Page 331 - Kinesiology of the musculoskeletal system foundations for physical rehabilitation

9C h a p t e r

Axial Skeleton: Osteology and Arthrology

DONALD A. NEUMANN, PT, PhD, FAPTA

C HAPTE R AT A G LAN C E

OSTEOLOGY, 309 ARTHROLOGY, 326 Kinematics, 343
Components within the Axial Skeleton, 309 Typical Intervertebral Junction, 326 Lumbar Region, 346

Cranium, 309 Terminology Describing Movement, 327 Anatomy of the Articular Structures, 346
Vertebrae: Building Blocks of the Structure and Function of the Apophyseal Kinematics, 350
SUMMARY OF THE KINEMATICS WITHIN
Spine, 310 Joints, 327 THE VERTEBRAL COLUMN, 358
Ribs, 310 Structure and Function of the Interbody SACROILIAC JOINTS, 359
Sternum, 311 Anatomic Considerations, 360
Vertebral Column as a Whole, 312 Joints, 328 Joint Structure, 360
Normal Curvatures within the Vertebral REGIONAL ANATOMY AND KINEMATICS Ligaments, 361
Innervation, 362
Column, 312 ACROSS THE VERTEBRAL COLUMN, 332 Thoracolumbar Fascia, 362
Line of Gravity Passing through the Introduction to Spinal Coupling, 332 Kinematics, 363
Craniocervical Region, 333 Functional Considerations, 363
Body, 314 SYNOPSIS, 365
Ligamentous Support of the Vertebral Anatomy of Joints, 333 ADDITIONAL CLINICAL CONNECTIONS, 366
Sagittal Plane Kinematics, 336 REFERENCES, 374
Column, 315 Horizontal Plane Kinematics, 339 STUDY QUESTIONS, 378
Regional Osteologic Features of the Vertebral Frontal Plane Kinematics, 340
Spinal Coupling between Lateral Flexion
Column, 318
Cervical Region, 318 and Axial Rotation, 340
Thoracic Region, 322 Thoracic Region, 341
Lumbar Region, 323
Sacrum, 324 Anatomy of Thoracic Articular Structures,
Coccyx, 325 341

T he skeleton as a whole is divided into the axial skele- ing the axial skeleton. Disorders of the vertebral column are
ton and the appendicular skeleton. The appendicular often associated with neurologic impairment, primarily
skeleton consists of the bones of the extremities, includ- because of the close anatomic relationship between neural
ing the clavicle, scapula, and pelvis; the axial skeleton, in tissue (spinal cord and nerve roots) and connective tissue
contrast, consists of the cranium, vertebral column (spine), (vertebrae and associated ligaments, intervertebral discs, and
ribs, and sternum (Figure 9-1). As indicated in Figure 9-1, A, synovial joints). A “slipped” or herniated disc, for example,
the axial and appendicular skeletons are joined by the ster- can increase pressure on the adjacent neural tissues, resulting
noclavicular joints superiorly and the sacroiliac joints in local inflammation and also weakness, sensory distur-
inferiorly. bances, and reduced reflexes throughout the lower limb. To
further complicate matters, certain movements and habitual
The osteology and associated arthrology presented in this postures of the vertebral column increase the likelihood of
chapter focus primarily on the axial skeleton. This focus connective tissues impinging on neural tissues. An under-
includes the craniocervical region, vertebral column, and sac- standing of the detailed osteology and arthrology of the axial
roiliac joints, describing how these articulations provide sta- skeleton is crucial to an appreciation of the associated
bility, movement, and load transfer throughout the axial pathomechanics, as well as the rationale for many clinical
skeleton. Muscles play a large role in this function and are tests and interventions.
the primary focus of Chapter 10.
Table 9-1 summarizes the terminology used to describe the
Disease, trauma, overuse, and normal aging can cause a relative location or region within the axial skeleton.
host of neuromuscular and musculoskeletal problems involv-
307