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Joseph E. Muscolino, DCInstructor, Purchase CollegeState University of New YorkOwner, The Art and Science of KinesiologyStamford, Connecticut
KINESIOLOGY:The Skeletal System and Muscle FunctionSecond Edition
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Chapter 7:Joints of the Axial BodyJoseph E. Muscolino, DC
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
3Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Lesson 7.1 Objectives
• Define the key terms of this chapter and state the meanings of the word origins of this chapter.
• Describe the relationship between cranial suture joints and childbirth.
• List the major muscles of mastication and describe their role in mastication.
4Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Lesson 7.1 Objectives(cont’d.)
• Explain the possible relationship between TMJ dysfunction and the muscular system.
• Describe the structure and function of the spine.
• Define the curves of the spine and describe their development.
5Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Joints of the Axial Body
• Suture joints
• Temporomandibular joints (TMJs)
• Atlanto-occipital and atlantoaxial joints
• Cervical spinal joints
• Thoracic spinal joints– Rib joints
• Lumbar spinal joints
6Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Section 7.1—Suture Joints
Figure 7-1
7Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Structure Classification:
• Fibrous joint– Suture joint
Function Classification:
• Synarthrotic
Major Motions Allowed:
• Nonaxial
Section 7.1—Suture Joints (cont’d.)
8Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Section 7.2—Temporomandibular Joints
{Insert Fig. 7-2}
Figure 7-2
9Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Structure Classification:
• Synovial joint– Modified hinge
Function Classification:
• Diarthrotic– Uniaxial
Section 7.2—Temporomandibular Joints
(cont’d.)
10Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Major Motions Allowed:
• Elevation and depression
• Protraction and retraction
• Left and right lateral deviation
Section 7.2—Temporomandibular Joints
(cont’d.)
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Section 7.2—Temporomandibular Joints
(cont’d.)
{Insert Fig. 7-3 A and B}
Figure 7-3
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Section 7.2—Temporomandibular Joints
(cont’d.)
{Insert Fig. 7-4 A and B}
Figure 7-4
13Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Section 7.2—Temporomandibular Joints
(cont’d.)
{Insert Fig. 7-5 A and B}
Figure 7-5
14Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Major Ligaments of the TMJ:
• Fibrous joint capsule
• Temporomandibular ligament
• Stylomandibular ligament
• Sphenomandibular ligament
Section 7.2—Temporomandibular Joints
(cont’d.)
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Section 7.2—Temporomandibular Joints
(cont’d.)
{Insert Fig. 7-6 A and B}
Figure 7-6
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Section 7.2—Temporomandibular Joints
(cont’d.)
{Insert Fig. 7-6 C and D}
Figure 7-6
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Major Muscles of the TMJ:
• Lateral pterygoid
• Medial pterygoid
• Temporalis
• Masseter
Section 7.2—Temporomandibular Joints
(cont’d.)
18Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Section 7.2—Temporomandibular Joints (cont’d.)
From Muscolino JE: The muscular system manual: The skeletal muscles of the human body, ed 3, St Louis, 2010, Mosby
19Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Causes of TMJ Dysfunction:
• Tightness/imbalance of muscles that cross the TMJ
• Forward-head posture
Section 7.2—Temporomandibular Joints
(cont’d.)
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Elements of the Spine:
• Cervical spine
• Thoracic spine
• Lumbar spine
• Sacrococcygeal spine
Section 7.3—The Spine
21Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Section 7.3—The Spine (cont’d.)
{Insert Fig. 7-7 A and B}
Figure 7-7
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Shape of the Adult Spine(Viewed Laterally):• Primary spinal curves
– Thoracic curve– Sacrococcygeal curve
• Secondary spinal curves– Cervical curve– Lumbar curve
Section 7.3—The Spine (cont’d.)
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Development of the Spinal Curves:
• Born with one kyphotic curve
• Develops a cervical lordosis
• Develops a lumbar lordosis
Section 7.3—The Spine (cont’d.)
{Insert Fig. 7-8 A, B, C}
Figure 7-8
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Functions of the Spine:
• Provides structural support
• Allows movement
• Protects the spinal cord
• Provides shock absorption
Section 7.3—The Spine (cont’d.)
