Neck and Trunk

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Neck and Trunk
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Vertebral Curves

• The vertebrae are arranged in such a way as to
  form anterior-posterior (concave-convex) curves
  in the vertebral column, which can be seen from
  the side. These curves provide the vertebral
  column with much more strength and resilience,
  approximately 10 times more than if it were a
  straight rod.

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Spinal column

• 7 cervical vertebrae
• 12 thoracic vertebrae
• 5 lumbar vertebrae
• Sacrum is composed of 5 fused vertebrae

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Joint Motions

• The vertebral column is considered triaxial, with
  motion in all three planes
• Flexion
• Extension
• Hyperextension
• Lateral bending
• Rotation

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Cervical Spine

• Atlanto-occipital joint articulation between the
  head and C1 (atlas)
• Primary motion is flexion and extension, however,
  rotation also occurs between the atlas and axis,
  with articulation between the dens of the axis
  and atlas permitting rotation movement.

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Common Vertebral Column Pathologies

• Thoracic outlet syndrome compression of brachial
  plexus and subclavian artery and vein that runs
  from neck to axilla. The thoracic outlet is
  located between the first rib, clavicle and
  scalene muscles.
• Torticollis twisted neck head is laterally
  bent to one side and rotated toward the opposite
  side
• Sciatica pain that runs down the posterior thigh
  and leg, d/t pressure on the sciatic nerve
• Lordosis abnormally increased curve of the
  lumbar spine (swayback)
• Flat back abnormally decreased lumbar curve
• Kyphosis abnormally increased thoracic curve
• Scoliosis any amount of lateral curve in spinal
  column

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Common Vertebral Column Pathologies

• Spondylosis degenerative disorder of the
  vertebral structure and function, which may lead
  to nerve root and spinal cord compression
• Spinal stenosis a narrowing of the vertebral
  canal
• Herniated disks weakness or degeneration of the
  annulus fibrosus, allowing a portion of the
  nucleus pulposus to bulge (herniated) through the
  annulus. Symptoms occur when herniation places
  pressure on spinal cord or nerve root. L4 and L5
  are most common sites for disk lesions.
• Spondylolysis vertebral defect in the pars
  interarticularis (the part of the lamina between
  the superior and inferior articular processes).
• Spondylolisthesis one vertebra slips forward in
  relation to an adjacent vertebra (commonly L5
  slipping anterior on S1)
• Osteoporosis disease in which bone is removed
  faster than it can be laid down, leading to a
  decrease in bone mass and density

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Muscles of the Neck and Trunk

• Neck
• Sternocleidomastoid
• Scalenes
• Prevertebral group (4)
• Erector spinae group (3)
• Splenius capitis
• Splenius cervicis
• Suboccipital group (4)

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Muscles of the Neck and Trunk

• Trunk
• Rectus abdominis
• External oblique
• Internal oblique
• Transverse abdominis
• Erector spinae group (3)
• Transversospinalis group (3)
• Interspinales
• Intertransversarii
• Quadratus lumborum

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Sternocleidomastoid
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Sternocleidomastoid

• O Sternum and clavicle
• I Mastoid process
• A Bilaterally flexes neck, hyperextends head
• Unilaterally laterally bends the neck
  rotates head to opposite side
• N Accessory nerve (cranial nerve XI) second and
  third cervical nerves

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Scalene
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Scalene

• O Transverse processes of the cervical vertebrae
• I First and second ribs
• A Bilaterally assists in neck flexion
• Unilaterally neck lateral bending
• N Lower cervical nerve

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Prevertebral Group
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Longus colli

• O Bodies and transverse processes of C3-T2
• I Transverse processes and bodies of C1-C6
• A Flex neck

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Longus capitis
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Longus capitis

• O Transverse processes of C3-C6
• I Occipital bone
• A Flex head

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Rectus capitis anterior
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Rectus capitis anterior

• O Atlas
• I Occipital bone
• A Flex head

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Rectus capitis lateralis
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Rectus capitis lateralis

• O Transverse process of atlas
• I Occipital bone
• A Laterally bends head

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Suboccipital Muscles
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Suboccipital Muscles

• Obliquus capitis superior extension
• Obliquus capitis inferior extension, lateral
  bending, rotation to the same side
• Rectus capitis posterior minor extension
• Rectus capitis posterior major extension,
  lateral bending, rotation to the same side
• All suboccipital muscles are located posteriorly

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Splenius Capitis
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Splenius Capitis

• O Lower half of nuchal ligament spinous
  processes of C7 through T3
• I Lateral occipital bone mastoid process
• A Bilaterally extend head and neck
• Unilaterally rotate and laterally bend the
  head to same side
• N Middle and lower cervical nerves

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Splenius Cervicis
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Splenius Cervicis

• O Spinous processes of T3 thorugh T6
• I Transverse processes of C1 through C3
• A Bilaterally extend neck
• Unilaterally rotate and laterally bend the
  neck to same side
• N Middle and lower cervical nerves

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Muscles of the Trunk
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Rectus Abdominis
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Rectus Abdominis

• O Pubis
• I Xiphoid process and costal cartilages of
  fifth, sixth, and seventh ribs
• A Trunk flexion compression of abdomen
• N Seventh through twelfth intercostal nerves

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External Oblique
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External Oblique

• O Lower eight ribs laterally
• I Iliac crest and linea alba
• A Bilaterally trunk flexion compression of
  abdomen
• Unilaterally lateral bending rotation to
  opposite side
• N Eighth through twelfth intercostal,
  iliohypogastric, and ilioinguinal nerves

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Internal Oblique
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Internal Oblique

• O Inguinal ligament, iliac crest, thoracolumbar
  fascia
• I Tenth, eleventh, and twelfth ribs abdominal
  aponeurosis
• A Bilaterally trunk flexion compression of
  abdomen
• Unilaterally lateral bending rotation to
  same side
• N Eighth through twelfth intercostal,
  iliohypogastric, and ilioinguinal nerves

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Transverse Abdominis
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Transverse Abdominis

• O Inguinal ligament, iliac crest, thoracolumbar
  fascia, and last six ribs
• I Abdominal aponeurosis and linea alba
• A Compression of abdomen
• N Seventh through twelfth intercostal,
  iliohypogastric, and ilioinguinal nerves

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Erector Spinae Muscles

• Iliocostalis
• Longissimus
• Spinalis

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Erector Spinae Muscles
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Erector Spinae Muscles

• O Spinous processes, transverse processes and
  ribs from the occiput to the sacrum and ilium
• I Spinous processes, transverse processes and
  ribs from the occiput to the sacrum and ilium
• A Bilaterally extend
• Unilaterally lateral bend
• N Spinal nerves

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Transversospinalis Muscles
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Transversospinalis Muscles

• O Transverse processes
• I Spinous processes of vertebra above
• A Bilaterally extend
• Unilaterally rotate to opposite side
• N Spinal nerves

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Interspinales Muscles
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Interspinales Muscles

• O Spinous process below
• I Spinous process above
• A Trunk extension
• N Spinal nerves

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Intertransversarii Muscles
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Intertransversarii Muscles

• O Transverse process below
• I Transverse process above
• A Trunk lateral bending
• N Spinal nerves

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Quadratus Lumborum
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Quadratus Lumborum

• O Iliac crest
• I Twelfth rib, transverse processes of all five
  lumbar vertebrae
• A Trunk lateral bending
• N Twelfth thoracic and first lumbar nerves
• Hip hiking (elevation) of one side of the
  pelvis

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