EXAM 1 - APPLIED AND GROSS Flashcards
nervous system
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spinal cord cut
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motor and sensory neuron
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brain
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spinal cord pathway
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skull bones
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cerebrospinal fluid
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spinal cord meninges
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corticospinal tract
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upper and lower motor neuron lesions
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cranial nerves - test
I - close eyes, place something familiar for the patient to smell and identify (orange/lemon peel, coffee, or vinegar) under each nostril alone
II
- acuity - snellen chart with and without visual aids
- colour - ishihara plates identify patients who are colour blind
- fields - asking the patient to look directly at you whilst you wiggle one of your fingers in each of the four quadrants; ask the patient to identify which finger is moving; inattention can be tested by moving both fingers at the same time and checking the patient identifies this
- reflexes - place one hand vertically along the patients nose to block any light from entering the eye which is not being tested; shine a pen torch into one eye and check that the pupils on both sides constrict; tested on both sides
- fundoscopy - performed on both eyes
III / IV / VI - head perfectly still directly in front of you, you should draw two large joining H’s in front of them using your finger and ask them to follow your finger with their eyes; the patient does not move their head
V
- sensory - lightly touching the face with a piece of cotton wool followed by a blunt pin in three places on each side of the face: around the jawline, cheek, forehead; corneal reflex - lightly touching the cornea with the cotton wool; should cause the patient to shut their eyelids
- motor - ask the patient to clench their teeth together, observing and feeling the bulk of the masseter and temporalis muscles; open their mouth against resistance; jaw jerk on the patient by placing your left index finger on their chin and striking it with a tendon hammer - cause slight protrusion of the jaw
VII - asking the patient to crease up their forehead (raise their eyebrows), close their eyes and keep them closed against resistance, puff out their cheeks and reveal their teeth
VIII
- Rinne test - place a sounding tuning fork on the patient’s mastoid process and then next to their ear and ask which is louder; normal patient will find the second position louder
- Weber’s test - place the tuning fork base down in the centre of the patient’s forehead and ask if it is louder in either ear; should be heard equally in both ears
IX - tested with the gag reflex or by touching the arches of the pharynx
X - asking the patient to speak gives a good indication to the efficacy of the muscles; uvula should be observed before and during the patient saying “aah”; check that it lies centrally and does not deviate on movement
XI - ask the patient to shrug their shoulders and turn their head against resistance
XII - observe the tongue for any signs of wasting or fasciculations; ask the patient to stick their tongue out; if the tongue deviates to either side, it suggests a weakening of the muscles on that side
spinal nerves
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brachial plexus
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Axillary nerve
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Musculocutaneous nerve
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Radial nerve
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Median nerve
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Ulnar nerve
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Lumbosacral plexus
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Femoral nerve
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Obturator nerve
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Sciatic nerve
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Tibial nerve
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Fibular (peroneal) nerves
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blood circulation
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heart pump
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heart location
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aorta
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pulses
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head arterial flow
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heart arterial and venous flow
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arm arterial flow
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leg arterial flow
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brain arterial flow
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knee arterial flow
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blood and lymph capillaries
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femoral triangle
