L2: Intro to Posrure and Principles of Movement Flashcards
why do we assess posture
- part of the objective examination
- begin to build a picture what structures and changes may be contributing to symptoms
- it affects stability and balance
- it affects movement and function
- it can cause pain and injury
why does everyone not have the same ‘normal posture’
- no 2 individuals have the same body type
- variations in leg, trunk, arm dimensions, distribution of fat, muscle bulk influence posture
- people adapt and use their bodies differently in various environments or prefessions
frontal (coronal) plane
splits body into front and back
sagittal plane
splits body left and right
transverse (horizontal) plane
splits body top to bottom
what is the importance of good posture and alignment
- prevents postural deformities
- prevents muskuloskeletal pain syndromes
- reduces stress on joint surfaces
- maintains joint integrity
- contribute to optimal joint patterns
suggested framework for the postural assessment
- start at the top
- work methodically in one direction
- look at key bony landmakrs
- consider symmetry of the posture
- consider weight bearing (base of support)
- look at muscle bulk
- look at skin creases
- anterior, lateral and posterior aspects
how is ideal posture measured
using the ‘plumb line’ as a reference point for assessing posture
- intersection of sagittal and coronal planes
- body is in equilibrium and there should be a balanced distribution of weight and a stable position of each joint
anatomical/ surface pointsof plumb line of reference for lateral posture
Slightly anterior to:
- lateral malleolus
- axis on the knee joint
Slightly posterior to:
- axis of the hip joint
Passess through:
- bodies if lumbar vertebrea
- bodies of most cervical vertebrae
- ear and should joint
Spinal curves - gentle ‘S’ shape
- cervical lordosis
- thoracic kyphosis
- lumbar lordosis
anatomical/ surface pointsof plumb line of reference for posterior posture
- head - neither tilted or rotated
- cervical spine - straight
- shoulders - level, not elevated or depressed
- scapulae - neutral position (medial borders parallel, 3-4 inches apart)
- Tx and Lx straight
- hip joints - neutral, neither abducted or adducted
- lower extremities - neither knocked knees (valves) or bowed (varus)
- feet - parallel of slight toeing out
curve of cervical spine
lordosis (inward curve)
curve of thoracic spine
kyphosis (outward curve)
curve of lumbar spine
lordosis (inward curve)
shoulder and scapular anatomical landmarks need ot be aware of
medial border
lateral border
spine
inferior angle
postition of scapula for normal posture
lie flat against thorax approx 15-30 degrees forward of coronal plane
- foraward/ protected scapula more than 30 degrees foraward. Retracted scapula less than 15 degrees forward
- no angle or border is prominent (no winging where medial border is prominent, no tipping where inferior anfle of scapula is prominent)
- medial edge of the spine of the scapula should be level with T3
- inferior angle should be level with T7
- the medial border or the scapula should be approximately 2-2.5 inches from the spine
positon of shoulders for normal posture
- should be level
- observe for muscle activity - if they are forwards/ one higher than the other
position of clavicles for normal posture
should be symmetrical
bony landmarks you shoud look/ feel for on pelvis
- anterior superior iliac spine
- posterior superior iliac spine
some factors that may contribute to abnormal posture
- pain
- fatigue
- pathology
- weakness
- msucle tone
common altered neck positions
posterior neck tilt, anterior head tilt, forward head posture
what is this altered neck position
posterior head tilt
what is this altered neck position
anterior head tilt
what is this altered neck position
forward head posture
what abnormal postural alignment is this
kypho-lordosis
what abnormal postural alignment is this
sway back posture
what abnormal posture alignment is this
flat back posture
anatomical movements that take place at shoulder
flexion
extension
abduction
adduction
circumduction
meadial rotation
lateral rotation
what movements happen at the neck
flexion
extension
rotation
anotomical movements at the elbow
flexion
extension
pronation
supination
anatomical movements at the hips
flexion
extension
adduction
abduction
medial rotation
lateral rotation
anatomical movements at the knee
flexion
extension
anatomical movements at the ankle
dorsi flexion
plantar flexion
inversion
eversion
anatomical movements of the jaw/ mandible
retraction
protraction
elevation
depression
anatomical movements of the fingers
flexion
extension
opposition
name the postural muscles of the trunk
multifidus
rotatores
erector spinae
rectus abdominis
transverse abdominis
what muscle is this
multifidus
origins of multifidus
- posterior surface of sacrum
- PSIS
- mammilary processes of all Lx vertebrae
- transverse processes of all Tx vertebrae
- articular processes of lower 4 Cx vertebrae
insertion of multifidus
intro-spinous process 2-4 vertebrae above the origin from L5-C2
action of multifidus
- protects spine from movements made by more powerful prime movers
- contributes to extension, lateral flexion and rotation of the spine
- helps maintain upright posture and spinal stability in all movments
what muscle is this
rotatores
origin of rotatores
transverse processes of each vertebrae
insertion of rotatores
base of spinous process of vertebrae above
action of rotatores
- rotation and assist in extension of spine
- helps maintain upright posture and spinal stability in all movments
what muscle is this
erector spinae
a.k.a. sarcospinalis
what are the 3 groups of muscles in erector spinae
- iliocostalis
- longissimus
- spinalis
origins of erector spinae
- sacrum
- iliac crest
- spinous and transverse processes of vertebrae
- ribs
insertion of erector spinae
- ribs
- transverse and spinous processes of vertebrae
- occipital bone
action of erector spinae
- extension and lateral flexion of spine
- helps maintain curvature or the spine in upright positions
what muscle is this
rectus abdominis
origins of rectus abdominis
pubic crest
pubic tubercle
pubic symphysis
insertion of rectus abdominis
- xiphoid process
- 5-7th costal cartilages
action of erector spinae
flexion
stabilises pelvis
what muscle is this
transverse abdominis
origins of transverse abdominis
- iliac crest
- costal cartilages of lower 6 ribs
- thoracolumbar fascia
insertion of transverse abdominis
linae alba via an abdominal aponeurosis
action of transverse abdominis
- compresses abdomen supporting against pull of gravity
- helps maintain posture
- contributes to forced expiration