The Spinal Column & Thorax

Spinal Column Functions

1. Provides stability
2. Permits movement in all directions
3. Supports structures of considerable weight
4. Provides attachments for tendons & ligaments
5. Transmits forces to the pelvis
6. Acts as a shock absorber
7. Encases & protects the spinal cord

Spinal Column Features

Our focus:
Spinal column as a mechanism of maintaining posture
& permitting movement of the head, neck & trunk

Examine the trunk as a whole

Evaluate the different regions of the trunk
Cervical (7 vertebrae)
Thoracic (12 vertebrae)
Lumbar (5-6 vertebrae)
Sacrum (5 fused vertebrae)
Coccyx (3-5 fused vertebrae)

Spinal Column Features

Spinal Curves
Primary Curves
Thoracic
Convex to
The rear
Sacrococcygeal
Secondary Curves
Cervical
Convex to
The front
Lumbar
2ndary curves develop in infancy in response to gravity
Head holding
Upright posture & mobility

Spinal Column Features

Exaggerated curvature
Kyphosis- thoracic
Lordosis- lumbar
Scoliosis- lateral

Vertebrae become larger from cervical to

lumbar regions
Greater weight-bearing potential

Sacrum (part of the pelvic girdle) transfers

weight to the femoral head

Spinal Column Articulation

Articulation of the Vertebral Bodies
= cartilaginous joints
Joined by fibrocartilaginous discs
Shock absorption
Permits movement
Larger discs= greater motion
Fibrous outside, pulpy inside
Dehydrate with age
Ligamentous Reinforcement
Anterior longitudinal & posterior longitudinal
ligaments
Connect vertebral bodies to each other

Spinal Column Articulation

Articulation of Vertebral Arches (Facets)
= non-axial diarthrodial joints
Articular cavity
Joint capsule
Slight gliding motion (few degrees)
Cumulative joint motion = great spinal ROM
Orientation of facets
Changes: cervical, thoracic, lumbar

Spinal Column Articulation

Atlanto-Occipital Articulation
Skull & neck
Pair of joints
Lateral condyles on base of occipital bone of skull
articulate with superior fossa of the atlas
Condyloid joints
Flexion, extension, limited lateral flexion
NO rotation

Atlantoaxial Articulation
Pivot joint
Dens of axis projects upward into the anterior arch of atlas
Atlas (+ skull) rotates on the axis

Movements of the Spinal Column

Flexion
Forward bending in saggital plane (bilateral axis)
Cumulative gliding motion of articular processes
Greatest in the lumbarsacral joint, lumbar & cervical
regions
Compresses anterior portion of discs

Movements of the Spinal Column

Extension & Hyperextension
Return from flexion & backward bending
Saggital plane (bilateral axis)
Greatest in lumbar sacral junction, cervical & lumbar
regions
Limited in thoracic region
Impeded by spinous processes

Movements of the Spinal Column

Lateral Flexion
= sideways bending in the frontal plane (AP axis)
Greatest in the lumbar & cervical regions
Limited in thoracic region by ribs
Always accompanied by some rotational movement
between vertebrae

Movements of the Spinal Column

Rotation
= rotary movement in the transverse plane (vertical
axis)
R or L rotation refers to the arrangement of the UPPER
spine in relation to the lower spine
Turning head & shoulders to Ror
Turning legs & pelvis to the L
Accompanied by some lateral flexion (ipsilateral)
Greatest at atlantoaxial joint & thoracolumbar
junction
Very limited I lumbar region

Factors that Affect Stability & ROM

1. Active stability
Muscle action drives spinal stability
Requires trunk muscles to work together
Position, loading, breathing pattern
Voluntary & reflex controlfeedback loops

2. Passive stability
Vertebral discs push vertebrae apart & ligaments pull
vertebrae together
Discs are shockabsorbers
Greater ROM where discs are thicker

Factors that Affect Stability & ROM

3. AP Curves
Influence nature of motion
Influence ROM
Varies by region

4. Thickness & Strength of Ligaments

Most spinal ligaments work to limit flexion
Varies by region

5. Orientation of facets
Varies by region

Factors that Affect Stability & ROM

6. Orientation of Spinous Processes
Overlapping, downward arrangement in thoracic
spine limits hyperextension
More horizontal and parallel in lumbar region

7. Articulation with Ribs

Limits lateral flexion in thoracic region

Muscles Operating the Spinal Column

Most have > 1 attachment on the spinal column or skull
Exceptions: abdominal & hyoid muscles

