Transcript TRUNK FLEXION

3 Movements of the Trunk
Flexion
Rotation
Extension
TRUNK FLEXION
TRUNK FLEXION: Rectus Abdominalis
• O: Crest of Pubis &
ligaments covering front of
symphysis pubis.
I: By «3 portions into
cartilages of 5th, 6th & 7th
ribs.
• N: Lower intercostal nerves.
• Accessory Ms.:
• Internal Obliques & external
obliques (reverse action).
TRUNK FLEXION: ROM
•
In backlying: flex. of
thorax on pelvis is
possible until scapulae
are raised from the table.
•
Motion is mainly at the
thoracic spine.
Fixation:
1) Reverse action of hip
flexor muscles.
2) Weight of legs and pelvis.
TRUNK FLEXION: Rectus Abdominalis
Limited ROM if:
• Tension of the posterior longitudinal
ligament, ligamenta flava & interspinal
& infraspinal ligaments.
• Tension of the spinal extensor
muscles.
• Apposition of lower lips of vertebral
bodies anteriorly with surfaces of
subjacent vertebrae.
• Compression of intervertebral
fibocartilages in front.
• Contact of lower ribs with abdomen.
Each vertebra is made up of
TRUNK FLEXION: Testing Grade 1-0
• Note: observe deviation of
umbilicus.
• Upward movement indicates
stronger contraction of upper
section muscle,
& downward movement, stronger
contraction of lower section.
Trunk Rotation: Internal & External Oblique
External Oblique:
• O: 8 digitations from
external surfaces &
inf. borders of lower 8
ribs.
• I: Ant. ½ of iliac crest
& aponeurosis to
pubic tubercle.
• N: Lower intercostals.
Trunk Rotation: Internal & External Oblique
Internal Oblique
• O: lateral half of upper
surface of inguinal
ligament, anterior 2/3
of iliac crest.
• I: Crest of pubis, linea
alba, inf. bordres of
cartilages of 3 last ribs.
• N: Lower intercostals.
Trunk Rotation: Int. & Ext. Oblique: ROM
ROM in backlying: until
scapula on side of forward
shoulder is raised from
Fixation:
table.
• Reverse action of hip
Limited by:
flexors.
• Tension of annulus fibrosus
between vertebrae.
• Tension of oblique
abdominal muscles on side
opposite to those being
tested.
• In thoracic area, tension of
the costovertebral
ligaments.
In Lumbar area, interlocking
of articular facets.
• Accessory muscles:
–
–
–
–
–
Lattissimus Dorsi.
Semispinalis.
Multifidus.
Rotatores
Rectus abdominis
(combined trunk
rotation & flexion).
Facet joints:
Inter-vertebral disc (IVD):
Trunk Rotation: Int. & Ext. Oblique: Gr. 1 & 0
• Note: Observe deviation
of umbilicus, which will
move towards the
strongest quadrant if
there is a difference in
strength of opposing
oblique muscles.
Trunk Extension
5 muscles:
• Iliocostalis Dorsalis
• Longissimus dorsi
• Spinalis dorsi
• Iliocostalis lumborum
• Quadratus lumborum
• Sacrospinalis
Trunk Extension
Accessory muscles:
• Semispinales
• Rotatores
• Multifidus.
ROM:
• Thoracic spine extends only to
approximately a straight line.
• Lumbar spine extends freely.
Fixation:
• Contraction of gluteus max. &
hamstring muscles.
• Weight of pelvis & legs.
•
Limitation of ROM:
• Tension of anterior
Longitudinal ligament of spine.
• Tension of ant. Abdominal
Muscles
• Contact of spinous processes.
• Contact of inf. articular margins
with laminae.
Thoracic Spine