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Section 7.3—The Spine (cont’d.)
Figure 7-9
(B modeled after Kapandji IA: Physiology of the joints: the trunk and thevertebral column, ed 2, Edinburgh, 1974, Churchill Livingstone.)
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Average Ranges of Motion:
• Flexion 135 degrees
• Extension 120 degrees
• Right lateral flexion 90 degrees
• Left lateral flexion 90 degrees
• Right rotation 120 degrees
• Left rotation 120 degrees
Section 7.3—The Spine (cont’d.)
27Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Lesson 7.2 Objectives
• State the major difference between the function of the disc joint and the function of the facet joints.
• Describe the orientation of the planes of the facets in the cervical, thoracic, and lumbar regions of the spine.
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Lesson 7.2 Objectives(cont’d.)
• Describe the structure and functionof the median and lateral joints ofthe spine.
• Describe the structure and functionof the atlanto-occipital and atlantoaxial joints of the cervical spine.
29Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Joints of the Axial Body
• Suture joints
• Temporomandibular joints (TMJs)
• Atlanto-occipital and atlantoaxial joints
• Cervical spinal joints
• Thoracic spinal joints– Rib joints
• Lumbar spinal joints
30Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Segmental Structure:
• One median joint
• Two lateral joints
Section 7.4—Spinal Joints: General
Figure 7-10
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Types of Spinal Joints:
• Intervertebral disc joints
(disc joints)
• Vertebral facet joints
(facet joints)
Section 7.4—Spinal Joints: General (cont’d.)
32Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Section 7.4—IntervertebralDisc Joint
Figure 7-11
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Structure Classification:
• Cartilaginous joint– Symphysis
Function Classification:
• Amphiarthrotic
Section 7.4—IntervertebralDisc Joint (cont’d.)
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Functions of a Disc Joint:
• Determines amount of movement
• Absorbs shock
• Bears the weight of the body
• Maintains opening for spinal nerves
Section 7.4—IntervertebralDisc Joint (cont’d.)
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Section 7.4—VertebralFacet Joint
Figure 7-13
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Structure Classification:
• Synovial joint– Plane
Function Classification:
• Diarthrotic
Function of a Facet Joint:
• Guides movement
Section 7.4—VertebralFacet Joint (cont’d.)
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Motion Freely Allowed
by the Facet Joints:
• Cervical facets– Right and left rotation in
transverse plane– Right and left lateral
flexion in frontal plane
Section 7.4—VertebralFacet Joint (cont’d.)
Figure 7-14
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Motion Freely Allowed
by the Facet Joints
(cont’d.):
• Thoracic facets– Right and left lateral
flexion in frontal plane
Section 7.4—VertebralFacet Joint (cont’d.)
Figure 7-14
39Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Motion Freely Allowed
by the Facet Joints
(cont’d.):
• Lumbar facets– Flexion and extension in
sagittal plane
Section 7.4—VertebralFacet Joint (cont’d.)
Figure 7-14
40Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Flexion and Extension:
• Sagittal plane
• Mediolateral axis
Section 7.4—Spinal Joints: Motions
Figure 7-15
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Right and Left Lateral Flexion:
• Frontal plane
• Anteroposterior axis
Section 7.4—Spinal Joints: Motions (cont’d.)
Figure 7-16
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Right and Left Rotation:
• Transverse plane
• Vertical axis
Section 7.4—Spinal Joints: Motions (cont’d.)
Figure 7-17
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Gliding Translational Movements:
• Right-side and left-side translation
• Anterior and posterior translation
• Superior and inferior translation
Section 7.4—Spinal Joints: Motions (cont’d.)
Figure 7-18
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Section 7.4—Spinal Joints: Ligaments
Figure 7-19
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Major Ligaments of the Spinal Joints:
• Fibrous capsules of the facet joints
• Annulus fibrosus of the disc joints
• Anterior longitudinal ligament
Section 7.4—Spinal Joints: Ligaments (cont’d.)