Anterior Aspect
Cervical: prevertebral & hyoid muscles
Thoracic & lumbar: abdominal muscles

Posterior Aspect
Cervical: splenius & suboccipital muscles
Thoracic & lumbar: erector spinae, deep posterior & semispinalis
muscles

Lateral Aspect
Cervical: scalenes, sternocleidomastoid & levator scapulae
Thoracic & lumbar: quadratus lumborum & psoas major

Functional Characteristics of
Individual Muscles: Anterior Aspect
Cervical Region: Prevertebral Muscles (4)
= longus colli- upper thoracic vertebrae to atlas
longus capitis- lower cervical vertebrae to
occipital
rectus capitis anterior- atlas to skull
rectus capitis lateralis- atlas to skull
Flex head & neck, lateral flexion,
contralateral rotation
Exception: longus colli- acts only on neck
during resisted flexion, resisted lateral flexion,
ipsilateral rotation

Functional Characteristics of
Individual Muscles: Anterior Aspect
Cervical Region: Hyoid Muscles (8)
= 4 suprahyoids & 4 infrahyoids
Resisted flexion of head & neck, swallowing
strap muscles

Functional Characteristics of
Individual Muscles: Anterior Aspect
Thoracic & Lumbar Regions:
Abdominal Muscles (4)
1. Obliquus Externus
Fibers run diagonally upward &
outward from lower abdomen
Spinal flexion, ipsilateral lateral
flexion, contralateral rotation
Most heavily activated in supine
position
Stabilizes spine during loading &
lower limb motion

Functional Characteristics of
Individual Muscles: Anterior Aspect
Thoracic & Lumbar Regions: Abdominal
Muscles (4)
2. Obliquus Internus
Fibers run diagonally
upward and inward from ilium to rib
cartilages & sternum,
horizontally toward linea alba,
inward & downward to pubic crest
Flexion, lateral flexion, ipsilateral
rotation

Functional Characteristics of
Individual Muscles: Anterior Aspect
Thoracic & Lumbar Regions: Abdominal Muscles (4)
3. Rectus Abdominis
Fibers run vertically on either side of linea alba from
pubis to chest
Most superficial abdominal muscle
Flexion, lateral flexion
With pelvis stabilized
Upper: trunk flexion
With ribs stabilized
Lower: posterior pelvic tilt
Enclosed within aponeurosis of abdominal wall
Horizontal tendinous inscriptions

Functional Characteristics of
Individual Muscles
Thoracic & Lumbar Regions: Abdominal Muscles (4)
4. Transversus Abdominis
broad sheet of fibers that run horizontally from
thoracolumbar fascia & lower rib cartilages to linea
alba
Inward compression of abdominal wall, ipsilateral
roation & trunk stabilization
Mediates intra-abdominal pressure

Abdominal Muscles as Spine Flexors

Internal & external obliques + rectus abdominis
coordinate to flex the trunk
Against resistance
Against gravity (supine position)
Stabilize pelvis against hip flexor action
Static contraction during pelvic stabilization without
spinal flexion
If abdominal muscles fatigue during pelvic
stabilization, abdominal muscles eccentrically
lengthen resulting in anterior pelvic tilt

Abdominal Wall & Trunk Stability

Internal & external obliques + rectus abdominis +
transverse abdominis = anterior abdominal wall
Provide strong anterior support for viscera
Can be stretched if weak, with gravity

Co-contraction of abdominal wall muscles

increases intra-abdominal pressure
Increases stiffness of the trunk
Increases load carrying capacity of the trunk
Prevents buckling of spine under loading

Trunk muscle arrangement

Functional Characteristics of
Individual Muscles: Posterior Aspect
Cervical ONLY
Splenius
Cervicis- connects thoracic & cervical vertebrae
Capitis- connects cervical vertebrae & skull
Central inferior attachments to more lateral superior
attachments
Bilateral: head & neck extension
Unilateral: head & neck lateral flexion & ipsilateral
rotation
Actively support head in upright posture

Functional Characteristics of
Individual Muscles: Posterior Aspect
Cervical ONLY
Sub-Occipital Muscles
4 short muscles that connect the axis or atlas with
the occipital bone
Rectus capitis posterior minor & major
Obliquus capitis superior & inferior
Bilateral: extension & hyperextension of head
Unilateral: lateral flexion or ipsilateral rotation of the
head