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head venous flow
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leg venous flow
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arm venous flow
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temporomandibular joint / TMJ motions - retrusion
anterior-posterior movement within the upper joint space
- mandibular condyle and disk move as one unit against the mandibular fossa and articular tubercle of the temporal bone
- no rotation; forward and backward motions of all parts of the mandible are equal
- horizontal plane
- vertical axis
arteries
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veins
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temporomandibular joint / TMJ motions - depression
- lower joint space - convex-on-concave articulation where the mandibular condyle rotates on the disk creating an anterior glide of the condyle while the distal end (ramus/angle) moves posteriorly
- upper joint space - involves gliding the disk forward and downward under the articular tubercle; articular disk is more firmly attached to the mandible than the temporal bone, it allows the disk to move forward with the condyle of the mandible when the mouth opens; It returns posteriorly when the mouth closes
- sagittal plane
- frontal axis
lymph angion
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lymph node
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lymph system
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temporomandibular joint / TMJ
synovial joint
- modified hinge shape; allows some gliding motion, it is not a pure hinge joint
third-class lever system
- force arm (distance from joint axis to muscle attachment) being shorter than the resistance arm (distance from joint axis to con- tact point of teeth)
- contact between the more anterior molars or front teeth creates a long resistance arm and less biting force
- the greatest amount of biting force can be generated at the rear molars because the resistance arm is the shortest
temporomandibular joint / TMJ motions - elevation
- reverse action; gliding of the disk and condyle posteriorly and superiorly in the upper joint space and rotation of the condyle on the disk creating a posterior glide within the lower joint space
- sagittal plane
- frontal axis
temporomandibular joint / TMJ motions - lateral deviation
- one condyle rotating in the mandibular fossa while the other condyle glides forward
- move the mandible toward the left, the left condyle will rotate and the right condyle will glide forward
- horizontal plane
- vertical axis
temporomandibular joint / TMJ motions - protrusion
anterior-posterior movement within the upper joint space
- mandibular condyle and disk move as one unit against the mandibular fossa and articular tubercle of the temporal bone
- no rotation; forward and backward motions of all parts of the mandible are equal
- horizontal plane
- vertical axis
temporomandibular joint / TMJ landmarks - mandible
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temporomandibular joint / TMJ landmarks - temporal and zygomatic bones
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temporomandibular joint / TMJ landmarks - sphenoid and maxillary bones
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temporomandibular joint / TMJ ligaments
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temporomandibular joint / TMJ articular disk
divides the joint space into two separate compartments
- larger upper joint space - superioir surface is both concave and convex to accommodate the shape of the fossa
- smaller lower joint space - concave inferior surface accommodates the convex surface of the condyle and allows the joint to remain congruent (compatible) throughout the motion
temporomandibular joint / TMJ motion - rotate and glide
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temporomandibular joint / TMJ motion - spin and glide
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temporomandibular joint / TMJ prime mover - temporalis
whole muscle - mandible elevation, ipsilateral lateral deviation
posterior muscle - mandible retrusion
temporomandibular joint / TMJ prime movers - masseter
ipsilateral lateral deviation, elevation
temporomandibular joint / TMJ landmarks - hyoid bone
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temporomandibular joint / TMJ prime movers - lateral pterygoid
depression, protrusion, contralateral lateral deviation
temporomandibular joint / TMJ muscle - suprahyoid - geniohyoid
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temporomandibular joint / TMJ muscle - suprahyoid - stylohyoid
temporomandibular joint / TMJ prime movers - medial pterygoid
elevation, protrusion, contralateral lateral deviation
temporomandibular joint / TMJ muscle - suprahyoid - mylohyoid
temporomandibular joint / TMJ muscle - suprahyoid - digastric
temporomandibular joint / TMJ muscle - infrahyoid - sternohyoid
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temporomandibular joint / TMJ muscle - infrahyoid - sternothyroid
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temporomandibular joint / TMJ muscle - infrahyoid - thyrohyoid
temporomandibular joint / TMJ muscle - infrahyoid - omohyoid
atlantooccipital (AO) joint motion - neck extension