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Major Ligaments of the Spinal Joints
(cont’d.):
• Posterior longitudinal ligament
• Ligamentum flava
• Interspinous ligaments
Section 7.4—Spinal Joints: Ligaments (cont’d.)
47Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Major Ligaments of the Spinal Joints
(cont’d.):
• Supraspinous ligament
• Intertransverse ligaments
• Nuchal ligament
Section 7.4—Spinal Joints: Ligaments (cont’d.)
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Section 7.4—Spinal Joints: Ligaments (cont’d.)
Provide Stability and Limit Motion:
Figure 7-20
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Section 7.4—Spinal Joints: Ligaments (cont’d.)
Provide Stability and Limit Motion (cont’d.):
Figure 7-20
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Major Muscles of the Spinal Joints:
• Spinal extensors
• Spinal flexors
• Lateral flexors
• Rotators
Section 7.4—Spinal Joints: Muscles
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Section 7.5—Atlanto-Occipital Joint
{Insert Fig. 7-22}
Figure 7-22
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Structure Classification:
• Synovial joint– Condyloid
Function Classification:
• Diarthrotic– Triaxial
Section 7.5—Atlanto-Occipital Joint (cont’d.)
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Major Motions Allowed:
• Flexion and extension
• Right and left lateral flexion
• Right and left lateral rotation
Section 7.5—Atlanto-Occipital Joint (cont’d.)
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Section 7.5—Atlanto-Occipital Joint (cont’d.)
Figure 7-23
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Section 7.5—Atlanto-Occipital Joint (cont’d.)
{Insert Fig. 7-24 A and B}
Figure 7-24
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Section 7.5—Atlanto-Occipital Joint (cont’d.)
{Insert Fig. 7-25 A and B}
Figure 7-25
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Average Ranges of Motion:
• Flexion 5 degrees
• Extension 10 degrees
• Right lateral flexion 5 degrees
• Left lateral flexion 5 degrees
• Right rotation 5 degrees
• Left rotation 5 degrees
Section 7.5—Atlanto-Occipital Joint (cont’d.)
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Section 7.5—Atlantoaxial Joint
Figure 7-26
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Structure Classification:
• Synovial joints– Atlanto-odontoid joint: Pivot joint– Lateral facet joints: Plane joints
Function Classification:
• Diarthrotic– Biaxial
Section 7.5—Atlantoaxial Joint (cont’d.)
60Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Major Motions Allowed:
• Right and left rotation
• Flexion and extension
• Right and left lateral flexion
Section 7.5—Atlantoaxial Joint (cont’d.)
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Average Ranges of Motion:
• Flexion 5 degrees
• Extension 10 degrees
• Right lateral flexion Negligible
• Left lateral flexion Negligible
• Right rotation 40 degrees
• Left rotation 40 degrees
Section 7.5—Atlantoaxial Joint (cont’d.)
62Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Major Muscles of the Occipito-
Atlantoaxial Region:
• Suboccipital group
• Rectus capitis anterior
• Rectus capitis lateralis
Section 7.5—Occipito-Atlantoaxial Region
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Section 7.6—Cervical Spine
Figure 7-30
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Special Vertebrae of the Cervical Spine:
• C1 — atlas
• C2 — axis
• C7 — vertebral prominens
Section 7.6—Cervical Spine (cont’d.)
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Special Characteristics of the
Cervical Vertebrae:
• Transverse foramina
• Bifid spinous processes
• Bifid transverse processes
• Uncinate Processes– Uncovertebral joint
Section 7.6—Cervical Spine (cont’d.)
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Section 7.6—Cervical Spine (cont’d.)
Figure 7-32
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Functions of the Cervical Spine:
• Bears the weight of the head
• Allows movement in all three planes
Section 7.6—Cervical Spine (cont’d.)
68Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Major Motions Allowed:
• Flexion and extension
• Right and left lateral flexion
• Right and left rotation
• Gliding translational movements in all three directions
Section 7.6—Cervical Spine (cont’d.)
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Section 7.6—Cervical Spine (cont’d.)
Figure 7-33
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Section 7.6—Cervical Spine (cont’d.)