Functional Characteristics of
Individual Muscles: Posterior Aspect
Cervical, Thoracic, and Lumbar
Erector Spinae
Commences as a large mass in the lumbarsacral
region and divides into 3 branches moving upward
1. Iliocostalis Branch
2. Longissimus Branch
3. Spinalis Branch
Attachments on the ribs, transverse processes of
thoracic & cervical vertebrae, & mastoid processes
NOT a major contributor to erect standing posture
Contracts eccentrically w/ forward bending &
concentrically with return to standing

Functional Characteristics of
Individual Muscles: Posterior Aspect
Cervical, Thoracic & Lumbar
Erector Spinae
Bilateral: extension of head &
spine
Unilateral: lateral flexion &
ipsilateral rotation
Most active during resisted
extension, hyperextension, &
lateral flexion

Functional Characteristics of
Individual Muscles: Posterior Aspect
Cervical, Thoracic & Lumbar
Deep Posterior Muscles
Small, connect adjacent
vertebrae
Bilateral: extension &
hyperextension of spine
Unilateral: lateral flexion &
contralateral rotation

Functional Characteristics of
Individual Muscles: Posterior Aspect
Cervical, Thoracic & Lumbar
Semispinalis
Deep to erector spinae
Bilateral: extension & hyperextension
Unilateral: lateral flexion & contralateral
rotation

Functional Characteristics of
Individual Muscles: Lateral Aspect
Scalenes
Diagonal attachment of lateral aspect of top 2 ribs
to transverse processes of cervical vertebrae
Bilateral: neck flexion
Unilateral: lateral flexion & extension

Functional Characteristics of
Individual Muscles: Lateral Aspect
Sternocleidomastoid
Connects superior surface of sternum & medial
clavicle to mastoid (temporal) process
Bilateral: head & neck flexion
Unilateral: head & neck lateral flexion &
contralateral rotation

Functional Characteristics of
Individual Muscles: Lateral Aspect
Quadratus Lumborum
Situated behind abdominal cavity
Extends medially from iliac crests to transverse
processes of lumbar vertebrae and lower ribs
Bilateral: spine & pelvic stabilization
Unilateral: lateral spinal flexion
Assists in stabilizing the trunk during walking

Functional Characteristics of
Individual Muscles: Lateral Aspect
Psoas
Situated behind the abdominal cavity
With the QL, makes up the posterior abdominal wall
Primarily a hip muscle (major)
Connects femur & pelvic girdle with lateral lower
thoracic (T12) & lumbar vertebral bodies &
transverse processes
Bilateral: spinal stabilization
Unilateral: lateral flexion

Muscular Analysis of Fundamental

Movements: Head & Cervical Spine
Atlanto-occipital Joint & Cervical Spine
Flexion
Sternocleidomastoid
Scalenes
Prevertebral muscles
Hyoid muscles (asst.)

Extension & Hyperextension

Splenius
Erector spinae
Semispinalis
Deep posterior muscles
Suboccipitals
Trapezius (asst.)

Muscular Analysis of Fundamental

Movements: Head & Cervical Spine
Lateral Flexion- co-contraction of flexors & extensors
on same side
Splenius
Erector spinae
Semispinalis
Scalenes
Sternocleidomastoid
Suboccipitals (asst.)
Deep posterior muscles (asst.)
Levator scapulae (asst.)

Muscular Analysis of Fundamental

Movements: Head & Cervical Spine
Rotation
Sternocleidomastoid
Contralateral Side
Deep posterior muscles
Splenius
Ipsilateral Side
Erector Spinae
Suboccipitals

Muscular Analysis of Fundamental

Movements: Thoracic & Lumbar Spine
Flexion
Rectus Abdominis
Internal Obliquus
External Obliquus
Hip flexors (asst. in pelvic stabilizaiton
Extension & Hyperextension
Erector spinae (especially from prone position)
Semispinalis
Deep posterior muscles

Muscular Analysis of Fundamental

Movements: Thoracic & Lumbar Spine
Lateral Flexion
Erector Spinae
Internal Obliquus
External Obliquus
Quadratus lumborum
Semispinalis (asst.)
Rectus abdominis (asst.)
Deep posterior muscles (asst.)
Psoas (asst.)
Latissimus dorsi (asst.)

Muscular Analysis of Fundamental

Movements: Thoracic & Lumbar Spine
Rotation
Erector spinae
Ipsilateral Side
Internal obliquus
External obliquus
Semispinalis
Contralateral Side
Deep posterior muscles
Latissimus dorsi (asst.)