- sagittal plane
- frontal axis
- articulation between the head and C1 (atlas)
atlantooccipital (AO) joint motion - neck flexion
- sagittal plane
- frontal axis
- articulation between the head and C1 (atlas)
atlantooccipital (AO) joint motion - neck hyperextension
- sagittal plane
- frontal axis
- articulation between the head and C1 (atlas)
atlantoaxial (AA) joint motion - neck rotation
- transverse plane
- vertical axis
- articulation between the C1 (atlas) and C2 (axis)
atlantooccipital (AO) joint motion - neck lateral bending
- frontal plane
- sagittal axis
- articulation between the head and C1 (atlas)
facet / zygapophyseal joint - trunk flexion
- sagittal plane
- frontal axis
facet / zygapophyseal joint - trunk extension
- sagittal plane
- frontal axis
facet / zygapophyseal joint - trunk hyperextension
- sagittal plane
- frontal axis
facet / zygapophyseal joint - trunk lateral bending
- frontal plane
- sagittal axis
facet / zygapophyseal joint - trunk rotation
- transverse plane
- vertical axis
atlantooccipital (AO) joint landmarks - skull
atlantooccipital (AO) joint landmarks - C1 (atlas)
atlantoaxial (AA) joint landmarks - C2 (axis)
facet / zygapophyseal joint landmarks - cervical spine
facet / zygapophyseal joint landmarks - thoracic spine
facet / zygapophyseal joint landmarks - lumbar spine
parts of vertebrae
atlantoaxial (AA) joint
facet / apophyseal joint
vertebral line of pull
parts of the intervertebral disk
vertebral ligaments
nuchal ligament / ligamentum nuchae
facet / zygapophyseal joint - cervical orientation
facet / zygapophyseal joint - thoracic orientation
facet / zygapophyseal joint - lumbar orientation
atlantooccipital (AO) joint prime mover - prevertebral / anterior - longus colli / longus cervicis
N - C2-C7
- head flexion
atlantooccipital (AO) joint prime mover - prevertebral / anterior - longus capitis
N - C1-C4
- head flexion
atlantooccipital (AO) joint prime mover - prevertebral / anterior - rectus capitis anterior
N - C1-C2
- head flexion
atlantooccipital (AO) joint prime mover - prevertebral / anterior - rectus capitis lateralis
N - C1-C2
- head flexion
atlantooccipital (AO) joint prime mover - suboccipital / posterior - obliquus capitis superior
- head extension
atlantooccipital (AO) joint prime mover - suboccipital / posterior - obliquus capitis inferior
- head extension
atlantooccipital (AO) joint prime mover - suboccipital / posterior - rectus capitis posterior minor
- head extension
atlantooccipital (AO) joint prime mover - suboccipital / posterior - rectus capitis posterior major
- head extension
atlantoaxial (AA) joint prime mover - sternocleidomastoid
- neck flexion, lateral bending, contralateral rotation
atlantoaxial (AA) joint prime mover - splenius capitis
- neck extension, lateral bending, ipsilateral rotation
atlantoaxial (AA) joint prime mover - splenius cervicis
- neck extension, lateral bending, ipsilateral rotation
atlantoaxial (AA) joint prime mover - erector spinae - spinalis cervicis and thoracis
- neck extension, lateral bending
- trunk extension, lateral bending
atlantoaxial (AA) joint prime mover - erector spinae - longissimus capitis and thoracis
- neck extension, lateral bending
- trunk extension, lateral bending
atlantoaxial (AA) joint prime mover - erector spinae - iliocostalis cervicis and thoracis
- neck extension, lateral bending
- trunk extension, lateral bending
atlantoaxial (AA) joint prime mover - transversospinalis - semispinalis, rotatores, multifidus
- neck extension, contralateral rotation
- trunk extension, contralateral rotation
- semispinalis - spans 5+ vertebrae
- rotatores - spans 1 vertebra
- multifidus - spans 2–4 vertebrae
atlantoaxial (AA) joint prime mover - interspinales
- neck extension
- trunk extension
atlantoaxial (AA) joint prime mover - intertransversarii
- neck lateral bending
- trunk lateral bending
atlantoaxial (AA) joint prime mover - scalenes
- neck lateral bending
facet / zygapophyseal joint - rectus abdominis
- trunk flexion, compression of abdomen
facet / zygapophyseal joint - external oblique
- trunk flexion, lateral bending, contralateral rotation, compression of abdomen
facet / zygapophyseal joint - internal oblique
- trunk flexion, lateral bending, ipsilateral rotation, compression of abdomen
facet / zygapophyseal joint - quadratus lumborum
- trunk lateral bending
facet / zygapophyseal joint - transverse abdominis
abdominal ligaments
thoracic cage landmarks
thoracic joints
respiratory structures
respiratory prime mover - diaphragm
respiratory prime mover - external intercostal
respiratory prime mover - internal intercostal
respiratory accessory muscles
skin
fascia
skin lines
bone segment
body joints
skull landmarks - lateral and frontal
skull landmarks - superior
skull landmarks - inferior
skull openings
head forces
head and scalp region
cervical spines landmarks
cranial nerves - function
cranial nerves - location
organs
palpate - suprasternal / jugular notch
palpate - xiphoid process
palpate - anterior superior iliac spine (ASIS)
palpate - iliac crest
palpate - posterior superior iliac spine (PSIS)
palpate - spinous process (C7, T1, T3, T7, S1/S2)
palpate - inferior angle of the scapula
palpate - spine of the scapula
palpate - acromion process
palpate - greater trochanter
