joseph e. muscolino, dc instructor, purchase college state university of new york owner, the art and...

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

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Chapter 7:Joints of the Axial BodyJoseph E. Muscolino, DC

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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.

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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.

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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

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Section 7.1—Suture Joints

Figure 7-1

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Structure Classification:

• Fibrous joint– Suture joint

Function Classification:

• Synarthrotic

Major Motions Allowed:

• Nonaxial

Section 7.1—Suture Joints (cont’d.)

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Section 7.2—Temporomandibular Joints

{Insert Fig. 7-2}

Figure 7-2

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Structure Classification:

• Synovial joint– Modified hinge

Function Classification:

• Diarthrotic– Uniaxial

Section 7.2—Temporomandibular Joints

(cont’d.)

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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

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Section 7.2—Temporomandibular Joints

(cont’d.)

{Insert Fig. 7-5 A and B}

Figure 7-5

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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.)

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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

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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

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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.)

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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.

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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

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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.)

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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

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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

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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.)

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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.)

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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.)

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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.)

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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 7.6—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.

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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

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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.)