ch.9

• Vertebral column


  • Triaxial movement
• Movements of the vertebral column

  1. Flexion/extension = sagittal plane, frontal axis

  2. Lateral flexion (side or lateral bending) = frontal plane, sagittal axis

  3. Rotation = horizontal plane and vertical axis
• Atlanto-occipital Joint (C1 and Occiput)


  Provides flexion, extension, minimal lateral flexion
• Axial extension "tucking in your chin"

  AO joint flexes and C2-C7 extends
• Axial flexion "cervical protraction"


  AO joint extends and C2-C7 flex
• Atlantoaxial Joint (C1 and C2)


  Provides the movement of cervical rotation
• Shaking the head "no"
• AA rotation may be accompanied by cervical spine rotation
• Muscles having the most control over moving head on the neck

  Prevertebral muscles anteriorly and suboccipital muscles posteriorly
• Cervical Spine (C2 and C7)

  • Movement in all 3 planes and 3-axis
  • Lateral portion of the facet is anterior to the medial portion of the facet
  • Facet allows angulation of facet surfaces allows movements within all 3 planes
• Lumbar Spine (L1-L5)


  • Orientation of facets on sagittal plane
  • Intervertebral movement is primarily flexion and extension, slight lateral flexion, no rotation
• Sternocleidomastoid muscle


  • Origin: Sternum and clavicle
  • Insertion: mastoid process
  • Actions: Bilaterally: head and neck flexion
  • Unilaterally: lateral neck flexion to same side; rotation of head to opposite side
  • Accessory muscle of ventilation
  • Nerve: accessory nerve (cranial nerve XI); 2nd and 3rd cervical nerve
• Scalene muscle


  • 3 scalenes anterior, middle, posterior
  • Origin: transverse process of cervical vertebrae
  • Insertion: 1st and 2nd ribs
  • Actions: Bilaterally: neck flexion
  • Unilaterally: lateral neck flexion to same side
  • Accessory muscle through ventilation
  • Nerve: 3rd through 8th cervical nerves
• Prevertebral muscles


  • Longus colli
  • Longus capitis
  • Rectus capitis anterior
  • Rectus capitis lateralis
• Suboccipital Muscles

  • Obliquus capitis superior
  • Obliquus capitis inferior
  • Rectus capitis posterior minor
  • Rectus capitis posterior major
• Suboccipital muscle movements


  1. Extension and stabilization of AO joint - Obliquus capitis superior

  2. Extension, lateral flexion, rotation to the same side, and stabilization of AA joint - Obliquus capitis inferior

  3. Extension and stabilization of AO joint - Rectus capitis posterior minor

  4. Extension, lateral flexion, rotation to the same side, and stabilization of AO joint - Rectus capitis posterior major
• Vertebral column


  • Triaxial movement
• Movements of the vertebral column

  1. Flexion/extension = sagittal plane, frontal axis

  2. Lateral flexion (side or lateral bending) = frontal plane, sagittal axis

  3. Rotation = horizontal plane and vertical axis
• Atlanto-occipital Joint (C1 and Occiput)


  Provides flexion, extension, minimal lateral flexion
• Axial extension


  Occurs at the AO joint flexes and C2-C7 extends
• Axial flexion


  Occurs when the AO joint extends and C2-C7 flex
• Atlantoaxial Joint (C1 and C2)


  Provides the movement of cervical rotation
• AA rotation


  May be accompanied by cervical spine rotation
• Muscles controlling head movement

  • Prevertebral muscles anteriorly and suboccipital muscles posteriorly
• Cervical Spine (C2 and C7)


  • Movement in all 3 planes and 3-axis
  • Lateral portion of the facet is anterior to the medial portion of the facet, allowing angulation of facet surfaces and movements within all 3 planes
• Thoracic Spine (T1- T12)

  • Orientation of facets is within the frontal plane, thus intervertebral movement primarily lateral flexion
  • Lesser amount of intervertebral rotation also occurs
  • All intervertebral movements within thoracic region are limited by articulation between ribs and thoracic vertebrae
• Lumbar Spine (L1-L5)


  • Orientation of facets on sagittal plane, intervertebral movement is primarily flexion and extension, slight lateral flexion, no rotation
• Sternocleidomastoid muscle


  Origin: Sternum and clavicle

  Insertion: mastoid process

  Actions: Bilaterally: head and neck flexion; Unilaterally: lateral neck flexion to same side, rotation of head to opposite side

  Accessory muscle of ventilation

  Nerve: accessory nerve (cranial nerve XI); 2nd and 3rd cervical nerve
• Scalene muscle


  3 scalenes: anterior, middle, posterior

  Origin: transverse process of cervical vertebrae

  Insertion: 1st and 2nd ribs

  Actions: Bilaterally: neck flexion; Unilaterally: lateral neck flexion to same side

  Accessory muscle through ventilation

  Nerve: 3rd through 8th cervical nerves
• Prevertebral muscles


  • Longus colli
  • Longus capitis
  • Rectus capitis anterior
  • Rectus capitis lateralis
• Suboccipital Muscles


  • Obliquus capitis superior
  • Obliquus capitis inferior
  • Rectus capitis posterior minor
  • Rectus capitis posterior major
• Erector Spinae Muscles


  • Origin: spinous processes, transverse process, and posterior ribs from the occiput bone to the sacrum and ilium

  Insertion: spinous process, transverse processes, and posterior ribs from the occiput to sacrum and ilium
• Rectus abdominis


  Origin: pubis

  Insertion: Xiphoid process and costal cartilages of fifth, sixth, and seventh ribs

  Action: trunk flexion; compression of abdomen

  Nerve: seventh through 12th intercostal nerves
• External oblique


  Origin: lower eighth rib laterally

  Insertion: iliac crest and linea alba

  Action: Bilaterally: trunk flexion; compression of the abdomen; Unilaterally: lateral bending, rotation to opposite side

  Nerve: 8th through 12th intercostal, iliohypogastric, and ilioinguinal nerves
• Internal Oblique muscles


  Origin: inguinal ligament, iliac crest, thoracolumbar fascia [stabilization]

  Insertion: 10th, 11th, 12th ribs; abdominal aponeurosis

  Action: Bilaterally: trunk flexion, compression of abdomen; Unilaterally: lateral bending, rotation to same side

  Nerve: 8th through 12th intercostal, iliohypogastric, and ilioinguinal nerves
• Transverse Abdominis muscle


  Origin: inguinal ligament, iliac crest, thoracolumbar fascia, and last 6 ribs

  Insertion: abdominal aponeurosis and linea alba

  Actions: compression of abdomen

  Nerve: 7th through 12th intercostal, iliohypogastric, and ilioinguinal nerves
• Trunk Posterior Surface Muscles

  • Transversospinals
  • Interspinales
  • Intertransversarii
  • Quadratus Lumborum
• Transversospinals


  Origin: transverse processes

  Insertion: spinous process of vertebrae above

  Actions: Bilaterally extend neck and trunk; Unilaterally: rotate neck and trunk to opposite side

  Nerve: spinal nerves
• Interspinales


  Origin: spinous process below

  Insertion: spinous process above

  Action: neck and trunk extension

  Nerve: spinal nerves
• Intertransversarii


  Origin: transverse process below

  Insertion: transverse process above

  Action: neck and trunk lateral bending

  Nerve: spinal nerves