palpate - thyroid cartilage
palpate - hyoid bone
palpate - angle of the mandible
palpate - angle of the mouth
palpate - nasolabial fold
palpate - temporomandibular joint
palpate - mastoid process
palpate - lobule of ear
palpate - sternum
palpate - temporal and carotid pulse
GONI process
- patient position
- practitioner position
- demonstrate action and procedure
- ID and palpate bony landmarks
- AROM
- current patient status
- PROM for end feel
- correct GONI, align against bony landmarks
- test
- current patient status
- normal range and result range
- inform of how test relates to occupation
MMT Grade Scale
MMT process
- patient position
- practitioner position
- demonstrate action and procedure
- ID and palpate bony landmarks
- ID prime movers
- AROM
- current patient status
- PROM for end feel
- stabilize and apply resistance
- current patient status
- asses and tentatively grade or increase resistance
- muscle grade
- inform of how test relates to occupation
GONI - neck flexion
End Positions. Flexion: The patient flexes the neck to the limit of the motion. Extension: The patient extends the neck to the limit of motion
Substitute Movement. Mouth opening (for tape measure- ments), trunk flexion–extension
Goniometer Axis. Over the lobule of the ear
Stationary Arm. Perpendicular to the floor
Movable Arm. Lies parallel to the base of the nares. In the start position, the goniometer will indicate 90°. This is recorded as 0°
Flexion. The goniometer is realigned at the limit of neck flexion. The number of degrees the movable arm lies away from the 90° position is recorded as the neck flexion AROM (45°)
Extension. The goniometer is realigned at the limit of neck extension. The number of degrees the movable arm lies away from the 90° position is recorded as the neck extension AROM (45°)
GONI - neck extension
End Positions. Flexion: The patient flexes the neck to the limit of the motion. Extension: The patient extends the neck to the limit of motion
Substitute Movement. Mouth opening (for tape measure- ments), trunk flexion–extension
Goniometer Axis. Over the lobule of the ear
Stationary Arm. Perpendicular to the floor
Movable Arm. Lies parallel to the base of the nares. In the start position, the goniometer will indicate 90°. This is recorded as 0°
Flexion. The goniometer is realigned at the limit of neck flexion. The number of degrees the movable arm lies away from the 90° position is recorded as the neck flexion AROM (45°)
Extension. The goniometer is realigned at the limit of neck extension. The number of degrees the movable arm lies away from the 90° position is recorded as the neck extension AROM (45°)
GONI - neck lateral flexion
End Positions. The patient flexes the neck to the left side (without rotation) to the limit of motion. The patient flexes the neck to the right side (without rotation) to the limit of motion
Substitute Movement. Elevation of the shoulder girdle to approximate the ear; ipsilateral trunk lateral flexion
Goniometer Axis. Over the C7 spinous process
Start position: universal goniometer alignment neck lateral flexion
Stationary Arm. Along the spine and perpendicular to the floor
Movable Arm. Points toward the midpoint of the head. In the start position, the goniometer will indicate 0°
Lateral Flexion. The goniometer is realigned at the limit of neck lateral flexion. The number of degrees the movable arm lies away from the 0° position is recorded as the neck lateral flexion AROM (45°) to the side measured
GONI - neck rotation
End Position. The patient rotates the head to the left to the limit of motion. The patient rotates the head to the right side to the limit of motion
Substitute Movement. Elevation and/or protrusion of the shoulder girdle to approximate the chin (tape measure); trunk rotation
Goniometer Axis. Over the midpoint of the top of the head
Stationary Arm. Parallel to a line joining the two acromion processes
Movable Arm. Aligned with the nose. In the start position, the goniometer will indicate 90°. This is recorded as 0°
Rotation. The goniometer is realigned at the limit of neck rotation. The number of degrees the movable arm lies away from the 90° position is recorded as the neck rotation AROM
MMT - neck and head flexion
The head and neck flexors are tested in the against gravity position. The anterior head and neck flexors are tested as a group; followed by isolation of the sternomastoid muscles
Start Position. The patient is supine. The arms are over the head resting on the plinth. The elbows are flexed
Stabilization. The trunk is stabilized by the plinth. The anterior abdominal muscles must be strong enough to provide anterior fixation of the thorax on the pelvis. In a patient with weak abdominals, stabilization is provided by downward pressure of the therapist’s hand on the thorax
Movement. The patient flexes the head and neck through partial (grade 2) or full range (grade 3). The patient is instructed to keep the chin depressed (i.e., tucked in toward the manubrium sternum) as the neck is flexed
Palpation. Longus capitis, longus colli, and rectus capitis ante- rior are too deep to palpate. The sternomastoid muscle may be palpated proximal to the clavicle or sternum. The muscle is more easily palpated in the isolated test involv- ing rotation. The scalenus anterior may be palpated above the clavicle and behind the sternomastoid
