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OTA 130 - Kinesiology > Head, Neck and Trunk > Flashcards

Flashcards in Head, Neck and Trunk Deck (34)
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Head and Neck Muscles’ Motion

Head and neck muscles allow for motion in all three planes. Motions are:
• Flexion (sagittal)
• Extension (sagittal)
• Lateral Flexion (frontal)
• Rotation (transverse)


Bones of the Neck

• 7 Cervical Vertebrae (C1–T1)
• C1 = Atlas
• C2 = Axis


Atlas vs. Axis

Two top-most vertebrae of neck. C1 and C2. Different from other vertebrae as they have no body and no disk between.

ATLAS: C1; articulates with occipital process of skull for flexion/extension (“YES”)

AXIS: C2; articulates with Atlas for rotation motion (“NO”)


Cervical Vertebrae

• Bear less weight than thoracic/lumbar
• More mobile; ½ of cervical rotation occurs at C1-C2
• C1 has extra space for spinal cord
• Body (wider, interior flat bone area) smaller than lower vertebrae


Vertebral Design

All vertebrae have similar structural design, but regional variation in size/configuration.
• Increase in size from Cervical to Lumbar, then decrease in size from Sacral to Coccygeal
• TRABECULAR SYSTEM: made of system of vertical, horizontal and oblique fibers that correspond to stress placed on body; pattern determines “hardness” of that area of vertebra


Intervertebral Disks

Round, fibrous gel-like disks located between the vertebrae (all but C1-C2).
• Shock absorbers and increase flexibility/mobility of spine
• ~25% of vertebral column height
• 3-9mm thick
• 2 parts: Nucleus Pulposus (gel center) and Annulus Fibrosis (outer fibers)
• Wedge-shaped to contribute to spinal curves in cervical and thoracic regions
• Nutrition occurs through osmosis, not directly (poor blood supply/slow healing)
• Herniation occurs when compressed (HNP=herniated nucleus pulposus)
• Degeneration begins ~age 20; gradual loss of water in nucleus; progressive fibrosis (hardening)


Number of muscles in head and face

Over 50 muscles are in the head and face. They are more than 1/5 of total muscles in body.


Brachial Plexus

Nerves C5 to T1; nerves for arms
• Provides neuromuscular protection and redundancy (if one nerve is damaged, another might take its place)
• Peripheral nerves of UE originate from brachial plexus
• System of trunks, divisions and cords which terminate in individual nerves (terminal branches)
• Originates in ventral rami of lower cervical spine (C5-T1)
• Mixed nerves that carry both sensory/motor


Ramus vs. Trunk

In Brachial Plexus, RAMUS is where nerve exits the spinal cord, and multiple rami come together to form 3 TRUNKS:
• Superior (C5 and C6)
• Middle (C7)
• Inferior (C8 and T2)


Trunk vs. Division

In Brachial Plexus, TRUNK is where rami come together. Trunk then branches into 3 DIVISIONS:
• Anterior (middle and superior trunks)
• Posterior (superior, middle and inferior)
• Inferior (inferior trunk)


Division vs. Cord vs. Terminal Branch

In Brachial Plexus, the DIVISIONS end in 3 different CORDS, which provide pathways for the terminal branches laterally, posteriorly and medially along arm. TERMINAL BRANCHES:
• Posterior Cord (branches to thoracodorsal, radial, axillary, subscapular)
• Lateral Cord (to lateral pectoral, musculocutaneous)
• Medial Cord (to medial pectoral, ulnar)
** Lateral cord joins with medial cord to form median nerve


Brachial Plexus Injuries

• Can have brachial plex injuries and be otherwise healthy.
• Only affects one arm (not like spinal cord injury SCI)
• Unless disabled by pain, remain active and can carry out ADLs one-handed
• May prefer to use sound limb and remain one-handed
• May lose sensory feedback from skin, muscles and joints; may need to be aware of insensate skin!


Muscle Contracture

When nerve injury causes muscle to get “stuck.” Ex: if wrist extensors are gone, you can flex but can’t go back (stays flexed).