{Insert Fig. 7-33 E and F only}
Figure 7-33
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Average Ranges of Motion
(C2-C3 through C7-T1 Joints):• Flexion 40 degrees• Extension 60 degrees• Right lateral flexion 40 degrees• Left lateral flexion 40 degrees• Right rotation 40 degrees• Left rotation 40 degrees
Section 7.6—Cervical Spine (cont’d.)
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Average Ranges of Motion
(C1-C2 through C7-T1 Joints):• Flexion 45 degrees• Extension 70 degrees• Right lateral flexion 40 degrees• Left lateral flexion 40 degrees• Right rotation 80 degrees• Left rotation 80 degrees
Section 7.6—Cervical Spine (cont’d.)
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Average Ranges of Motion
(AOJ and C1-C2 through C7-T1 Joints):• Flexion 50 degrees• Extension 80 degrees• Right lateral flexion 45 degrees• Left lateral flexion 45 degrees• Right rotation 85 degrees• Left rotation 85 degrees
Section 7.6—Cervical Spine (cont’d.)
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Lesson 7.3 Objectives
• List the joints at which rib motion occurs; explain how the movement of a bucket handle is used to describe how rib motion occurs.
• Describe the roles of the muscles of respiration.
• Explain the mechanism of thoracic breathing versus abdominal breathing.
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Lesson 7.3 Objectives(cont’d.)
• Describe the general structure and function of the cervical spine, thoracic spine, and lumbar spine.
• Describe the structure and function of the thoracolumbar fascia and abdominal aponeurosis.
76Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Joints of the Axial Body
• Suture joints
• Temporomandibular joints (TMJs)
• Atlanto-occipital and atlantoaxial joints
• Cervical spinal joints
• Thoracic spinal joints– Rib joints
• Lumbar spinal joints
77Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.
Section 7.7—Thoracic Spine
Figure 7-34
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Costospinal Joints of the Thoracic Spine:
• Costospinal articulations– Costovertebral joint– Costotransverse joint
• Structure classification– Synovial joints
Section 7.7—Thoracic Spine (cont’d.)
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Costospinal Joints of the Thoracic Spine:
• Function classification– Nonaxial
• Functions– Stabilize ribs– Allow ribs to move relative to the spine
Section 7.7—Thoracic Spine (cont’d.)
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Spinal Joints of the Thoracic Spine:
• Major motions allowed
– Flexion and extension
– Right and left lateral flexion
– Right and left rotation
– Gliding translational movements
Section 7.7—Thoracic Spine (cont’d.)
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Average Ranges of Motion
(T1-T2 through T12-L1 Joints):• Flexion 35 degrees• Extension 25 degrees• Right lateral flexion 25 degrees• Left lateral flexion 25 degrees• Right rotation 30 degrees• Left rotation 30 degrees
Section 7.7—Thoracic Spine (cont’d.)
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• Costospinal Joints
• Sternocostal Joints
• Intrasternal Joints
Section 7.8—Rib Joints (More Detail)
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Types of
Costospinal Joints:
• Costovertebral joint
• Costotransverse joint
Section 7.8—Costospinal Joints
Figure 7-35
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Section 7.8—Costovertebral Joint
Structure of the Thoracic Spine:
• Two costal hemifacets per vertebra
• Intervertebral disc
Ligaments of a Costovertebral Joint:
• Fibrous joint capsule
• Radiate ligament
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Section 7.8—Costotransverse Joint
Structure of the Thoracic Spine:
• One full costal facet per vertebra
Ligaments of a Costotransverse Joint:
• Fibrous joint capsule
• Costotransverse ligament
• Lateral costotransverse ligament
• Superior costotransverse ligament
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Section 7.8—Sternocostal Joints
Types of Ribs:
• True ribs
• False ribs
• Floating ribs
Figure 7-36
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Section 7.8—Sternocostal Joints (cont’d.)
Structure Classification:
• Cartilaginous joint– Synchondrosis
Function Classification:
• Amphiarthrotic– Gliding
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Section 7.8—Sternocostal Joints (cont’d.)