Resistance Location. Applied on the forehead
Resistance Direction. Head and neck extension
MMT - neck extension
The head and neck extensors are tested as a group in the against gravity position. The muscles include semispinalis capitis, rectus capitis posterior (major and minor), obliquus capitis (inferior and superior), splenius capitis, semispinalis cervicis, longissimus capitis and cervicis, splenius cervicis, spinalis capitis and cervi- cis, and iliocostalis cervicis. The strength of upper trapezius is tested as an elevator of the scapula
Start Position. The patient is prone. The arms are over the head resting on the side of the plinth. The elbows are flexed
Stabilization. The patient grasps the end of the plinth for stabilization. The therapist may stabilize the upper thoracic region to prevent trunk extension
Movement. The patient extends and rotates the head and neck
Palpation. The extensor muscles are palpated as a group paravertebrally
Resistance Location. Applied on the head just proximal to the occiput
Resistance Direction. Head and neck flexion and rotation
GONI - trunk flexion
Start Positions. Flexion: The patient is standing with feet shoulder width apart. A tape measure is used to measure the distance between the spinous processes of C7 and S2. Extension: For thoracolumbar extension, the patient’s hands are placed on the iliac crests and into the small of the back. A tape measure is used to measure the distance between the spinous processes of C7 and S2. The patient is instructed to keep the knees straight when performing the test movements
Substitute Movement. None
End Positions. Flexion: The patient flexes the trunk for- ward to the limit of motion for thoracolumbar flexion. The distance between the spinous processes of C7 and S2 is measured again. The difference between the start and end position measures is the thoracolumbar flexion ROM
GONI - trunk extension
Start Positions. Flexion: The patient is standing with feet shoulder width apart. A tape measure is used to measure the distance between the spinous processes of C7 and S2. Extension: For thoracolumbar extension, the patient’s hands are placed on the iliac crests and into the small of the back. A tape measure is used to measure the distance between the spinous processes of C7 and S2. The patient is instructed to keep the knees straight when performing the test movements
Substitute Movement. None
End Positions. Extension: The patient extends the trunk backward to the limit of motion for thoracolumbar extension. The distance between the spinous processes of C7 and S2 is measured again. The difference between the start and end position measures is the thora- columbar extension ROM
GONI - trunk lateral flexion
Start Position. Standing
Goniometer Axis. In the midline at the level of the PSIS (i.e., over the S2 spinous process)
Stationary Arm. Perpendicular to the floor
Movable Arm. Points toward the spine of C7
Lateral Flexion. The goniometer is realigned at the limit of trunk lateral flexion. The number of degrees the movable arm lies away from the 0° position is recorded as the thoracolumbar lateral flexion ROM to the side measured
MMT - trunk flexion
Start Position. The patient is supine
Stabilization. Flexion of the cervical spine serves to fix the thorax and when combined with a posterior pelvic tilt provides the optimal posture for decreasing the lumbar lordosis, reducing the stress on the low back, and activating the abdominal muscles in performing the curl-up. If the patient is unable to perform a posterior pelvic tilt and maintain the lumbar spine in a flexed position when being tested for abdominal muscle strength, the test is discontinued
To prevent contraction of the iliopsoas muscle and greater hyperextension of the lumbar spine, the therapist should not stabilize the feet
Movement. The patient initially tilts the pelvis posteriorly to flex the lumbar spine, flexes the cervical spine lifting the head off the plinth, and then flexes the thoracic spine to perform a curl-up. The movement is per- formed slowly
Substitute Movement. Hip flexors (lumbar lordosis)
Palpation. Lateral to the midline on the anterior abdominal wall midway between the sternum and the pubis
Grading
- Grade 0: No movement, and no palpable contraction is evident
- Grade 1: No movement is possible but a flicker of a muscle contraction may be palpated. When testing for grade 1, the patient may also be asked to cough while the therapist observes and palpates for the presence of muscle contraction
- Grade 2: With the arms held outstretched in front of the trunk, the patient lifts the head and cervical spine off the plinth. The scapulae remain on the plinth
- Grade 3: With the arms held outstretched in front of the trunk, the patient lifts the inferior angles of the scapulae clear of the plinth
Resistance. Resistance is not applied manually by the therapist but is provided through positioning of the arms. The resistance of the head, trunk, and upper limbs increases as the upper limbs are moved toward the head. Accordingly, the arms are positioned across the chest or at above shoulder level with the hands beside the ears throughout the movement, for grades of 4 and 5, respectively.
