capitis And Semispinalis Capitis

-Spinal Extension

Bilateral:-Extend Head-Straighten out Cervical Spine

Unilateral: -Assist in Lateral Flexion of head and neck-Assist in Rotation of head and neck

Splenius Capitis and CervicisOrigin Insertion Action

Capitis

Cervicis

Nuchal Ligament and Spinous Process of lower C and upper T

Spinous Process of T5-T7

Mastoid Process and Occipital Bone

Transverse Process of C1-C3

Bilateral: -Extend Head and Cervical Spine

Unilateral: -Sidebending -Ipsilateral Rotation

Levator ScapulaeOrigin Insertion Action

Levator Scapulae

Transverse Processes of C1-C4

Medial Scapula

When Scapula Fixed Reinforces splenius cervicis

Serratus PosteriorOrigin Insertion Action

Superior

Inferior

Spinous Processes of C7-T3

Spinous Processes of T12-L2

Ribs 1-5

Ribs 9-12

Elevates Ribs aids inspiration(inhale)

Depresses Ribs aids expiration(exhale)

RhomboidsAction

Rhomboids When scapula is fixed pull vertebrae laterally

Latissimus DorsiAction

Latissimus Dorsi -Structural integrity of trunk-Extends thoracolumbar spine

TrapeziusAction

Trapezius When shoulder is fixed

Bilateral: Extends neck

Unilateral (Superior): -Ipsilateral sidebending-Contralateral rotation

Anterior Neck Muscles● Longus Colli● Rectus Capitis● Longus Capitis● Scalenus● Sternocleidomastoid

Longus ColliOrigin Insertion Action

Longitudinal

Oblique Superior

Oblique Inferior

Bodies of C2-T3

Anterior Arch C1

Bodies of T1-T3

Bodies of C4-C7



Bilateral: Flexes head and straightens cervical spine

Unilateral: Assists in Sidebending

Longus Colli

Rectus CapitisOrigin Insertion Action

Lateralis

Anterior

Occipital Bone

Occipital Bone

Transverse Process of Atlas

Anterior Atlas

Flexion of head and sidebending

Flexion of head, sidebending and rotation

Longus CapitisOrigin Insertion Action

Longus Capitis

Transverse processes of C3-C6

Occiput Bilateral: Flexion of head and straighten cervical spine

Unilateral: Lateral Flexion of head

ScalenusOrigin Insertion Action

Anterior

Medius

Posterior




Anterior Part of Rib 1

Anterior Part of Rib 1

Lateral surface of Rib 2

Unilateral (3): SidebendingUnilateral (A&M): Contralateral RotationBilateral (A&M): Increase curvature of Cervical Spine, (3): Assist in Inspiration when cervical spine fixed

SternocleidomastoidOrigin Insertion Action

Sternum and Clavicle

Mastoid Process Skull Fixed: Elevates Sternum and Clavicle assisting in inspiration

Unilateral: Ipsilateral sidebending and contralateral rotation

Bilateral: Extension of head

Muscles of Respiration● Diaphragm● Internal Intercostals● External Intercostals ● Levatores Costarum● Transversus Thoracis● Scaleni● Sternocleidomastoid● Posterior Serratus● Abdominal Wall

Intercostals

Levator CostarumOrigin Insertion ActionTransverse processes of Thoracic vertebrae

1 or 2 ribs below

-Elevation of ribs-Assists with rotation of spine

Transversus ThoracisOrigin Insertion ActionInner surface of sternum and xiphoid process

Costal cartilage of ribs 2-6

Depresses Ribs assisting with exhalation

Diaphragm● Primary muscle of respiration● Origins

● Sternal: xiphoid process● Costal: Deep surfaces of Ribs 7-12● Vertebral:

● Right Crus – bodies of L1-L3● Left Crus – Bodies of L1-L2

● Insertion: Central Tendon● Inspiration – Diaphragm Contracts and

moves inferiorly● Expiration – Diaphragm Relaxes and

moves superiorly

https://www.youtube.com/watch?v=hp-gCvW8PRY

Psoas MajorOrigin Insertion Action

Bodies, Disks, Transverse Processes of T12-L5

Lesser trochanter Bilateral:● Straighten the

Lumbar SpineUnilateral:● Sidebending ● Flexion● Rotation

(contralateral)

Quadratus LumborumOrigin Insertion Action

Posterior Iliac Crest

•Rib 12•Transverse processes of L1-L5

•Sidebending

Abdominal Wall● Cylindrical Fascial Sheath

● From Spine to Linea Alba (midline)● Joins top of pelvis to bottom of rib cage● Back and sides

● 3 layers of muscle: Transversus, Internal and External Obliques

● Front and center● 1 layer of muscle: Rectus

Transversus Abdominis● Deepest layer● Compresses abdomen● Attachments

● Back: Lumbar Vertebrae● Sides: Iliac Crest and Inner surface of Ribs

6-12● Front: Inguinal ligament and deepest part of

aponeurosis

Internal Oblique● Front View – “A” Shape● Actions: Sidebending, Ipsilateral Rotation,

Compresses Abdomen, Assists in Flexion of trunk

● Attachments● Back: Thoracolumbar Fascia● Side: Ribs 9-12, Iliac Crest● Front: Inguinal ligament, and aponeurosis

External Oblique● Front View: “V” shape● Action: Sidebending, Contralateral

Rotation, Compression of Abdomen, Assists in Flexion of trunk

● Attachments● Front: External surface of ribs 5-12, inguinal

ligament, Joins aponeurosis

Rectus Abdominis● Inside Abdominal Sheath● Action: Flexes trunk● Attachments

● Lower: Pubic Crest and Symphysis● Upper: Xiphoid Process and costal cartilage

of Ribs 5-7

Pelvic Floor● Several layers of muscles and fascia that

connect pubic bones, ischial tuberosities, and sacrum

● Supports weight of pelvic organs● Provides sphincters for rectum, bladder

and vagina● Pelvic Diaphragm● Urogenital Diaphragm

Draw and Label Muscles

-Serratus Posterior--Splenius Capitis-Splenius Cervicis-Rectus Capitis Posterior Major and Minor-Obliquus Capitis Superior and Inferior--Intertransverse-Interspinales-Multifidus-

Landmarks● Go over landmarks from Partner Activity

● Suprasternal notch● Sternum● Ribs● Xiphoid notch● ASIS● Acromion Process of Scapula

Bone Markings

Video

Documents

Rib Cage The Trunk