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The Spine: Structure, Function, and Posture

The Spine: Structure, Function, and Posture. Chapter 14. Posture and Biomechanical Influences. Functional Components of the Spine. Anterior Pillar Posterior Pillar. Motions of the Spine. Six Degrees of Motion Flexion/extension Side bending Rotation Anterior/posterior shear

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The Spine: Structure, Function, and Posture

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  1. The Spine: Structure, Function, and Posture Chapter 14

  2. Posture and Biomechanical Influences

  3. Functional Components of the Spine • Anterior Pillar • Posterior Pillar

  4. Motions of the Spine • Six Degrees of Motion • Flexion/extension • Side bending • Rotation • Anterior/posterior shear • Lateral shear • Compression/distraction

  5. Arthrokinematics of the Zygapophyseal (Facet) Joints • Cervical Spine • Thoracic Spine • Lumbar Spine

  6. Structure and Function of the Intervertebral Discs • Annulus Fibrosus • Nucleus Pulposus • Cartilaginous End-plates

  7. Intervertebral Foramina • Located between each vertebral segment in the posterior pillar • Anterior boundary: intervertebral disc • Posterior boundary: facet joint • Superior and inferior boundaries: pedicles of the superior and inferior vertebrae of the spinal segment • Size is affected by spinal motion

  8. Biomechanical Influences on Postural Alignment • Curves of the Spine • Gravity (the gravity line) • Ankle-anterior • Knee-anterior • Hip-variable with sway • Trunk-bodies of cervical and lumbar vertebrae • Head-anterior to AO joint

  9. Stability • Postural Stability in the Spine • Inert Structures: Influence on Stability • Muscles: Influence on Stability • Role of global and segmental muscle activity Segmental Muscle Activity

  10. Muscle Control in the Lumbar Spine • Abdominal Muscles • Transverse Abdominis Stabilization Activity • Erector • Multifidus Stabilization Activity • Thoracolumbar (Lumbodorsal) Fascia

  11. Muscle Control in the Cervical Spine • Mandibular Elevator Group • Suprahyoid and Infrahyoid Group • Rectus Capitis Anterior and Lateralis, Longus Colli, and Longus Capitis • Multifidus

  12. Role of Muscle Endurance • Inactivity has been shown to change muscle fiber composition, leading to decreased muscular endurance during sustained or repetitive activities

  13. Stability • Neurological Control: Influence on Stability • Feedforward control and spinal stability • Effects of Limb Motion on Spinal Stability • Localized muscle fatigue • Muscle imbalance • Effects of Breathing on Posture and Stability • Effects of Intra-Abdominal Pressure and the Valsalva Maneuver

  14. Impaired posture

  15. Etiology of Pain • Effect of Mechanical Stress • Effect of Impaired Postural Support from Trunk Muscles • Effect of Impaired Muscle Endurance • Pain Syndromes Related to Impaired Posture • Postural fault • Postural pain syndrome • Postural dysfunction • Postural habits

  16. Common Faulty Postures: Characteristics and Impairments • Pelvic and Lumbar Region • Lordotic posture • Relaxed or slouched posture • Flat low back posture • Cervical and Thoracic Region • Round back (increased kyphosis) with forward head • Flat upper back and neck posture

  17. Common Faulty Postures: Characteristics and Impairments (cont'd) • Frontal Plane Deviations, Scoliosis, and LE Asymmetries • Scoliosis • Structural • Nonstructural • Frontal plane deviations from LE asymmetries • Characteristic deviations

  18. Management of Impaired posture

  19. General Management Guidelines • Awareness and Control of Spinal Postures • Posture training techniques • Axial extension (cervical retraction) to decrease a forward head posture • Scapular retraction • Pelvic tilt and neutral spine • Thoracic spine • Total spinal movement and control • Reinforcement • Postural support

  20. General Management Guidelines (cont'd) • Posture, Movement, and Functional Relationships • Relationship of impaired posture and pain • Relationship of impaired posture and extremity function • Joint, Muscle, and Connective Tissue Mobility Impairments • Impaired Muscle Performance • Body Mechanics

  21. General Management Guidelines (cont'd) • Ergonomics • Stress Management/Relaxation • Muscle relaxation techniques • Cervical and upper thoracic region • Lower thoracic and lumbar region • Conscious relaxation training for the cervical region • Modalities and massage • Healthy Exercise Habits

  22. Independent Learning Activities • Critical Thinking and Discussion • Laboratory Practice • Case Studies

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