Note: For grade 5 testing, the hands are positioned beside the ears, rather than behind the head, to prevent stress being placed on the cervical spine inadvertently during testing
Grading
- Grade 4: With the arms positioned across the chest, the patient lifts the inferior angles of the scapulae clear of the plinth
- Grade 5: With the hands positioned beside the ears, the patient lifts the inferior angles of the scap- ulae clear of the plinth
GONI - trunk rotation
Start Position. The patient is sitting with the feet supported on a stool and the arms crossed in front of the chest. The patient holds the end of the tape measure on the lateral aspect of the acromion process. The therapist holds the other end of the tape measure on either the uppermost point of the iliac crest at the midaxillary line (not shown) or on the upper border of the greater trochanter. The distance between the lateral aspect of the acromion process and the uppermost point of the iliac crest at the midaxillary line or the upper border of the greater trochanter is measured
Stabilization. The body weight on the pelvis; the therapist can also stabilize the pelvis
Substitute Movement. Trunk flexion, trunk extension, and shoulder girdle protraction (on the side the tape measure is held)
End Position. The patient rotates the trunk to the limit of motion. The distance between the lateral aspect of the acromion process and either the uppermost point of the iliac crest at the midaxillary line or the upper border of the greater trochanter is measured at the limit of rotation. The difference between the start position and end position measures is the thoracolumbar rotation ROM. The surface landmarks used in the assessment should be documented
Frost and colleagues described the use of the tape measure to measure trunk rotation (using the posterior clavicular prominence and the greater trochanter as landmarks) and noted that the accurate definition and palpation of the landmarks used in the assessment are critical for reliable assessment
Clarkson recommends using the lateral aspect of the acromion process and the uppermost point of the iliac crest as the preferred surface landmarks, as these are easily palpated.
MMT - trunk extension
The strength of the neck and hip extensors should be tested before testing the strength of the trunk extensor muscles. If neck extensors are weak, the head will have to be supported during testing. If the hip extensors are weak or paralyzed, the pelvis cannot be adequately fixed in an extended position on the thigh as the patient attempts trunk extension and the patient will be unable to extend the trunk. The trunk extensors are tested as a group in the against gravity position
Start Position. The patient is prone-lying with the feet over the end of the plinth and a pillow under the abdomen
Stabilization. A strap is placed over the pelvis to isolate the lumbar extensor muscles and the therapist stabilizes the legs proximal to the ankles
Substitute Movement. None
Palpation. The trunk extensor muscles are palpated as a group paravertebral to the lumbar or thoracic spines
Grading
- Grade 0: No movement, and no palpable contraction is evident.
- Grade 1: No movement is possible but a flicker of a muscle contraction can be palpated or observed as the patient attempts to lift the head.