Figure 7-37
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Section 7.8—Sternocostal Joints (cont’d.)
Composition of Sternocostal Joints:
• Costochondral joints
• Chondrosternal joints
• Interchondral joints
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Section 7.8—Sternocostal Joints (cont’d.)
Ligaments of the Chondrosternal Joint:
• Fibrous joint capsule
• Radiate ligament
Ligaments of the Interchondral Joint:
• Fibrous joint capsule
• Radiate ligament
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Types of
Intrasternal Joints:
• Manubriosternal joint
• Sternoxiphoid joint
Section 7.8—Intrasternal Joints
Figure 7-37
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Section 7.8—Intrasternal Joints (cont’d.)
Ligaments of the Intrasternal Joints:
• Manubriosternal ligament
• Sternoxiphoid ligament
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Section 7.8—Rib Joints: Movement
Inspiration and Expiration
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Roles of Muscles of Respiration:
• Inspiration– Elevate the ribs– Expand the thoracic cavity downward
• Expiration– Depress the ribs– Expand the abdominal cavity upward
Section 7.8—Rib Joints: Muscles
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Abdominal Breathing:
• Contraction of the diaphragm– Expanding thoracic cavity downward
Thoracic Breathing:
• Further contraction of the diaphragm– Elevating the lower ribs
Section 7.8—Rib Joints: Diaphragm
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Section 7.9—Lumbar Spine
{Insert Fig. 7-38}
Figure 7-38
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Functions of the Lumbar Spine:
• Bears the weight of the body
• Allows movement
Section 7.9—Lumbar Spine (cont’d.)
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Major Motions Allowed:
• Flexion and extension
• Right and left lateral flexion
• Right and left rotation
• Gliding translational movements in all three directions
Section 7.9—Lumbar Spine (cont’d.)
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Special Characteristics:
• Lumbosacral joint– Allows the pelvis to move
relative to the trunk
• Sacral base angle– Determines the curvature
of the spine
Section 7.9—Lumbar Spine (cont’d.)
Figure 7-40
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Average Ranges of Motion(L1-L2 through L5-S1 Joints):• Flexion 50 degrees• Extension 15 degrees• Right lateral flexion 20 degrees• Left lateral flexion 20 degrees• Right rotation 5 degrees• Left rotation 5 degrees
Section 7.9—Lumbar Spine (cont’d.)
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Major Motions Allowed:
• Flexion and extension
• Right and left lateral flexion
• Right and left rotation
Section 7.10—Thoracolumbar Spine
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Section 7.10—Thoracolumbar Spine (cont’d.)
Figure 7-41
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Section 7.10—Thoracolumbar Spine (cont’d.)
Figure 7-41
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Section 7.10—Thoracolumbar Spine (cont’d.)
Figure 7-41
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Average Ranges of Motion(T1-T2 through L5-S1 Joints):• Flexion 85 degrees• Extension 40 degrees• Right lateral flexion 45 degrees• Left lateral flexion 45 degrees• Right rotation 35 degrees• Left rotation 35 degrees
Section 7.10—Thoracolumbar Spine (cont’d.)
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Structure:
• Layer of fascia located in thoracic and lumbar regions
• Located posteriorly in the trunk
• Divided into three layers
Functions:
• Provides attachment sites for muscles
• Adds to the stability of the trunk
Section 7.11—Thoracolumbar Fascia
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Section 7.11—Thoracolumbar Fascia (cont’d.)
Figure 7-42(A, from Cramer GD, Darby SA: Basic and clinical anatomy of the spine, spinal cord, and ANS, ed 2, St Louis, 2005, Mosby.)
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Structure:
• Layers of fibrous connective tissue located in the abdominal region
• Located anteriorly in the trunk
• Left and right aponeuroses
Functions:
• Provides attachment sites for muscles
• Adds to the stability of the trunk
Section 7.11—Abdominal Aponeurosis
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Section 7.11—Abdominal Aponeurosis (cont’d.)
Figure 7-43( From Muscolino JE: The muscular system manual: the skeletal muscles of the human body, ed 3, St Louis, 2010, Mosby.)