Neurologic Impairment with loss of C5-6 (top of brachial plexus)

• Motor Deficit: shoulder abd and flexion; elbow flexion; wrist extension
• Sensory Loss: lateral arm, forearm, thumb/index fingers
• Functional Need: support shoulder; prevent subluxation; flex elbow


Order of nerve breakdown in brachial plexus (proximal to distal)

Ramus > Trunk > Division > Cord > Terminal Branch


Neurologic Impairment with loss of C6-7 (mid brachial plexus)

• Motor Deficit: shoulder abd and flexion; elbow flexion; wrist extension (same as C5), but also add elbow/wrist/finger extension weakness
• Sensory Loss: lateral arm, forearm, thumb/index fingers (same as C5), but also add middle finger
• Functional Need: support shoulder; prevent subluxation; flex elbow (same as C5), but also add support for wrist/finger/thumb extension


Neurologic Impairment with loss of C8-T1 (lower brachial plexus)

• Motor Deficit: Wrist/finger/thumb flexors; finger/thumb extensors
• Sensory Loss: Little/ring fingers; medial forearm
• Functional Need: Wrist stabilization; finger flex/extend; intrinsic function


Neurologic Impairment with loss of C5-T1 (all of brachial plexus)

• Motor Deficit: “flail arm”; no muscle control (+/- scapula)
• Sensory Loss: total forearm; lateral arm; entire hand
• Functional Need: Support and protect limb (wear a sling)


ROM for Head and Neck

• Difficult to measure, as there are few bony landmarks and soft tissue overlying.
Normal ROMs:
• Capital Extension: 0-25˚
• Capital Flexion: 0-15˚
• Cervical Extension: 0- <30˚
• Cervical Flexion: 0-45˚
• Capital + Cervical Extension: 0-45˚

**NOTE: OTA domain does not include MMT for head/neck so we don’t need to know this.


Movements of Lower Back

Moves in three planes:
• Flexion/Extension (sagittal)
• Lateral Flexion/Bending and Reduction/Return (frontal)
• Rotation (transverse)


Thoracic Vertebrae

Bones of upper/mid back. T1-T12.
• Each articulates with a pair of ribs
• Less flexible and more stable than cervical
• Rotation-free in upper area, and decreases caudally


Curves of Spine

• Cervical Curve (lordotic)
• Thoracic Curve (kyphotic)
• Lumbar Curve (lordotic)
• Pelvic Curve (kyphotic)


Lumbar Vertebrae

Largest vertebrae of lower back.
• Holds the most weight above
• L5 is a transitional segment; body is wedge-shaped to connect with sacrum
• L5 creates biggest curve/can cause spondylosis if out of place
• L4-L5 are usually where injury occurs



Five fused vertebrae below lumbar spine.
• Sacroiliac Joints: support HAT (head, arms, trunk); smooth motion in all directions in childhood, decreased motion later as surfaces change. Supported by 4 groups of ligaments.


ROM of Trunk

• Thoracic Spine Extension: 0˚
• Lumbar Spine Extension: 0˚ to 25˚
• Trunk Flexion: 0˚ to 80˚
• Trunk Rotation: 0˚ to 45˚


Pelvic Girdle

• Joins lower skeleton to upper body via the lumbrosacral joint.
• Movements include:
- Anterior tilt (ASIS anterior to pubic symphysis/inferior to PSIS; swayback)
- Posterior tilt (ASIS posterior to pubic symphysis/superior to PSIS; butt tuck)
- Lateral tilt (Iliac crest moves superior/inferior relative to contralateral side; one side rises)



ASIS = anterior superior iliac spine (top front points of pelvis)

PSIS = posterior superior iliac spine (top back points of pelvis)



Head, Arms, Trunk


Neutral Pelvic Tilt when Seated

• Pelvis midway between anterior/posterior tilt
• Equal weight on both femurs
• Erect spine/normal lordosis
• Head aligned over hips


Anterior Pelvic Tilt

When pelvis dips/tilts forward, lifting the buttocks upward.