- Grade 2: With the arms at the sides, the patient lifts the head and upper portion of the sternum off the plinth
- Grade 3: With the hands held behind the low back, the patient extends the trunk through partial ROM
Resistance. Resistance is not applied manually by the therapist. Resistance is provided through positioning of the arms and increases as the upper limbs are positioned toward the head. The hands are positioned behind the low back or behind the head to test for grades 4 and 5, respectively
Grading
- Grade 4: With the hands held behind the back, the patient extends the trunk through the full ROM, that is, lifts the head and upper portion of the sternum, so that the xiphoid process is off the plinth
- Grade 5: With the hands held behind the head, the patient extends the trunk through the full ROM and lifts the head and the sternum, so that the xiphoid process is off the plinth
facial muscle - buccinator
facial muscle - corrugator supercilii
facial muscle - depressor anguli oris
facial muscle - levator labii superioris
facial muscle - occipitofrontalis (frontal, occipital belly)
facial muscle - orbicularis oculi
facial muscle - orbicularis oris
facial muscle - platysma
shoulder girdle prime mover - trapezius (upper, middle, lower)
upper - elevation, upward rotation
middle - retraction
lower - depression, upward rotation
facial muscle - zygomaticus major
facial muscle - zygomaticus minor
ansa cervicalis
lesser occipital nerve
phrenic nerve
supraclavicular nerves (anterior, middle, lateral)
transverse / superficial / cutaneous cervical nerve
shoulder joint prime mover - deltoid
- anterior - flexion, medial rotation, horizontal adduction
- posterior - extension, hyperextension, horizontal abduction, lateral rotation
- whole - abduction
shoulder joint prime mover - latissimus dorsi
- extension, hyperextension, adduction, medial rotation
shoulder girdle prime mover - levator scapulae / scapula
- elevation, downward rotation
shoulder girdle prime mover - pectoralis minor
- protraction, depression, downward rotation, scapular tilt
shoulder joint prime mover - pectoralis major
- clavicular - flexion
- sternal - extension
- whole - adduction, horizontal adduction, medial rotation
shoulder girdle prime mover - rhomboideus/rhomboid major / minor
- retraction, elevation, downward rotation
shoulder girdle prime mover - serratus anterior
- protraction, upward rotation
shoulder joint prime mover - subscapularis
- medial rotation
shoulder joint prime mover - supraspinatus
- abduction
shoulder joint prime mover - infraspinatus
- horizontal abduction, lateral rotation
shoulder joint prime mover - teres major
- extension, adduction, medial rotation
shoulder joint prime mover - teres minor
- horizontal abduction, lateral rotation
shoulder girdle landmarks - scapula, sternum, clavicle
shoulder girdle ligaments
shoulder joint ligaments
shoulder joint landmarks - humerus
shoulder joint accessory muscle - coracobrachialis
respiratory accessory muscle - serratus posterior superior / inferior
trunk fascia
temporalis
masseter
lateral pterygoid
geniohyoid
stylohyoid
medial pterygoid
mylohyoid
digastric
sternohyoid
sternothyroid
thyrohyoid
omohyoid
longus colli / longus cervicis
longus capitis
rectus capitis anterior
rectus capitis lateralis
obliquus capitis superior
obliquus capitis inferior
rectus capitis posterior minor
rectus capitis posterior major
sternocleidomastoid
splenius capitis
splenius cervicis
erector spinae - spinalis cervicis and thoracis
erector spinae - longissimus capitis and thoracis
erector spinae - iliocostalis cervicis thoracis and lumborum
transversospinalis - semispinalis capitis and thoracis
transversospinalis - rotatores thoracis longi and breves
transversospinalis - multifidus
interspinales
intertransversarii posteriores cervicis and laterales and mediales lumborum
scalene (anterior, middle, posterior)
rectus abdominis
external oblique
internal oblique
quadratus lumborum
transverse / transversus abdominis
diaphragm
external intercostal
internal intercostal
buccinator
corrugator supercilii
depressor anguli oris
levator labii superioris
occipitofrontalis (frontalis, occipitalis)
orbicularis oculi
orbicularis oris
platysma
trapezius (upper, middle, lower)
zygomaticus major
zygomaticus minor
deltoid
latissimus dorsi
levator scapulae / scapula
pectoralis minor
pectoralis major
rhomboideus / rhomboid major / minor
serratus anterior
subscapularis
supraspinatus
infraspinatus
teres major
teres minor
serratus posterior superior / inferior
