anterior muscles and movements

anterior muscles

• Sternocleidomastoid m

• Scalene mm

• Abdominal mm

• Diaphragm m

• Intercostal mm

Sternocleidomastoid

Longus capitis m

• Anterior vertebrae in cervical region to skull

• Flex head

• Longus colli m

• Anterior vertebrae in cervical region

• Flex neck

P Watching an athletic event, socializing, driving

A Unilaterally:

Laterally flex the head and neck to the same side

Rotate the head and neck to the opposite side

Bilaterally:

Flex the neck

Assist to elevate the rib cage during inhalation

• Sternal head: Top of manubrium

Clavicular head: Medial one-third of the clavicle

Mastoid process of temporal bone and the lateral portion of superior nuchal line of occiput

N Spinal accessory (XI) nerve, C2

scalenes

· Anterior, middle, and posterior scalene mm

· Lateral flexion of cervical spine

P Driving, deep breathing with exertion (running,

cycling)

A Unilaterally: With the ribs fixed, laterally flex the head and neck to the

same side

Rotate head and neck to the opposite side

Bilaterally:

Elevate the ribs during inhalation

Flex the head and neck • Transverse processes of third through sixth cervical

vertebrae (anterior tubercles)

I First rib

N C3 to C8

Brachial plexus and subclavian artery

· Pass between anterior and middle scalene mm

· Tightness causes compression and can cause thoracic outlet syndrome

rectus abdominus

· Surrounded by rectus sheath

P Lower body dressing, bed mobility (supine to sit)

A Flex the vertebral column

Tilt pelvis posteriorly

• Pubic crest, pubic symphysis

I Cartilage of fifth, sixth, and seventh ribs and xiphoid process

N Ventral rami of T5 t

internal oblique

P Bed mobility, playing a racket sport (trunk rotation), lifting (increasing intra-abdominal pressure to stabilize lumbar spine)

A Unilaterally:

Laterally flex vertebral column to the same side

Rotate vertebral column to the same side

Bilaterally:

Flex the vertebral column

Compress abdominal contents

• Lateral inguinal ligament, iliac crest, and thoracolumbar fascia

I Internal surface of lower three ribs, rectus sheath to linea alba

N Ventral rami of T7 to T12, Li, iliohypogastric, and ilioin

external oblique

P Bed mobility, lifting (increasing intra-abdominal

pressure to stabilize lumbar spine)

A Unilaterally: Laterally flex vertebral column to the same side

Rotate vertebral column to the opposite side

Bilaterally:

Flex the vertebral column

Compress abdominal contents

• External surfaces of fifth to twelfth ribs

I Anterior part of the iliac crest, rectus sheath to linea alba

N Ventral rami of T5 to T12

transverse abdominis

P Carrying a child or pet (increasing intra-abdominal

pressure to stabilize lumbar spine)

A Compress abdominal contents

• Lateral inguinal ligament, iliac crest, thoracolumbar fascia, and internal surface of lower six ribs

I Rectus sheath to linea alba

N Ventral rami of T7 to T12, L1, iliohypogastric, and ilioing

diaphragm

P Singing, playing a trumpet (deep breathing)

A Draw down the central tendon of the diaphragm

Increase the volume of the thoracic cavity during inhalation

Costal attachment: Inner surface of lower six ribs

Lumbar attachment: Upper two or three lumbar vertebrae

Sternal attachment: Inner part of xiphoid process

Central tendon

N Phrenic C3 to C5

intercostals

P Singing, playing the trumpet (deep breathing) A External intercostals: Draw the ribs superiorly (increasing the space of the thoracic cavity) to assist with inhalation Internal intercostals: Draw the ribs inferiorly (decreasing

the space of the thoracic cavity) to assist with exhalation

• Inferior border of the rib above

I Superior border of the rib below

N Thoracic

neck flexion

sternocleidomastoid

activities like working on a car in supine

neck extension

Trapezius

activities like lifting your head up to watch a movie while in prone

neck rotation

· Ipsilateral Neck Rotation

ipsilateral neck rotation for activities like looking out the window while driving

· Contralateral Neck Rotation

contralateral neck rotation for activities like driving

neck lateral flexion

tilt head as far as possible toward each shoulder

trunk flexion

rectus abdominis

sitting up after a long night's rest

trunk extension

erector spinae

standing at the sink to complete self-care activities

trunk rotation

The external oblique, internal oblique, multifidi, and rotatores contribute to trunk rotation for activities like completing dowel rod exercises

Trunk Lateral Flexion

The iliocostalis, external oblique, internal oblique, longissimus, and quadratus lumborum contribute to trunk lateral flexion for activities like completing seated stretches

Rib Cage Elevation/Expansion

The anterior scalene, middle scalene, posterior scalene, sternocleidomastoid, and external intercostals contribute to expansion of the rib cage during inhalation for activities like running.

The internal intercostals and serratus posterior inferior contribute to depression of the rib cage during exhalation for activities like running.

trunk control

Essential motor component for many activities

· E.g. required for infant to crawl, safe lifting, sitting and standing balance

Patient Transfers and Safe Lifting

Stagger stance:

• One foot slightly in front of other, hips & knees flexed

• E.g. vacuuming or sweeping

Weight-shifting:

• Moving body weight from one leg to other

• E.g. lifting, carrying, moving patients

Recommendations:

· Stagger stance

· Bend the legs

· Keep back straight

· Hold load close to body

· Avoid rotation of trunk

· Contract abdominal mm

· e.g. patient transfer

Abdominal muscle contractions

stabilizes lunar spine

Occupational and Clinical Perspectives Rest and Sleep

Positioning

• Supine position recommended

• Supports neutral position and natural curvature of spine

Occupational and Clinical Perspectives Abnormal Muscle Tone

e.g. Abnormal muscle tone in cerebral palsy:

• Affects core strength, function, and development

• Example: unable to sit upright with low muscle tone

• Postural supports increase independence.

Occupational and Clinical Perspectives Spinal Injuries

Spinal cord injury:

· Blocks transmission of neurological signals from brain to/from body

· Creates functional impairments

Degenerative disease:

e.g.Compression of a spinal nerve root (radiculopathy) may create sensory and motor impairment over time

Adaptive equipment:

Supports occupations while limiting trunk flexion

• Reacher: Extension of UE for object manipulation, lower body dressing

• Sock aid: Don socks without trunk flexion

• Seating and postural support: Customized seating systems