vertebral column

BOS..makes us less stable, but more functional

requires more weight be borne by the vertebral column, pelvis, and lower extremities

gravity and stress on soft tissues

• base of support for the head and internal organs
• base of attachment for ligaments, bones, muscles, rib cage, and pelvis
• link between upper and lower extremities
• protection for spinal cord

• decrease shock
• maintain balance in an upright position
• help protect the vertebral column from fractures

gastrocnemius and soleus

• ear lobe
• shoulder joint
• just anterior to bodies of thoracic vert.
• through S2
• slightly posterior to hip joint
• through greater trochanter
• slightly ant. to midline of knee, but posterior to patella
• slightly anterior to lateral malleolus

• head upright
• symmetrical shoulder height
• position of scapula from s.p. are even
• straight verterbral column
• symmetrical height of iliac crest and PSIS
• no varus or valgus of feet
• no pronated or supinated feet

• head in midline and upright
• nose, sternum, umbilicus line midline
• heights of iliac crest and ASIS even
• position of patella normal

• rotation
• flexion
• extension (hyperextension)
• SB

roation and flexion/extension

• SB
• trunk flex/ext

• anterior pelvic tilt
• abdomen protrudes infront of plumb line
• tightness of hip flexors

sway back...pelvic segment forward, thoracic segment backward

• posterior pelvic tilt
• hamstring tightness

decreased thoracic kyphosis

• head lies anterior to plumb line
• excessive cervical lordosis
• tightness of cervical extensors muscles

• shoulder lie ant. to plumb line
• weakness in thoracic spinal extensor musculature, rhomboids, middle trap, tightness of pec mm. and subscap. mm.

lateral SB accompanied by rotation

• functional
• structural

functional

not progressive

structural

progressive..not corrected

direction of convexity

if more than one curve is present, the superior segment is named first

• unequal waist angle
• unequal shoulder height
• rib hump
• unequal pelvic height

SB and rotation is a coupled motion in the spine, they must happen together

• scoliosis
• musculature imbalance

• elongation of structures that have been subject to tension (stretching..wolfes law)
• weakening of elongated muscles (disturbance of length/tension relationship)
• weakening of elongaed ligaments (loss of passive resistance)

• adaptive shortening of structures held in shortened position
• decreased ROM due to restriction caused by shortened structures

• maintenance of faulty posture by shortened structures (stuck in the position)
• degeneration of articular cartilage due to abnormal weight bearing

*usually anatagonists of the elongated structures are shortened

spondylosis

spondylolysis

spondylolisthesis

avoid extension motions, flexion is better

• press down on top of pt head while sitting or lying down
• compression may reproduce pain referred to the upper extremity from the cervical spine, and help locate the neurological level of existing pathology

• have pt hold breath and bear down as they were having a BM
• tests the intrathecal pressure
• if a herniated disc or tumor is present is the cervical canal, the pt may develop pain in the cervical spine secondary to the increased presure

• take radial pulse, continue to feel pulse, abduct, extend, and ER arm
• instruct to take a deep breath and turn head toward the arm being tested
• if theres a compression of the subclavian artery, you will feel a marked diminution or absence of radial pulse

subclavian artery can be compressed by an extra cervical rib or tightened scalenus m.

• lay supine, lift leg upward by supporting at calcaneous, keep knee straight
• if painful, must determine if problems are in sciatic nerve or bc of hamstring tightness

• HS tightness-only posterior thigh, sciatic n.- extends all the way down the leg
• at the point where the pt exeperiences pain, lower leg slightly and then DF the foot to stretch the sciatic n. and reproduce sciatic pain (if no pain with DF, pain is probably from HS)

• have pt bear down like having a BM
• increased intrathecal pressure
• used to determine pathology of disc

L5-S1

• dont bend, lift, and twist in combination
• plan lift before performing
• dont jerk
• maintain good posture (pelvic neutral)
• get close, and stay close
• stagger your stance when reaching